M15: Opioid Emergency Response Plan

(3 points)

INTENT

Have a plan in place and resources available in the case of an acute opioid emergency.  

SUMMARY

This WELL feature requires projects to have a plan in place and resources available in case of an individual experiencing an opioid overdose, including emergency response training for occupants and the availability of an opioid emergency kit containing naloxone, a medication that can be used to reverse the life-threatening effects of an opioid overdose.

ISSUE

Drug overdose is not only the leading cause of accidental death in the U.S., but it is also the leading cause of death among Americans under 50 years of age, with overdose from opioids driving the epidemic. From 1999-2014, the rate of deaths from drug overdoses in the U.S. tripled, with over half a million Americans dying due to drug overdoses between 2000-2015. Of these deaths, over 60% involved an opioid. Deaths from opioids (prescription and illicit) have more than quadrupled since 1999, with approximately 91 Americans dying every day due to opioid overdose. Globally in 2010, there were 15.5 million opioid-dependent people, with the highest prevalence found in North America, Western Europe and Australia. Overprescribing, drug misuse and overdose of opioids (including prescription) are impacting the workplace, as workplace injuries are often a gateway to opioid abuse and addiction, with 65-85% of workers receiving narcotic painkillers after a workplace injury. Roughly 21–29% of patients prescribed opioids for chronic pain misuse them, and between 8–12% develop an opioid use disorder. Often, painkillers serve as a gateway for dangerous drug use, with about 80% of people who use heroin having first misused prescription opioids. In 2007, estimates of U.S. societal costs of prescription opioid abuse were $55.7 billion, of which $25.6 billion were workplace costs driven largely by lost earnings due to premature death ($11.2 billion) and reduced compensations or lost employment ($7.9 billion). Given the rapid rise of opioid addiction and death, 2015 estimates indicate the societal cost of prescription and illicit opioid use to be as high as $504 billion, the majority of which is composed of lost earnings due to opioid-related fatality. In 2015 for European countries including France, Germany and the UK, the estimated annual incremental costs to health care from prescription opioid abuse ranged from  €900 to €2551 per patient, with societal costs of prescription abuse likely to extend well beyond the health care costs.

SOLUTIONS

Naloxone is a treatment that can be used to reverse the life-threatening effects of an opioid overdose.^[129] Bystanders trained in recognizing the signs of an opioid overdose and instructed on how to administer naloxone can safely and effectively administer it to an individual in need. Increasing the availability of naloxone is a critical component of reducing opioid-related overdose deaths, with evidence suggesting that when naloxone and overdose education are available to community members, overdose deaths decrease in those communities.

IMPACT

Through emergency rescue kits and proper training, projects can provide a means of reducing the life-threatening impact of an opioid overdose in a way that is safe, cost-effective, and critically important for those at risk.

REQUIREMENTS

Part 1

Provide Opioid Emergency Response Kits and Training (3 points)

Verified by Policy Document

For All Spaces

Opioid response kits:

The following requirements are met:

1. All emergency preparedness or first aid kits include:

   1. Naloxone rescue kits. Projects may choose a single dose nasal spray, a multi-step nasal spray, a single step injection or a multi-step injection.
   2. Instructions for how to prepare and administer naloxone, as well as immediate next steps after administration. 
   3. A list of who on-site has received opioid response training.

2. Protocol is in place for follow-up after an opioid emergency event, including plan for:

   1. Debriefing for those affected.
   2. Immediate replacement of naloxone kit following use.

3. A schedule is in place for checking expiration dates of the kit.

Opioid response training:

The following requirements are met:

1. Employees receive opioid emergency training (in-person by a qualified provider or through video) covering:

   1. General information about opioid use and naloxone.
   2. Recognizing the signs of an overdose and immediate steps to take.
   3. How to safely administer naloxone and what steps to take following administration.

Note: for WELL Core and MFR Certification, projects must make training available to all tenants.

© International WELL Building Institute