Since 1990, deaths from narcotic painkillers have more than tripled in the nation. Perhaps more troubling, North Carolina ranks among the Top 5 states in the country in drug overdose fatalities. But Lisa Zerden, a clinical associate professor at UNC’s School of Social Work, thinks a new training project on overdose prevention could help save more lives.
Zerden, who was awarded a $3,200 grant from the School’s Armfield-Reeves Innovation Fund, is leading the project in cooperation with the Durham-based N.C. Harm Reduction Coalition.
The goals are twofold: First, to help those who are vulnerable to drug overdose to understand that there are risks with overusing prescription pain medication, especially as the body becomes more tolerant of the drug. In fact, research has shown that high doses of opioids, such as oxycodone, can lead to respiratory failure and death.
“We’re not talking about someone taking these pills because they want to end their life,” Zerden explained. “We’re talking about those who are taking drugs because it feels good and because they want to numb the pain. The problem is that as individuals become addicted, their body builds up immunity to the drug, and they have to take more and more and more. Ultimately, it gets to the point that they don’t even realize that their body can’t handle it.”
Zerden’s project will also focus on raising awareness, including within the law enforcement community, about SB20, North Carolina’s new “Good Samaritan/Naloxone Access” law. The law, which went into effect in April, reinforces the need to get immediate help to victims of drug overdose. The law was approved in an effort to remove the fear of criminal repercussions for people who call for help after either experiencing an overdose or witnessing one.
“Until this law was passed, someone who witnessed a friend’s overdose, for example, might be reluctant to call 911, especially if the overdose involved drugs that were not legally prescribed,” Zerden said. “But what we’re also reminding law enforcement officers is that you can’t just arrest people at the scene of an overdose. They have rights. Ultimately, what we hope is that the prevention training and education will empower people to respond and to call for emergency help to prevent an overdose fatality.”
Zerden’s project coincides with a growing national concern over the misuse and abuse of prescription painkillers. In October, the federal Food and Drug Administration announced plans to impose new restrictions on how some of these drugs are prescribed and used. Generally, patients in need of relief from a chronic aching back or a painful root canal have been able to get prescriptions from a doctor or dentist. The proposed changes would reduce the number of refills patients are allowed before seeing their doctor again.
Research has shown that easy access has contributed to a black market for opioid drugs and likely contributed to the abuse of the painkillers.
According to the Centers for Disease Control and Prevention, in 2010 alone, more than 12 million people reported using prescription painkillers for a non-medical purpose. Because opioids are so addictive, users sometimes turn to street drugs, including heroin, once their prescription medication becomes unaffordable or after their physicians refuse to prescribe more refills, Zerden said.
Research also has shown that individuals who abuse opioids are vulnerable to overdosing. Those particularly at risk include people who are incarcerated or in drug treatment centers—groups that Zerden and her project team plan to target for training and education. These individuals are more vulnerable, she said, because their tolerance levels for prescription opiates changes over time, especially if they have been drug-free and then return to using.
To help reach these groups, Zerden’s project team will offer overdose prevention training through the Durham County jail and Durham’s drug treatment court program.
“We know that people relapse as part of the disease process,” Zerden said. “So in trying to prevent them from overdosing when they get out, we’re training them to be aware of the risks so that they can call for emergency help if needed.”
Law enforcement officers participating in crisis intervention trainings will also receive the same overdose prevention training. Learning to recognize the signs of an overdose is a key part of the program, Zerden said. Although overdose symptoms vary depending on the drug used, some signs include abnormal pupil size, agitation, drowsiness, and difficulty breathing.
“I think the best part about this project is that it aligns harm reduction advocates who really want to work with people who are using and law enforcement, who have been very unlikely bed fellows,” Zerden said. “But in this case, they are working on this issue together, just from two different angles. That’s been really interesting for me. To think that we’re not adversaries—we’re partners, and we’re going to try to educate everyone at the same time so that we can have better outcomes.”
Zerden is thankful that the Armfield-Reeves grant helped to kick-start the pilot project and eventually hopes to broaden the study to include individuals who do not “necessarily associate with drug addiction,” including patients at pain clinics, those with insurance, and military service personnel.
“This is such a timely issue and the fact that we’re seeing such unprecedented and elevated numbers of overdoses in our state,” she said. “This is not what North Carolina needs to be known for.”
For more information about the Armfield-Reeves Innovation Fund, other fundraising priorities or the impact of private giving at the School of Social Work, please contact Mary Beth Hernandez, associate dean for advancement, marybeth@email.unc.edu.
