Scott Webb: Naloxone, also known as Narcan, is a life saving drug that can be administered to people who have suffered an opioid overdose, and the state of New Jersey has a new program that provides free naloxone anonymously to those over 14 years of age. And joining me today to tell us more about naloxone and this free life saving program are Ashley Bardi, she's the Senior Director of Substance Use Disorder Treatment at Bergen New Bridge Medical Center, and Greg Eilinger, he's the Director of Pharmacy with Bergen New Bridge Medical Center.

 Scott Webb: This is Wellness Waves, a Bergen New Bridge Medical Center podcast. I'm Scott Webb. So it's nice to have you both here today. We're going to talk about this New Jersey program that provides free naloxone, aka Narcan, anonymously to those over 14. I mentioned that in my intro. And so Greg, it's great to have you here and I'll start with you. What is naloxone?

Gregory Eilinger, PharmD: Naloxone's a product that's been out for a while. It was approved many years ago, and it's gaining more popularity since it moved over the counter. It's a reversal agent. So it's used for patients who have had too much of an opioid, and there's a need to pull back, to reverse that effect. And that's what naloxone is being used for.

Host: All right. So it's been around for a while, but now that it's available over the counter, so to speak, it's becoming more popular. Folks are talking about it like we are today, of course. So Greg, how does it work exactly?

Gregory Eilinger, PharmD: It works centrally. It works on receptors, on the same receptors that the opioid drug itself works on. When a patient takes an opioid, whether it's a prescription drug or an illicit substance; it works on opioid receptors, that's where it gets the name, and it has the effect of, it can alleviate pain, but it can also depress breathing and the respiratory drive for individuals, and that's really where the harm comes. And so, when folks have difficulty breathing, when they've had so much opioid ingested that they begin to stop breathing, the naloxone, when administered, will reverse that. It works by pulling the opioid drug off of those receptors and, bringing back your body's normal breathing rhythm, and stimulus to breathe.

Host: Yeah, and Ashley, it really does sound like it saves lives. I've certainly read news stories and social media things about folks who, you know, benefited by having it nearby or would have benefited by having it nearby. Am I hearing that right? Does this save lives?

Ashley Bardi, MSW, LCSW, LCADC: It most certainly saves lives. Everybody should be carrying it. And the beautiful thing is, is that if somebody is not having an opioid overdose, it does not affect them or harm them in any way. So it's kind of like a preventative action if you don't know what to do. We have so many patients who have stories about just carrying it on them or family. So the fact that families have access to this life saving prevention now, we have been able to prevent many overdose deaths.

Host: Yeah, it's really amazing. And Greg, I'm assuming that that's why New Jersey, why the state is offering the free anonymous doses because it is such a life saving drug.

Gregory Eilinger, PharmD: Absolutely. New Jersey's taking a very proactive stance here and, they're really looking at access and making sure that it's available in the community as being the number one goal. As Ashley mentioned, the concerns as far as side effects or somebody being harmed by naloxone are relatively low.

 And the benefits are truly life saving. So, New Jersey has developed a program to break down barriers and make sure that patients have, even if you don't have a prescription or you may be uncomfortable purchasing under your own name, you could receive it anonymously from a pharmacy at no cost, and it's available for anyone 14 years or older.

So again, the state is looking at this as something that it's not only for adults, it's for folks even younger than 18 years old, to be available. It's easy for them to use and it really can be a lifesaver.

Host: Yeah, I was sort of surprised when I was, you know, kind of going through and educating myself for our discussion today, that it's 14 and older. But as we're saying here and identifying today, it really is life saving. And there's no harm to take it if you don't need it to save your life. So it's just good to have around if you're someone who needs to have it around. Just wondering, Greg, how does it work with the participating pharmacies?

Gregory Eilinger, PharmD: As a participating pharmacy ourself, there is a signup process. It's very painless on the behalf of pharmacies. So, uh, we enroll with our board of pharmacy, and once we're approved, we're given instructions from the state on exactly how we process these prescriptions. So for the public, if they're interested in understanding how is it that the pharmacy can dispense this without knowing that it's me, you know, that's picking it up, we profile it in our computer systems as Jane Doe.

That's how we're instructed to profile this prescription. We use a physician that is a Department of Health physician that we're told we should record this as the prescriber on the prescription. We verify that the patient is 14 years of age, as part of our commitment to the state to participate in the program, but that's only verbal. We're not asking for identification. The patient doesn't need to provide a license or anything like that, as long as the patient verbalizes that they're over 14 years of age and that they're capable of being educated and comfortable taking the drug, that's fulfilling our commitment as a pharmacy. So it's very low barrier. And, and again, it's intended to make sure that as much Narcan that we could get into the community as possible can go out.

Host: Yeah. There's no doubt that it's just so important to help with those barriers. There's just so many barriers in life and medicine. So, good to know that all the I's are being dotted, T's are being crossed, so to speak. Ashley, I think we've covered this, but I want to really give you an opportunity to hear why it's so important to have access to naloxone.

Ashley Bardi, MSW, LCSW, LCADC: The importance of naloxone is because opioids, especially synthetic opioids, we don't really know what they're being made with and it can just be used as a protective factor. I think the hardest thing is, is that if somebody is overdosing, it is pretty hard to use it on yourself. However, New Jersey also is proactive that if you are using a substance or if you are with somebody who is using a substance and you call the police, or you call 9 1 1 for a response, you are not going to get in trouble for calling.

 So this also helps with the proactiveness of being able to save a life. We don't realize how many people are being affected by opioid use disorder until it happens in our own backyards or our homes, until we see it, and oftentimes we panic. But knowing we have this Narcan on us can really make us a lot more comfortable to be proactive and know what step is first in really assessing somebody.

And, you know, we work with families and individuals on how to use naloxone, which is very important because it takes out the panic and automatically allows you to go into response mode.

Host: Yeah, that's really interesting. We were talking here about the barriers, right? And you could understand, especially maybe somebody who's 14, 15 years old or a friend of someone that they would be perhaps afraid to call because they're using opioids and they shouldn't be. And we're just, you know, the whole point of this is to save lives, not to get people in trouble, so to speak, because of what led to them needing the naloxone, right?

Ashley Bardi, MSW, LCSW, LCADC: Correct.

Host: Yeah.

Ashley Bardi, MSW, LCSW, LCADC: And most of the time, with vapes or, you know, with marijuana and things like that, most of the kids do not know, what is being inserted into these things, right? So, even if it's just a preventative action where, you know, they know this is handy and they can tell the first responders, hey, we did this.

We are educating students about it. We're educating families about it. Our whole community is involved in understanding this is a precaution. And if you don't know anything else to do, this is not going to hurt you long term and it's a preventative action.

Host: Right. And I just loved hearing that just the state and everyone is being so proactive and preventative. It's been really educational today. Glad to have you both on. Greg, I want to finish up with you. Who should have naloxone on hand?

Gregory Eilinger, PharmD: There's no wrong answer to this question. I think that anybody, whether it's somebody that believes that they are a high risk for either themselves or folks that they socialize with, or if it's just somebody who wants to have it as a safeguard to make sure that they're available.

We have plenty of staff members at the hospital, physicians, nurses, pharmacists who have taken advantage and gone ahead and taken a package of naloxone for themselves, but just to have available, because you never know, you could be at the mall, you could be at somebody's sports game, and something could happen, and so to make sure that you have it available, you could be saving somebody's life.

 There's nobody that is the wrong person for having naloxone.

Ashley Bardi, MSW, LCSW, LCADC: So I just wanted to inform everybody, I keep naloxone. I keep one in my purse. I keep several in my house. And when we're going out, we always have them with us because you never know, even the stranger on the street, or who's going to need it. And so everybody really should be carrying it.

Host: Oh, that's perfect. Again, I appreciate you both being here and educating me. I mean, I love hearing how proactive New Jersey and everybody is being. Everybody's sort of pulling on the same end, so to speak. And, you know, when it comes to saving lives, especially saving lives of teenagers, that warms the heart. So thank you both. I really appreciate your time.

Gregory Eilinger, PharmD: Thanks, Scott.

Ashley Bardi, MSW, LCSW, LCADC: Thank you, Scott.

Host: And for more information go to newbridgehealth.org/health-services/substance-use-disorder-treatment. And if you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for additional topics of interest. Thanks for listening to this episode of Wellness Waves. I'm Scott Webb. Stay well.