Hamilton County, Ohio, will distribute 30,000 doses of an overdose-reversing drug to try to stop a rash of deaths that has besieged the area.
In what is believed to be the first program and clinical study of its kind in the country, the county will partner with hospitals, jails, faith-based groups and syringe exchanges that will distribute the medication, naloxone. The goal is to get it as close to people who are using drugs as possible to save their lives should they overdose.
Officials will gather and analyze data to answer this question: What would happen to the rate of opioid-related overdose deaths if a community were to be completely saturated with naloxone?
“The bottom line here,” said Hamilton County Health Commissioner Tim Ingram, “is this is about saving people’s lives and giving them a second and third chance at life and getting them into treatment so they can be treated for this disease of opioid addiction.”
Hamilton County had at least 350 overdose deaths in 2015. First responders in the county carry naloxone and saved lives with it, but too many people were still dying.
Ingram and Shawn Ryan, the president and chief medical officer at BrightView Health, which runs treatment facilities in the area, wanted to do something. So they partnered with stakeholders across the county, including the county’s five major health systems, the University of Cincinnati College of Medicine, and Interact for Health, a local nonprofit.
They also went right to the source of naloxone: Adapt Pharma, which manufactures the drug under the brand name Narcan. It donated 30,000 doses of the drug in a nasal spray form, which can easily be used on others.
“This is the first time anyone’s approached us to say, ‘Let’s all get on the same page,’ “ said Mike Kelly, the president of Adapt. “We’re going to blanket the community with Narcan nasal spray.”
Now all of the groups will work together to distribute the drug and gather and analyze data to determine whether getting naloxone into the hands of tens of thousands of people will help decrease the number of overdose deaths.
Officials plan to distribute the drug in the next 45 days. The dissemination will be targeted at places in the county that have had some of the highest rates of overdose, based on data. Officials will collect data about every three months for about two years. The data will measure the number of doses distributed, the number used and the number of opioid overdoses that result in death or admission to an intensive care unit in Hamilton County.
Ingram said the plan is still a bit of a work in progress as it looks to collaborate with as many stakeholders as possible.
For example, Ingram said the coalition has been soliciting advice from people who are using drugs. The county sheriff’s office suggested that they get extra doses of Narcan so they can distribute them to the spouse or partner of a person on whom they use Narcan when called to a drug overdose. It will be made available to people in the county jail whose charges or convictions involve opioids and are about to be released.
Hamilton County has been dealing with a rash of deaths from synthetic opiates, including fentanyl, a synthetic opioid 50 times more powerful than heroin, and carfentanil, which is used as a large animal tranquilizer and can kill people in minuscule amounts. The drugs are cut into heroin, and users often don’t know what they are getting. Last year 174 overdoses were reported in Hamilton County, which includes Cincinnati, in less than a week.
Because the drugs on the street are now so powerful, a typical two milligram dose of naloxone wasn’t reversing overdoses; authorities or doctors needed to use more than one. So the naloxone distributed as part of the program will be a higher dose: four milligrams.
Ingram said hospitals will provide Narcan to people who are treated for opioid overdoses and that the initiative plans to work with the county chamber of commerce to perhaps make some Narcan available to the business community. The goal, officials said, is to save people’s lives and get them into treatment programs.
“In a perfect world maybe they can be the blueprint of what other communities need to do,” Kelly said.