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Opioids: Saving One Life

Dispatch from Stigler: Far south of Muskogee, and further east of Oklahoma City, one small town recently confronted the Opioid Epidemic on a very personal level. Nurses at the HRSA-supported Stigler Health and Wellness Center knew just what to do.
Dispatch from Stigler: Far south of Muskogee, and further east of Oklahoma City, one small town recently confronted the Opioid Epidemic on a very personal level. Nurses at the HRSA-supported Stigler Health and Wellness Center knew just what to do.

 

In the tiny hamlet of Stigler, Okla. – population, 3,000 – no one at the local health center was quite sure what might happen when they offered a recent community training session on how to use the lifesaving opioid-reversal drug naloxone.

"We expected, maybe, 20 to 30 people to show up," said staff pharmacist Sarah Byrum. "But it was more like 120. It just sort of blossomed … we handed out a lot of Narcan kits."

Only recently trained themselves under a grant from HRSA's Federal Office of Rural Health Policy, the staff of the Stigler Health and Wellness Center were overwhelmed and heartened by the Jan. 31 turnout in this remote, 2.7-square-mile, prairie preserve well south of Muskogee – where the opioid epidemic was still largely unseen and unspoken.

Three weeks later, a 54-year-old patient walked into their waiting room, fell to the floor and went into a seizure. On her way down, she dropped a shopping bag full of prescription medications at the in-take counter.

The Stigler staff flew into action, immediately recognizing the telltale signs of an acute overdose.

In the nick of time: (Left to Right) Sarah Byrum, Cynthia Del Rosario, Donna Horton and Kristina Lyons converged on a stricken patient in their health center -- just weeks after receiving training on how to administer the life-saving, opioid-reversal drug naloxone.
In the nick of time: (Left to Right) Sarah Byrum, Cynthia Del Rosario, Donna Horton and Kristina Lyons converged on a stricken patient in their health center -- just weeks after receiving training on how to administer the life-saving, opioid-reversal drug naloxone.

 

Well-known to the Stigler nurses, the patient had received routine care and instructions on medication management six or seven times during the previous 8 months. Nurse Practitioner Kris Lyons was expecting a similarly uneventful encounter that day.

Lyons and fellow NP Donna Horton immediately launched into the standard "STAT" protocol in urgent situations at the health center.

"When I got in the room, she was seizing," Lyons recalled.

"Her eyes were rolled back in her head and her mouth was open," recalled Horton, who checked the patient's pulse and respiration.

A nursing student quickly opened the abandoned bag of drugs and found it contained multiple bottles of mental health medications – apparently prescribed by various doctors.

"That's when I asked the nurse to get me the Narcan,"Horton said, applying the lessons she so recently learned.

"Because of that training," said Theresa Huggins, CEO of the Wellness Center for the past 14 years, "(We) knew the signs and symptoms."

Narcan trainees are taught not to hesitate in administering an additional dose of Naloxone if one isn't enough, because "it is not going to hurt them if it is not an overdose," Huggins said.

As the patient – a mother of two grown children -- stabilized, staff set an IV and summoned an ambulance to transport her to a local emergency room, where she spent six days as an in-patient.

Since then, hers has been "a good outcome," health center staff agreed, as the patient was back at the clinic for her regularly scheduled March 14 appointment.

Lives in the balance: (from left) Mike Blodgett, who heads FORHP's overdose reversal program -- which provides funds for rural communities to buy naloxone and train emergency responders -- met with Stigler CEO Teresa Huggins, CFO Stephanie Long and Board Member Wanda Leathers on March 29. Every day,
Lives in the balance: (from left) Mike Blodgett, who heads FORHP's overdose reversal program -- which provides funds for rural communities to buy naloxone and train emergency responders -- met with Stigler CEO Teresa Huggins, CFO Stephanie Long and Board Member Wanda Leathers on March 29. Every day, 116 people die from opioid overdoses nationwide, and the CDC reports that drug-related death rates are now 45 percent higher in rural communities than in urban areas, which have far more treatment centers. "What happened in Stigler is happening in small towns all across the country," Blodgett said. "What it shows is just how great the need is. If the HRSA-funded training hadn't come when it did, we might have seen a very different outcome."

 

Since then, public understanding of opioids has continued to increase in Stigler, a ranching and farming town in the southeastern part of the state, where gas exploration is a growing industry.

That's reflected in the turnout at the three Naloxone trainings conducted since the Wellness Center received $250,000 in grant funds through HRSA's Rural Health Opioid Program last fall. So far, the agency has awarded $25.5 million to more than 120 organizations across the country.  

The trainings have drawn a cross-section of local residents -- from nurses to school officials, church groups, local addiction counselors, managers at the Stigler Wal-Mart and regular folks who may have been suffering in silence with a friend or loved one. Another four are planned in the region. Narcan kits are distributed at each. When all the scheduled trainings have been completed, CEO Huggins estimates that close to 1,000 injectors will have been distributed.

"All of our communities have really stepped up and done their part to protect" friends and neighbors, Byrum said. "They are preparing themselves, in the event something does happen."

As attitudes have evolved, so too has public policy shifted. All Oklahoma pharmacists are now licensed and authorized to prescribe Naloxone – a growing practice nationwide. These changes are taking place as CDC figures show drug overdose mortality rates in southeast Oklahoma to be among the state's highest, Byrum said.

Added Horton, a nurse practitioner for 30 years, two recent overdose deaths involving young people have underscored the quiet crisis in one rural town. She now meets with local law enforcement officials monthly to discuss the epidemic. "I knew I wanted to get involved," she said, noting that the health center has added telehealth and integrated care specialists to identify patients who may need help.

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Date Last Reviewed:  May 2019