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 Vox Medicus'Vox Medicus,' is a periodic feature in DOC-Line that provides a showcase for editorials from members of the medical staff. Members of the medical staff are encouraged to submit editorials to Dr. Matt Miller or Dr. Tom Koobatian. This month’s editorial, “Save a Life!” is by Peter O. Rostenberg, MD FASAM SAVE A LIFE!Prescription opioids and heroin are the leading cause of unintentional death of Connecticut residents 18-44 years old. Many others suffer from opioid use disorder; which is prevalent within the WCHN community. The purpose of this editorial is to inform our physicians about naloxone (Narcan), the life-saving medication that reverses an opioid overdose. Recent changes in Connecticut law encourages physicians to prescribe this medication. Naloxone (Narcan) is the drug of choice to treat opioid-induced respiratory arrest and coma (overdose). It has been used in emergency departments for decades. Connecticut licensed physicians may now prescribe naloxone without fear of civil actions or legal prosecution (P.A. 12-159). Those who administer naloxone are similarly protected, thanks to a bill signed by the Governor last month (P.A. 14-61). Naloxone (Narcan) is an opioid receptor antagonist that displaces the full agonist opioid and restores respiration and mental function within seconds of administration. Its effects last for 30 minutes or so. A repeat dose may be required if the person has used long-acting opioids like methadone. Naloxone is not controlled or scheduled. It is inexpensive and has only one indication. Danbury ambulance teams carry naloxone HCL in pre-filled syringes to which an intranasal atomizer device is attached. Other users may choose IM injecting. Detailed prescribing and administration information can be found at www.preventtoprescribe.com. Later this summer FDA-approved Evzio, a naloxone auto-injector, will come to the market. It is similar to an EpiPen auto-injector. Evzio will be more convenient and more costly. The Rhode Island Pharmacy Board has taken the position that everyone who asks for a naloxone prescription is a stakeholder, no questions asked, and through a Collaborative Practice Agreement, Walgreen Pharmacy certifies its pharmacists on Narcan use and provide patient information. A physician’s prescription is on file. That is a model Connecticut should follow. Opioid addiction with its deaths and ruined lives is one of the great medical epidemics of our time. Naloxone is an important component of our medically appropriate response. One Connecticut barrier is that not all pharmacies carry it in the Danbury area. Pharmacies in New Fairfield, Danbury , Newtown and Middlebury stock Narcan. Another barrier is that some people believe that Narcan administration facilitates drug use. Whether is does that or not has not been demonstrated, but there is no question that it saves lives. Think patients, friends, family, professional staff and neighbors who ask for your guidance. Peter O. Rostenberg, MD FASAM |