Ohio OKs increased use of overdose-treatment drug by first responders

By Ed Runyan



Lane LifeTrans Medic-Rescue’s vice president says a recent change in rules on who can provide the drug Narcan to overdose victims in Ohio happened at one of the fastest rates he’s ever seen because of the seriousness of the heroin epidemic.

The change, called “scope of practice,” announced recently by the Ohio Department of Public Safety, makes it possible for lesser-trained responders to administer the spray version of the drug. Narcan has been shown to reverse the effects of drug overdoses.

The change means that emergency-medical responders who have received training and have been approved to administer the drug by a medical director can administer it, said Randy Pugh of Lane LifeTrans.

“In overdoses, time counts,” Pugh said. “If we can get to them before they stop breathing, the Narcan brings them right out of it.”

Trumbull County had the seventh-highest per-capita drug overdose rate in the state in 2011, the most recent year statewide statistics are available, with 59 deaths. The number dropped to 36 in 2012, according to Dr. Humphrey Germaniuk, Trumbull County coroner. Mahoning County was ranked 19th in 2011, officials said.

Statewide, drug-overdose deaths — mostly involving prescription painkillers and heroin — have risen 440 percent in the past decade, overtaking car crashes and falls as the leading reason for accidental deaths starting in 2007.

“Obviously, we do have an epidemic of this problem,” Pugh said of narcotic addiction in the Mahoning Valley. Lane LifeTrans personnel use Narcan on average about four times per day on people who have overdosed in Mahoning and Trumbull counties.

The changes were made to “reduce the number of deaths due to an increase of drug overdoses in Ohio,” the Ohio Department of Public Safety said.

The state’s Division of Emergency Medical Services also has developed a training module on how to administer the drug at www.ems.ohio.gov.

“Traditionally, [Narcan] is given intravenously, and this method has been within the Ohio EMS scope of practice for advanced EMTs and paramedics for many years,” said Division of EMS Executive Director Mel House.

“Recent studies including several conducted in the pre-hospital setting show the benefits of [the spray version] that include the reduction in the risk of a needle- stick injury and the associated potential infectious disease exposure for EMS providers,” House said.

Pugh, also Weathersfield Township fire chief, said paramedics and EMTs generally use Narcan in an intravenous tube instead of in the spray version, but there are times when the spray version would be beneficial even to the better-trained providers, such as paramedics and EMTs — such as when a drug abuser’s veins are difficult to access.

Legislation has been sponsored in Ohio to remove the legal liability for police offices and firefighters if they administer Narcan on drug- overdose victims. Other proposed legislation would make it possible for any resident to administer the drug.

Jeff Orr, commander of Trumbull County’s primary narcotics-fighting law enforcement unit, Trumbull Ashtabula Group Law Enforcement Task Force, has said the use of Narcan by law enforcement could cut drug overdose deaths in half.

There are costs, however — $16 per dose — and it has a shelf life of two years, so a funding source will be needed for law enforcement to afford the drug, he said.

Pugh said there also would be other challenges — police departments usually don’t have a medical director, and a department would need a drug license and training.

He added that most areas in the Mahoning Valley have ambulance-response times of about four minutes, so Narcan use by police officers probably isn’t necessary. In more rural areas, where response times are longer, it might be more necessary, he said.

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