Although news stories about COVID-19 have pushed the opioid epidemic from people’s minds, the crisis is still simmering in the communities we serve. In fact, for those addicted to opioids, the impact is far greater.
“Individuals struggling with substance use disorder already suffer from social isolation, now amplified by required social distancing,” said Bonnie Milas, MD, of Anesthesiology & Critical Care Medicine. “The current need for social distancing limits their access to medication, recovery care, and social supports thereby increasing the chance of relapse or suffering a drug overdose.”
As a result, “COVID-19 has made it even more important to carry Narcan nasal spray.”
It Can Happen Anywhere
Nalaxone (Narcan) is the antidote to an opioid overdose. It can not hurt a person, Milas stressed, but it can save lives. Margaret Hudson, BSN, a nurse in HUP’s MICU, knows this firsthand.
Late last year, she was sitting a short distance from a person at a concert who had passed out and fallen to the ground. She found him sweaty, shaking, and taking shallow breaths. After her attempts to rouse him brought no response, she yelled for someone to call 911 and took her Narcan nasal spray from her purse and administered a dose. After a couple minutes, “the person jerked awake and started thrashing,” she said. By then, the venue’s medical staff had arrived on the scene and shortly thereafter an ambulance came.
Two years ago, Philadelphia had more than 900 overdose deaths involving opioids, and chances are the pandemic will worsen the situation. As restrictions ease, more people will be traveling to work, many on public transportation where drug overdoses routinely occur, Milas said. But any place can be vulnerable, including public restrooms and libraries … and private homes.
What to Do
No matter where you are, if a person suddenly collapses nearby, there are certain steps anyone can take to assess the situation, Milas said. After establishing that the person is unconscious and cannot be roused, alert others nearby to call 911. Look for symptoms of an overdose, including “pinpoint” pupils (which can barely be seen), lips that are blue or bluish grey and barely breathing or not breathing at all. If you’re uncomfortable taking these steps, “ask if there are any doctors or nurses close by,” she said. And if you’re alone, “call 911 yourself, put the phone on speaker, and follow the dispatcher’s directions.”
Milas said that wearing gloves — or having hand sanitizer available — and a mask will help protect individuals who choose to intervene with Narcan nasal spray. “If the victim has a mask on, remove it and administer the nasal spray in the nose of the victim with your gloves and mask on.”
To use the Narcan inhaler, place two fingers on either side of the plunger, put the inhaler into the person’s nostril and push the pump once to the top. “If you’re nervous about using it, at the very least tell others trying to assist that you have Narcan.”
Pharmacists in Pennsylvania can dispense naloxone without requiring an individual prescription, according to phila.gov. And, once you have it “always carry it with you.”