VA to Add Naloxone to AED Cabinets

"The overwhelming evidence is that it just saves lives," said Dr. Ryan Vega with the VA's Center for Innovation. "We're hopeful that other health systems take notice and think about doing the same."

Veteran Affairs, building on a project that began in Boston, aims to add naloxone kits to the automated external defibrillator (AED) cabinets in its buildings across the country. Naloxone, also known as Narcan, can be used to reverse opioid overdoses.

After a 2015 incident at the Boston Veteran Affairs building in which it took more than 10 minutes for paramedics to arrive to administer naloxone to an overdose victim, Boston VA patient safety Manager Pam Bellino wanted to find a way to have the overdose reversal drug on hand. "That was the tipping point for us to say, 'We need to get this naloxone immediately available, without locking it up,'" she said, according to an Oct. 3 Kaiser Health News report.

Bellino thought the easiest way to make the medication readily available would be to add it to the AED cabinets already in place on the walls of VA cafeterias, gyms, warehouses, clinic waiting rooms, and some rehab housing.

Naloxone is not harmful if given to someone who hasn't overdosed, but because it is a prescription drug, the VA had to work with the accrediting agency, The Joint Commission, to approve guidelines for the AED naloxone project. The Joint Commission requires the AED cabinets to be sealed and alarmed so staff can tell if they've been opened. The cabinets also must be checked daily and refilled when the naloxone kits expire.

The Joint Commission did not allow the VA to put the words "Narcan" or "naloxone" on the cabinet doors to let the public know that the kits contained the drug, but the commission did allow the VA to add the letter
"N".

The AED naloxone project will expand nationwide in December, with VA hospitals across the United States adding the drug to their AED cabinets. "The overwhelming evidence is that it just saves lives," said Dr. Ryan Vega with the VA's Center for Innovation. "We're hopeful that other health systems take notice and think about doing the same."

According to Amy Bohnert, an investigator with the VA Ann Arbor Healthcare System, veterans have nearly twice the risk of overdose compared to civilians. She said she's heard criticism that easy access to naloxone allows drug users to feel a false sense of safety, but she disagrees. "Think of this as you would a seat belt or an air bag," she said. "It by no means fixes the problem, but what it does is save a life."

Bellino said she hopes that manufacturers of AED will start selling cabinets that meet the new hospital accreditation standards. According to the Boston VA, 132 lives have been saved with all three parts of its naloxone project: training veterans at high risk, equipping police with the drug, and providing naloxone in the AED cabinets.

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