In 2018, Virginia had 1,213 fatal overdoses, a decrease from the 1,230 in 2017, but still high.
Numbers can take away the humanity of this crisis. Take a moment and try to think of 1,213 people—maybe this is the number of Facebook friends you have. Your entire high school? Neighborhood? Imagine if all those people vanished, not just the number documenting their existence, but all of their memories and contributions. Parents, children, husbands, and wives. Put a face to each of those numbers. Let these thoughts remind us of why this program is essential.
REVIVE! is evolving, the program has done an excellent job at educating the greater public on how to respond to an overdose and the importance of carrying naloxone. Now, we are entering Phase II. This next chapter is working to target more Virginians that are at most considerable risk of witnessing or experiencing an overdose. REVIVE! has relied heavily on classroom curriculum and a more structured setting; however, if the goal is to reach deeper into affected communities, we need to make education/training more accessible. The need for classroom setting training is still there, but now there is a more targeted option too.
This overdose prevention education is shorter and covers essential topics for saving lives. The aim is for peer to peer learning, community health workers, quick training for high volume events, and most importantly, pairing with naloxone dispensing. Training may be conducted in a variety of settings, including on the street or in a more conventional private indoor environment. The training may be in small groups or conducted one-on-one. The duration of the training will depend on the number of responders in the class and their familiarity with drug administration and overdose (typically 10-15 minutes). Responders will still receive a REVIVE! kit and a REVIVE! card upon successful completion of the curriculum and practical demonstration of an understanding of the subject matter. Attached to this email, you will find the required topics and a patient handout to be provided in a Rapid REVIVE! training.
This training is not suitable for law enforcement or other persons expected to respond to overdoses in a professional capacity. The “Rapid” curriculum is most beneficial to persons in active drug use/high risk that have limited time for a full class.
Changes to the Protocol and Curriculum
The steps to respond are now changed. Previously administering naloxone came before calling 911, this is no longer the recommendation, the steps are now:
- Check for Responsiveness
- Call 911, if the person is not breathing,
- Give Two Rescue Breaths.
- Administer naloxone
- Continue Rescue Breathing
- Assess and respond based on outcome of first naloxone administration.
Note: Currently produced REVIVE! kits will have the incorrect protocol inside of them.
Research supports providing two rescue breaths before administering naloxone, especially if you have to get naloxone or assemble a device. There is now more of a push to practice rescue breathing at training. If someone doesn’t have naloxone on them, they will call 911 and provide breaths, many REVIVE! trainings don’t have naloxone dispensing. We want people to be able to respond appropriately, even without naloxone.
Injectable naloxone is now in the presentation, and the assembled intranasal device is out. The intranasal device is no longer being widely dispensed at pharmacies in Virginia and can complicate an already scary situation. Several organizations across the state are dispensing injectable naloxone to at-risk groups, and it is essential that lay rescuers are aware of its existence. Injectable naloxone will NOT be demonstrated by groups not dispensing injectable naloxone. This option is preferred by some because they feel it works a little faster, you can taper the dosing, and it has a much lower cost.