New research led by medical experts at Cook County Health indicates that providing a comprehensive Naloxone education and dispensing program to patients at Cook County Jail has positive, long-term effects for opioid users returning to the community, increases patient safety and has higher success rates in the number of lives saved.
The study results are published in the most recent issue of the Journal of Correctional Health Care.
Following a routine health screening during the intake process, every year, 10,000 detainees with a substance abuse disorder are housed in a detox unit at the jail where they are provided with medical care and treatment to address their individual needs. In 2016, Cook County Health began providing comprehensive naloxone education and training. Naloxone is a medication designed to rapidly reverse the effects of opioid medication, including extreme drowsiness, slowed breathing, or loss of consciousness. It is often given via a nasal spray and is highly effective.
“We know medication is effective in preventing overdose deaths and relapse with opioid use disorder,” said Tony Leung, PharmD, study principal investigator and assistant director of pharmacy at Cermak Health Services of Cook County Health. “Individuals discharged from a correctional system are 40 times more likely to overdose than the general population in the first two weeks post-discharge.”
Over the past four years, naloxone education has been provided to nearly 8,000 patients, and more than 6,000 naloxone kits have been given to patients at discharge.
According to the study, more than a third of patients who were surveyed (38.3 percent) discharged from Cook County Jail, who participated in the survey, reported using a naloxone nasal spray provided to them at time of discharge on themselves or others. Of those who reported using the nasal spray, 95.7 percent achieved life-saving, positive outcomes following a potential opioid overdose.
Cook County Health provides healthcare to detainees at the Cook County Jail.
According to the study, despite a history of drug abuse, 51.7 percent of patients surveyed did not know about naloxone’s effectiveness or how to use it.
During a session with pharmacy staff at the jail, patients are educated on the importance of having naloxone available as well as the drug’s mechanism of action. They are educated on signs and symptoms of overdose, proper technique for naloxone usage on themselves or others, and storage requirements.
Upon discharge, patients are given a naloxone nasal spray kit that includes two nasal sprays, a patient medication administration pamphlet, and information on available treatment clinics.
Researchers also found that:
83.1 percent of the patients stated the training they received by Cook County Health staff provided them with information that they did not previously have
93.3 percent of the patients reported they were confident in their ability to use the naloxone nasal spray based on the training they received
70 percent of the patients reported educating friends or family on the proper technique for using naloxone in the event of an overdose
30 percent of the patients disclosed reaching out to the treatment clinics provided on the patient referral sheet inside the naloxone kit
62.7 percent of the patients stated they would take the sprays with them when going out
Patients who participated in the naloxone training during their previous incarceration as well as had been provided with a naloxone kit prior to discharge were invited to be a part of the study.
The leading cause of injury-related death since 2009 is related to drug overdose. About 1,400 people in Cook County have died of opioid overdoses in 2020, already surpassing last year’s death toll, according to the Cook County Medical Examiner’s Office.
“While these promising results show that naloxone can save lives, more needs to be done to solve the opioid epidemic,” Leung said. “We hope to do further research around the stigma associated with the possession of naloxone, a lack of knowledge on the use and mechanism of the medication, or a fear of being reported to law enforcement as well as address any other issues that impact the availability of naloxone to the community.”
“Opioid addiction has exacted a terrible toll on too many people in our society, including many who are ordered into my custody,” Sheriff Thomas J. Dart said. “These individuals face long, frustrating battles toward recovery, and unfortunately many have suffered fatal overdoses. This study confirms what I and the staff at Cermak have long believed, that providing life-saving Naloxone to detainees in our care and custody who struggle with opioid addiction drastically increases the chance that they or someone they love will survive.
Caitlin Polochak, Communications Manager