Narcan through insurance

[Llewtrah381]

99% of lay rescuers are unwilling/unable to manage the airway and bag an overdose patient until EMS arrives.

Somehow that needs to shift. It’s safe, effective, and simple. Narcan is an option but ventilation is universally available - with proper, simple training

 

[Tarheelpilot]

Use cash. Not your insurance.

 

[Daleandee]

I'd like to do without the lecturing of whether I should or shouldn't have it.

Hate to be the one to break the news to you but this is POA and getting sound advice (or not) about every facet of your question is part of the price of admission. Just the way it is.

I wasn't trying to lecture you at all. Do what you like but realize that if/when something doesn't go as planned someone else may own a lot of the stuff that you used to.

 

[bbchien]

...without the appropriate training.

And judgement…..

 

[OneCharlieTango]

Somehow that needs to shift. It’s safe, effective, and simple. Narcan is an option but ventilation is universally available - with proper, simple training

As someone who mask ventilates about 800 people a year, I’ll point out that it’s sometimes unsafe, ineffective, and impossible. When I do continuing education for paramedics, I’m routinely disappointed by how many of them know how to use a mask properly — it’s much less than half.

These are complicated issues, not unlike a decision about whether to carry a gun. There’s a lot of responsibility in trying to manage an airway, or in assuming a narcotic overdose. I’m an anesthesiologist with 30 years’ experience. I don’t carry a mask or narcan, and have never been in a situation where I wished I did.

 

[flyingron]

Somebody randomly carrying Narcan around "just in case" sounds like someone with "hero" syndrome, a person that wanted to be a cop or firefighter but never quite made it.

You carry an Epi too?

Beats carrying around an AR15.

 

[Zeldman]

but then I remembered I don't like to touch people.

That is what stopped me from becoming a doctor.

That and the 7th grade...

 

[nauga]

You carry an Epi too?

I have in circumstances where there's a higher-than-normal likelihood it will be needed and they were available.

Nauga,
and the right tool for the job

 

[MyDimeIsUp]

Postpone the inevitable?

https://www.cnn.com/2017/10/30/health/naloxone-reversal-success-study/index.html

Pretty hard to say. So many people struggle with opioid withdrawal. I've heard it's literally the worst thing ever. Someone described it as if the entirety of hell was living in your body for weeks. I was also told to imagine having a severe hangover, with the flu, while you suffer from depression, and you have arthritis; that's how someone described withdrawal. The only thing to make the unbearable pain go away is more opioids which get rid of the symptoms... and also get you high. Pretty scary and not surprised that so many users relapse your brain gets so ****ed up and adapts to these drugs to need them as my dad has said.

 

[PaulS]

Pretty hard to say. So many people struggle with opioid withdrawal. I've heard it's literally the worst thing ever. Someone described it as if the entirety of hell was living in your body for weeks. I was also told to imagine have a severe hangover, with the flu, while you suffer from depression, and you have arthritis; that's how someone else described withdrawl. The only thing to make the unbearable pain go away is more opioids which get rid of the symptoms... and also get you high. Pretty scary and not surprised that so many users relapse.

Opioid rehab is a huge business in this country, mostly paid for by states. There was a guy running for AG in Mass. whose son died of an opioid od. He said he had done his research and the model for opioid recovery is based on alcoholic rehab, at least what the state is willing to pay for. The problem he said was that alcoholics need intense supervised rehab for a few weeks to a month, if managed correctly the cravings go away and recovery can continue in an out patient environment for most. I forget the exact timeframes, but for an alcoholic it's about 4 weeks to get to have them out of crisis mode. He said he learned that with opioid addicts, getting out crisis mode is much slower. He said he learned that opioid addicts need at least six months supervised recovery, the brain takes that long to adjust to not having the drugs. The state sponsored programs do not accommodate this time frame, these people are booted after a month. The recidivism rate is like 95%. These people spiral pretty quickly and end up back in a program that doesn't work. Some go through many times before they end up killing themselves by overdose.

I liked his ideas, he was going to hold the state and the private contractors responsible for sucking at their job. Unfortunately he lost to a lady who has made zero progress in this mess. She now wants to run the state as governor.

We need to hold politicians responsible for stuff like this, rather than giving them a pass "because they tried".

 

[Llewtrah381]

I hate to be a buzzkill here but, at least as far as I see, epipens require a prescription. Prescribers usually do so for the patient who needs it or a caregiver (parent) of such. You MAY be able to persuade a provider to give you a script for one for some unknown stranger and situation but if you came to me, I wouldn’t do so; when prescribed appropriately, the patient or caregiver knows what to look for in the individual who needs one. If I wrote such a script and someone, with the best of intentions, misused it and the person was harmed, I’d fully expect my actions to be looked into - and my license at risk. If I had written a script for someone who had a legitimate risk of anaphylaxis and THEY chose to use it on a bystander, that’s on them.

Plus, if it needs a script, we’ve circled back to the insurance fraud potential. If you choose to find a way to carry an epipen you don’t personally need, I’d suggest paying for it out of pocket. And they aren’t cheap. And they expire.

 

[SkyDog58]

Beats carrying around an AR15.

while also pretending to be a medic caring for people.

 

[MauleSkinner]

would the FAA notice that and what would they say?

My guess is the FAA would say the same things that you didn’t want to hear here.

 

[weilke]

Oh behold the

Sometimes it's better to just stand back and watch. But I can't help myself and have to make a few points (I will not comment on the overall merit of Narcan and its role in perpetuating the opioid abuse problem):

- I would not get this on my own health insurance. You have health insurance for YOUR medical issues, so having your insurance buy you a drug to treats drug abuse, may create the presumption that you in fact have the disease you are buying the drug for.
- Look at your states good samaritan law. Some states have specifically included the administration of narcan by someone who is not a licensed medical professional (or working under their supervision e.g. a EMT) as a covered activity. Unless giving narcan is covered under that law/rule, you are going out on a limb by administering a medication to someone.
- In some states, narcan is available without a prescription, either for purchase at the pharmacy or by picking up a kit at the county health department. Some are 'dont ask dont tell', others require you to state that you are living with someone who has an abuse problem. If you want to have this available, that is going to be the legal way to obtain a dose.

 

[Everskyward]

Around here they pass out Narcan to junkies, so that they can use it on their junkie friends, or perhaps someone will use it on them. I don't think it's hard to use.

 

[ThatOtherGuy]

He said he learned that with opioid addicts, getting out crisis mode is much slower. He said he learned that opioid addicts need at least six months supervised recovery, the brain takes that long to adjust to not having the drugs. The state sponsored programs do not accommodate this time frame, these people are booted after a month. The recidivism rate is like 95%. These people spiral pretty quickly and end up back in a program that doesn't work. Some go through many times before they end up killing themselves by overdose.

I've heard recovery rates less than 3% for opiates, and from my first hand anecdotal experience I totally believe this.

One of the major killers with opiates is the patients get out of a controlled setting (inpatient) after a few weeks and their bodies have already started to lose tolerance. I've known several addicts that were taking many times the dose of hydrocodone or oxycodone that would kill a large man when they went into treatment. With alcohol and many other drugs you have time to intervene and catch a relapse. With opiates if the patient has time under their belt, reduced/normal tolerance, and they go back to their normal pre-treatment dose the first relapse could be a death sentence. Nevermind exposure to street drugs laced with fentanyl/carfentanil at unpredictable concentration.

I was in environments where I faced an increased risk of encountering someone I knew or a relative stranger overdosing on opiates. I carried Narcan in my car and wouldn't have hesitated to use it to save a life.

OP, I'd check with your state health department about obtaining the Narcan through an intervention program. Most states will provide it free of charge and provide training on how to administer it. It's really not rocket science, although the info about people coming out of overdose and being violent is a real thing. Just don't let anyone write you a prescription that could be tied to a diagnosis code.

 

[Lindberg]

Narcan is available over the counter in all 50 states. Deploying it isn't rocket science, and the downside risk is tiny. It's probably safer to give an OD victim Narcan that to give a choking victim the Heimlich. The pearl clutching here is really something else. The easiest thing to do is buy it OTC and pay cash. But I'd have zero concerns discussing it with my AME.

 

[danhagan]

I carry a CPR mask and a full first-aid kit in my car. I've used it too. Carry one when I bike also. Used it a couple weeks ago. Carrying stuff "just in case" is called "being prepared." 50,000 people die of opioid overdoses annually in this country. How many more OD and are saved?

Around here they pass out Narcan to junkies, so that they can use it on their junkie friends, or perhaps someone will use it on them. I don't think it's hard to use.

You guys knock yourself out injecting narcan. Am sure the good samaritan laws cover mistaking a narcan overdose with a diabetic going into shock ... stay alert as you administer that narcan as "your friend' might come up with a knife as we awakes, or just push you in front of the subway

 

[BladeSlap]

Based on the FAA, I’d be wearing a disguise and paying cash with gloves on if I was going to buy it, or they ask for ID and it ends up in some database the FAA gets in nose in, even if you can prove your innocence, bad spot.

Plus if the person comes around, says you assaulted them, or doesn’t and dies, it gets recorded you had narcan, there’s stories on here of a guy getting attacked by the FAA for getting stabbed, or the woman who the FAA went after when she was sexually assaulted, and they were just at bars, you want to play with narcan?

If you like abuse, much better ways

Jokes aside, I think you’re asking for trouble, not the fun sexy kind ether.

 

[Everskyward]

You guys knock yourself out injecting narcan. Am sure the good samaritan laws cover mistaking a narcan overdose with a diabetic going into shock ... stay alert as you administer that narcan as "your friend' might come up with a knife as we awakes, or just push you in front of the subway

I didn't say I was interested in doing it. I can't tell if someone is sleeping ODing or dead. I said it was probably easy to get and easy to administer.

 

[Lindberg]

You guys knock yourself out injecting narcan. Am sure the good samaritan laws cover mistaking a narcan overdose with a diabetic going into shock ... stay alert as you administer that narcan as "your friend' might come up with a knife as we awakes, or just push you in front of the subway

You don't have to inject it, it's a nasal spray. And no harm done if you give it to someone not having an OD. But you knock yourself out pearl clutching. I hope no one you care about is ever in need while a bunch of uninformed bystanders debate good samaritan laws and legal liability.

 

[Daleandee]

You don't have to inject it, it's a nasal spray. And no harm done if you give it to someone not having an OD.

If it's not needed it and it is administered unnecessarily by someone without valid medical credentials it may not be a good day for the administrator of the "nasal spray".

Good Samaritan laws are for giving aid to people in distress but dispensing medication to people is serious business ... regardless of how harmless anyone says it is.

Buyer beware!

 

[weilke]

If it's not needed it and it is administered unnecessarily by someone without valid medical credentials it may not be a good day for the administrator of the "nasal spray".

I dont know how this is done in other states, but locally (MD) they passed a law that says:

(a) Individuals. -- An individual who, in accordance with this subtitle, is administering naloxone to an individual experiencing or believed by the individual to be experiencing an opioid overdose may not be considered to be practicing:

• (1) Medicine for the purposes of Title 14 of the Health Occupations Article; or

• (2) Registered nursing for the purposes of Title 8 of the Health Occupations Article.

They also spelled out:

A person who dispenses naloxone in accordance with this subtitle is exempt from any laws that require a person to maintain a permit to dispense prescription drugs.

You are not practicing medicine or nursing and you don't need a CDS (controlled dangerous substances) license. The administration of naloxone by a layperson to another person is specifically authorized in state law.

If you give naloxone to someone who is not opiate tolerant, they may experience nausea, but that's pretty much it. Lets say someone is unconcious from a diabetic event, they wont wake up, but it won't harm them either.

Good Samaritan laws are for giving aid to people in distress but dispensing medication to people is serious business ... regardless of how harmless anyone says it is.

That's exactly what the good samaritan laws are for. And to not leave that up to individual courts interpretation, the legislature specifically spelled out that it is covered:

(a) Individuals. -- An individual who administers naloxone to an individual who is or in good faith is believed to be experiencing an opioid overdose shall have immunity from liability under §§ 5-603 and 5-629 of the Courts and Judicial Proceedings Article.


As always, know your state laws and regs. Many states have a similar framework for administration by laypersons.

 

[steingar]

Lots of ways to be a Good Samaritan. Work at your local shelter. Volunteer for your favorite charity. Donate to your local food banks. Administering drugs to strangers sounds really, really loopy.

 

[PaulS]

A lot of police departments have cars carrying Narcan, they've been trained and can handle the junkie rage that can happen. Just dial 911.

 

[OneCharlieTango]

"When seconds count, the police are only minutes away!"

 

[PaulS]

"When seconds count, the police are only minutes away!"

Let's see, so I'll have to start carrying a rescue inhaler, narcan, an epi pen, cpr mask, defribulator, tourniquet, rescue rope, life ring ........

 

[midwestpa24]

Let's see, so I'll have to start carrying a rescue inhaler, narcan, an epi pen, cpr mask, defribulator, tourniquet, rescue rope, life ring ........

Don't forget a fire extinguisher!

 

[Lindberg]

Wow. I was once shocked on arriving at the scene of a motorcycle wreck that no one from the five cars ahead of me had approached the rider to check on him and no one had called 911. I've never regretted stopping to help someone or render aid. Every single time they've been appreciative, even if they don't need any help. But I guess bystanding is the sorry state of our society today. I guess all I can ask is that you hold your phone horizontally while filming.

 

[Lowflynjack]

I don't know how I missed this thread... some troll shows up as a guest, named TheOpiodReverser and gets a huge response!! I don't know about you guys, but I'm pretty sure I could drive around for hours in the rough part of town, see people laying on the street and not know they needed narcan. I would help more people if I drove around with Zyrtec.

 

[midwestpa24]

Wow. I was once shocked on arriving at the scene of a motorcycle wreck that no one from the five cars ahead of me had approached the rider to check on him and no one had called 911. I've never regretted stopping to help someone or render aid. Every single time they've been appreciative, even if they don't need any help. But I guess bystanding is the sorry state of our society today. I guess all I can ask is that you hold your phone horizontally while filming.

And that is why I became a volunteer firefighter. I was one that always felt the need to assist, and found myself on the side of the highway more than once. Becoming a firefighter gave me the training and tools to actually help. But notice, when we show up, it's in a 50,000 lb vehicle packed to the gills with the tools of the trade, and we are constantly training in all of their uses.

I carry very little in my personal vehicle, just a small jump bag with some PPE and bandages/gauze to try to slow bleeding until help arrives. Anything else can wait until the rigs show up.

 

[Llewtrah381]

I would help more people if I drove around with Zyrtec.

…and that, Ladies and Gentlemen, is how Z-man got his start…

 

[Rgbeard]

I've been the motorcycle accident victim. I was really happy for the guy that came to me and gave me his jacket as something for my head to lie on, and to the nice lady that simply sat there and talked to me.

I'd be happy to repay the same kindness to a motorcycle accident victim.

 

[Rgbeard]

…and that, Ladies and Gentlemen, is how Z-man got his start…

Z-Man is not to be confused with V-Man.

 

[Lindberg]

I've been the motorcycle accident victim. I was really happy for the guy that came to me and gave me his jacket as something for my head to lie on, and to the nice lady that simply sat there and talked to me.

I'd be happy to repay the same kindness to a motorcycle accident victim.

And if you were bleeding profusely from an extremity, would you appreciate someone putting a tourniquet on it? If you weren't breathing, would you appreciate receiving CPR? So why wouldn't you want help if you're victim of an overdose?

Three weeks ago, I stopped at the scene of an older guy who'd flown face-first off his bicycle. I was heartened that several others stopped to help as well. 911 had already been called, and an ambulance was "on it's way."

Half an hour later, after all his bleeding had been stopped, the ambulance arrived. This in the middle of the 8th largest city in the US, within 2 miles of multiple fire stations. It's clear some of you weren't boy scouts.

 

[Rgbeard]

And if you were bleeding profusely groin an extremity, would you appreciate someone putting a tourniquet on it? If you weren't breathing, would you appreciate receiving CPR?

Yes to all those things.

 

[Lindberg]

Yes to all those things.

But not Narcan if you or someone else is dying from an overdose? It's first aid, and health departments across the country are practically begging people to get it.

 

[Rgbeard]

But not Narcan if you or someone else is dying from an overdose? It's first aid, and health departments across the country are practically begging people to get it.

Bingo. I wouldn't walk across the street to help an OD person.

 

[Llewtrah381]

Bingo. I wouldn't walk across the street to help an OD person.

But would you give him Viagra? A hard decision…

 

[Jeff Oslick]

Bingo. I wouldn't walk across the street to help an OD person.

There seems to be a misperception here that the only people who OD are street addicts. The statistics of opioid drug use in this country say otherwise.