The Wild and Wonderful fights for control in the war against opioids
Orange County, CA - August 17th 2016 - Huntington, West Virginia is a small city that sits along the Ohio River in the western part of the state struggling with rampant opioid addiction. While locals are no stranger to the opioid problem, on Monday the town had an unimaginable 26 reported opioid-related overdoses in a span of four hours. The rush of overdoses was so overwhelming that no ambulance in the entire county was available for a solid half-hour and locals believe that more reports will come in before the week is through.
Huntington is the heroin overdose capital of the United States and there have been more than 440 overdoses in Huntington from various types of drugs starting this year through mid-July. Thankfully none of the overdoses on Monday were fatal, but the Cabell County EMS director has said that the batch of heroin was laced with a strong substance that has yet to be identified. Dr. Michael Kilkenny, director of the Cabell-Huntington Health Department called the drug problem an, “epidemic of monumental proportions."
Since 2000, the rate of deaths caused by drugs has risen 137% and deaths caused by opioids has risen 200%. In 2014, West Virginia had the highest rate of drug overdose deaths at 35.5 deaths per 100,000 people. That same year, the statistic for the entire United States was 14.7 deaths per 100,000 people.
That same year the World Health Organization (WHO) launched guidelines on the community management of opioid overdose. Many doctors started arming police, EMT’s, and friends and family of users with Naloxone, an opioid overdose antidote. The programs go by Take-home Naloxone or THN. THN programs typically entails training opioid users and/or their family members and peers in overdose risk awareness, overdose emergency management and naloxone administration. The programs are hard to evaluate and some have doubted their effectiveness.
In a 2016 study Rebecca McDonald and John Strang took 22 observational studies with a total of 1397 records and evaluated them using the nine Bradford Hill criteria for causation. These criteria were devised to assess a potential relationship between public health interventions and clinical outcomes when only observational data is available. McDonald and Strang found that all studies met all nine Bradford Hill criteria.
A fatal outcome was reported in one in 123 overdose cases, but Take-Home programs are found to reduce overdose mortality among the community and have a low rate of adverse events. With such positive results, more THN programs might be headed toward West Virginia.
