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Philly Offers Free Training on Use of Narcan

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By Alicia Vitarelli

PHILADELPHIA (WPVI) — Officials call it nothing short of a lifesaver, and Wednesday city officials offered anyone who lives in Philadelphia free training on how to use Narcan.

Narcan is the brand name of the drug used to reverse the effects of an opioid overdose.

Overdoses are skyrocketing and officials want everyone to have the tools and skills to save a life.

The city’s behavioral health department offered education about the epidemic, the drug and access to Narcan. They also gave a hands on demonstration on how to administer Narcan. The goal was simple: combating the crisis one person at a time.

“A lot of people are faced with this crisis in their own households,” said Pamela McClenton of the Department of Behavioral Health. “This is a way for us to destigmatize the opioid substance use disorder and treatment.”

Narcan can be purchased over-the-counter at drug stores in Philadelphia, you do not need a prescription.

Officials said it can reverse a fatal overdose almost immediately, and restore breathing within two to eight minutes.

Kennedy Health in Berlin, Camden County is tackling the opioid epidemic in New Jersey.

Medical experts spent the day discussing the crisis and the efforts to fight it.

U-S Congressman Donald Norcross was the opening speaker and Tony Luke, the cheesesteak franchise founder, shared his emotional story after his son recently died from a heroin overdose.

Fighting the War Against Opioid Addiction with Narcan

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PHILADELPHIA, PA (WTXF) – As the country continues to grapple with the opioid epidemic, many view overdose reversal medication as an essential tool to fight back.

Some counselors, like Rick Tull of Philadelphia’s Office of Behavioral Health, believe making these drugs more accessible deserves consideration.

“With all the people who passed, including the three people who passed in Philadelphia last night, I think it’s appropriate to have a moment of silence,” he says.

Wednesday was one in a series of events hosted by the city to get the message out that residents must be prepared to save a life when the moment calls for it. Participants heard Tull present the staggering statistics.

“Every day, 100 people will die from opioid overdoses nationwide, [with] at least three to four in Philadelphia alone,” he said.

But it honestly wasn’t the stats that made the biggest impact, it was the attendees..

Elvis Rosado works in addiction prevention and demonstrated Narcan because he knows firsthand its impact.

“The agency staff has reversed over 200 people. By myself, as of last week, I’m at 37 people,” he told FOX 29’s Bill Anderson.

Onzie Travis is a counselor who shocked attendees with his sincerity when he explained only one person he worked with died from drug use.

“Some people I’ve worked with have overdosed,” he said. “Fortunately, only one of them passed away. The others were revived.”

Health worker Allison Herens administered Narcan following a training session less than 24 hours after purchasing it.

“I purchased Narcan the day before, and when I got to Somerset Station a man on the platform overdosed and I reversed him,” she said.

Whether making Narcan more accessible makes users more likely to continue abusing opioids, the training sessions made a simple point clear. While we debate the merits of these overdose reversal drugs, we should save lives while we do it.

Philadelphia Taking Fentanyl Fight to the Streets

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Fentanyl is killing more and more people in Philadelphia, and most people who take the drug don’t even know they are taking it, health officials said Friday.

Overdose deaths from fentanyl, an extremely potent opioid 100 times stronger than morphine, have risen sharply in the city over the past several years. And the problem, which looks to be getting worse, requires a new strategy to combat it, they said.

“This is the most significant epidemic that this country has seen, in regards to opioids,” said Dr. Arthur Evans, Philadelphia’s Behavioral Health Commissioner.

Most people who take fentanyl think they are taking heroin.

A synthetic, short-acting opioid originally developed for medical use during surgery or for acute pain relief, fentanyl is often sold as heroin to users or mixed with heroin by dealers to create a more intense euphoria. But the combination of drugs also promotes drowsiness, nausea and confusion. That combination of effects, and fentanyl’s rapid potency, is especially dangerous as users may not realize how much they’re taking.

That makes it much more likely for a user to stop breathing and die from an overdose.

At City Hall on Friday morning, Evans joined Dr. Thomas Farley, the city’s health commissioner, and Jeremiah Laster, deputy fire commissioner for emergency medical services, to raise awareness about the disturbing rise in usage and overdose deaths both locally and nationally.

Deaths by overdose of all drugs in Philadelphia grew by 50 percent, from 459 in 2013 to 701 in 2015, the officials said. During that same period, fentanyl overdose deaths grew by more than 600 percent, from 23 in 2013 to 184 in 2015.

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During a press conference on Friday, Philadelphia health officials Dr. Arthur Evans, Jeremiah Laster and Dr. Thomas Farley said overdose deaths from the drug fentanyl are rising dramatically.

Already, Farley said, in the first four months of 2016, fentanyl-related overdose deaths are up 17 percent over the same period last year. Of the 262 overdose deaths so far this year, he said, 99 of them — about 38 percent — were due to fentanyl. In the first four months of 2015, by comparison, about 20 percent of overdose deaths were attributed to fentanyl.

“This is a drug that is far more likely to kill you than heroin is,” said Laster.

According to Farley, one of the most difficult things about fighting this epidemic is that most people who use the drug have no idea that they are using it.

“Probably, most of them think they are buying heroin,” he said.

And while Narcan, a life-saving heroin antidote, also can be effective at arresting the effects of fentanyl overdose, health officials downplayed it as a solution.

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Fentanyl, shown at top in brick form, is often mixed with heroin, bottom, by dealers. It’s a dangerous combination.

Fentanyl “stops you from breathing,” Laster said. “Narcan isn’t going to stop the problem. Only prevention can do that.”

Moreover, the cost of Narcan is steadily raising, making it a more expensive solution to the problem.

All Philadelphia fire companies and EMTs are stocked with Narcan, but each shot costs about $34 today. In 2014, Laster said, Narcan shots only cost the city about $13 a piece.

The problem is shocking enough that the city is stepping up efforts in a multi-pronged approach to prevent overdose deaths.

Evans said street teams from the health department will canvass neighborhoods where drug use is most rampant — “Kensington, in particular,” he said — to engage with users and try to get them to recovery houses before they die of an overdose.

“Prevention is the key to stopping this problem,” he said. “People need help.”

His office is also working with physicians and health officials in area hospitals, to educate them on the specific risks of fentanyl and to push them to prescribe fewer opioids to patients or use lower amounts, Evans said.

And an initiative called “Centers of Excellence” is launching that will help connect Medicaid patients who have substance abuse disorders to access and use services that can help them. Thomas Jefferson University Hospital, The Wedge Medical Center and Temple University have all been named as “Centers of Excellence.”

Funding for these initiatives, city officials said, is being provided by the Pennsylvania Department of Human Services.

In addition, Evans said he’s working with the city’s methadone treatment centers to find ways to help 500 more people a day who are trying to overcome their addictions. That could mean more people are served at each center or the centers are open longer hours, but either way, there will be a push to help more users looking to quit.

“This is a very complicated issue and, I think, we need to use multiple strategies,” said Evans.

As Fentanyl ODs Have Surged in Philly, Price of Antidote Has Tripled

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Fatal overdoses involving the powerful synthetic painkiller fentanyl have surged more than 600 percent in Philadelphia during the last three years, city officials said Friday. Illicit use of the opioid was implicated in 184 deaths in 2015, up from 25 in 2013.

“Clearly, we have an epidemic of overdoses in Philadelphia involving this drug fentanyl,” said Health Commissioner Tom Farley at a Friday news conference.

At the same time, the price of the antidote used to treat opioid overdoses has skyrocketed.

In 2013, a dose of Narcan, the brand name of the antidote naloxone, cost the city $13.34. Last year, the cost soared to $37.82.

“It’s a drastic increase and that’s the government rate that we pay,” said Jeremiah Laster, Deputy Commissioner of Emergency Medical Services. “There are other departments in the country that pay more than $100 a dose for Narcan.”In hospitals, fentanyl is an effective painkiller used in operating rooms. It is sometimes used to manage severe chronic pain. Though overdoses on legally prescribed fentanyl are not common, the death of musician Prince in April was attributed to the drug.

On the street, illicit fentanyl is often added to heroin to boost the drug’s potency. According to the Drug Enforcement Administration, fentanyl is 25 to 50 times more powerful than the equivalent amount of heroin.

“Users are often using this drug unaware how potent it is, putting them at greater risk for overdose,” said Arthur Evans, the city’s behavioral health commissioner.

The city has been issuing alerts about fentanyl since 2006.

“This has been a significant issue that has happened over the last decade with increasing frequency,” Evans said.

In Philadelphia, the number of all fatal drug overdoses has risen dramatically, spiking from 458 in 2013 to 701 last year.

“That means we have more than twice as many overdose deaths as we had deaths from homicide,” said Farley.

Many emergency services workers carry a supply of Narcan. Last year, EMTs in Philadelphia administered 3,035 doses. But not all overdose victims immediately respond, Laster said.

Due to fentanyl’s strength, EMTs often need to use more than one Narcan dose to bring a drug user back from the brink of death.

Health Officials Warn About Sharp Increases in Drug Overdoses Involving Fentanyl

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Philadelphia, PA – Health Commissioner Dr. Thomas Farley, Behavioral Health Commissioner Dr. Arthur Evans and Deputy Fire Commissioner for Emergency Medical Services Jeremiah Laster today warned about sharp increases in fatal overdoses involving the opioid drug fentanyl.  The Philadelphia Department of Public Health (PDPH) and Department of Behavioral Health and Intellectual disAbility Services (DBHIDS) also released a Health Alert to Philadelphia medical and behavioral health providers describing the increase in overdoses and steps that providers can take to reverse the effects of an overdose involving fentanyl.  Fentanyl is 50-100 times more potent than morphine, which makes it more likely that people who inject the drug will stop breathing and overdose, and overdoses from fentanyl may require higher doses of antidote to reverse.

Fatal drug overdoses have risen sharply in Philadelphia in the past several years, growing by more than 50% from 459 deaths in 2013 to 701 deaths in 2015.  During that time period, overdoses involving fentanyl grew more than 600%, from 25 deaths in 2013 to 184 deaths in 2015.In addition, in the first four months of 2016, 99 (38%) of 262 overdoses have involved fentanyl, compared to 44 (20%) of 224 overdoses in the first four months of 2015.

“Drug overdose, which is a national crisis, has now become a leading cause of death of young adults in Philadelphia,” said Commissioner Farley, “killing more than twice as many people as homicide and more than four times as many as suicide.  We all can help prevent these overdoses.  In particular, physicians should prescribe fewer opioid painkillers to reduce the number of people who become addicted to these drugs, and everyone who comes in contact with people who use heroin or other opioid drugs should encourage them to seek drug treatment.”

“The rise in fentanyl-related overdoses makes it even more important to expand the work we do to prevent addiction, treat substance use disorders and reduce overdoses,” said Commissioner Evans.  “Fatal overdoses are preventable, through medication-assisted treatment for substance use disorder and increased availability of drugs that reverse overdoses.”

Opioid drugs are chemically similar to morphine and heroin.  Opioid painkillers include oxycodone (in OxyContin and Percocet) and hydrocodone (in Vicodin).  Fentanyl is a synthetic, short-acting opioid drug, with effects similar to heroin.  It was originally developed for medical uses, including anesthesia during surgery and acute pain relief.  It has recently been appearing around the country as an illicit drug, and is sold on the street the same way that heroin is.  Most users probably believe that fentanyl is heroin when they purchase and inject it.

Fatal drug overdoses have been growing nationwide.  In 2014, more than 47,000 people in the United States died of drug overdoses, more than double the number of fatal drug overdoses in 2000.  The opioid drug overdose epidemic was initially related to the overuse of prescription opioids such as OxyContin, but since 2010 overdose deaths have increasingly involved heroin and more recently involved fentanyl.  Opioids are also more dangerous when used in combination with drugs called benzodiazepines, such as Xanax and Klonopin.

PDPH and DBHIDS are using several approaches to reduce opioid overdoses, including those involving fentanyl.  City health officials say the best way to prevent drug overdoses is to prevent opioid addiction, which Philadelphia seeks to do by encouraging physicians and other health professionals to prescribe opioids to fewer patients, in lower amounts, and for shorter time periods.  The agencies also encourage physicians to prescribe benzodiazepines less often.

For those who are already dependent on opioids, the City is working to expand the number of providers who offer medication-assisted treatment with buprenorphine (Suboxone).  In addition, the Pennsylvania Department of Human Services seeks to improve treatment with “Centers of Excellence” that will help Medicaid patients with substance use disorders access and use services.  Thomas Jefferson Narcotic Addiction Treatment/Maternal Addiction Treatment, Wedge Medical Center and Temple University have all been selected as “Centers of Excellence” in Philadelphia and will begin providing these additional services by this fall.   These Centers of Excellence are also funded by DBHIDS.

PDPH and DBHIDS are also expanding the availability of the opioid antidote naloxone (Narcan) for people in contact with those who overdose.  Naloxone reverses the effects of overdoses and can be life-saving; when treating overdoses involving fentanyl, higher or repeated doses of naloxone may be needed.  Pennsylvania ACT 139 of November 2014 greatly expanded access to naloxone and provides legal protections for those who intervene in the case of an overdose.  These groups including first responders and family members of people addicted to opioids.

In coordination with today’s event and press release, PDPH and DBHIDS are working to educate physicians about the specific risks that fentanyl presents to opioid users and how to manage overdoses that may involve fentanyl.  This outreach and education includes a Health Alert released today to PDPH’s Health Alert Network, which includes primary, specialty and emergency-room based providers throughout Philadelphia.

Drug overdoses from fentanyl are happening across the city and affecting multiple demographic groups.  Of the 99 overdose deaths involving fentanyl this year through April, 64% were male, 57% were white and 56% were aged 25-44.  More details on the rise in drug overdoses are available in the PDPH CHART Volume 1 Issue 1.