Local officials prepare to battle opioid epidemic

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First responders to carry Narcan, health dept. to offer needle exchange

BUCKHANNON — Upshur County Health Department’s nurse director informed Buckhannon City Council Thursday that West Virginia is “in a state of epidemic proportions” regarding the opioid overdose problem.

Sue McKisic was invited to speak at Thursday’s council meeting to brief council on the issue after the health department agreed to provide training and materials to municipal first responders, who will soon be equipped with the life-saving opioid antagonist, Narcan. Narcan is a form of Naloxone that comes in the form of nasal spray and can be easily administered to bring someone who has overdosed on an opioid out of a coma and potentially save their life, McKisic said.

Thus far, the health department has provided three Narcan trainings to Corhart Refractories employees, McKisic said. A training for the Buckhannon Police Department and Upshur County Sheriff’s Department is slated for 10 a.m. Nov. 9.

“We are in a state of epidemic proportions,” McKisic told council. “I’m hoping that we can start to make a difference in our community. This is a medication that is administered nasally so there is no invasiveness to the patient to bring them out of an opioid overdose. This blocks the receptors in the brain so everything stops. These people come out of their coma or overdose state, hopefully with just one or two doses, but sometimes it takes many more.”

McKisic said West Virginia is currently ranked first in the nation for opioid overdoses. Heroin, fentanyl, carfentanil, oxycodone, hydrocodone and suboxone are all classified as opioids.

“Our little state compared to New York City and big cities in California, we are number one in the nation,” she said. “We are also number one in the nation for newly acquired Hepatitis B and Hepatitic C and HIV cases, and of course, a lot of that is due to needle use.”

The health department is working toward jumpstarting a harm reduction program in the county, part of which would involve a needle exchange program.

“It would be needle for needle,” McKisic said. “I give you 40 needles, and you bring 40 back if you want 40 more. If you bring 10 back, you only get 10 more.” Alcohol pads will also be supplied.

Although McKisic believes the needle exchange program will be controversial, she thinks it will discourage the sharing of needles and ultimately, stop the spread of Hepatitis B, Hepatitis C and HIV.

“I know we are going to get a lot of opposition because a lot of people are going to say, ‘you are just feeding them, you are encouraging them,’ but no, we are trying to stop the blood-borne pathogens involved in Hep B, Hep C and HIV,” she said. “Many babies are born addicted (to some form of opioids) or have contracted Hep B, Hep C or HIV, so we do want to kind of squash that here in Upshur County.”

McKisic explained how the opioid epidemic originated. Originally, when pharmaceutical companies developed drugs like oxycodone and oxycontin, they conducted closed studies and determined that those pain medications were non-narcotic, and hence, not addictive. Nevertheless, many people who were prescribed some form of opioids for moderate to severe pain management — such as in cases of arthritis or post-surgery — became addicted to the pills.

“They will keep coming back to the doctor asking for a prescription, and the question is, ‘well, do you still have the pain or do you just like the feeling?’ We don’t know,” McKisic explained. “I was always taught as a nurse that a patient’s pain is what the patient says it is. So we continue to give them meds and they become addicted, and the pharmaceutical (companies) are saying, ‘You doctors have caused this. You wrote [prescriptions] and wrote [prescriptions]. So both (sides) are at fault.”

Often, when individuals are no longer able to obtain a prescription for opioids, they begin using heroin recreationally, McKisic said. McKisic said Dr. Joseph Reed, health department medical director, and health department board members all back the department’s Narcan training program.

Mayor David McCauley observed that West Virginia seemed rather slow to begin equipping first responders with Narcan and other life-saving forms of Naloxone.

Councilwoman Pam Cuppari asked whether there was a limit to the number of times Narcan could be administered to an individual.

“Is there a timeline to how close Narcan can be administered?” Cuppari asked. “If you get it one day, can you get it the next? Do people get the mindset that ‘I can do what I want because I know this is going to save me?’”

McKisic said she wasn’t sure what type of mindset opioid users get.

McCauley replied, “If you’re in a comatose situation by yourself, you die. You’ve got to have somebody else there to administer this.”

McKisic said it took her “a lot of soul-searching” to become comfortable with administering Narcan. She ultimately decided to think of every patient as if he or she were her own child.

“My job is to help people, and I love my job,” she said. “You never know what’s led someone to use. Were they a victim of physical abuse? Sexual abuse? Was anybody there to bring them up or did they have to raise themselves? Did their parents have a substance abuse problem? Many of these things contribute to addiction. Some of these people may have mental health issues that don’t even know it.”

Councilman CJ Rylands said it’s “a certainty” that most people addicted to opioids also have one or more co-occuring mental health conditions.

“I think we really missed the ball on servicing people with mental health needs because of the stigma attached to that,” Rylands said. “There isn’t really much open-minded counseling out there.”

McCauley thanked McKisic for coming to the meeting and said he was looking forward to partnering with the health department.

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