DHHS bringing awareness to opioid abuse during Opioid Awareness Week

Opioid overdose deaths are a growing concern in Nebraska. In 2019, 168 people died of a drug overdose and at least 64 of those deaths were opioid related. Nebraska's drug overdose death rate per 100,000 people has increased from 3.6 in 2004 to 8.68 in 2019. The Lincoln Police Department (LPD) reports that as of August 19, it has responded to 50 overdose cases within the past 30 days. About half of those cases required officers to administer the life-saving drug naloxone. Four of the people died.

LPD reports that the overdose spike is a significant increase from previous years. LPD documented an increase from 2019 to 2020 in fatal and non-fatal drug overdoses. In that same time, there was also an increase in the number of opioid-related deaths and the number of fentanyl-related deaths. Ten opioid-related deaths were documented by LPD in 2019; three were fentanyl related. Twenty opioid-related deaths were documented by LPD in 2020; 13 were fentanyl related.

Naloxone, a medicine that rapidly reverses an opioid overdose, is an opioid antagonist. This means that it attaches to opioid receptors and reverses and blocks the effects of other opioids. Naloxone can quickly restore normal breathing to a person if their breathing has slowed or stopped because of an opioid overdose. However, naloxone has no effect on someone who does not have opioids in their system. Examples of opioids include heroin, fentanyl, oxycodone (OxyContin), hydrocodone (Vicodin), codeine, and morphine.

“Expanding the availability of naloxone to friends, family and bystanders will increase the likelihood that it will be administered in a timely manner, and prevent death from an opioid overdose,” said Dr. Janine Fromm, MD, executive medical officer of Nebraska DHHS, who issued the standing order allowing pharmacists to dispense naloxone to friends, families, and bystanders.

The Division of Behavioral Health offers programs supplying naloxone kits at no charge to the consumer or pharmacy, often in partnership with the Nebraska Pharmacists Association. 2,476 free naloxone kits have been distributed so far in 2021 via Regional Behavioral Health Authorities. https://dhhs.ne.gov/Behavioral%20Health%20Documents/NaloxoneMap.pdf

Neb. Rev. Stat §28-470 provides protection from administrative action or criminal prosecution when a pharmacist dispenses naloxone under the following limited circumstances:

• A person who is apparently experiencing or who is likely to experience an opioid-related overdose; or
• A family member, friend, or other person in a position to assist a person who is apparently experiencing or who is likely to experience an opioid-related overdose.
• A family member, friend, or other person who is in a position to assist a person who is apparently experiencing or who is likely to experience an opioid-related overdose, other than an emergency responder or peace officer, is not subject to actions under the Uniform Credentialing Act, administrative action, or criminal prosecution if the person, acting in good faith, obtains naloxone from a health professional or a prescription for naloxone from a health professional and administers the naloxone obtained from the health professional or acquired pursuant to the prescription to a person who is apparently experiencing an opioid-related overdose.

Also, Nebraska’s Good Samaritan law is an important harm-reduction tool in the context of the ongoing opioid crisis. Good Samaritan laws are laws that grant immunity for low-level drug crimes to persons having an overdose and bystanders who call 911 during overdose emergencies.

Signs and symptoms of opioid-related overdose:

• Unresponsive or unconscious individuals
• Not breathing or slow/shallow respirations
• Snoring or gurgling sounds (due to partial upper airway obstruction)
• Blue lips and/or nail beds
• Pinpoint pupils
• Clammy skin
• A history of current narcotic or opioid use or fentanyl patches on skin or needle in the body

Many Nebraska pharmacies offer ways to dispose of unwanted medications every day. Locations can be found on the Nebraska MEDS Coalition's website, https://www.nebraskameds.org. Nebraska MEDS is a coalition of state and community partners dedicated to educating residents about the safe disposal of prescription and over-the-counter medications. In addition to educational work, the coalition supports disposal programs that allow residents to dispose of unused and leftover medications.

Sites will accept prescription medication (be sure to remove identifying patient labeling); over-the-counter medication; creams, lotions, or ointments; liquid medication less than four ounces; pet medication, and all of the above in pill, tablet, and capsule form. The drug disposal program does not accept needles, syringes, or lancets; rubbing alcohol or hydrogen peroxide; home-based care or medical equipment supplies; liquid medication greater than four ounces, or thermometers.

Help is available. If you or a loved one need assistance, please reach out to:

• Your faith-based leader, your healthcare professional, or student health center on campus.
• Nebraska Family Helpline – Any question, any time. (888) 866-8660
• Rural Response Hotline, (800) 464-0258
• Disaster Distress Helpline: 1-800-985-5990 (oprime dos para Español) or text TalkWithUs to 66746.
• National Suicide Prevention Lifeline: 1-800-273-TALK (8255) for English, 1-888-628-9454 para Español
• National Domestic Violence Hotline: 1-800-799-7233 or text LOVEIS to 22522
• National Child Abuse Hotline: 1-800-4AChild (1-800-422-4453) or text 1-800-422-4453
• National Sexual Assault Hotline: 1-800-656-HOPE (4673)