UT’s College of Pharmacy has started the nation’s first comprehensive university opioid-overdose prevention campaign: Operation Naloxone.
Operation Naloxone is a student-led training program organized by Lucas Hill, a UT clinical pharmacist. Hill said the program was developed in response to recent legislation allowing Texas pharmacies to hold standing orders of naloxone — commonly known by its brand name, Narcan — a drug which reverses opiate overdoses.
Hill said he was introduced to the anti-overdose initiative at UT by two leaders in community outreach, Mark Kinzly and Lori Holleran Steiker.
“I thought that a good role for pharmacy would be to train our students to go out and do public teachings,” Hill said.
According to the U.S. Department of Health and Human Services, naloxone reverses the life-threatening symptoms of overdosing on opioids, which include prescription painkillers and heroin, by pushing out and replacing opioid molecules in nervous system receptors that attach to opiates and cause overdoses.
The drug, called Narcan, is administered as a nasal spray. It gives anyone overdosing 90 minutes of normal breathing to get medical attention, which, according to Hill, may mean the difference between life and death.
Naloxone is now covered under UT insurance and can be picked up at the Forty Acres Pharmacy without an individual prescription.
According to Hill, between 2000 and 2010, opioid overdoses were the fastest-growing causes of death in the U.S., and the death rate is still increasing.
“In medicine, we like to think about how we work to prevent problems before they start or get worse,” Hill said. “We are way too late already. We are digging out of a hole.”
Hill said the problem was created by incentives put in place in 1999 to push physicians to identify and treat pain without limitations.
“In the 10 years that followed that incentive, opioid prescribing quadrupled and opioid-related deaths quadrupled,” Hill said. “Now, it’s a problem everywhere.”
According to a 2016 KXAN investigative report, Travis County has seen a spike in overdoses and deaths related to fentanyl, a surgical-grade painkiller that is commonly mixed with heroin to increase potency.
After hearing one of Hill’s lectures on opioid overdose, two student leaders in the College of Pharmacy, JP Sanchez and Andrea Laguado, decided to address the problem on campus.
“We started off with pharmacy students, [by] teaching naloxone administration in the college,” Sanchez said. “Then we started reaching out to and visiting co-ops and, recently, residence halls.”
Hill said this student-led, in-home model is more effective than dispersing information at large events.
“We are going into dorm rooms, sitting on people’s couches and presenting on someone’s laptop monitor,” Hill said. “There’s this accessibility [and] guerilla outreach feel. That is really cool.”
Hill said while the federal government has no protocol for how bystanders should respond to opioid overdoses, he and other faculty have designed one for UT. Sanchez, Laguado and other pharmacy students are following this protocol to train these communities.
“The training includes how to prepare a dosage of Narcan,” Sanchez said. “We teach that, when dealing with an overdose, you should check for responsiveness, call 911 immediately and administer naloxone, even if you are unsure the patient is overdosing.”
According to Laguado, the next step is to get the patient medical attention or another dosage of naloxone.
Despite the potential benefits of naloxone, some Texas legislators have opposed its widespread use.
Texas House Bill 225, which calls for medical amnesty for overdosing patients and associated individuals, was vetoed by Gov. Greg Abbott, despite approval from the Texas Legislature, according to a Texas Tribune legislative report.
The reluctance to expand these laws is rooted in traditional views of drug usage, Hill said.
“There is a lot of resistance to combining the two groups [prescription addicts and heroin addicts],” Hill said. “The reality is that there are more similarities [between the two] than we like to admit.”
According to Hill, pharmacy students will soon be training a wider range of people, including first responders.
“It has been quoted to us that UTPD arrives on the scene within 5 minutes, so they would be a great partner to stop overdoses,” Hill said. “UTPD wants every officer trained and carrying naloxone.”
Operation Naloxone has already had successful events at co-ops around campus and Jester East, according to Sanchez. They are expanding to more residence halls, off-campus communities and student organizations and hope to have social work, nursing and medical students to lead trainings.
According to Laguado, the overall goal of Operation Naloxone is awareness.
“Educate yourself, be proactive, talk to friends,” Laguado said. “We don’t want someone who could have done something see one of their friends overdose and have no idea what to do.”