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Indiana State nursing student offers deputies potentially life-saving training

October 23, 2014

Indiana State University doctoral student Donna Purviance hopes the training she provided sheriff's deputies week allows them to quickly, and without fear, administer an antidote to reverse the effects of an opiate overdose when time is of the essence.

Having worked several years in chronic pain management, Purviance, who is pursuing a doctor of nursing practice degree, was sometimes required to prescribe opiate pain pills per the American Society of Interventional Pain Physicians and Regional Anesthesia guidelines.

"But the more I studied pain and perception of pain, I realized that oftentimes prescribing opiates, by the nature of the dependency and addictive properties of the medications, I was either contributing to addiction or creating addiction in the patients," she said. "It's scary to realize there might be opiates out there that I have prescribed that could get into the hands of people other than the intended patient, or patients may legitimately take their opiate and still overdose. Having the antidote readily available in those circumstances is a positive step in preventing death."

After speaking to a mother from Terre Haute who lost her son to a methadone overdose, Purviance said it solidified for her the need to train law enforcement officers to deliver a dose of nasal naloxone that works only in the case of opiate use. On Wednesday, she provided such training for deputies at the Vigo County Sheriff's Office.

"That mother spoke about the torment her son went through and all the difficulties they had in securing help to assist him," Purviance said. "I can't help but think that if the facility had had the antidote or police had the training and could have gotten to him quickly, that child might still be here today.

She provided training to share facts on overdose and how to administer the antidote with nearly 40 of the county's deputies. Once the proper policies are in place, likely within the next two weeks or so, the deputies can begin carrying the antidote when on patrol.

"Our No. 1 job is to protect lives and this is another tool we can use to do that," Sheriff Greg Ewing said. "If we can save even one life with this, we're all winners."

The training was made possible with help from the Rural Health Innovation Collaborative and Erik Southard, assistant professor of advanced practice nursing and director of the doctor of nursing program who serves as Purviance's faculty mentor.

"I set up a fundraising link with the Wabash Valley Community Foundation to help purchase tools for the training, including narcan syringes, mucosal atomizers and zipper bag containers for the officers. I also went rode on two- to eight-hour shifts with two sheriff's deputies to get acquainted with the department and spent six hours at the jail watching the process of booking individuals," Purviance said. "I have been fortunate to network with other law enforcement agencies in Indiana, including LaPorte, Columbus and Indianapolis as a part of the process."

The need for such training is growing statewide, as use of opioids among Hoosiers escalates.

"In Indiana alone, there were 111 deaths due to heroin in 2013. Combine that with the fact that 3 percent of all high school seniors have used heroin once and it's not hard to see the challenges we face," Southard said. "As opiate prescription medications become harder to obtain legally or otherwise, the use of heroin, which is a form of opiate, will likely rise. Unlike prescription opiates, heroin comes in many different potencies and the risk for overdose is very high."

More than 6 million people abuse prescription drugs, which contribute to the deaths of 50 Americans die each day from overdose, Southard said.

"In recent years heroin has crept into our state and now its use is climbing at staggering rates," he said. "In 2012, drug overdoses claimed 999 Hoosiers - a 57 percent increase in deaths over the past decade. As a result of these shocking statistics, Indiana has taken drastic and important steps to monitor the prescribing of opioids and there has been an 11 percent reduction in the number of opioid scripts written in Indiana."

Luckily, Purviance said, lawmakers foresaw the issue and adopted Senate Bill 246 as a means to control opiate prescribing.

"The bill was not intended to stop opiate prescribing but make the provider employ the tenets of the physician society's guidelines. Since the bill's inception, the state has seen a decrease in opiate prescribing, opening the doors for heroin, as a substitution," she said. "Our legislators recognized that, with a decrease in opiate prescribing, heroin use might increase and they made amendments to Senate Bill 227 - the Good Samaritan Bill - to allow law enforcement and first responders the option of giving intra-nasal narcan, the antidote for a heroin/opiate overdose, without civil liability."

Southard applauds the Vigo County Sheriff's Office for providing its deputies with more tools to aid them in protecting the public.

"Much like carrying an AED (defibrillator) for treating time sensitive cardiac arrhythmias, training officers to recognize opiate/heroin overdose and giving them naloxone they can administer through the patient's nose has the potential to save lives," he said. "While we hope they never have to fire a shot of nasal naloxone, the evidence supporting its use is coming in from all across the country."

Vigo County will be the second county in the state - behind Marion County - to have put in place this public safety practice that is credited with saving 37 people in thecounty during the last year.

"The forward thinking of Sheriff Ewing and many others may be just the thing that saves someone's son or daughter from falling victim to these horribly addictive substances," Southard said. "The overwhelming evidence supports peace officers being trained to administer naloxone and, as a DNP student at Indiana State, Donna Purviance translated the evidence into practice to make a difference in the Wabash Valley."

Writer: Betsy Simon, media relations assistant director, Office of Communications and Marketing, Indiana State University, 812-237-7972 or betsy.simon@indstate.edu

Story Highlights

Indiana State University doctoral student Donna Purviance provided Vigo County Sheriff's Office with training on administering an antidote to reverse the effects of an opiate overdose when time is of the essence.

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