BG Narcan - Kate (copy)

A new program would allow first responders in Frederick County to leave behind Narcan, the overdose reversal medication, after responding to an overdose case where the person refuses to go to the hospital.

A new grant will help emergency medical personnel in Frederick County leave behind a lifesaving overdose reversal medication with overdose patients who refuse to go to a hospital.

The initiative will be rolled out as a pilot program in Frederick and eight other counties around the state once the Maryland Department of Health is able to put together a concrete list of guidelines for how it will work, said Dr. Barbara A. Brookmyer, the county’s health officer, announcing the program at a heroin consortium meeting in Winchester Hall on Wednesday.

“We’re hearing reports, over this past year, [of] increasing numbers of people refusing transport and it’s led to some ... frustration because of the concern that folks, if they’re not making it to the hospital, then they’re less likely to come in contact with a referral to one of our peer recovery support specialists,” Brookmyer said.

Naloxone, commonly marketed as Narcan, is already available without a prescription, and all county law enforcement officers and rescue personnel are trained and equipped with doses.

Doses of the drug are also given to overdose patients or their family members who agree to be taken to Frederick Memorial Hospital for treatment, but not all patients agree to be transported and EMTs were not previously allowed to leave the medication behind, Brookmyer said.

“It’s technically viewed as distribution of a medication, which, prior to this, was not an approved, authorized activity for them to do,” Brookmyer told the group of 17 heroin consortium members, including County Executive Jan Gardner, Sheriff Chuck Jenkins and others.

Referred to as the “leave behind” program, the new initiative serves as an added “harm reduction” tool to help first responders keep people alive and increase their chances to seek addiction recovery, said Tom Owens, the county’s fire and rescue chief.

“Really the basis of this program is the concern that an individual could refuse treatment, then overdose again and, if Narcan is not available, that overdose could be fatal,” Owens said.

As of April 30, the county was on pace to match recent years, with 124 opioid-related overdoses handled by law enforcement agencies this year, including 21 fatal overdoses, according to the sheriff’s office’s most recent totals.

The leave behind program drew some criticism from Jenkins, who said the prevalence of naloxone could lead to further gaps in his agency’s ability to track illegal opioid use.

“I’m just not sure that’s the right approach,” Jenkins said. “We’re leaving behind naloxone to basically say the next time you overdose, you self-administer or somebody else administers and you don’t report it? So I don’t see this as a real good strategy.”

Frederick police Capt. Patrick Grossman said he could sympathize with Jenkins’ concern, citing the importance of analyzing overdose data.

After each reported overdose, drug detectives try to interview victims to gain valuable information that could help them make arrests. Follow-ups can also help guide people with an addiction toward recovery services by allowing officers another chance to put that person in touch with peer recovery specialists, Grossman pointed out.

That said, Grossman ultimately agreed with Brookmyer and Andrea Walker, the county health department’s behavioral health services director, who argued that the leave behind program was worth implementing because it will help prevent further deaths.

“Yes, we will have gaps, most likely, in knowing who has had non-fatal overdoses; that’s possible and that should be expected,” Walker said. “But our number that we want to focus on is reducing the number of fatalities.”

Cynthia Terl, who was present at Wednesday’s meeting on behalf of the Wells House recovery center, also pointed out that, in her experience, access to naloxone doesn’t affect an addicted person’s decision to use drugs.

“If they are going to use, they are going to use whether they have Narcan or not,” Terl said. “The idea is, if they have the Narcan, then maybe they’re not going to die this time.”

Speaking after the meeting, Owens cautioned that, while the general framework was in place, the county has yet to receive firm guidelines from the state.

“Today’s meeting is actually so early on the front end of this, we don’t have a lot of the details coming yet because the word of the award of these pilot programs are just coming out,” Owens said.

Once the state sets its guidelines, county officials will sit down to hammer out how the model can best be implemented to fit how Frederick County handles its emergency response, Owens said.

At that point, county officials can begin looking at how else they could use the program to persuade overdose patients to seek treatment, even if they decline to be taken to the hospital.

Owens did not have an exact amount the state health department grant would allocate to the county or when exactly the program was likely to be up and running, again citing the early stages of the agreement.

Follow Jeremy Arias on Twitter: @Jarias_Prime.

Jeremy Arias is the Frederick city and government reporter for The Frederick News-Post.

(16) comments

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I'm glad that there are media outlets like patch giving this topic the attention that it deserves. Narcan also known as Naloxone is pivotal in the fight against opioid addiction in America. Thankfully, the American legislators know this and are trying to make it as accessible as possible. In some states law enforcement is carrying it and in others, school nurses. However, this isn't a cure-all for the epidemic. We have allowed this disease to progress so much in America that we are beginning to need more than is being distributed. Narcan, as well as the policy, 's surrounding it and it's distribution are a complex but important issue. If you'd like to learn more about the state of Naloxone and what it means for America, I would recommend checking out this article, very informative. https://mhdetox.com/blog/narcan/?utm_source=google&utm_medium=comment&utm_campaign=MHD_Narcan

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Chunk1985

Not sure how I feel about this. If someone had given this to me personally when I refused treatment while being in active addiction I’d have more than likely thrown it away because I didn’t see it as a life saving medication I saw it as a medication that sent me into full blow withdrawal in a matter of seconds. Addicts want to avoid withdrawal at any cost. Also u can’t narcan urself if u overdose. Ur either dead or unconscious slowly dying unable to help urself. Most of us use alone and want privacy. Now....If they respond to a home where multiple people live with the addict who’s refusing treatment I think it would be good to leave narcan in that situation. If someone else in the house found the addict overdosing then they could administer the narcan in an attempt to bring the addict back to life. I just don’t wanna see wasted resources with addiction. Uneducated people already look down on and judge addicts and addiction too much already. They do not need any extra assistance with that.

sofanna

Thank you FNP for re-posting my comments.

sofanna

FNP, why did you delete my posts?

I am not indifferent to the suffering of addicts. I thought we had free speech in America. I guess if the FNP doesn't like someone's comments, that by the way, did not break any of the "comment rules", they just choose not to post them.

sofanna

Oops, there are a few typos in my comment. The subject of epi pens costing so much is appalling. I've seen the results of someone being stung and having to have 3 epi pen shots before they could be transported to the hospital ER, where it was hours for them to receive additional treatment so they would not die.

sofanna

I do not believe Frederick County is considering this program. If users overdose and EMT's or other agency responders are contacted, the individual who refuses to go to the hospital should be arrested. Ok, give them the overdose medication, after they are arrested and on the way to the hospital.

Although the FNP says grant funds will be used, who is paying for the grants ~ the taxpayers.

And, m21701m, is exactly right. People who need the epi pens to survive bee stings and other allergies they have NO control over, should NOT be required to pay $500 for an epi pen. This is a scam by the manufacturers, insurance companies, etc. on innocent individuals. Someone who is stung by a bee, could be die in 5-10 minutes. If there is no epi pen because the cost is too high, they cannot count on emergency response to get to them in time to avoid death.

Addicts make the choice the to use. People needing epi pens have no choice.

Scott_grimes1

I am sorry, I know this is well intentioned, but it has no common sense to it. If anything, it is enabling, and also providing junkies a false sense of security. "Oh, I have an overdose Narcan here, let me up my high a little". Yet, when going into OD, will they be able to administer? Will they remember to tell someone they have it handy? Or will they most likely turn around and sell the Narcan so they can get some more $ for their next fix? At some point, you cant make life death proof. I just do not see this working at all.

sofanna

Agree. the FNP chose not to post my comments.

sofanna

The FNP changed their mind and reposted my comments.

Chunk1985

I’m in recovery myself and I do not see this working very well either but one thing I can guarantee u is this drug does not hold any street value and in no way enables us. It sends us into immediate withdrawal. If this was given to me when I was using it would have gone straight in the trash. It’s not a pass to use more dope. Like u said if we are ODing we are either dead or slowly dying and we can’t narcan ourselves. 99% of addicts also use alone away from people. They won’t ask someone to standby while they shoot up in case they OD. Educate urself if u wanna speak about addiction. Ask an active addict their opinion on narcan. None of them use it nor do they want it used on them. It’s sad but it’s the truth.

FyremanEd

Supporting Junkies, what a great idea.

Chunk1985

Lol this is in no way supporting a junkie.

m21701m

Yet a live saving epipen is $500... our society is so backwards

sofanna

Totally agree, m21701m!

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