FDS Insight Magazine Jun - Sep 2023

44 ‘By the time the patient comes to the hospital, naloxone is reviving the breathing and our drug is beginning to remove it from the body so that it does not have the long-term effects,’ Shetty said. ‘We see our drug being used in the continuum of care.’ Record number of overdose fatalities Detection of multiple drugs in the body has escalated as drug overdose deaths have more than doubled in just a few years. A report published Feb. 21 by Millennium Health found positive drug tests for fentanyl jumped 146% between 2019 and 2022. Out of those positive tests, more than 83% of them also contained additional drugs, including heroin, prescription opioids, methamphetamine, or cocaine. There are overdose-reversal medications for sedatives like benzodiazepines, but they carry the risk of seizures. Holly Geyer, an addiction medicine physician and a hospital medicine physician at the Mayo Clinic in Phoenix, said if someone is chronically dependent on sedatives, providers will support those patients through the withdrawal process as opposed to reversing the over-sedation process because of the toxicities. ‘We can actually induce more problems than we fix outside of use of naloxone,’ Geyer said. Having safe options for non-opioid overdose reversal such as benzodiazepines or the sedative xylazine is important, Wakeman said. ‘If we had similar medications that didn’t have side effects and have risks like seizure and could be given in the field, I think they would be used and would be really helpful.’ However, some doctors and harm- reduction specialists question whether new drugs are the right path to pursue, or whether it’s better to focus efforts on getting existing overdose reversal medications like naloxone into the hands of people who can use them to save lives. ‘The scientists have done their part. What we need are social service programs and medical clinics to serve people who use drugs to get the overdose reversal medication into the hands of people who could use it,’ along with low-cost options, Mary Sylla, director of overdose prevention policy and strategy for the Harm Reduction Coalition, said. Timothy W. Westlake, an emergency room physician in Oconomowoc, Wis., about 35 miles from Milwaukee, said there is not ‘a lot of utility’ for non- opioid reversal agents, as they usually treat those patients with supportive care. ‘It’s OK to just wait for it to where it wears itself out in the body to metabolize it and break it down. There’s not a threat to having the drugs still circulating in the body like there is with opiates as far as causing respiratory suppression,’ Westlake said. ‘I don’t know that there’s a need for reversal agents in the same way.’ But Shetty recalled how staff at a San Diego hospital told him four emergency nurses had been physically assaulted by a patient who had taken methamphetamine. ‘They would love