Class Project: Narcan Survey

[Elizabeth 2]

Hello!

 

I need some help with a project for my Business Ethics class.  

I'm looking at the ethical consideration in the use of Narcan and how people feel about it. If you don't know anything about it, that's okay too. I just need 15 responses.  

8 Questions.  

3 are demographic

I CANNOT identify the survey takers and I do not ask for identifiying information beyond basic demographics: age, gender, education level.  

 

Thank you! 

 

https://www.surveymonkey.com/r/9HXFRWH

[displace]

Done. Question 3 referred to question above" but I think it should refer to question 1 or 2 by number so there is no confusion.

[justasque]

Done.  Would love to discuss the topic after you've gotten enough responses.  OP, will you start a thread about it once it won't mess up your survey results to have a discussion going?

[KarenNC]

Done.

[Arctic Bunny]

Done

[AmandaVT]

done!

[trulycrabby]

Done! Sounds like a very interesting project!

[Hen]

done

[StephanieZ]

Done. Please do post a summary of your results, etc, once you are done. Living in the heart of the opiate epidemic in WV, I'm very interested in this topic.

[clementine]

Done

[MercyA]

Done! Very interesting topic. I, too, would love to see the results of your survey and have more discussion on this.

[dirty ethel rackham]

Done.  I would love to see the results as well had talk about this.

[Rebel]

Done

[Guest]

We just drafted up more regs in response to legislation about broadening naloxone use in the state and obtaining it without a personal use prescription.

[Granny_Weatherwax]

Done

 

[SparklyUnicorn]

Of course I could google it, but I don't know what Narcan is.  Would be nice to have added a brief explanation of that.

 

 

[Elizabeth 2]

Of course I could google it, but I don't know what Narcan is.  Would be nice to have added a brief explanation of that.

That was actually part of the point of the project.  If people don't know what it is, then how can they vote or inform their community decision makers on a topic?

 

The basis of this is "what ethical dillemmas are faced in your community?  How do people feel about it?  How does that align with a decision making framework?  Have the decision makers considered both aspects in their decision?  Conduct a survey and write a letter to the decision makers about the ethical considerations, including the survey results and community response." 

[Elizabeth 2]

Done.  Would love to discuss the topic after you've gotten enough responses.  OP, will you start a thread about it once it won't mess up your survey results to have a discussion going?

 

I will post my final results, as well as the research I've done, which y'all are welcome to discuss.  While part of the project calls for a recommendation, I am will not provide it for my own ethical reasons.  

[Elizabeth 2]

We just drafted up more regs in response to legislation about broadening naloxone use in the state and obtaining it without a personal use prescription.

 

I'm wondering if we are in the same state.  I will say that this is part of why I used this topic for research.

[MedicMom]

It isn't the ethical dilemmas, but the medical issues narcan poses that concern me. Like any drug, it is not 100% safe and frequently has side effects and complications that the general public would not be able to manage.

[Tangerine]

I sat in a support group a few weeks ago and listened to a man describe cradling his son that weekend and administering the single dose he had while waiting for the paramedics. Before that it hadn't even occurred to me that parents could keep it on hand.

[SparklyUnicorn]

That was actually part of the point of the project.  If people don't know what it is, then how can they vote or inform their community decision makers on a topic?

 

The basis of this is "what ethical dillemmas are faced in your community?  How do people feel about it?  How does that align with a decision making framework?  Have the decision makers considered both aspects in their decision?  Conduct a survey and write a letter to the decision makers about the ethical considerations, including the survey results and community response." 

 

So what is narcan?  I can't find it by googling.

[umsami]

Done.  Interesting....I didn't know people would be against it.  I guess it never occurred to me that people think people should die just because they're addicts?  I really hope we can do a better job treating addiction, mental health issues, etc. in this country.  We're failing big time.

[Jean in Newcastle]

So what is narcan? I can't find it by googling.

It's an opioid antagonist. I.e. It makes it so that the opioids are not effective for getting a high and work against its effects.

[justasque]

So what is narcan? I can't find it by googling.

It reverses heroin overdoses, and as such can save lives. Cities with serious heroin problems are issuing it to first responders, and in some areas also community workers and family members. I recently read an article about a school that had decided to keep it on hand. All of the articles I have read were positive, so I would be interested to hear the down side, esp. from folks in the trenches like Medic Mom

 

 

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[Guest]

I'm wondering if we are in the same state. I will say that this is part of why I used this topic for research.

It's a nationwide push by NABP as well as multiple state legislatures. I'm in Alaska and a board member, for what it's worth, so I kind of love and breathe this stuff right now.

[Guest]

It isn't the ethical dilemmas, but the medical issues narcan poses that concern me. Like any drug, it is not 100% safe and frequently has side effects and complications that the general public would not be able to manage.

Board of pharmacy perspective here -

We have discussed this ad nauseous, like epinephrine, the side effects are minor given the condition it is treating, so that negligible in terms of the public safety effect. Even a healthy child being dosed would potentially suffer only minor complications, and not fatal or permanent ones either. Access is really more critical at this juncture, since it is a life and death situation - that was the decision of the governor and legislature, anyway.

 

The way the kits are designed and what delivery device is used is something different states are varying on - we kept it very broad since costs are massively different with the nasal spray or autoinjector vs a preloaded syringe, but all are effective and relatively free of side effects compared to the benefits even when misused. Certainly safer than adrenaline/epinephrine. I do believe we restricted purchase of it to legal adults though, since minors obtaining non-patient-specific prescriptions is fraught with ethical issues.

Edited March 14, 2017 by Arctic Mama

[SparklyUnicorn]

It reverses heroin overdoses, and as such can save lives. Cities with serious heroin problems are issuing it to first responders, and in some areas also community workers and family members. I recently read an article about a school that had decided to keep it on hand. All of the articles I have read were positive, so I would be interested to hear the down side, esp. from folks in the trenches like Medic Mom

 

 

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Ok, I have heard about this.  Why am I not allowed to have an opinion about it? (question not directed at you.)

[Guest]

This is a really good article about it from a few years back:

https://www.ems1.com/drugs/articles/1922308-Why-intranasal-naloxone-is-a-safe-antidote-for-anyone-to-administer/

[Elizabeth 2]

It reverses heroin overdoses, and as such can save lives. Cities with serious heroin problems are issuing it to first responders, and in some areas also community workers and family members. I recently read an article about a school that had decided to keep it on hand. All of the articles I have read were positive, so I would be interested to hear the down side, esp. from folks in the trenches like Medic Mom

 

 

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Unfortunately, it's not just heroin.  It's methadone, vicodin, and OxyCotin, which are often easier to obtain in smaller communites. It is being issued in 28 states to all first responders due to this. 

 

It's a nationwide push by NABP as well as multiple state legislatures. I'm in Alaska and a board member, for what it's worth, so I kind of love and breathe this stuff right now.

{face palm} Feeling like an idiot now, because I knew that! I've been lurking the posts on Ben. LOL  (Must remember to compose thoughts after sufficient caffeine.)

 

I am in SW Ohio.  Someone I went to school with was in a vehicle collision with someone that was in the middle of an overdose.  He survived, but it brought the issue home. 

 

People do believe that withholding is the only way to deal with it around here. The comments on social media for the local news outlet demonstrates the lack of empathy for anyone having difficulty.  I surveyed it for eight weeks worth of posts. I just copy and pasted names on Facebook to see if it was a lot or if a few repeated  No less than 500 people commented something to the effect, 'let them die and the problem will be taken care of.'  I hoped the survey would reveal more empathy than what I have been seeing. <--not the results, but my initial thoughts prior to the survey.

 

I still can't thank you all enough for this. 

[MedicMom]

I don't think I've ever heard the "let them die" mentality. That said, we revive the same people over and over. We give them narcan, they get violent and vomit, we take them to the hospital where they sign out or are discharged quickly, and three hours later we are back again at the apartment or car giving more narcan. I don't think not giving narcan is the answer; I think though that if you're administered narcan you should be required to be admitted to a rehab, similar to a psychiatric hold. Of course this requires more rehab beds and availability, which is a problem. The other thing to realize is that narcan is only supposed to be given if the patient is not responsive and not breathing. The people we give narcan to are about to die. I also support very stiff criminal penalties for drug dealers who are selling heroin that is cut with fentanyl or other opiates to unsuspecting addicts. It's cheaper, but the people are taking drugs that are much higher potency than what they expect and overdose quickly. A few weeks ago someone was selling a bad batch and we had 17 overdoses in 48 hours. The local news stations and police were putting out bulletins telling people not to use the heroin they had bought because it was more deadly than usual.

The other thing we are seeing is addicts who are angry that their high can be taken away so easily, so they are starting to use drugs other than opiates. Narcan only works on opiate overdoses.

I do think cost is going to become another issue. Ten years ago it was $2 a dose and one dose was sufficient to reverse the overdose. Today it's running around $50 a dose and we are finding we need to use 2-3 doses because of the potency of the drug.

[SparklyUnicorn]

I don't think I've ever heard the "let them die" mentality. That said, we revive the same people over and over. We give them narcan, they get violent and vomit, we take them to the hospital where they sign out or are discharged quickly, and three hours later we are back again at the apartment or car giving more narcan. I don't think not giving narcan is the answer; I think though that if you're administered narcan you should be required to be admitted to a rehab, similar to a psychiatric hold. Of course this requires more rehab beds and availability, which is a problem. The other thing to realize is that narcan is only supposed to be given if the patient is not responsive and not breathing. The people we give narcan to are about to die. I also support very stiff criminal penalties for drug dealers who are selling heroin that is cut with fentanyl or other opiates to unsuspecting addicts. It's cheaper, but the people are taking drugs that are much higher potency than what they expect and overdose quickly. A few weeks ago someone was selling a bad batch and we had 17 overdoses in 48 hours. The local news stations and police were putting out bulletins telling people not to use the heroin they had bought because it was more deadly than usual.

The other thing we are seeing is addicts who are angry that their high can be taken away so easily, so they are starting to use drugs other than opiates. Narcan only works on opiate overdoses.

I do think cost is going to become another issue. Ten years ago it was $2 a dose and one dose was sufficient to reverse the overdose. Today it's running around $50 a dose and we are finding we need to use 2-3 doses because of the potency of the drug.

 

I agree with getting them into rehab, but it is sometimes difficult to get a spot!  So even if they WANT to go, sometimes they can't find anywhere to go.

[MedicMom]

I agree with getting them into rehab, but it is sometimes difficult to get a spot! So even if they WANT to go, sometimes they can't find anywhere to go.

Exactly. There aren't enough programs or beds, which is an issue that has to be addressed. There needs to be more addiction services,but that's a really tough sell to those in charge of those things.

[ktgrok]

It isn't the ethical dilemmas, but the medical issues narcan poses that concern me. Like any drug, it is not 100% safe and frequently has side effects and complications that the general public would not be able to manage.

 

Yeah, but if a person is currently coding from an overdose, I don't know that side effects really even matter. I mean, if they are going to die from an overdose, better to TRY narcan and have side effects than let them die. 

[brehon]

Medic Mom, you and I are separated by a large geographical distance and I'm seeing the same things you are. Treat a patient, bring them back from the brink of death, take them to the ER, and treat them again 4 hours later. It can be a never ending cycle.

 

We're also seeing the heroin cut with fentanyl. And it's massive amounts of fentanyl per little bit of heroin. Absolutely fatal. I just wonder when the inevitable national backorder is going occur.