The Nevada Health and Human Services Department recently launched an online, Virtual Naloxone Dispensary system to track the state’s supply of naloxone in terms of both funding and distribution, following nearly three years of development.
Naloxone is an anti-opioid overdose drug, credited as a lifesaver in the midst of the opioid epidemic. The Virtual Naloxone Dispensary app was originally launched two years ago, as a means of tracking where and when Nevada purchased and distributed naloxone, allowing utilizing agencies to register through that system. The state can track and chart rates of overdose increases or decreases, and see how that aligns to money spent.
This is particularly important since funds used to purchase naloxone include taxpayer and federally appropriated dollars.
“States have been receiving funding from federal agencies to fight this crisis and much of it is Congressionally appropriated, which means they are not ‘forever dollars’ and the funding comes with a huge amount of scrutiny,” Stephanie Woodard, DHHS Senior Advisor on Behavioral Health for the State of Nevada, said. “Purchasing a bulk amount of naloxone isn’t a great strategy because it has a shelf life of 18 to 24 months. But purchasing small amounts over and over, using one funding stream at a time, is more difficult to monitor, report on and ensure it makes it to those who need it most. We needed a solution that enabled us to track results on the business side (funding, distribution operations, and reporting), and the mission side (saving lives).”
Since the app first launched, Woodard estimates that 11,861 naloxone kits have been dispensed to community-based organizations, along with 4,942 naloxone kits to first responder agencies. The results speak for themselves: in that time, there have been 856 reports of overdose reversals.
“The creative use of technology to support the distribution and monitoring of naloxone has enabled us to be more responsive to the rapidly evolving crisis happening in our communities and ultimately save more lives,” Woodard said.
The app is cloud-based and powered by the Salesforce Platform. Its use allows for DHHS staff to focus their time on other efforts, like training, while at the distribution level, the department has a flexible means of adjusting inventory based on supply and demand needs among community-based organizations. Included in the app is information voluntarily provided by individuals anonymously seeking doses of naloxone, which provides context for administrators trying to determine where and how the drug is being used.
While prescription-induced cases are declining, deaths from heroin and fentanyl have taken their place. Over the course of the decade between Jan. 1, 2010 and May 21, 2020, the Nevada DHHS estimated 4,067 state residents died of opioid overdoses. Of these, 357 died last year before the COVID-19 pandemic that, according to the American Medical Association, has brought a new need for sterile needle services and naloxone, among other things.
“The AMA is greatly concerned by an increasing number of reports from national, state and local media suggesting increases in opioid-related mortality—particularly from illicitly manufactured fentanyl and fentanyl analogs,” the AMA wrote in an August report. “More than 40 states have reported increases in opioid-related mortality as well as ongoing concerns for those with a mental illness or substance use disorder counties and other areas within the state.”
The reason for these increases comes in many forms: limited access to non-urgent medical care, spiking unemployment and economic uncertainty, among them.