Arlington County Government, VA County Board Meetings, 21 Mar 2023

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From YouTube: Arlington County Board NARCAN Training

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From the recessed meeting of March 21, 2023

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You all are, um even though your item is concluded, I.

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Really hope you will stay for the next, because it's something that is of a preeminent Community concern and you'll find out how just easy it is and I hope you share it with all of the networks that you're a part of uh colleagues for this part of the board meeting is.

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We've talked a lot about how to support um various stakeholders in caring for individuals who may suffer from substance abuse challenges, and we know that we have ongoing issues with access to opioids that may or may not be laced with substances which can cause catastrophic overdoses.

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We also know that there is a solution to that particular problem and one that's fairly easy to deploy, if only everyone understood it so to to help us demonstrate to the community just how straightforward it is and how much Arlington County is willing to support people in getting access to the critical tools that can save lives. We've invited Emily sigelin to conduct a a training one that Arlington County has has home honed in on.

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In order to show how quick, efficient and easy it is to learn how we can actually be agents in saving people's lives, so Emily take it away. Thank you. Thank you for having me. Let me first hand out some Narcan.

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And information.

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Thank you so, first off. Thank you so much for having me here today and for giving this the attention that um I have been really wanting it to receive, and so I really appreciate you all taking the time to have us here today. So I am going to walk you through a very brief Narcan training. I know. Many of you have actually already been through one of these, but I appreciate the opportunity to just illustrate exactly how simple this medication is.

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So the very first thing when we talk about Narcan is what is it and why do we use it right? So Narcan is a medication that quickly reverses the effects of an opioid overdose. It works in about 20 to 30 seconds. It is a super simple, nasal sprays, just a very quick nasal spray. You insert it into a nostril, you spray and you have administered the medication.

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It only works to reverse the effects of opioid overdoses, but it is really important that when we talk about what an opioid overdose is that we understand, we are not just talking about illicit opioids like heroin or illicitly obtained a legally obtained fentanyl. We're also talking about prescription pain, medications like oxycodone Percocet, those sorts of things that doctors prescribe us when we have a serious surgery when there's a wisdom tooth removal right. So this medication works in the event of an overdose. On any of these things, we also are very concerned now about counterfeit pills.

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These are pills that are made to look exactly like the real thing. We know that it's not just counterfeit pills that look like pain pills like your Percocets.

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It's also counterfeit pills that look like a Xanax bar or an Adderall right, so we are very concerned about fentanyl being in our pills, and unfortunately, these pills look exactly like the real thing, so it would take having two exact ones next to each other, and even then you might not be able to tell the difference so the reason we want to get this medication out and the reason we want everyone to carry this medication is because really everyone is at risk of witnessing an overdose right.

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All of us have a role in our community to carry this and to respond to an overdose.

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It is so simple and you cannot cause harm if you administer it when it's not needed so I always say when I'm giving the training I've got. Two young kids at home I've got a five-year-old and a two-year-old. This is the only medication my kids have. Access to. This is the only thing they can reach. When my father was going through treatment for cancer, he had tons of opioid prescriptions in the house.

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My parents had to have it in this in the house for my kids to be in the house right, because this is so safe. My five-year-old could be up here, teaching the training, that's how safe and easy this medication is to use. There are two laws that are really very important to know. One is the Good Samaritan law. If you've been through CPR training, it's the same law that you would have learned in CPR training. We are not civilly liable for the outcome.

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If we are doing working in our best efforts to reverse an overdose, we are not liable for the outcome. The other is the safe reporting of Overdose law. This law is pretty new. Still it's about it's not even quite three years old, but this law is also safe, reporting of overdose or Safe Harbor Law. This law states that anyone who calls for help for someone who's overdosing and the person who is overdosing will not be charged with a misdemeanor related substance use crime.

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So that's going to cover underage drinking, public, intoxication, drug paraphernalia and other illicit substances on scene. Again, it's going to be just for misdemeanor related crimes; okay, so it doesn't cover like a felony. We highly encourage folks that when they come across someone that they think may have overdosed that they administer this medication. How do we know someone's overdosed? Really what you're looking for is if the person's unresponsive, because this medication is so safe, you don't need to be a medical professional to determine what is really happening right.

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You just want to see this person's, not responsive, hey, Emily, Emily, you, okay, I, don't respond! Do a sternum! Rub your fist up and down my sternum or or pinch my earlobe. If I don't respond, you have a medical emergency. You want to administer this medication and call 9-1-1 again. Super simple insert it into the nostril spray one time step back, give the person a little bit of space to recover if they don't respond within a minutes time. You want to do chest compressions or rescue breathing. At this point.

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Hopefully, you have called 9-1-1 and they'll prompt you through the rest. What I always like to make sure our community understands? Is you don't have to be good in emergency situations either right? You can kind of turn your brain off. If you administer this medication, then call 9-1-1 and let them do all the thinking for you. They'll walk through everything else with you. So the key thing is: don't wait, don't worry. You won't cause harm, just administer it's incredibly safe and it's safe for kids, it's safe for Animals, it's safe for pregnant women.

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It is safe for everyone. There are very few contraindications besides the fact that what you're doing when you administer this is you're, knocking all the opioids off the person's brain, so you're immediately sending someone who has a physiological dependence on opioids into withdrawal, so they will be feeling very sick if they have a physiological dependence.

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But besides that, you're not going to cause any harm, that is the very brief training. Any questions that I can answer. Okay, I mean first of all, that was impressively done. um I mean.

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Impressively done, thank you, questions and conversations Ms Garvey yeah. Thank you, I didn't know. This worked on more things than just fentanyl. That's really.

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Good to know- um and you know remember anybody- who's had a sinus infection and done you know Flonase or whatever. This is just the same sort of thing. I am I'm wondering about storage, so because I've thought about leaving in my car but I think that might get too hot or too cold. Could you talk about that a little bit sure? So the recommendation is that it's essentially stored at room temperature. However,.

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It can go on excursions up to 104 degrees and the manufacturer has not defined exactly how long an Excursion is.

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But one thing to note: is our police carry it on their person or sometimes they have it in their bag in their car and they use it to reverse overdoses, all the time in Arlington, so I'm not super concerned about it, although in the summer I would recommend taking it out of your car if you're gonna like if you're gonna, leave it for more than six hours, let's say I would recommend putting it inside in the winter. It is a liquid in here. So you, you know.

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If it's freezing like last night, if I tried to pull it out of my car in the middle of the night, it wouldn't have worked, it would have been frozen, so I would have had to warm it up. First to let it defrost. That's great and I shouldn't put anybody on the spot, but do we have.

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This available in our office like right here, if something happens, do we know where to grab it in the building? Just yes, Graham's got his hand up yes, and we all have it on our persons. We do now. We do now and there's some in the office great.

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Thank you, I will say, um I really.

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Appreciate it and I'm glad to have this, I actually gave mine to my grandson, who was going back to college and he's studying medicine and he was thrilled to have it and pocketed it and took it off and I figure. You know good good for him to have it down there, but um I'm glad to have another. Thank you before I recognize Mr Mr, Karen Thomas, a quick question about expiration dates.

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So with epinephrine, for example, you know famously you know when it's um you know delivered in the form of an EpiPen. It comes with a year, expiration date and there's a whole lot of stuff about whether or not that's real or just uh manufacturer's desire to get people to throw out good epinephrine so that they can charge you another hundred bucks to give you a new pen. uh Do we have any data understanding whether or not the expirations on naloxone are truly real?

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Should people toss them when they've reached it, or is there a chance that it may still be effective after the expiration date? So what the state says, the state training guidance is, if all you have is.

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Expired Narcan, you should always use it. What we know is that it's probably good for at least two years past expiration date and in fact we have a non-profit in our region that takes expired, Narcan from folks that are uncomfortable having expired, narcanum one unexpired, so we know that they're using it to reverse overdoses as well. Thank you. Thank you.

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Thomas, thank you. Mr chair.

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Mean one very helpful feature of this packaging. Is that all the the instructions that one needs are here? That's a very good refresher, very, uh very well.

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And and succinctly conveyed, there is a final stage. Three is to put the person into the recovery position. Is that absolutely necessary sometimes could be difficult to do that? Yes, so the recovery position would be necessary if you're going to walk away so.

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The example I would give is, if someone overdoses right here- and we didn't have all this Narcan in front of us and we had to run across the hall to grab Narcan, and it was just me and that one person and I had to leave them. I would put them in the recovery position just because there was no one else to monitor them when you're actually administering the medication. You want them just lying back, so you wouldn't have them in the recovery position for that. So the recovery position is only necessary if you're leaving them.

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Is Crystal I just feel like we'd be remiss.

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In case, anyone is watching and thinking that was so easy I want.

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To do the same thing with my PTA or neighborhood group, or my fellow students at APS school Narcan arlingtonva.us, is how great how you can schedule a training of your own and get your hands on on your own um uh Narcan tools as well, and thank you so much I actually don't have given how quality that presentation was that your kindergartner could probably deliver an equally compelling one.

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So, hopefully, there's not not needed that at that young of an age but really appreciate it and I think that emphasis that it's the how how incredibly low the risk of acting is, especially in light of How High. The risk of not acting is so thank you Mr, chair for coordinating this I'm glad. We could have this opportunity today. Absolutely so don't wait and don't worry so everybody in.

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Our community should remember and don't worry and thank you Miss Crystal- for telling them how they can go about signing up to receive this training. It's offered in a couple of different forms for many arlingtonians who I know want to do a deeper dive.

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There is a one hour virtual training, but you can see that our Department of Human Services also can Flex it so that you can provide a 10-minute phone training to get you equipped with the necessary skills and let you know how you can get access to Narcan at no cost to you so that you can be sure to be able to deploy whenever necessary, Emily. Thank you so very much for joining us today. Thank you.