CHARLESTON, W.Va. — A new state law letting more people carry and administer naloxone, a medication that reverses opiate overdoses, will take effect on May 27, but many questions remain about how exactly it will be implemented throughout West Virginia.
Up to now, only EMS personnel have handled naloxone, also known by brand name Narcan.
With the new law, additional individuals including police officers, firefighters, other emergency responders or family members of drug addicts can carry it, but they must be trained in the proper way to use naloxone by emergency medical professionals first.
“It’s going to be difficult to get everyone trained properly and then get Narcan into everyone’s hands. The expense is another thing,” said Veronica Neale, professional relations manager for HealthNet Aeromedical Services.
She attended a “training the trainers” seminar from the state Department of Health and Human Resources in Kanawha County Wednesday, the third in a series of such training events being held statewide this week.
Similar sessions are scheduled for Thursday in Beckley and Friday in Martinsburg.
“It’s a very large expense for a department to have to take on,” Neale said of the medication that sells at retail for roughly $58.
Larger EMS departments, like the Kanawha County Emergency Ambulance Authority, have been able to negotiate lower prices with bulk purchases and are currently in the process of establishing protocols to expand its availability to other departments, like the Charleston Fire Department.
Justin Spence, regional educator for Air Evac Lifeteam, said that will not be an option in some parts of West Virginia.
“We’re looking at a big cost and a lot of our EMS agencies in the state are running on minimal anyway,” Spence said. Early in the process, he had one main question: “How do we get the drug from on the shelf into the general public’s hands for use?”
Grant money to cover the costs of naloxone could one day be an option but, at least immediately, such funding help is not guaranteed.
These additional first responders are not required to carry naloxone. The new law reads, “You may carry and administer” the medication, leaving the decision up to specific departments. Individuals will be able to access it through prescriptions from their doctors.
“The Narcan will come in a kit. It’ll have a syringe, the medication and this little atomizer,” explained John Thomas, workforce section chief for the West Virginia Office of Emergency Medical Services. Naloxone is sprayed through the nose to temporarily block the effects of opiates like morphine, codeine and heroin.
Signs of overdose include no response, no breathing, poor breathing, a bluish color to skin, small pupils or other external indications of drug use at the scene.
“It doesn’t hurt. Basically, it’s like giving a nasal spray,” Thomas said. Naloxone usually takes three to five minutes to kick in and lasts for approximately 45 minutes, he said. Once it’s administered, rescue breathing or CPR must be performed until paramedics arrive.
According to the law, anyone who gives naloxone to a person who has overdosed is required to call 911 or seek other immediate medical attention. That person is granted immunity from criminal prosecution for that specific situation, as the law is written.
If opiates are not the cause of person’s overdose-like state, Thomas said the naloxone will not further harm that person, but it will not help them. A smaller dosage can be used for children.
The Legislature approved the bill expanding access to naloxone during the 2015 Regular Legislative Session. Governor Earl Ray Tomblin signed the Opioid Antagonists Act into law during a ceremony at the State Capitol in early March.