REVIVEme
Myron Yaster MD
In last week’s PAAD (Consider the Opioid Crisis Again? Yes! Why? Because- “Repetitio est mater studiorum” (repetition is the mother of learning, March 23,2023), Drs. Alan Schwartz and Bonnie MIlas once again revisited the role that anesthesiologists can play in the opioid crisis. In preparation for the upcoming SPA meeting in Austin, I wanted to alert all of you to the following:
The American Society of Anesthesiologists has launched a website REVIVEme to bring senior leaders from the medical, law enforcement, fire/rescue, and emergency medical services to work together in a coordinated manner to mitigate loss of life and limit injury of opioid overdose through this public initiative. PLEASE open the webpage and take a few minutes to watch the video by Dr. Bonnie Milas. It may change your life and save the life of others.
https://www.asahq.org/advocating-for-you/reviveme
The goals of the ASA’s REVIVEme initiative is to (1) develop strategies and tactics for multidisciplinary teams in the innovation and implementation of efficient and effective (patient, care delivery, work, and information) opioid use reduction and liberalization of naloxone use. (2) Guide and educate public and healthcare providers on implementation processes and resources; assuring that work intersects with other national and regional initiatives. (3) Educate public and professionals in the identification of opioid overdose and the use of opioid reversal agents as a lifesaving measure.
Why is this so important? Almost 107 000 Americans died from a drug overdose in 2021, continuing a 2-decade-long trend of increasing overdose deaths that accelerated during the COVID-19 pandemic.1 The consequences are just simply staggering. Life expectancy in the United States in 2021 has fallen to its lowest level since 1996 largely driven by drug overdoses and COVID-19.2 As discussed in many previous PAADs, this calamitous epidemic of drug overdose deaths is largely driven by illicitly manufactured fentanyl.3
As readers of the PAAD know, I’ve been advocating for more widespread use, distribution, and availability of intranasal Naloxone. I think we should be co-prescribing it with outpatient opioid prescriptions particularly in high risk patient groups like patients with sleep disordered breathing, teenagers, teenagers in the household etc. Additionally, as discussed by Dr. Milas in her video, I think we should ALL be carrying Intranasal Naloxone in our daily lives to resuscitate people we encounter outside of the hospital who have overdosed. Indeed, I’m posting this today because at the upcoming SPA MEETING in Austin tomorrow, Dr. Meera Gangadharan has assembled a team of SPA members who will man a booth to discuss and demonstrate how to use and obtain intranasal Naloxone (and combat tourniquets) to all of the attendees. Just look for us in the exhibitors hall during meeting breaks.
PS: In about 2 weeks the PAAD will review a basic science paper that will help you understand how opioids produce respiratory depression and some exciting new drugs to help prevent or treat it.
References
1. Kuehn BM. Fentanyl Drives Startling Increases in Adolescent Overdose Deaths. Jama. 2023;329(4):280-281. doi:10.1001/jama.2022.23563
2. Kuehn BM. US Life Expectancy in 2021 Lowest Since 1996. Jama. Jan 24 2023;329(4):280. doi:10.1001/jama.2022.23562
3. Kharasch ED, Clark JD, Adams JM. Opioids and Public Health: The Prescription Opioid Ecosystem and Need for Improved Management. Anesthesiology. Jan 1 2022;136(1):10-30. doi:10.1097/aln.0000000000004065