Mid November 2014, I received a Maryland State Health Alert from our Secretary of Health & Mental Hygiene, Joshua M. Sharfstein, MD titled, Prescribe Naloxone and Save Lives: An Alert for Maryland Clinicians. The body of the text stated the following:
- Anyone who has completed the Overdose Response Program;
- Anyone with a known history of intravenous drug use or misuse of prescription opioids;
- Anyone who receives high-dose opioids or receives opioids chronically;
- Anyone who used opioids with antidepressants, benzodiazepines, alcohol, or other drugs;
- Anyone who uses opioids with a history of major organ dysfunction (renal, hepatic, cardiac, pulmonary);
- Anyone using opioids with a history of mental illness; and
- Anyone receiving treatment for substance use disorder.
As you can see highlighted, there are four indicators that may directly impact people living with pain who are prescribed opioid medications as part of their pain treatment plan. These recommendations, I feel are well-thought out and a forward step in promoting safe prescribing which may help reduce unintentional overdose. Maryland’s Governor O’Malley set into motion a statewide overdose prevention plan in 2012, which every county has created. Recent state legislation has paved the way for the broad implementation of Naloxone Programs throughout the state as one strategic solution. Fred Branson from Project Lazarus has spent time with many county health departments, prescribers, and other stakeholders to help understand how to implement successful training programs. These trainings are open for healthcare providers, law enforcement, patients, families and friends. The hope is that those at higher risk for overdose will have faster access to the reversal agent for opioids and therefore prevent an unwelcomed, premature death IF opioids are the cause.
Maryland is only one state of many who are looking at this issue. I live here and have worked with my own local health department, so that people with pain will be represented and not seen as the source of the problem. Appropriate prescribing and safe use of opioid pain medications is critical, so that these pain medications are available for legitimate medical need. I applaud Maryland and other states who are trying to create realistic and balanced solutions.
Yet, what is missing here? Where is the outreach to people with pain and their caregivers about Naloxone? If my crystal ball is working, I can foresee that soon, when someone is prescribed an opioid, the prescription for its antidote will be also written. How would you react? Does this give you and/or your family comfort or raise alarm? Have you ever heard of Naloxone (aka Narcan)? Would you understand how, when and why it could be used? How much will it cost and will your insurance cover it? Will you be able to have this prescription filled at your local pharmacy? These are important questions that require clear answers. See if TPC’s Naloxone FAQ is helpful. Talk with your healthcare provider and your pharmacist for additional information. Better yet, look into how to become trained.
Whether given in the nose or in the muscle even through clothes or directly in the vein (by EMS, physician or nurse), Naloxone can save the life of someone who has overdosed from opioids. This does give promise in dire situations.
Note: Narcan will not work if opioids are not the cause of an overdose, as with sedatives, alcohol, stimulants or illegal drugs other than heroin. Giving it will not harm someone in those situations and if given may help direct emergency responders to other possible causes, when overdose is suspected.
Mr Hopeless,
Do you need someone to talk to? I am more than willing to talk with you on the phone and help you sort things out. I have been down that dark tunnel myself and not too far back. I am a disabled vet and talked to the VA Hotline after I had swallowed a lot of morphine. Chronic pain and depression go hand in hand. I am going to private message you my cell phone number. Please call me and talk to me, I know the loneliness and isolation a person can face when hurting.
I can’t stop wanting to end my life
Mr. Hopeless,
After reading your message, we are very concerned for you and your well being. Please know that you are not alone.
There is nothing more important than your life. Nothing.
We know it does not feel that way right now, however, there are people around who are willing to talk to you, to listen to you, to help you. Know that there are phone numbers that you can call 24 hours a day – 7 days a week from anywhere in the United States. Just take one more step and reach out to:
• 1-800- SUICIDE (1-800-784-2433)
• 1-800-273-TALK (1-800-273-8255)
Your life is extremely important to us and your family. Please call either or both of the numbers above to talk to trained professionals who can help support you through this difficult time.
It is our hope that you will also continue to talk with us here at TPC. We are here to listen—we will never judge you, we want only to support you.
TPC YaYa
“The views or opinion(s) contained herein do not necessarily represent those of The Pain Community.”
Mr. Hopeless
I can’t begin to know what you are dealing with day to day. I do understand that you are in a horrible place. Many of us are facing issues that will lead along nasty paths and ultimately horrible deaths. Personally I can only look at my issues “out of the corner of my eye”. To face them directly is too scary and to try to fight them is worse. That would drive me crazy and leave me right where you are. Perhaps I am crazy. All I can do is laugh at the twists and turns that my body throws at me. When the muscle spasm has me flopping around like a fish out of water, what else is there to do but laugh? Look for the good in each day. Admittedly my definition of good has changed if only to let me see the “good”. Some days it’s a child’s laugh or the sun on my back. One thing that keeps me going is wondering what could possibly go wrong next.
I do know that whatever issues you face the community here will try and support you. We can’t do it alone. You have to be stubborn! I know you’re tired of being stubborn and fighting. Probably your docs don’t seem to know, understand, or care. Good docs are hard to find. Your family and friends (if you have any left) can’t understand and may have gotten tired of hearing about your issues. They’re hard and scary for everybody.
I don’t have a doc at the moment. I had to give up my last home and am still trying to get settled. Part of that is also deciding how I want to spend the last of my energy before things shut down completely. Do I want to fight to find a new doc? If I do and even if they’re good I can’t be fixed so why waste what little energy I have left? Trips to the doc and the tests they order are exhausting. These are questions we all face every day. There are no good or right or wrong answers, only the answer that gets you through the day. Then you still have to get through the night. You shouldn’t have to deal with that, no-one should! Unfortunately most of us have to. We can’t fix you. All we can do is hold each others hand so that we don’t have to face this journey alone.
You signed on with a statement that is a plea for help. By reaching out you have made a decision, no matter how temporary. Please don’t back away from that will to overcome. Lets us help you find your path through your nightmare.
your brother in pain
bd
I’m so lost. I don’t think I have A chance at a real life
Please consider joining us on chat. We are together every M,W.F from 11am-12 noon ET. You are NOT alone.
Hi Mr. Hopeless,
My name is Noki4. I do not know what is going on that makes you feel the way you do. However, I want you to know that I do understand the journey of chronic pain. I was in my early 20’s who the pain first started and I had three little girls to take care of. It was hard but I did it. I did it because I had people that supported me and cared about me.
I want to be one of those people for you — I care about you and I want to support you. You are not alone!
TPC YaYa said it perfectly, “There is nothing more important than your life. Nothing.”
Please reach out and allow me and the others here to support you, to care about you, to help you in whatever way we can. There is a chat room here at TPC, you don’t have to have a password or anything to enter, it is open 24/7 and if you like I will meet you there. You name the time and day. I also know there are others that would join us to support you if you like.
If you would like to come to chat on one of the days that it is hosted that works too. TPC has chats every Monday – Wednesday – Friday at 11am eastern standard time. The folks are caring, compassionate and understand.
Whatever works for you, just please reach out for support and please call one or both of the numbers that TPC YaYa shared, talk to the professionals.
Noki4
I live in NY and work in healthcare , police near me now carry narcan as overdoses happen often and they can quickly help before ambulance arrives. I like the fact that the state of yours is proactive in prevention – good for them!
This is a very important blog for all people living with pain who are prescribed opioids. A couple months ago I attended a pain event where the speaker demonstrated how easy and quickly this medication can be administered. He spoke about how you can get an empty injector so you and your family or friends can practice the correct way to administer. So there is no guessing if the need should arise.
To answer your question this gives me comfort and does not cause alarm because I do not use illegal drugs or abuse pain medications. Having this in the house would give me comfort knowing that in the event something did happen it was there.
Some medications interact with heat and can cause the medication to be absorbed too quickly and can cause overdose. I am sure there are many opioids that have interactions like this and even though we try very hard to be very careful and do exactly what we need to do to stay safe, things can and do happen.
The FAQ you provided is also a wonderful tool.
I will be talking to my healthcare provider about this and hope that all people living with pain has the same conversation with their healthcare providers.