Albemarle County is trying to stem a rising tide of opioid overdoses and deaths: distributing the life-saving drug naloxone and training school and public safety staff to use it.
Last year alone, naloxone was administered more than 700 times — a testament to the immediate need for the drug and the significant uptick in overdoses.
In the past few years, opioid overdose and death have only been increasing nationwide, and Albemarle County is no exception.
The county has seen a significant increase in fatal opioid overdoses, compounded by the increased presence of fentanyl in the drug supply. In 2021, the most recent year with data, there were 2,622 overdose deaths in the commonwealth of Virginia, up roughly 25% over the year before, according to the Virginia Department of Health. Of that 2,622, 18 of those overdose deaths occurred in Albemarle County.
Naloxone, commonly known by the brand name Narcan, can prevent overdose deaths by reversing the effects of opioids on the body. It can be easily administered through a nasal spray and is safe to give, even if someone has not consumed opiates.
Albemarle County recently expanded staff access to naloxone and implemented training programs among staff members in public safety departments and Albemarle County Public Schools.
For first responders, it is “enormous” to be able to administer the drug, buying time to transport an individual to a hospital for immediate and longer-term treatment, said Lynn Kohan, medical director of the University of Virginia’s Pain Management Center.
“The more prevalent naloxone is, the better,” Kohan said. “It gives everyone a chance to save a life.”
In April, Albemarle police officers began carrying two nasal spray doses of naloxone in their patrol cars’ response kits and received training to recognize an overdose and administer the drug. Within 24 hours of implementing the program in the police department, two separate incidents occured where officers administered naloxone to individuals, saving their lives.
The fire department, which already equips emergency vehicles with naloxone, has begun distributing “Leave Behind” naloxone kits to individuals who have called 911 for someone experiencing a substance use crisis.
“We’re bridging the gap between the emergency response and the access to ongoing support,” said Titus Castens, Albemarle County assistant fire marshal who works in the community risk and resilience division. “We recognize that there’s going to be relapses, we recognize that these individuals need more support.” Leave-Behind kits will allow family members or close individuals to administer naloxone more quickly than it takes for first responders to arrive on the scene.
The kits contain two nasal spray doses of naloxone, fentanyl test strips and a pair of gloves. Castens said the department will begin to distribute kits at “community fairs” in addition to offering kits to households and individuals.
The fire department is conducting a data analysis to identify “hot spots” of overdoses in the area, targeting these spots with increased access to naloxone and training for staff of libraries and businesses.
Albemarle County Public Schools also recently expanded access to naloxone kits across the district, part of an effort to address overdoses among teenagers. Castens said there have been “several overdoses” in younger people as substance use becomes more prevalent at their age. As a result, the district trained school nurses in the administration of naloxone and will expand training to other school employees in the upcoming school year.
In 2022, Albemarle County Fire Rescue distributed naloxone 761 times. Individuals’ states improved in about half the cases, indicating previous use of opioids, Castens said. Those numbers represented a sharp uptick from previous years, part of an upward trend beginning in 2020.
“We’re seeing a big decrease in overdoses from actual opioid prescriptions, but a huge increase in overdoses from illicit substances like fentanyl,” Kohan said. Fentanyl is a powerful synthetically made opioid that is often mixed with other drugs and unknowingly consumed.
The good news: Naloxone can reverse the effects of a fentanyl-related overdose, although it might take repeated doses to do so.
Naloxone acts immediately to reverse the effects of an overdose on the body. An overdose occurs when opioids saturate opioid receptors in the body, some of which occur in the part of the brain that controls breathing.
Naloxone “unsticks” narcotics from the opioid receptors, reversing the effects of an overdose and allowing someone to breathe again, Kohan said.
In the commonwealth, individuals can access naloxone with or without a prescription from a medical provider. The Food and Drug Administration also recently approved Narcan for over-the-counter sale, although Kohan said her biggest worry is how affordable it will be in pharmacies.
The next step for addressing the overdose crisis is expanding long-term treatment programs and prescription of buprenorphine, a medication used to treat addiction, Kohan said. She said she hopes the two will go “hand in hand” to first address overdose and then link patients to treatment.
“Opioid use disorder is a disease, and people deserve treatment,” Kohan said. “Naloxone can really get them a chance to live in order to receive that treatment.”