Baltimore County gives hospitals naloxone to send home with at-risk patients

The Baltimore County Department of Health gave four county hospitals a total of more than 4,000 doses of naloxone last week to help combat opioid overdose deaths.

Greater Baltimore Medical Center and University of Maryland St. Joseph Medical Center in Towson each received about 1,200 doses of the antidote, which is sold as a nasal spray under the brand name Narcan. MedStar Franklin Square Medical Center in Rossville and Northwest Hospital in Randallstown, also got doses, according to a county press release.

“We have an opioid epidemic and people are dying,” said Dr. Gregory Wm. Branch, director of Baltimore County Health and Human Services, saying that fentanyl and carfentanyl are to blame. “One tool in our arsenal is to be able to save peoples’ lives by administering Narcan.”

Hospitals will distribute the doses to high-risk patients — often those who overdosed — as they are being discharged from hospitals or to their loved ones, Branch said. Family members will be trained in how to administer the nasal spray to save lives, he said.

“If the drugs are going to be on the street, we gotta get the Narcan on the street,” Branch said.

GBMC emergency room physician Dr. John Wogan said that the hospital used to just give patients prescriptions for naloxone. Because the drug is safe to use and nonaddictive, however, he said removing barriers by giving it to patients directly “makes a lot of sense.”

“So many people with substance-abuse problems are challenged to negotiate life’s daily travails,” Wogan said. “Everything we can do to facilitate them beginning this process of turning their lives around … the E.R. is such an opportune moment to take this intervention.”

Opioid overdoses are deadly because high doses of opioids suppress breathing. Naloxone temporarily counteracts those effects.

The doses will help supplement GBMC’s naloxone supplies as demand soars, said Dr. Harold Tucker, the hospital’s chief medical officer.

“We use a great deal of it, and it costs a lot of money to have it stocked and available to the emergency room,” Tucker said. “This is a great help.”

The drug cost the county $75 a dose — about $350,000 total.

Wogan estimated that the emergency department will give naloxone to about five people each day. The program, he said, will likely roll out over the next month.

Branch said the idea came during one of the department’s regular meetings with the hospitals.

Baltimore County saw 238 fatal opioid overdoses in the first three quarters of 2017, the most recent data available from the state’s Behavioral Health Administration. The figure represents an increase of nearly 10 percent over the previous year.

Across the state, opioid deaths have skyrocketed, much driven by fentanyl. Between 2015 and 2016, deaths from fentanyl more than tripled, according to state statistics.

“We’re all going to be using more of it,” Tucker said of naloxone. “It’s a temporary fix, not a treatment of an underlying disease.”

Gail Cunningham, chief medical officer at St. Joseph Medical Center, which is also getting doses from the county, said though naloxone is a temporary fix, it is necessary.

“While ultimately prevention and long-term treatment is the desired outcome, we need to make sure families have a readily available antidote,” Cunningham said. “We are giving people a tool that will save lives.”

To address that underlying disease, Tucker said the hospital works to connect overdose patients in the emergency room with treatment programs and peer recovery specialists within 24 hours.

Branch said the county is also involved in those intervention efforts, sending outreach teams to talk with people using drugs and “convince people it’s time to get treatment.” Baltimore County’s budget this year allocates more than $6 million in health department funding to combat or prevent substance abuse.

“Our philosophy in Baltimore County is to meet people where they are,” Branch said.

Cunningham disputed what she said is a common “old-school” way of thinking, that giving patients naloxone just “enables people to use.”

“I think if you have a full appreciation for the disease of addiction, you can understand why you need to have this available until people can be treated effectively,” she said.

Baltimore County residents seeking information on treatment for themselves or a loved one can call 410-88-REACH.

asolomon@baltsun.com

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