West Lebanon
Now, anyone in the Twin States can gain access to the knowledge and tools necessary to save a family member, friend or stranger who may fall victim to the epidemic.
Earlier this week, nearly two dozen people from the Upper Valley and beyond attended training sessions at Kilton Public Library, where attendees learned how to administer naloxone, often known by the brand name Narcan, and received their own two-dose kit.
“It is a very real issue in our area,” said Beverly Widger, senior vice president of human resources at Mascoma Savings Bank, who plans to share what she learned with employees. “As an HR professional, I think it is important that we know about this.”
Bridget Aliaga, the facilitator for ALL Together, which is a working group of the Public Health Council of the Upper Valley, ran Monday’s sessions.
The training sessions are part of an initiative launched by the New Hampshire Department of Health and Human Services, one that followed the 2015 passage of legislation that allows New Hampshire doctors to prescribe and distribute naloxone to a third party.
The law also gives immunity from liability to both the prescriber and the person administering the drug.
“Harm reduction is part of … trying to address the epidemic that is going on,” Aliaga said. “From prevention to recovery, we are trying to put an end to it. This specifically addresses the biggest or worst part of it, which is someone dying.”
DHHS and ALL Together’s goal is to get as many kits as possible out into the community so that access is broad, she said.
To help, DHHS is partnering with certain nonprofits in each county in New Hampshire and setting them up to be “their own distributor,” so if a resident needs naloxone, they can access a kit there for free.
Businesses also can hold community events, and each person who attends gets to take home a kit.
The Public Health Council of the Upper Valley is housed in Community Health at Dartmouth-Hitchcock Medical Center, which is the fiscal agent for the money that funds the free program.
For those who find themselves in a situation where a person may have overdosed, there are five simple steps to follow, Aliaga told the 22 people who attended this week’s clinics.
The first step is to assess the situation for personal safety. There could be needles or harmful substances, such as fentanyl, on the scene.
The second, and perhaps the most important step, she said, is to call 911.
After a bystander has done those two things, he should look closely at the individual for signs of an overdose, which include a blue or dark appearance, slow or stopped breathing, a snore-like gurgling noise and non-responsiveness, according to a fact sheet produced by the New Hampshire Statewide Addiction Crisis Line that was distributed to attendees.
If the person is not breathing, CPR should be attempted before naloxone is administered.
Participants received Narcan at the session, a substance that reverses the effects of an overdose.
To administer a dose of Narcan like the ones distributed at the training, a bystander would shoot the nasal spray into one of the overdose victim’s nostrils, and then wait three to five minutes for the person to respond to it. If there is no response, a second dose should be administered. (Naloxone also can come in needle and syringe form.)
By then, emergency personnel should be arriving, officials said.
Even if a person is not suffering from an overdose but instead a seizure or diabetic episode, naloxone won’t harm them, according to harmreduction.org. The medication has no effect on someone who doesn’t have opioids in their system, the website states.
“I don’t think you could ever have enough doses on hand,” Matt Herbert, a member of the Norwich Fire Department who also sits on the ALL Together board, said after a training session. “The reality is that you may be treating more than one person. One person may call and you may need to save a dose for yourself for exposure.”
Another factor not to be overlooked is the risk of second-hand exposure to drugs, Herbert said.
If an overdose victim has fentanyl, for example, the person trying to help may be exposed to it and also overdose. Fentanyl is a synthetic opioid that is more potent than morphine. It is sometimes mixed with heroin.
“As a first responder, one of our biggest concerns is secondary exposure,” Herbert said. “The opioid epidemic is very real; there is genuine concern in the Upper Valley.”
He noted that there are budget constraints in small towns, and receiving a two-dose kit at Monday’s event will prove helpful.
“If I am in another town or even across the river, I can help somebody without worrying about any of the expenses,” Herbert said.
The naloxone distribution program is funded using about $536,000 in federal money from the Substance Abuse and Mental Health Services Administration and roughly $610,000 from the New Hampshire DHHS general fund budget, for a total cost of about $1.15 million, state DHHS spokesman Jake Leon said. The kits were purchased at $75 each.
About 13,800 kits have been given out to to date, and DHHS has about 1,450 kits remaining in inventory, Leon said.
Naloxone can also be obtained outside of the program. A person can either use a prescription or buy it over the counter at costs that vary based on the brand and insurance coverage.
The next set of free sessions hosted by ALL Together will take place at the Kilton Public Library on Feb. 13 between 4 p.m. to 6 p.m.
Widger, with Mascoma Savings Bank, said she plans to take the free kits she and a co-worker received on Monday back to the bank, just in case.
“You never know if there is going to be a customer or an employee who may have an emergency situation and might have to use this,” Widger said.
Jordan Cuddemi can be reached at jcuddemi@vnews.com or 603-727-3248.
Clarification
If a person suffering an overdose has stopped breathing, the first priority should be to perform CPR. The opioid-reversal drug naloxone can still be effective, but restoring respiratory function is critical. An earlier version of this story was unclear on naloxone’s role in such situations.