Neighbors Helping Neighbors: Empowering Individuals to Help Stop the Opioid Epidemic

Clockwise from top left: Sen. Ralph Alvarado (R-KY-28), Lt. Patrick Glynn (MA), Overdose Lifeline’s Justin Phillips and Shatterproof’s Kevin Roy discuss the important role of community members in saving lives from overdose.

“Currently, you are more likely to administer naloxone in a public place than you are to administer CPR.”

Opioid overdose deaths in the U.S. rose dramatically in 2020, worsened by the pandemic and the spread of fentanyl, a high potency synthetic opioid. In recent years, programs have been developed in communities to train and provide likely bystanders and first responders to an overdose with FDA approved opioid overdose reversal therapeutics. On November 17, 2021, Opiant gathered together a panel of experts to offer their perspectives on this topic. The panel included Kentucky State Sen. Ralph Alvarado (R-KY-28), Chair of Kentucky Senate Health and Welfare Committee; Justin Phillips, Executive Director and Founder of Overdose Lifeline; and Lt. Patrick Glynn, Director, South Shore Drug Task Force Commander, Quincy Police Special Investigations and Narcotics Units. Kevin Roy, Chief Public Policy Officer, Shatterproof, moderated the discussion.

Following is an edited version of their conversation.

How is this epidemic changing with the presence of illicit fentanyl?

Senator Alvarado: “We started getting to the point where ER doctors would go on TV if they started seeing people come in [for fentanyl related conditions] saying please, there’s a batch of bad fentanyl out there. Before you inject anything, it’s good to make sure you’ve got Narcan available.
The medical community is trying to respond and be proactive, but we’re seeing a lot more heavier duty, a lot stronger medicines. We know [fentanyl is] probably responsible for many of the deaths that we’re seeing right now and the surge. We also know the profit margins are higher for a lot of dealers, that they’re able to sell smaller amounts of drugs for larger amounts of money and it’s much more lethal. We are seeing a lot of it here in Kentucky at least.”

Lieutenant Glynn: “It’s buyer beware on the street. Since fentanyl is basically in just about every substance — it’s in methamphetamine, it’s in cocaine — people do not know what they’re taking, never mind the counterfeit pills that are being manufactured in someone’s garage or basement with pill presses that are very easy to come by on the internet. The public has to be fully informed on the profit margins, because again, as Senator Alvarado said, they’re through the roof.”

Justin Phillips: “I think it’s really important that we also pay really close attention to some of the truths and non-truths around fentanyl and fentanyl exposure. We can cause more damage by making people believe that they will overdose upon touching something without really having access to mucous membranes or open wounds or things. So, people won’t respond if they’re too afraid that fentanyl is there, even though the fentanyl is real and very dangerous.”

What are ways that both communities and individuals can mitigate the risk of overdosing from the all too present illicit fentanyl?

Justin Phillips: “I think from a policy standpoint, we have to look at ways to also mitigate the risk by making access to fentanyl test strips available. Health and Human Services recently announced that they were supporting the funding of harm reduction approaches. The federal government is now allowing states to use their opioid response dollars for harm reduction approaches. And we are distributing fentanyl test strips. And we do that with instructions on how to test amphetamines as well as opioids because it’s not the same. The risk is real, as the other speakers have already mentioned, as it relates to methamphetamines and other drugs.”

Lieutenant Glynn: “It is important to let bystanders know that they need [Naloxone] in their home. That is one of the biggest things we impress upon individuals when we get into their homes, to speak with them about it and train them that it may not necessarily be for your loved one, it could be for someone else, someone who thought they took one thing and then it was a counterfeit drug that was just riddled with fentanyl. It’s just incredible what people are doing out there, and we have to get that message out there and be able to protect them with [Naloxone]. It has to be available everywhere.”

How is policy keeping up with the opioid crisis? Is there more to be done?

Senator Alvarado: “In Kentucky, we passed our Good Samaritan laws back in 2015. We were seeing our numbers gradually decline, a lot more education. The laws increased the ability to get [Naloxone] freely at the pharmacy and we’ve received some federal grants that have combined with efforts at the university to start educating the average person on our campus, giving them a free canister, saying “keep this with you, even if you don’t have a loved one that might be using, just as a citizen, know how to administer it, know how to use it, be able to give it to somebody if they find them down and then call for help.” There’s been a lot more education. We want to try to destigmatize a lot of this, where in the past, you saw somebody down, you might run away, now we want people to rush and try to and call for help.”

Lieutenant Glynn: “Once the Good Samaritan Law was amended and prohibited the arrest of the individual that was overdosing if someone called for their assistance, the floodgates opened, people were not afraid to call anymore. They would say, “this is an overdose,” as opposed to saying someone fell or someone was short of breath. That itself saved numerous lives. People were calling because they were not afraid of being arrested, they knew they would not be.

The other thing that really helped was the diversion program, we have partnered with our district attorney’s office and if we did have a narcotic situation where we served a search warrant, we would go back and find the customers and give them a card, would not arrest them. Those individuals are able to go to an outreach program and have free services and go into a program if they needed, no strings attached.”

Justin Phillips: “We still could use some better policy around Good Samaritan laws in this country. I’ll admit that Indiana’s Good Samaritan protections aren’t perfect, because they’re not necessarily going to protect the individual who goes down for an overdose. We have a prosecutor in one of our counties who thinks prosecuting someone for being reversed with Naloxone is a way to get them into treatment.

Everyone should be at the table, whether they understand how it’s affecting them or not. It’s affecting their workforce. Whether they recognize it or not, it’s affecting government. Whether we recognize it or not, it’s affecting the economy. There’s so much cost benefit to reducing drug misuse, and overdose deaths in the basic loss of life and loss of potential. Getting all the stakeholders together, it’s coalition work. We need to pull everyone together and create those public-private partnerships. We need to get everyone, including law enforcement, to understand what’s in it for them, what’s their benefit, what they can contribute — we all have to beat this and work together and not in opposition.”

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Getting to grips with substance use disorders takes scientific breakthroughs, advocacy, education, and brave policy. Saving Lives: Perspectives on Addiction and Overdose, are Q&A’s between Opiant and the people shaping our understanding and response to addiction and overdose.

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Opiant Pharmaceuticals, Inc., the company that developed NARCAN® Nasal Spray, develops medicines to combat addictions and drug overdose.

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