Discover and read the best of Twitter Threads about #naloxone

Most recents (11)

Thanks @UTMBFamilyMed for inviting me to present Grand Rounds today! I'm going to share a few pearls for other interested folks in #FamilyMedicine, #TwitteRx, & beyond.

A long but extremely visual🧵🧵🧵
To understand the "opioid crisis", you have to accept that the first wave was driven by excessive prescribing. BUT you also have to accept that reactionary supply reduction interventions drove a totally preventable second wave of deaths due to heroin.
In order to help the people who are actually dying today, you must recognize that deaths to Rx opioids accounted for fewer than ⅓ of all opioid overdose deaths, and that proportion is shrinking every year.
Read 29 tweets
Advice from the DHHS about maintaining continuity for pharmacotherapy treatment is here. Key principals include writing prescriptions for longer (with regular phone check-ins with patients) and increased TA doses where clinically appropriate (1/3)
bit.ly/3e4EpSu
Guidance to support assessing appropriateness for additional takeaways are here. Where clinically appropriate, increasing takeaways means that people can stay safe at home and travel pharmacies. #Naloxone is recommended with takeaways bit.ly/2UQgmiy (2/3)
Documents to support dose delivery are here bit.ly/2RilpGe (3/3) Much credit to the dedicated staff at @VicGovDHHS @VAADAENEWS and the broader sector in developing these resources for those providing #methadone and #buprenorphine @psa_vic @HRV_Aust @RACGP @DrGrinzi
Read 4 tweets
Thank you 2 all hard-working MATOD/ORT prescribers.
As MATOD/ ORT prescribers we are in a position to help reduce community spread by the way we work. An informal group of committed people put together some unofficial (at this stage) guidelines.
Here are our suggestions:

1/6
SCRIPT DURATION - give *up to* 6m duration scripts (in the event you become unwell to give time for a replacement to be found).
BUDDY / DELEGATE - particularly important for solo practitioners to have a colleague who can cover them in the event that they become unwell. 2/6
TAKE AWAYS - increase take aways for stable patients: *up to* 1 month for #Suboxone, *up to* 1-2 weeks for #Methadone
Ongoing risk assessment is essential.

NALOXONE - give all patients scripts for Nyxiod or Prenoxad. #Naloxone education found here: bit.ly/COPEnaloxone 3/6
Read 6 tweets
Hear ye, hear ye!

Ye old #Alberta government has released its FLAWED, and GASLIT #SCS review report.

Associate Minister @jasonluan88 promised an unbiased perspective.

The only ones who look stupid here, are those of us who believed him.
#AbLeg

open.alberta.ca/publications/9…
Before we dive into the report, let’s talk about the Associate Minister and his esteemed panel for a moment.

Not a single member who has worked at or accessed an SCS; surely criminologists and retired cops will present an unbiased approach. 😒

alberta.ca/supervised-con…
Next, let’s see what the Ass. Minister has had to say about SCS and #harmreduction.

Surely his beliefs about Big Pharma funding research for harm reduction, and that #naloxone is an enabler couldn’t have impacted the committees viewpoints?
Read 24 tweets
Today for #MSSAdvocacyWeek our Wayne State chapter in Detroit will be working with two other student orgs packing up naloxone kits and other health supplies (blankets, food, etc) to hand out to our homeless community this weekend to combat the opioid crisis
Michigan has the 8th highest drug overdose deaths in the country with ~75% of those being attributed to opioid overdoses. Folks with substance use disorder need support, management, and a community adqueately prepared to help them should an overdose occur
Naloxone (Narcan) is an opioid antagonist that can reverse opioid overdoses. It is most commonly given intranasally - and multiple doses can be given if one doesn’t work! However, be mindful of the signs of overdoses vs somnolence as naloxone can induce opioid withdrawal rapidly
Read 6 tweets
Alberta Q2 Opioid Reporting fresh off the press!

As previously noted by @ehyshka, this quarter demonstrates an increase in fentanyl-related overdose compared to Q1 2019.
#AbLeg #ABpoli

open.alberta.ca/dataset/f4b74c…
This is one of many reasons why it’s important to avoid overgeneralizing from a single data point—overdose deaths occur in ebbs and flows.

Sometimes a single bad batch can make the difference between a low point vs a surge in deaths.
Opioid related overdose deaths in the province related to fentanyl—important to note we are STILL in CRISIS. We are STILL LOSING 2 people everyday.

We are not doing enough to protect the vulnerable.

A reminder that there are still three communities waiting for SCS funding.
Read 8 tweets
Tomm we start a journey at @ZuckerSoM w/ 3rd yr #MedicalStudents to enhance #Awareness #Education #Skills #Comfort #Hope re: #OpioidCrisis

13.5 hours - "#OpioidEpidemic" themed week (3rd iteration)

Follow/RT as Students, Colleagues, & I tweet - #OURcrisis

#MEDeD #RecoveryMonth
1️⃣0️⃣0️⃣ MS3 #Students

6️⃣0️⃣ Faculty/Facilitators

3️⃣0️⃣ Clinical/Non-Clinical Depts

#OURcrisis @ZuckerSoM

@GIMaPreceptor @DrYili @MartinsWelchMD @JoeCMD @medicmin911 @ektrenchard @ethanfried @ginofarina @LindaWDeMasi @AFornari1 @joemd @DrAhuja @santhoshpaulus6 @TomMcGinn4
#Strategic Full Circle
1. from Health System (need)
2. to School of #Medicine (access)
3. to Health System (access/mission)

Our #OpioidEpidemic themed week is part of a 30+hour 4-yr longitudinal 'Addressing #SubstanceUse' curriculum
#OURcrisis #MEDeD
🔗: sgim.org/File%20Library…
Read 28 tweets
Hi, I’ll be live-tweeting today’s Chicago Board of Health public meeting. #ChiDocumenters
@ChiDocumenters #publichealth #chicagopublichealth
@CHIdocumenters Dr. Arwady reviews high-level updates from the dept, including an anti-#syphillis campaign, a research study on Chicago maternal mortality (#maternitymatters) that will be released soon, and a new program that will provide assistance to #newmom s at 3 Chicago hospitals.
Dr. Arwady shares info about the new training video aimed at Chicago employees who work with youth, centers a #traumainformed approach to working with them.
Read 57 tweets
Wrote this piece with the help of a great team including @DrKevinHill. Below I'll share some of my thoughts about #opioids and opioid use disorder and how they present in #hpm and #palliative care, plus why we need to do a better job of addressing #addiction at end of life. 1/x
2/x Training in #KY gave me a front row seat to the #opioidcrisis. With an interest in #hpm I kept wondering what would happen to these individuals who developed an OUD and years later were prescribed opioids. How would I keep those patients safe and manage their pain?
3/x I continue to think that our field will struggle in years to come when survivors of the #opioidcrisis age, develop serious illness, and develop pain. Thinking about this, and reading @jeff_deeney article in @TheAtlantic theatlantic.com/health/archive… made me want to do more.
Read 13 tweets
I debated sharing but decided there are important lessons within. Yesterday, I came face-to-face w/ the #overdose epidemic. Shortish story... I was one of the first people on the scene of two 40-ish men slumped over in their work van that was stopped on the hwy.
Alone with kids in the car, I was waved down by a panicked commuter. I stopped & was joined by two other men. Both driver & passenger were unresponsive. Driver had shallow breathing but passenger had no pulse or respiration. We pulled him out of the car & I started 2-person CPR.
It was evident they had overdosed. While I keep a trauma/GSW kit in the car, I do not carry #Naloxone. So all we could do is continue CPR (about 6 cycles) before EMTs arrived, at which point he had a weak radial pulse. Shaken, I shook hands & went on my way. So lessons/thoughts:
Read 9 tweets
#NARCAN Nasal Spray would be vastly more affordable/accessible if we acknowledged that 1 dose per kit is sufficient. Comparing plasma #naloxone concentrations following administration of various doses by intranasal (IN) & intramuscular (IM) routes tells us a lot. THREAD
Consider this graph from #NARCAN prescribing info (ignore top 2 lines). 0.4mg IM (vial+syringe) achieves lowest peak level...but it still works & has saved countless lives. 2mg IN (prefilled+MAD) achieves higher peak, & 4mg IN (NARCAN) achieves highest peak.
Follow concentration x6 hours...level of #naloxone in circulation 3 hours after receiving #NARCAN 4mg IN is higher than peak level after 0.4mg IM. Based on this data, it is reasonable to assert that NARCAN is effective for much longer than 30-90 minutes.
Read 6 tweets

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