The opioid crisis is something emergency rooms nationwide deal with every day. Some areas are more affected than others, but I have seen opioid misuse and overdoses everywhere I have worked.
Fortunately, while we certainly do see overdoses at Novant Health Brunswick Medical Center, the number is far less compared with places I have previously worked — in bigger cities here in North Carolina, as well as in Pennsylvania.
But opioid overdoses here at home in our own community are a serious, growing crisis, and one that demands action.
By both ensuring that life-saving supplies of naloxone remain available to our family members, friends and neighbors, and by educating ourselves, we can help stop opioid misuse.
When a patient who has overdosed first comes in to the emergency room, doctors often won't have much, or any, information on the patient.
Unfortunately, in some cases the patient is dropped off at the door alone.
Once it’s recognized that a patient has a possible or likely overdose, the emergency room team needs to act quickly to stabilize and save the patient. Fortunately, there is a readily available drug, naloxone, for these emergency situations that quickly and safely reverses the effects of opioids and opioid overdoses.
When people get to the point of an overdose, they’ve consumed too much of the opioid, causing their breathing to slow to a dangerous level. In some cases, it can cause a person to stop breathing altogether.
Because of this, we’re racing against the clock to save lives.
We need to act quickly to reverse the overdose and increase oxygen flow to the brain before it is too late. Minutes matter. The ER team must work rapidly to treat such patients.
In most cases, naloxone works very well to get the patient safe and stable enough for discharge. On our end, our team works to counsel our patients on what options they may have — at-home naloxone, counseling, rehabilitation or referral to a medication-assisted treatment center.
The goal of medication-assisted treatment is to help patients recover through a treatment plan of medication and counseling, or behavioral therapy. It’s been proven to improve patient survival, increase retention in treatment and increase a patient’s ability to gain and maintain employment.
We try to work with families of patients to figure out the best treatment plan with the same goal in mind — get our patient the best care. At Novant Health, we sometimes provide families with at-home naloxone.
It’s disheartening to see some areas of the country, heavily impacted by the opioid epidemic, have discussed withholding naloxone for individuals who have had repeat overdoses. Something like three strikes and you’re out of luck. I am strongly against this recommendation – I took an oath to do my best to save every patient and this is no different. I’m going to fight to give people another chance at life.
To me, this is against everything medicine stands for. If there is a life-saving medication readily available, it needs to be given regardless of the situation. Just because someone has overdosed previously, no matter how many times, does not mean that they will continue to do so in the future. We are here to save lives and we are always here to help them overcome substance misuse.
The root cause of the opioid epidemic, like most problems of this scale, is complicated. And as with every patient, their stories are different.
Many people assume that those with opioid misuse problems look a certain way, are of a specific socioeconomic class, or are using a hard drug. That’s not the case.
Having worked now for many years and having seen hundreds of overdoses, I can tell you that patients who have overdosed come from all backgrounds. It's truly a nationwide epidemic.
There’s also the misunderstanding of what opioids are. It doesn’t just mean heroin or fentanyl. Often times, patients come in who have overdosed on strong pain medications like oxycodone or hydrocodone.
There are some people who began misusing prescription pain medications, while others have struggled with substance misuse their whole lives. There are many factors that go into the opioid epidemic, but the problem exists and something needs to be done about it on all levels.
My hope is for more awareness, better treatment of the psychiatric components of opioid misuse and better options for those dealing with opioid misuse – only then can we start to remedy the situation.