At the Pennsylvania Harm Reduction Coalition, we believe everyone deserves professional evidence-based care that is sensitive to the needs of the individual and the reality of the current drug supply. Individuals with opioid use disorder or those who use opioids, along with those recently released from treatment programs, are at highest risk of overdose. To mitigate risk in these populations, we are introducing the Treatment Overdose Prevention (TOP) Initiative. TOP faces the overdose crisis head on and delivers overdose prevention education, training, and naloxone distribution to those who need it most.
In 2018, almost 70,000 Americans died from a drug overdose, and among those two thirds were associated with opioids. In Pennsylvania, we have the third highest rate of drug overdose deaths in the country — and a rate that is twice the national average. Our overdose death public health crisis is directly related to the increased use of illicit, short acting, and high potency fentanyl. The good news is that we have naloxone, an effective evidence based harm reduction medication that prevents overdose deaths.
Naloxone is an opioid antagonist that is the standard of care for the treatment of fatal respiratory depression caused by opioid overdose. Research demonstrates that expanding awareness, education and availability to this medication saves lives. In the past 10 years, naloxone distribution has increased in the United States, including the provision of statewide standing orders, and funding opportunities to get naloxone in the hands of first responders, medical professionals, and the general public.
In Pennsylvania there have been over 21,150 doses of naloxone administered by EMS alone, and thousands more doses distributed across the state thanks to several initiatives. Despite rapid expansion, opioid related overdoses continue to be a major public health challenge. Expanding access to naloxone, especially among those who use drugs is a high priority.
The TOP Initiative is a partnership between state and county substance use disorder treatment facilities and public health departments. This program will distribute naloxone to patients and their family members at discharge, and deliver harm reduction education, to better engage patients in realistic conversations about future risk of overdose.
The TOP Initiative creates partnerships with substance use disorder treatment facilities, experts in addiction medicine, advocates, families, and those with substance use disorders. This collaborative strategy based on science and real world challenges is an important part of the solution to our current crisis.