Opioid overdoses are on the rise among older adults, with a 300% increase in opioid overdose deaths among adults 65 years of age and older since the year 2000. Naloxone, also known by the brand name Narcan, is a life-saving medication that reverses opioid overdoses with no contraindications for use in emergencies. Thankfully, Narcan widely available for emergency use as an over-the-counter medication, encouraging everyday citizens and non-clinicians to administer Narcan to those showing signs and symptoms of opioid overdose.
CMS has identified a need to improve guidance related to meeting the unique health needs of residents with mental health diagnoses and substance use disorders (SUDs). Access this CMS memo which outlines when facilities care for residents with these conditions, policies and practices must not conflict with resident rights or other requirements of participation. CMS further clarified that facility staff should have knowledge of signs and symptoms of possible substance use, and are prepared to address emergencies (e.g., an overdose) by increasing monitoring, administering naloxone, initiating cardiopulmonary resuscitation (CPR) as appropriate, and contacting emergency medical services.¹
The Nursing Home Naloxone Policy and Procedure Toolkit, developed by IPRO is a valuable resource for developing these policies and protocols.
Ensuring nursing homes have naloxone available, along with staff trained to use it, improves the overall safety of residents and helps mitigate the risks associated with opioid use in these vulnerable populations.
Why is Access to Narcan In Nursing Homes Important?
1. Increasing opioid use among older adults. Many older adults, including nursing home residents, are prescribed opioids for pain management related to chronic conditions, such as arthritis, cancer, or after surgeries. Long-term use or higher doses of opioids increases the risk of overdose, either due to accidental misuse, drug interactions, or weakened health.
2. Risk of overdose. Older adults often take multiple medications, which can lead to dangerous interactions with opioids. Additionally, as people age, their bodies may process drugs differently, making them more susceptible to overdose even at standard doses.
3. Chronic conditions and sensitivity. Aging can slow metabolism and impair kidney and liver function, leading to slower drug clearance from the body. This increases the risk of opioids accumulating to dangerous levels, especially in those with chronic health conditions.
4. Opioid misuse and dependency. Although less common in older adults, opioid misuse can still occur, either intentionally or accidentally. Having naloxone on hand ensures immediate intervention if an overdose happens.
5. Potential exposure to opioids. In addition to prescribed medications, there’s the risk that residents or staff may inadvertently come into contact with or misuse opioids, either through prescription diversion or accidental exposure. Naloxone ensures safety in these scenarios.
6. Rapid response capability. Nursing home staff are trained to provide medical care, but in the case of an overdose, time is critical. Naloxone acts quickly to reverse the effects of opioids, providing critical time to get further medical attention.
1. Revised Long-Term Care Surveyor Guidance | CMS. www.cms.gov.
Save a Life I Complete Naloxone Training Today
Great Plains Quality Innovation Network developed this Naloxone training for ANYONE interested in learning more about how Naloxone can be used to save a life. This 20-minute training provides an overview of the signs and symptoms of an opioid overdose, three different naloxone administration techniques and Good Samaritan Laws in North Dakota and South Dakota.
“We all have a moral obligation to be prepared to administer naloxone in the event of an overdose. Our goal in offering this video is to prepare anyone who wants to save a life. Watching this video will help you feel comfortable with administering naloxone in an emergency. The risk of being unprepared in the event of an opioid overdose can result in loss of life. The risk of giving naloxone when it may not be needed with an unresponsive individual is negligible,” shared Carrie Sorenson, PharmD, Great Plains Quality Improvement Advisor.
After completing the training video, a QR code/link is provided to access a Naloxone Training knowledge check. The knowledge check consists of 5 questions. A certificate of completion will be provided once the knowledge check is submitted.