Not everyone will overcome their addiction to opioids on the first attempt.1 In just a few minutes you can have an important discussion about the factors that may put someone at risk for an opioid overdose. It may be a difficult conversation to have, but it can make all the difference.
Best practices to consider for having a 2-minute conversation with your patients
You’ve reached an important milestone in your recovery. Let’s talk about strategies as you transition to the sober living home. Tell me, do you know anyone who overdosed?
Unfortunately, I recently had a patient relapse and overdose. He had just completed opioid withdrawal treatment, so his tolerance wasn’t what it had been. When he used at the same level before he went into recovery, he couldn’t tolerate it and overdosed. Luckily, he was revived and is back in treatment.
Initiate the discussion
- Asking the patient if he/she knows someone who overdosed helps reassure the patient you are not questioning their ability or commitment
- Encourage your patient to always bring their care partner to appointments or sessions
Whether it’s you or others in recovery around you, it’s important to remember that circumstances in your everyday life can be triggers for relapse. As I think about you moving into the sober living home, I’m glad you’ll be around others going through recovery who can provide support and perspective. However, I’m also mindful the home is in your old neighborhood and it is likely you will run into your old crowd. This can create a pull to the places you used to frequent when you used opioids.
I want to help you and the folks around you manage the risk. One way to do that is to make sure you have take-home naloxone on hand. As you likely know, naloxone is used to reverse an opioid overdose. By having it on hand, you can help save the life of someone around you, or if something were to happen to you, and you overdosed, someone could help you. That’s also why it’s so important that you keep it in an easily accessible place so you can get to it quickly and you let those around you know where it is. Can we complete the paperwork to get you take-home naloxone?
Reinforce relapse is part of the recovery process
- Remind them risk factors are diverse and vary from patient to patient depending on their life circumstances
- Consider patient-specific factors such as opioid used, family relationships, home life, support systems, state regulations concerning take-home naloxone, etc.
Although there are different take-home naloxone options available, I prescribed EVZIO for you. EVZIO is designed to be easy to use. It has voice and visual guidance to help nonmedically trained people administer naloxone during an opioid overdose. EVZIO is not a substitute for emergency medical care. It is important to seek emergency medical attention after use. Here is a Trainer for EVZIO. I want you to spend a couple of moments using it so you can see how it works and then we can discuss any questions you have. And remember to tell those around you that you have EVZIO and where you keep it so they too can get to it quickly if needed.
EVZIO is an important part of my treatment protocol. We will ask you about your EVZIO prescription at every visit to ensure your prescription was filled and you have it on hand.
Educate on EVZIO and take-home naloxone
- Keep EVZIO/naloxone on your desk or table as a reminder to discuss it with your patients
- Have your office staff help train patients and care partners on EVZIO, as well as provide them with educational materials
- Document the conversation and make a note to discuss EVZIO with them at every appointment, and check to make sure their prescription is not expired
Help your patients be EVZIO-Ready
Seek emergency medical assistance immediately after use. The use of EVZIO may result in symptoms of acute opioid withdrawal.
- Substance Abuse and Mental Health Administration. TIP 63: Medications for opioid use disorder. https://store.samhsa.gov/system/files/sma18-5063exsumm.pdf. Accessed January 28, 2019.