THE DALLES — YouthThink, Wasco County’s alcohol and other drug prevention program, has worked with a local overdose prevention taskforce and partners to distribute more than 500 emergency kits containing naloxone, the opioid reversal drug.
The most well known brand name for naloxone is Narcan.
While YouthThink is chiefly focused on preventing drug use and misuse, Director Debby Jones said, “We also believe in the great importance and value in preventing death.”
A key to that thinking, she said, is “we believe that for healthy young people to thrive, there needs to be healthy adults that surround them.”
Some of the emergency kits have gone to people who have witnessed fatal overdoses, Jones said. “They were very eager to know” there was something available for them to use in such situations.
The opioid fentanyl has dominated the nation’s illicit drug supply so extensively that it is also often found in other drugs, including methamphetamine and cocaine.
It is a drug like no other — many times more potent than morphine or heroin, but also shorter-acting, so users have to take it frequently to avoid extremely painful withdrawal.
“Some individuals, who have become dependent on opioids, have shared that they don’t even experience the high anymore. Their main motivation to use is to avoid the horrible withdraw side effects that cause them to get violently ill,” Jones said.
Jones said naloxone should be viewed as a first aid kit item. “This is really literally first aid on the streets.”
Jones manages an overdose prevention grant, which over the last few years has funded several efforts, including forming an overdose prevention task force, creating an overdose emergency response plan, and tracking overdoses through ODMAP, a program that allows police and fire agencies to enter real-time suspected overdose data. The data are provisional and are not confirmed drug overdoses.
The ODMAP data shows a significant increase of suspected overdoses so far in 2023, with 52 suspected overdoses through Nov. 14 this year, compared to 30 at this point last year.
However, the efforts to increase availability of naloxone may be a factor in another important aspect of the ODMAP data. By mid-November 2022, there had been five fatal suspected overdoses, or one in every six suspected overdoses.
In 2023, there have been four fatal suspected overdoses through Nov. 14, or one of every 13 suspected overdoses. The rate of suspected fatal overdoses is less than half of what it was a year ago.
That may be due to a key effort this year of the overdose prevention taskforce, which was making naloxone distribution a priority.
With funding from the grant, and county-level funding through what are called Behavioral Health Resource Networks (BHRNs), YouthThink purchased 3,000 naloxone emergency kits to distribute for free.
Overdose prevention taskforce members collaborated over many months to develop small naloxone nasal kits, which come on a bright yellow lanyard, include two doses of naloxone, gloves, a face shield for rescue breathing, information about the Good Samaritan law that protects people who administer naloxone, and a list of local resources for those seeking help for a substance use disorder.
The resource card states, “Please know that your life has value and that you are not alone. When the time is right, and you are ready, please contact one of the organizations listed below. We want to make sure you get the help you need and deserve.”
It lists the phone numbers for Eastern Oregon Center for Independent Living, a regional source of harm reduction services; Mid-Columbia Center for Living, a local mental and behavioral health agency; Bridges to Change, which supports people in recovery; One Community Health, a local health agency; and Lines for Life, a 24/7 helpline.
Jones said, “A big reason that we wanted to do this is to combat the stigma surrounding substance use disorders. A lot of people say, ‘You’re just enabling people to continue harmful behavior.’ But we need to dig in deeper and understand that harmful behavior is a coping mechanism that now completely dictates every part of their life.”
She said, “The most important thing we can do with this population is for them to know they’re not judged, their life has value, and we want them to live.”
YouthThink was contacted earlier this year by One Community Health, which has branches in The Dalles and Hood River, to help with both distribution of naloxone and training on its use.
Naloxone is an easy-to-use nasal spray. It can quickly, but temporarily, reverse the effects of an overdose. People who are treated with naloxone and come out of their overdose should go to the hospital, since effects of the naloxone will wear off and the overdose can resume.
Jones said it’s important for people to know that naloxone is harmless if given to someone who is not actually experiencing an overdose. “So even if you’re not sure if it’s an opioid-type overdose, go ahead and do it.”
Of the kits purchased, Jones said, “The greatest goal would be we don’t need to distribute all 3,000 because people are getting help. People are alive another day and people choose to get help.”
On International Overdose Awareness Day, Aug. 31, Bridges to Change staff went door to door to businesses in The Dalles with public bathrooms, offering free naloxone to have on hand. They had 20 takers, said Victor Veloz, regional manager of Bridges to Change in The Dalles.
Adventist Health Columbia Gorge (formerly Mid-Columbia Medical Center) has been providing naloxone take-home kits to at risk patients for several years. Due to recent changes in state pharmacy rules, they will be able to do so even more widely now.
The regional jail in The Dalles is also a distribution site for the naloxone kits.
“Right now we are in a prevent-death triage mode,” Jones said. The goal is treatment and recovery, “and we can’t get that if that person isn’t still alive.”
The first push for the naloxone kits was to get it to users who are most at risk.
Middy Tilghman, a nurse practitioner and team lead of a mobile medical unit at One Community Health, provides a weekly mobile clinic to the houseless population in The Dalles.
He lauded the naloxone distribution work. “It’s a really powerful thing, and we’re just one of the distributing groups helping to get it out.”
He added, “I think most people know it’s pretty widely available and free, if you’re in that community.”
For more information about naloxone kits, please call YouthThink at 541-506-2673.
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