With rising heroin use, Peninsula doctor lobbies for an antidote

Dr. Sarah Spencer explains the benefits of Naloxone - Photo by Quinton Chandler/KBBI
Dr. Sarah Spencer explains the benefits of Naloxone – Photo by Quinton Chandler/KBBI

Opioids are either, like morphine, naturally derived from the opium poppy or they’re man-made, synthesized from natural opioids. Examples of synthetic opioids are heroin and prescription pain killers like oxycodone.

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According to the National Center for Health Statistics in 2013 16,000 Americans died from prescription opioid overdose and 8,000 died of heroin overdose. At the Ninilchik Tribal Council Community Clinic Dr. Sarah Spencer is looking to make a dent in the Southern Kenai Peninsula’s contribution to those numbers. She’s introducing an overdose antidote called Naloxone that is proven to counteract the effects of opioids. She wants to give Naloxone kits to patients who are at risk.

“The states that have the biggest program that distribute these kits like in Massachusetts where the kits are widely distributed among community members who have an interest in trying to help…they’ve shown that they’ve reduced their overdose death rates by approximately half,” says Spencer.

Spencer works at the clinic, the emergency room at South Peninsula Hospital in Homer and she’s also working in addiction medicine at the Homer Medical Clinic. She says overdoses are relatively rare in these small communities but they happen often enough.

“I think all doctors who have worked in the emergency room in the last year have seen at least one or more overdoses come in. Hopefully if the person makes it to the emergency room we can save their [life]. But, we’ve had a few deaths in the community from people accidentally overdosing so if we can save one of those people by having those kits available that would be great,” says Spencer.

Overdoses are unpredictable. They can potentially kill in just a few minutes or their victims could live for a matter of hours.

“What happens is they become very sleepy and their breathing slows down sometimes stopping completely but sometimes just slowing down so much the person can’t get enough oxygen in. They turn blue and eventually when you don’t have enough oxygen then you die,” says Spencer.

Having Naloxone kits on hand will give the friends and family of overdose victims a chance to reverse those symptoms immediately. Armed with tales of Naloxone’s success in the Lower 48, Spencer is introducing the antidote to her co-workers at the Ninilchik Clinic. She and a handful of her colleagues are seated in a semi-circle around a small tray holding the Naloxone.

“This is a trainer for it like there [are] trainers for the epi pen,” says Spencer.

Spencer is demonstrating how to use the most expensive option, an automatic injector. The white and black trainer has a kind of rectangular shape and fits easily in Spencer’s palm. Its biggest perk…it talks its user through the injection. The price might push people away from the auto injector but it’s not the only choice. The Naloxone itself is a clear liquid and it also comes in a transparent vial that can be attached to a syringe. The medicine is then injected or it can be squirted up a person’s nostrils. This route means more steps but it’s much cheaper.

“If you’re going to be paying cash at a local pharmacy, if you don’t have insurance, you’re going to be paying between $80 to about $120 for the medication. And it is covered by many insurances,” says Spencer.

Spencer stresses the Naloxone kits are most effective if their users have practiced and know exactly how to assemble and deliver the antidote before they’re faced with an overdose.

“If you overdose you’re going to be unconscious and you can’t help yourself. So the key thing is to have patients when they get the kit, they take it home, and sit down and read the instructions with their friends and family members,” says Spencer.

Naloxone is now available at the clinic in Ninilchik. Spencer says there are a few local pharmacies on the Southern Peninsula carrying the kits, and they’re also available at the Homer Medical Clinic. She’s eventually hoping to have the kits for overdose patients who come into South Peninsula Hospital’s emergency room.

“Previously we didn’t really have anything to offer them when they left the emergency room other than counseling them to see a counselor and try not to let it happen again. As far as being able to give them a kit to use in case of emergencies that hasn’t been an option,” says Spencer.

Spencer encourages anyone struggling with addiction to reach out for help. She says there is hope and community resources they can lean on.

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Quinton Chandler is a reporter at KTOO in Juneau.