June 15, 2021

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Initiatives help prevent overdose deaths

A series of initiatives and programs implemented by the Administration of Mental Health and Anti-Addiction Services (Assmca) has managed to reduce the number of overdose deaths on the Island, particularly in cases of opioid overdoses.

According to Suzanne Roig, executive director of Assmca, opioid overdose cases continue to be a very serious concern, and are not limited to prohibited substances, such as heroin, but also include a number of drugs that are used to relieve or attend various health conditions.

The issue of overdoses, Roig added, is not limited to that vision that many of the battered addict who walks around a corner asking for money or lying on the pavement might have, as there are many people who develop addictions to controlled prescription drugs, who they arrange to live in community as if they were not experiencing an addiction.

“We are trying to attend to all overdose situations, including those related to opioids, and in particular fentanyl, which arrived abruptly in 2017 and is highly lethal,” said the director of Assmca.

He explained that fentanyl and its lethal effect had already been known since before that year, but it was not until 2017 that official reports of deaths from that substance began to be received, and initiatives to address that specific issue began.

“The use of the drug Narcan has been very effective. In fact, we have distributed $ 1 million as part of the Narcan treatment initiative that we have given to community organizations. This must be in the hands of the people and organizations that are closest to addiction and overdose situations, ”said Roig.

“The same thing happened in (the Department of) Correction (and Rehabilitation), where there were deaths from overdoses from time to time and we entered, reported, trained correction officers and that has decreased,” he added, clarifying that Narcan also has the advantage that If it is used on a person who is suspected of being overdosed and it is not really that, “the risk is very minimal” and it has hardly any effect on the body.

“It is a rapid response drug. They already have it Medical Emergencies, Emergency Management, the Police, the Fire Department, the (community) organizations ”, he affirmed.

Beyond fentanyl and other prohibited drugs, Roig reiterated that “there are many functional addicts in the general community who go unnoticed, because a doctor prescribes a drug to treat pain.”

“And we are not criticizing whoever needs a drug to relieve pain. But what happens is that those are not drugs for continuous use. And then part of the addiction and withdrawal syndrome is also pain, and people confuse it with that initial pain that they were treating ”, he added. “That’s why we insist that people talk to their doctor, that they know what an opioid is, that it is addictive, for how long to use it, and what are the treatment alternatives that exist.”

For this type of case, the Controlled Medicines Monitoring Program in force since 2018, in which pharmacies and doctors participate, has been highly effective, and which also includes collaborative agreements with 48 other jurisdictions, including some in which more Puerto Ricans live, and from where the largest number of tourists that the Island receives come from.

With this program, by law, pharmacies must record the dispatch of the controlled drug and document who receives it, who prescribes it, what dose, and other data that allows creating a tract and identifying whether the patient has received the same or similar drugs. in other pharmacies, if the combination with another drug prescribed by another doctor could affect you. This tracking has made it possible to detect tourists who came to look for medicines claiming to suffer from chronic pain, and has even led some doctors who abused prescribing this type of drug to lose their license, although “there have been few, and in general doctors and pharmacies they have been very responsible with this ”.

In fact, Roig argued that the company that provides this tracking system, which also provides it in dozens of other jurisdictions, has classified the work in Puerto Rico as “very robust” and added that it has also prevented more medicines from entering the US market. illegal sale on the streets.

With all these and other initiatives, and despite the fact that during this time of pandemic, “obviously, everything has been more difficult,” Roig said that from 2017 to the present, deaths from opioids have been reduced by 21%.

However, he insisted that “we are still very concerned about overdoses, it is a very serious concern.”

This year, between Medical Emergencies, the Department of Correction and Rehabilitation and the communities, 278 overdose situations have been reported, “and of those 262 are lives saved using Narcan. But sadly, 16 have been fatalities “, added the director of Assmca.

The figures, he clarified, do not include cases treated by municipal medical emergencies and private ambulance systems. However, they hope to be able to unify all these data with an electronic overdose surveillance system that may come into force shortly and by integrating all ambulance, hospital and other systems, so that a more accurate picture of the cases can be obtained. of overdoses and how many survive.

“Addictions have never been in control. Addiction is a very severe condition, very acute, very difficult to treat. It is something that has a physical, psychological and social aspect. And you have to see it from all those perspectives. We have saved many lives. But there are still those deaths. Our hope that they reach 0, and that all people with addiction can be integrated into a recovery process, ”said Roig.

Finally, the director of Assmca assured that all the programs to which she referred are run with federal funds and that there is no reason for them to stop working in the event of changes of direction in the agency.

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