APPA on 4/1/2019 by APPA Technology Committee
The U.S. Surgeon General has recommended that all individuals who may come into contact with opioid abusers carry and know how to use naloxone, an opioid overdose reversal drug that saves lives (U.S. Department of Health and Human Services, 2018). Because community supervision agencies regularly interact with opioid abusers, it is important they consider equipping staff with naloxone. This paper outlines why agencies should consider adding naloxone to their toolkit and provides guidance for successful implementation.
Drug overdose has become a national crisis that affects every segment of the population. Provisional data from the Centers for Disease Control and Prevention indicate that in the 12-month period ending in October 2017, over 68,000 Americans died from drug overdose–a 12% increase from the previous year (Centers for Disease Control and Prevention, Vital Statistics Rapid Release, 2018). This is the largest number ever recorded and equates to an average of more than 187 overdose-related deaths per day.
These statistics are largely driven by the opioid epidemic that is plaguing the United States. Opioids are a large family of drugs that include illegal substances such as heroin, synthetic drugs such as fentanyl and methadone,
and prescription pain relievers such as morphine or codeine. Blue Cross and Blue Shield reports that the number of opioid use disorder diagnoses increased over 490% between 2010 and 2016 (Blue Cross/Blue Shield, 2017). Opioids are now responsible for more than 68% of all overdose deaths, with nearly 45,000 Americans dying from opioid overdoses in the 12-month period ending in October 2017 (Centers for Disease Control and Prevention, Vital Statistics Rapid Release, 2018). As a result, several states and the federal government have officially declared the opioid addiction crisis a public health emergency.
Justice-involved individuals are disproportionately represented among substance abusers (National Institutes of Health, 2018). Further, those recently released from correctional facilities (many of whom are under some form of community supervision) are at an elevated risk of death due to drug overdose (Binswanger, Stern, Deyo, Heagerty, Cheadle, Elmore & Koepsell, 2007). This increased risk is attributable to a number of factors, including the psychological stress of reentry and the danger of immediately returning to pre-incarceration levels of drug use. Underscoring this risk, one study, conducted in Washington State, found former inmates died at a rate 12.7 times higher than the general population, with drug overdose the leading cause of death during the two-week period following release (Ibid).
Naloxone is a medication that can reverse the adverse effects associated with an opioid overdose. Because community supervision officers regularly encounter opioid abusers and may themselves be vulnerable to exposure overdose, agencies should consider the pros and cons of equipping staff with naloxone.