Abstract
Improving public access to and knowledge of the opioid reversal agent naloxone are part of national, state, and community harm reduction recommendations to prevent death from overdose from prescription and illicit opioids. Naloxone is part of a comprehensive plan to address the opioid epidemic that includes prevention, treatment and recovery. The purpose of this presentation is to underscore the importance pain management nurses play in screening patients for risk for overdose and to provide options for obtaining naloxone. According to Substance Abuse and Mental Health Services Administration (SAMHSA) high risk individuals encompass more than those using illicit opioids or misusing prescription opioids and should also include those using opioids for treatment of chronic pain, opioid rotation, or reduced opioid tolerance. Since overdose often occurs at home and Emergency Medical Services response times vary, having naloxone available for those who would most likely be at the scene can save lives. The aim of the eight month pilot was to determine the feasibility of emergency department (ED) nurses and providers screening for and providing high risk ED patients with naloxone nasal spray (NNS) and harm reduction patient teaching at discharge. The setting included four EDs within one hospital system. Methods used included involving the ED staff in developing the protocol including workflow, order set, and patient teaching resources. Staff education was provided prior to implementation. Of the 154 patients in the pilot 140 (91%) took the provided NNS for home use, demonstrating the acceptability of the intervention and feasibility of the pilot protocol. The presentation will also include options for improving access to NNS for patients, families and communities; strategies to address stigma about and barriers to caring for patients with SUD and hospital-wide education on SUD. In addition, Good Samaritan laws, naloxone pharmacokinetics and resources for program implementation will be discussed.
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