The University of Arkansas for Medical Sciences was recently awarded a $1 million grant to create a statewide naloxone training program, designed to train and educate healthcare providers on how to use the drug to prevent opioid overdoses. Naloxone is a drug that reverses the effects of an opioid overdose. In 2021, there were 386 opioid overdose deaths in Arkansas, accounting for more than 60% of all drug overdose deaths in the state. Dr. Meghan Breckling is the lead on this training program. She’s a pharmacist, an assistant professor at UAMS, and she’s also a clinical research pharmacist with the Center for Addiction Services and Treatment in the UAMS Psychiatric Research Institute. She says that over the last few years she’s her passion has grown over opioid recovery and healthcare provider education.
Meghan Breckling: It's a really common challenge everyone is facing, you know, and it's all different populations that are having trouble with opioid use and misuse and I feel that the availability of a life saving medication out there is necessary for everyone to be able to have access to and the ability to use it if needed. So it kind of triggered me to see this grant when it popped up and I was like, you know, this would be a great thing for Arkansas because we're struggling with it very much. So I just decided to go for it. You know, I was really excited about it. And I'm so excited we got it, and I'm excited for the work that we're going to do.
Matthew Moore: I think there's there's kind of some misconceptions or there's there's kind of some assumptions that are made around the kinds of people who struggle with opioid abuse or opioid addictions or those sorts of things. It's not a very specific group of people. right? I think one of the things that may be a bit misleading is that opioid addiction and abuse happens to a full range of individuals.
MB: Yes, and I've seen the whole gamut of everyone. I work with incarcerated patients that have struggled with substance use. I also work with chronic pain patients that got started on opioids for a disease that they've been struggling with. It's many people in Arkansas, in the nation in the world that are struggling with this.
MM: As someone who's not a pharmacist, can you explain to me what naloxone does and how it counteracts an overdose?
MB: Naloxone is a reversal agent. So it is reversing the effects of what opioids do to our brain and our system. So when someone goes into an overdose, they've had too much of an opioid into their system and it's basically shut down their ability to breathe, and we know at that point, that's a very dangerous situation to be in. So giving naloxone is very rapid, it reverses that effect. However, it's not a long term effect. So it's something that keeps someone alive for a short period of time. But knowing it's very important to be calling 911 and that somebody is coming with more ability to keep that person alive. So it's kind of that short term solution to keep someone alive similar to what we would do with CPR, or you know, an EpiPen and a severe allergy. So it's very important to know how to use it. It's also not difficult to use. It's not something that somebody needs advanced medical training for. It's very much so could be used by anyone, even a younger child could use it, especially the nasal spray. So that's why I feel like training anyone and everyone about it and helping spread the word about it because you just never know when you might encounter a situation when it's needed.
MM: Is there any sort of concern if say, some naloxone got on my hands or got on me? And I'm not experiencing any sort of overdose symptoms at that moment? Is anything going to happen to the person administering it?
MB: It's a safe medication in that way that it only works in the way that it's designed to go up the nose, and it's also not going to affect someone that is not having an opioid overdose. So if you come across somebody or you yourself, get it on you, and you're not having that overdose problem happening, it's not going to cause you to have a side effect or a harmful reaction to you. So that's why I always tell people, even if you're unsure of what is going on with the person in front of you, it's better to give them this life saving medication and hopefully save their life and you're not going to cause harm to them.
MM: The program is is geared towards health care providers. Are you hearing from a whole range of health care providers too, who were just like, I never thought I would need to use this until I had this one client or I had this one group of people come in and you know, it makes you realize like how wide of a problem it really is.
MB: It was an overwhelming response when I started reaching out to some of the people I've worked with on other projects, just because I think, like you said, it's affecting everyone out there, all of Arkansas, rural Arkansas, all the health care providers. I think we also should touch on the possible drug interactions that can happen when someone's taking an opioid, even if you're taking it correctly. If you take it on top of another medication, you drink some alcohol with it, you could have that adverse effect of a respiratory depression and overdose. So it's not just the people that are misusing opioids. It's the fact that the opioid is a medication that can cause this side effect, this respiratory depression. So I like to say, we're not prescribing the Naloxone for risky patients, it's for risky medications. So we really need to just know that this medication is something that can be harmful to anyone.
MM: You mentioned the element of Arkansas having plenty of rural spaces. I think that's a really important element of this, too. There are plenty of places in Arkansas where they don't have quick and easy access to a hospital to an emergency room. And so working alongside smaller rural health care providers can be a pretty big a pretty big impact, too. If someone is on a pretty rural county in Arkansas and they don't have quick and easy access to a hospital, but these health care providers who work on a smaller scale know how to use this and can do it effectively and help save someone's life... I mean, that's the ballgame.
MB: Yes, for sure. And I mean, it just gives you more time to get that person to where they need to be to really get the help that they need.
MM: What is something that excites you about the opportunity to to lead and to administer this sort of education and training program?
MB: I think it's really that potentially I could help save some lives out there. I think that's a big thing for me, and then also just making families and Arkansans feel safer. I think it's very scary when we start hearing about all the fentanyl that's out there, and that kids that are getting a hold of it. If we can train parents and schools and anyone out there, you know, we can potentially save lives and I just feel like if this medication is available and enabled to be had and we need to know about it. So that's kind of what excites me the most,
MM: As part of this grant money will a portion of it go towards procuring and getting access to Naloxone as well?
MB: Yes. We've budgeted money to be able to provide free Naloxone kits for the participants that are coming to the classes. They'll learn about the Naloxone and how to administer it, so we will give them free naloxone. We will also provide resources on how to get free replacement kits so if they use it and they need a kit. There's a lot of great organizations in Arkansas that are partnering with us on the grant that will help us get those those replacement kits if needed. There's a lot of news going around about over the counter Naloxone that is coming as well. So I think this grant hit at a perfect time because eventually it will be over the counter. And we want people to be able to know how to use it if they do end up buying it. And I think this will kind of be a great start to that.
