PORT ANGELES — Public health officials in Clallam and Jefferson counties have joined a national push to make a life-saving heroin overdose antidote more available to the public.
The Clallam County Board of Health voted Tuesday to ask area pharmacies to stock and dispense naloxone, a non-narcotic antidote to opiates that can be administered in the form of a nasal spray.
“This is a legitimate prescription drug,” said Dr. Tom Locke, public health officer for Clallam and Jefferson counties.
“It’s present on every emergency crash cart at every hospital and clinic,” he added.
“But this is a different idea. This is to trying to get it out in the public, just based on the chance that it might be used in a life-saving way.”
In a letter signed by Locke and health board Chairman John Beitzel, Clallam County pharmacies were asked if they would stock naloxone with nasal atomizers for patients with a prescription and whether they would consider dispensing the antidote under a standing order from the health officer.
Only one pharmacy in Clallam County stocks naloxone now, Locke said.
“We would like to begin providing prescriptions for naloxone inhalers to heroin users as soon as possible,” the letter says.
The Jefferson County Board of Health recently approved a similar letter, Locke said.
Naloxone, also known by its brand name Narcan, is administered intravenously by emergency medical technicians and health care providers after an opiate user loses consciousness.
“If you take a higher dose [of heroin] than your body’s used to, you stop breathing, and you’ve got about four minutes for someone to do something about that,” Locke told the Clallam County Board of Health.
“But there is an antidote.
“The question is how to make this more available to those who might have the opportunity to save a life with it.”
Naloxone has had a surge of national visibility since the heroin overdose death of actor Philip Seymour Hoffman in February, Locke said.
Washington state has been ahead of the curve in the distribution of the antidote because of its high opiate-related death rate.
The state medical association and pharmacy boards have removed barriers to naloxone access, and the state Legislature has expanded good Samaritan laws to protect people who administer the antidote to intravenous drug users from legal liability.
“Washington state has had one of the highest opiate-related mortality rates in the country,” Locke said.
“Several years ago, Clallam County had the very unwelcome distinction of having the highest rate in the state of Washington,” Locke said.
“Those numbers have actually been coming down over the last several years. They peaked in 2009, and they’re dropping.
“But the type of opiate misuse is changing in Clallam County.”
In 2009, the most common opiates being used on the North Olympic Peninsula were prescription methadone pills.
The state has since cracked down on people filling multiple prescriptions, and heroin is “moving into the vacuum,” Locke said.
Based on survey data from a syringe exchange program run by Clallam County Health and Human Services, heroin and methamphetamine are now “running about 50-50,” Locke said.
“Heroin has some unique dangers,” Locke added.
“With heroin, you never really know what the dose of the drug is that you’re taking. You’re procuring it from a completely illegal supply chain. At least with a prescription opiate, you generally know what the dose is that you’re taking.”
Naloxone is routinely provided to heroin-addicted jail inmates upon their release.
“We know that if you’re a heroin addict and you’re released from jail, you have a significant chance of overdosing in the next four weeks,” Locke said.
“People almost always go back to resume heroin use, and because their tolerance for heroin has gone down, you’re at an increased risk for overdose once you resume it.”
Although some needle exchanges and most treatment centers discourage naloxone, the antidote has become “much less controversial in the last six months as there’s a national push to make it available,” Locke said.
Seattle-area pharmacies are dispensing the antidote to people close to heroin addicts.
“If you find someone who has lost consciousness from a heroin dose, they’re no longer able to administer naloxone themselves,” Locke said.
“But if there’s someone with them and the drug is available, it’s simple to squirt it in the nose.”
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Reporter Rob Ollikainen can be reached at 360-452-2345, ext. 5072, or at rollikainen@peninsuladailynews.com.
