“Who’s Willing to Save A Life?”: Opioid Overdoses and the Challenges of Community Response

If your community is interested in joining our work to stop fatal opioid overdoses, read more about the grants we’re offering to public health, public safety, and advocacy organizations here.

Trek Medics builds communications tools to help communities and community members save lives. We originally built Beacon, a text message-based emergency dispatching platform, to transform how emergency medical care is delivered in developing countries. Now, we have the opportunity to stem the tide of fatal opiate overdoses plaguing the United States. As we’ve engaged with communities most affected by the opioid epidemic, the point is driven home that tools have to be put into the hands of people willing to do the work in order to make a difference.

 

At face value, our proposal with Beacon seems a straightforward use of common technology to address a life-threatening problem. When someone reports an opioid-related overdose to 9-1-1, in addition to dispatching formal emergency responders, Beacon also sends alerts via text message to nearby community responders equipped with the life-saving medication naloxone. When the alert’s received, the community responders can respond to the scene, administer naloxone and reverse the overdose to save a life.

 

Seems like a pretty straightforward proposal.

 

But nothing’s ever that simple, and as we’ve worked to launch new programs, we’ve run into several concerns from prospective partners who are already doing the hard work to save overdose victims. We’d like to share some of these common challenges and how we answer them.

Challenge: This program isn’t worth implementing because the only people getting hurt are drug addicts and they’ve brought this on themselves.

Response: In the last few years, it’s become clear that illicit drug users are not the only ones dying from opioid-related overdoses. Patients with legitimate medical conditions, including terminal cancer and chronic pain, may have originally been overprescribed an addictive substance without a proper plan, ultimately leading to a condition considered to be drug abuse. No matter how someone got to a point of an overdose, we believe it is in all communities’ best interests to act.

Challenge: Community-based response may dissuade people from calling 9-1-1.

Response: Many people suffering from opiate use disorder are already unlikely to call 9-1-1, which means it is unlikely for victims to get emergency help. Our best-case scenario involves Beacon and 9-1-1 services working together so emergency service professionals and community responders can prevent overdoses when it makes the most sense.

Challenge: Community-based response programs increase the risk that overdose victims won’t get proper medical care after being resuscitated.

Response: These programs will operate best in places where resources are limited — where it’s unlikely that medical professionals can provide proper medical quickly enough to save a life due to limited first responder staffing levels, long ambulance response times, or challenging locations. In addition, research shows minimal risks with treat-and-release overdose response. [1],[2],[3],[4],[5]

Challenge: A community-based approach puts good Samaritans in harm’s way.

Responders: Not every overdose victim is necessarily an illicit drug user caught up in an inherently dangerous situation, and our own extensive research has found no evidence available detailing instances involving injury to these ‘Good Samaritan’ responders to opioid overdoses. Nonetheless, peers recognized and trusted by persons with OUD, and who are experienced in the scenarios they may encounter during an overdose, are the only people who should be community responders. This means partners must recruit the right people and give them access to trainings on the use of naloxone, the dangers that may exist near drug abuse, and any location-specific issues that responders need to know. Our significant experience responding to opioid overdoses has taught us the potential safety risks, but we also believe that some of these fears are overstated.

Conclusion

There are more opiate overdose victims than motor vehicle collision fatalities, and there are proving easier to save. Naloxone is part of a proven strategy for saving lives and it needs only two new factors: communications and coordination. We have the communications solution, so all that’s needed now is community groups to come together and decide that they’ll do what’s needed to respond to overdoses whenever and wherever they happen.

If your community is interested in joining our work to stop fatal opioid overdoses, read more about the grants we’re offering to public health, public safety, and advocacy organizations here.

References

[1] Wampler DA, Molina DK, McManus J, Laws P, Manifold CA. No Deaths Associated with Patient Refusal of Transport After Naloxone-Reversed Opioid Overdose. Prehosp Emerg Care. 2011 15(3):320–4.

[2] Rudolph SS, Jehu G, Nielsen SL, Nielsen K, Siersma V, Rasmussen LS. Prehospital treatment of opioid overdose in Copenhagen — Is it safe to discharge on-scene? Resuscitation. European Resuscitation Council, American Heart Association, Inc., and International Liaison Committee on Resuscitation. 2011 82(11):1414–8.

[3] Neale J, Brown C, Campbell ANC, Jones JD, Metz VE, Strang J, et al. How competent are people who use opioids at responding to overdoses? Qualitative analyses of actions and decisions taken during overdose emergencies. Addiction. 2018 114(4):708–18.

[4] Vilke GM, Buchanan J, Dunford JV, Chan TC. Are heroin overdose deaths related to patient release after prehospital treatment with naloxone? Prehospital Emergency Care. 2009 3(3):183–6.

[5] Michael W. Willman, David B. Liss, Evan S. Schwarz & Michael E. Mullins. Do heroin overdose patients require observation after receiving naloxone?. Clinical Toxicology. 2019 55:2, 81-87.
Recommended Posts

Leave a Comment

Retype the CAPTCHA code from the image
Change the CAPTCHA codeSpeak the CAPTCHA code
 

Send us an email to share how you think Beacon can help your service.

Not readable? Change text. captcha txt