U.S. Rep. Derek Kilmer calls for greater rural access to opioid overdose antidote

By Rob Ollikainen
Peninsula Daily News

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U.S. Rep Derek Kilmer is calling for more access to a life-saving antidote to heroin overdose, particularly in rural areas that need it most.

Kilmer this week urged the U.S. Department of Health and Human Services to expand grants and programs that make naloxone more available in places like the North Olympic Peninsula.

Public health officials in Clallam and Jefferson counties say they applaud the effort.

“Congressman Kilmer understands the problems faced by rural counties in dealing with the opioid/heroin epidemic,” said Iva Burks, Clallam County Health and Human Services director.

“As a provider of naloxone, we know it can save lives.”

Naloxone is an opioid antagonist that temporarily blocks the effects of heroin or opioid-based prescription pills like oxycodone.

It can prevent overdoses from becoming fatal by reversing the depression of the central nervous system and respiratory system, allowing the patient to breathe long enough for medical help to arrive.

Lives saved

Fifteen lives were reported as being saved from opioid overdose in Port Angeles since Clallam County Public Health began offering naloxone through its syringe exchange program last July 24, Clallam County Public Health Program Manager Christina Hurst said.

“While communities on the Olympic Peninsula in my home state and elsewhere continue to pursue long­-term solutions to the growing challenge of drug abuse, more can be done in the short ­term to save lives,” Kilmer wrote in a Monday letter to Health and Human Services Secretary Sylvia Mathews Burwell.

“For this reason, I urge the Department of Health and Human Services to increase access to naloxone in rural areas and continue to work with local leaders to bolster opioid treatment resources.”

Kilmer, D-Gig Harbor, is a Port Angeles native who represents the 6th Congressional District, which includes the North Olympic Peninsula.

Death rate

In his letter, Kilmer notes that Clallam County’s opiod overdose death rate is nearly twice the state average, yet funding for its first naloxone distribution program was slow to come.

Clallam County’s overdose death rate was 29.0 per 100,000 people in 2013, while the state rate was 14.8 per 100,000.

Jefferson County’s overdose death rate is lower than Clallam County’s but higher than the state average, said Jean Baldwin, Jefferson County Public Health director.

“Based on limited information, we’re not seeing the same intensity of overdose activity as Clallam County, although we think it’s increasing,” said Dr. Tom Locke, Jefferson County health officer.

Availability of naloxone

Clallam County public health began providing naloxone auto-injectors to heroin users thanks to a pair of grants from the Richmond, Va.-based pharmaceutical company Kaléo.

The grants provided 200 cartons of the antidote, each containing two doses of Evzio-brand naloxone and one training device.

Of the two batches of 100, 51 cartons remain.

The Port Angeles Police Department received 64 naloxone auto injectors last year through a grant from Kaléo, becoming the only law enforcement agency on the North Olympic Peninsula to carry the antidote in the field.

Port Angeles police received a new supply of naloxone after the first batch expired.

“We have used them eight times since March of 2015 where the patient survived and on two other instances where they were not successfully resuscitated and died,” Port Angeles Deputy Police Chief Brian Smith said.

Because seconds matter in an overdose, Locke believes that law enforcement should carry naloxone just as emergency medical personnel do.

Public health officials are promoting naloxone to health care providers, who can write prescriptions for the non-narcotic drug for opioid users and their family members.

Jefferson County Public Health recently began offering naloxone through its own syringe exchange program.

A start-up supply of 25 two-dose kits was provided by the Center for Opioid Safety Education, a University of Washington program that assists rural public health jurisdictions.

“It’s so important to at least get started in preventing deaths,” Baldwin said.

Those who receive a naloxone kit in Jefferson County are required to pay a $15 fee for training on how to use the self-injection kits.

“They need to know how to use it and under what circumstance,” Locke said.

Baldwin said the price of naloxone ranges from “shocking to oh my gosh.”

More than 500 people die from opioid overdoses every year in the state, according to Kilmer’s office.

“While opioid use has no boundaries, limited public transportation, a lack of treatment facilities and long distances between health care providers can make it difficult for those who live in rural communities to access necessary drug treatment,” Kilmer wrote in his letter.

“In an emergency situation, such as an overdose, access to treatment and care can become even more difficult.”

Notifiable condition

Last year, the Clallam County Board of Health approved county Health Officer Dr. Christopher Frank’s request to make overdoses a notifiable condition, meaning health care providers must report them to the county as they would for cases of communicable diseases.

Jefferson County’s Board of Health took the same action last month.

“Jefferson County is following Clallam County’s lead in making overdoses a notifiable condition,” Locke said.

Emergency rooms and coroners are often the best places to find information on opioid overdoses, Locke said.

Kilmer co-sponsored a 2015 bipartisan bill to help local law enforcement and medical personnel deal with the heroin epidemic.

“We applaud the congressman for his efforts, and it very much dovetails into what we’ve been trying to do at Jefferson County Public Health,” Locke said.

Said Burks: “No one element or approach will stop the epidemic.”

“Close work among many agencies and multiple approaches will lead to a positive outcome,” she said.

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Reporter Rob Ollikainen can be reached at 360-452-2345, ext. 5072, or at rollikainen@peninsuladailynews.com.

Last modified: February 04. 2016 6:40PM
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