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Bill could save overdose victims

Dr.David Rottinghaus
It increases access to heroin antidote naloxone

A drug considered to be an antidote to heroin overdoses may soon be available to the public and to all emergency rescuers in Pennsylvania.

Senate Bill 1164, which is on its way to Gov. Tom Corbett’s desk, would provide immunity from criminal prosecution for “good Samaritans” who use the drug naloxone to assist victims of opioid drug overdoses.

If the bill is signed into law, police and firefighters would be able to carry naloxone in their vehicles and administer it to victims of suspected overdoses. Only paramedics currently are allowed to administer the drug outside an emergency room.

Naloxone, often referred to by its brand name, Narcan, is a federally approved drug that reverses the effects of opioid overdoses. Perhaps the most common opioid used illegally is heroin.

The bill, which has been passed unanimously by both the state House and Senate this month, also would allow physicians to prescribe naloxone to people who are at-risk of opioid drug overdoses, or to friends and family members of at-risk individuals.

Dr. David Rottinghaus, medical director of the emergency department at Butler Memorial Hospital, said naloxone is a safe and effective drug in treating overdoses.

“It’s a very safe drug,” he said. “It’s an easy drug to administer.”

The drug is most commonly given in the form of a nasal spray, although it also comes in the form of an injection.

Rottinghaus said the nasal spray is effective and prevents those giving the drug from having to deal with needles.

“It’s a selective drug that reverses the effects of opiates at the receptor level,” Rottinghaus said.

Naloxone will quickly stop narcotic-induced breathing problems experienced during an overdose.

“It acts very rapidly,” Rottinghaus said, adding a patient can go from flatlining to being conscious in a matter of seconds.

The drug has no side-affects if given to a person who is not suffering an opioid overdose.

Butler Fire Chief Nick Ban said the bill offers potential to help save lives.

Ban said he would be in favor of his department having access to the drug since it is often the first to arrive at scenes.

“I think it would be a good thing,” he said, adding the fire department’s response time averages 3 minutes and 25 seconds.

Ban said his department is typically first on scene to about 95 percent of emergency calls that it responds to in the city.

The extra minutes it takes for an ambulance to arrive at the scene of an overdose could be the difference in life or death.

“I think it’s comparable to AEDs,” said Rottinghaus, referencing automated external defibrillators, which are devices able to re-establish a heart rhythm. “The thing that is most important is getting the earliest shock possible. Time is of the essence for both.”

Delayed treatment with naloxone adds to the time the brain goes with oxygen.

The bill still would require training for any emergency responder to carry the drug. Ban has no concerns about the training needed because all of his firefighters are at least trained as EMTs.

Police Chief Ron Brown said he agreed that the city fire department would be well served to carry the drug.

“They’re already trained medically,” he said. “That sounds like something they’d be suited for.”

Brown said he would need more information on the legislation before commenting on whether his department would soon be carrying the drug.

Neither Brown nor Ban have read the proposed bill.

But Brown said he knows the impact the antidote can have in helping overdose patients.“I know it works pretty quick,” he said.

Both chiefs agreed attention to heroin overdoses is a need in Butler.

Ban said the department often responds to heroin overdoses.

“We have a fair amount of overdose calls,” he said. “For a week or two, we won’t have any. But then the next week or two we’ll have one every other day.”

But opioid overdosed are not limited to just heroin. Rottinghaus said an increase in prescription painkillers is driving up overdose numbers.

“I think we will begin to see more restrictions on prescription practices,” Rottinghaus said.

Ban said it would be up to Butler Memorial to determine if the fire department would use the drug.

“We take our medical direction through the hospital,” he said, adding there have been no talks about the bill at this point.

Rottinghaus said the hospital will follow state law and guidelines.

While Ban said he would like to see more emergency responders having the drug, he said there are some aspects to think about by opening it up to the public.

Many people say providing the drug to addicts will allow them to push the limits of getting high, and could result in more overdoses.

“I think that is a concern,” Ban said. The fire chief also questioned what the protocol on prescriptions of the drug would be if the law is passed.

Ban said it is still better for the public to have the drug to save a life, but said the state needs to do more to increase education on drug use.

“This is just a Band-Aid to the drug problem,” he said of the bill.

Rottinghaus agreed with the need for more education. “People need to become more aware of seeking help for friends and family abusing heroin,” he said. “And there needs to be better education on prescription medications.”

Rottinghaus acknowledged there will be controversy in allowing the public to have access to the drug, but said he doesn’t have an issue with it.

“I don’t think people should fear distribution,” he said. “It could save a lot of young lives.”

Ban said that is the most important thing.

“It’s always more important to save a life,” he said.

According to a new county study by the Center for Rural Pennsylvania, Butler County is below state average when it comes to heroin overdose deaths.

Between 2007 and 2011, there were 9.9 overdose deaths per 100,000 people in Butler County. The state average was 12.7 overdose deaths per 100,000.

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