Emergency Overdose Treatment

The opioid epidemic has been raging for several years and the state of Minnesota has made various attempts to respond. A new piece of legislation from the most recent session addresses certain behavioral providers and the at risk population they serve. Beginning August 1, 2023, programs will need to have a supply of opiate antagonists to hopefully decrease deaths related to emergency opioid overdoses. 

 

What does the new law require?

License holders of certain DHS licenses will be required to have a supply of opiate antagonists, such as naloxone hydrochloride, available to treat emergency opioid overdoses. Programs must have a written standing order protocol from either a licensed physician, licensed physician assistant, or licensed advanced practice registered nurse. The standing order will allow the license holder to keep the supply of opiate antagonists on site. All staff of the license holder must be trained in opiate antagonist administration, that is specific to the type of opiate antagonist that the program will be using, which may include intranasal administration, intramuscular injection, or both. 

 

Which providers are included in this new law?

The following DHS licensed programs are included:

• Substance use disorder treatment programs (Minn. Stat. 245G);
• Children’s residential facility substance use disorder treatment programs (Minn. Rules 2960.0010, 2960.0220, and 2960.0430);
• Detox programs (Minn. Rules 9530.6510-9530.6590);
• Withdrawal management programs (Minn. Stat. 245F); and
• Intensive residential treatment services, or IRTS, (Minn. Stat. 245I and 245I.23).

 

Should staff persons who serve clients in the community have the opiate antagonists on them?

Yes. If program staff persons serve clients out in the community, they should have the opiate antagonists on them after they have received training on how to administer them.

 

If the prescription is written for the program, what is the liability in providing staff with opiate antagonists? 

Health care staff persons do not need the prescription to be written for them or for any of the clients they serve as there is legal immunity for possessing and administering opiate antagonists without a prescription. Programs only have a responsibility to train their staff persons in opiate antagonist administration. 

 

Where can programs get a standing order prescription so they can obtain opiate antagonists?

There are a few ways programs can go about doing this:

1. Contact a physician, physician assistant, or advanced practice registered nurse and ask them to write a standing order prescription for the program. Someone who works in the behavioral health care realm may have more experience in addiction medicine and be willing to do this. 
2. Contact a pharmacy in the same county or area as the program and inquire about the pharmacist writing a standing order prescription. Statewide protocol allows pharmacists to dispense opiate antagonists to certain people or programs. Click Here for a list of pharmacies that participate in the Naloxone protocol with the Minnesota Department of Health.  Click here for a naloxone finder website, Know the Dangers.
3. Contact one of the organizations below to see if they will assist in supplying the program:

• Steve Rummler Hope Network  http://steverummlerhopenetwork.org/
• Rural AIDS Action Network  https://raan.org/about-us
• Red Door Clinic  https://www.reddoorclinic.org/ 
• Indigenous People Task Force http://indigenouspeoplestf.org/ 
• LSS Street Works Collaborative https://www.streetworksmn.org/ 

 

Who does the training for opiate antagonist administration?

Below are some resources for organizations that offer training:

• The Steve Rummler Hope Network http://steverummlerhopenetwork.org/ 
• The National Coalition Against Prescription Drug Abuse NCAPDA.org 

Below is a sample policy programs can use and implement to remain in compliance with this new law.  

 

Emergency Overdose Treatment Policy

Program will keep a supply of opiate antagonists, such as naloxone hydrochloride, on site and to give to all staff persons to keep with them when they are providing direct services to clients. Opiate antagonists are to be used when a client is showing signs of opioid overdose. A licensed physician, physician assistant, advanced practice nurse, participating pharmacist, or a community based program will write a standing order prescription for the opiate antagonists or provide opiate antagonist kits, that can be refilled or resupplied when program is in need.  

All staff persons will receive training on how to administer the opiate antagonist, specific to the type Program will be supplying, which may include intranasal administration, intramuscular injection, or both. All staff persons will complete training and receive a certificate of completion prior to receiving a supply of opiate antagonists. 

It is in the best interests of the individual in an overdose emergency situation to receive an opiate antagonist, therefore, health care staff persons do not need for the order to be written specifically for them, or for any of the clients they serve, as legal immunity applies when a person possesses or administers an opiate antagonist that is not prescribed to them. 

**Program Name**

Policy Approved By: _______________________________________________

Signature

Last Revision: _______________________________ 

Date