Health department works to combat naloxone stigma

Hancock Public Health has worked hard this year to get naloxone — the medication that reverses an opiate overdose — into the hands of community members. So far in 2021, the health department has distributed 1,542 naloxone kits to the general public, up from 824 in 2020. This is in addition to 125 kits this year and 142 last year distributed to first responders. The health department has also recorded 177 overdose visits to the emergency room and 11 accidental drug overdose deaths so far in 2021. This compares to 232 ER visits and 22 deaths in 2020. These numbers are preliminary, however, as there may be a delay before the coroner rules on a death. Gary Bright, injury prevention coordinator for Hancock Public Health, said it's a good idea for everyone to have naloxone in their first aid kit, as you never know when, say, a neighbor's child might need it. With the prevalence of fentanyl being mixed with other drugs, a teenager who is experimenting or an adult who's using a drug to cope might inadvertently overdose, he said. Jamie Decker, a peer support specialist with the health department's Bloodborne Infectious Disease Prevention program, said that when he and Bright were at the Hancock County Fair distributing naloxone, it became apparent that more people were interested in it than he had thought. Participants in the Bloodborne Infectious Disease Prevention program have reported 309 overdose reversals since October 2020, although Bright noted many of these overdoses may not be reported in official statistics. Changing perceptions Decker said there is still a lot of stigma, and people may feel like having naloxone on the site tarnishes their organization or business' image. But he likened it to having an AED on hand in case it might be needed, adding that any organization from a doctor's office to a church might make use of this. Decker added that naloxone won't harm someone who turns out not to be overdosing, as all it does is block the opiate receptors in the brain. Bright said he has heard people suggest that by giving someone Narcan (the brand name for naloxone), you're sending the message that you condone drug use. "The only message you're really sending them is that you value their life," he said. And Decker said many prescription medications can be said to "enable" different behaviors, like high blood pressure medication "enabling" someone to eat more salty food. But, Bright said, doctors are constantly prescribing medications like these, as the goal is to keep the patient alive. When it comes to naloxone, when a person is ready to have a conversation about changing their behavior, they can. In the meantime, the naloxone is keeping them alive, he said. "You don't tell somebody you value their life, but only under these conditions," Bright said. Bright said sometimes a person is using drugs because the only alternative they see is killing themselves. Drug use may not seem like a healthy coping skill, but sometimes it's the only one a person has, he said. In all of the 2020 overdose deaths where information was available, the person who died "had experienced a significant loss or trauma," the health department reports. The same was true in 2019. Bright said each of the people whose deaths he reviewed had experienced a loss of some kind — perhaps the death of a loved one, or a divorce. Bright said health department staff are attempting to learn how to better reach those who survive overdoses. They are also reaching out to survivors whose loved ones have fatally overdosed, to get a sense of what type of support these survivors need. Bright emphasized that they're asking people who use these kits to reverse an overdose to report when they've done so to Hancock Public Health, which is trying to get an accurate picture of how many overdoses are happening in our community. Taking steps The Bloodborne Infectious Disease Prevention program takes a "harm reduction" approach, meeting people wherever they are. Bright said a drug user might first commit to carrying naloxone, or to using clean syringes. These, too, are positive steps. "The conversations will happen as the person's ready," Bright said. And he said those conversations sound different with Decker than with him. Decker is a peer support specialist, and he tells participants that he has lived experience as an IV drug user. People find out he knows the "lingo" and they start opening up to him more. Sometimes, they mention that they are thinking about entering detox. Of 37 active Bloodborne Infectious Disease Prevention program participants, at least five have entered substance use disorder treatment so far, Bright said. In addition, several have sought hepatitis C treatment. Decker said people are starting to become more willing to join the program. But, as a lifelong resident of the area and a former drug user himself, he noted that people who use drugs often have a distrust of "the system," which can include public health along with agencies like law enforcement. "They're afraid. … They don't want to be made to feel ashamed," and they want to feel like they're being treated with respect, he said. Too often, in medical settings, people feel like they're being talked to like they're children, he said. For a naloxone kit, call 567-250-5151. Arthurs: 419-427-8494