HomeMy WebLinkAbout20160204_Naloxone Distribution and Overdose Reporting AdvisoryAlways working for a safer and healthier community
615 Sheridan Street
Port Townsend, WA 98368
www.JeffersonCountyPublicHealth.org
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360-385-9400 360-385-9444
360-385-9401 (f) (f) 360-379-4487
February 4, 2016
To: Jefferson County Health Care Providers
From: Tom Locke, MD, MPH, Jefferson County Health Officer
Re: Naloxone Distribution and Designation of Opiate Overdose as a Notifiable Condition
Epidemiology: Increased prescribing of potent opiates during the last several decades led to a
steady rise in opiate related fatalities, usually a result of unintentional overdoses. Methadone
was the most frequently involve drug in fatal overdoses. Efforts to reduce inappropriate
prescribing of opiates and unlawful diversion of these drugs have been largely successful.
Unfortunately, use of “black tar” heroin of Mexican origin has increased dramatically and with it
increased rates of opiate-related hospitalizations and fatal overdoses. During the period from
2012 to 2014, the rate of opiate-related hospitalization in Jefferson County was 177.2/100,000
(as compared to the State average of 208.3 and the Clallam County rate of 292.8). The opiate-
related death rate for Jefferson County in this same period was 9.7/100,000 (as compared to the
State average of 8.4 and the Clallam County rate of 13.4). Data on rates of non-fatal opiate
overdoses are lacking.
Jefferson County Public Health (JCPH) Initiatives:
1) Distribution of Naloxone Kits through the JCPH Syringe Exchange Program:
Emergency administration of parenteral or intranasal naloxone is a safe and effective treatment
for opiate overdose. In response to the growing number of opiate overdoses associated with
injectable heroin, JCPH will begin distributing naloxone kits at its Syringe Exchange Program
(SEP). Clallam County Health and Human Services implemented this program in 2015 and has
distributed 129 doses of naloxone through its SEP with 14 successful overdose reversals and
lives saved in its first year of operation. JCPH will distribute kits with two doses of injectable
naloxone. While there is no charge for the medication, a $15 fee will be charged for the training
program that is required for anyone who is eligible for a kit. The initial supply of naloxone kits
has been donated by the University of Washington’s Center for Opioid Safety program.
Naloxone can also be prescribed by a primary care provider and is covered by many insurance
programs for individuals who are taking prescription opioids for chronic pain. Prescription
templates and instruction materials are available from JCPH.
Always working for a safer and healthier community
Community Health Environmental Health
Developmental Disabilities Water Quality 360-385-9400 360-385-9444
360-385-9401 (f) (f) 360-379-4487
2) Designation of Opiate Overdose as a Notifiable Condition: Washington State law allows
local health officers to designate conditions of public health importance as notifiable conditions
within their jurisdictions. The Jefferson County Board of Health is following the lead of the
Clallam County Board of Health and has directed their health officer to designate both
fatal and non-fatal overdoses of opioid-contain drugs such as heroin, methadone,
hydrocodone, oxycodone, fentanyl and morphine as a notifiable condition. To limit the
burden of reporting, this notification requirement will only be applied to health care entities most
likely to see overdose victims – hospital emergency departments and the county coroner.
Notification will begin on March 1, 2016. In addition to compiling quarterly reports of overdose
cases, JCPH staff will contact reported cases to offer harm reduction strategies such as naloxone
kits and referral for chemical dependency evaluation and medication assisted treatment of opiate
use disorder. When the overdose is due to a prescription medication, the prescribing health care
provider will be contacted.