BY VIBHUTI ARYA
In 2016, the United States lost more than 63,000 lives due to drug overdoses—more than the 58,000 American lives lost during the Vietnam War.
While such states as West Virginia, Ohio, New Hampshire and Pennsylvania struggle with having the highest rates of overdoses in the country, the impact of this epidemic is not lost on New Yorkers. Neighborhoods, particularly in the Bronx and Staten Island, have the highest rates of overdose deaths in New York City, but this problem has affected families across all of the boroughs. In our city, every seven hours, a person dies of a drug overdose, and we lose more New Yorkers to overdose deaths than suicide, motor vehicle accidents and homicides combined.
Opioids include prescription opioids, such as OxyContin, as well as heroin. Overdose from opioids can cause a person to stop breathing, which is the main cause of death from opioid overdose. Naloxone (“Narcan”) is a safe and effective antidote that can reverse this by knocking the opioid off its receptor, essentially its “seat” in the brain. It’s not quite as dramatic as stabbing someone in the chest as the famous scene in Pulp Fiction would have you believe, but it can easily be either injected or sprayed nasally, so a person experiencing an overdose may live.
Many avenues exist for the prevention of an overdose, including prescribing guidelines for providers and public education about opioid use and harm reduction strategies, such as the use of naloxone to reverse an overdose. At approximately $40 per two doses of naloxone, this cost is an easy price to pay for saving a life. Across New York City, naloxone can now be seen in the hands of the NYPD, FDNY and thousands of lay individuals who carry naloxone, hoping to never use it, but equipped in case they witness an overdose. They, too, can potentially save a life.
At St. John’s University, I seek to help expand naloxone access at community pharmacies. Here, pharmacists can join a NYC Health Department “standing order” that allows any pharmacist or pharmacy intern to dispense naloxone to any person based on suggested eligibility criteria—e.g. if a patient is on long-term opioid medication or if they have a loved one who may be at risk of overdose. I also work on a project with St. John’s University Doctor of Pharmacy students to educate the university community as well as local area high schools in New York City, Long Island and New Jersey that may be impacted by the opioid epidemic. We concentrate on opioid use awareness and overdose prevention.
As part of this project, we train interested students on administering naloxone. Through our grassroots efforts, we hope to increase awareness and decrease deaths from overdose. Still, continued efforts are required to reduce stigma around the use of these risky drugs and increase access to resources for individuals and families in our communities. It is my hope, and that of my passionate students, that one day we can learn from both the successes and challenges we have faced in battling this epidemic. I hope that we can also collectively work towards more proactive policies and programs that can render this fatal epidemic obsolete.
Vibhuti Arya, PharmD, MPH, is an associate clinical professor at St. John’s University and clinical advisor to the New York City Department of Health and Mental Hygiene.