Treating Heroin and Opioid Use Disorder

Treating Heroin and Opioid Use Disorder




Every day, we lose 10 Pennsylvanians to substance use disorder. This disease affects each and every Pennsylvanian and threatens entire communities in our commonwealth. 

Help is available for Pennsylvanians battling substance use disorder and their loved ones. This guide will connect you to the resources you need to live a long and productive life.

Need treatment? Call the Get Help Now Hotline at 1-800-662-4357 to speak with a professional.

Take Action

Get Treatment

Call the hotline

Are you or is someone you know suffering from substance use disorder? We can help. Call 1-800-662-HELP (4357) for information about treatment resources. Your call is confidential. The hotline is staffed by trained professionals 24 hours a day, seven days a week, and is available in both English and Spanish.

 

Find a County Single County Authority

Local treatment programs are administered through county drug and alcohol offices called Single County Authorities. These programs can help with treatment funding, assess the need for treatment or other services, and make referrals to match treatment and/or service needs. 

Find your Single County Authority.

 

Find a Center of Excellence

Centers of Excellence, created by the Wolf Administration in 2016, are designed to get more people into treatment and keep them engaged in their care. The centers coordinate care for people with Medicaid. Treatment is team-based and “whole person” focused, with the explicit goal of integrating behavioral health and primary care. More information about Centers of Excellence.

To find a Center of Excellence near you, view the map below:

 

Find a treatment provider

You also can reach out directly to treatment providers near you. A treatment provider or facility provides treatment options for those suffering from substance use disorder.

Find a treatment provider near you.

Get Naloxone

Free distribution dates

Naloxone kits will be distributed for free on:

  • Wednesday, Sept. 25 (9 a.m. to 3 p.m.)

See the map below or download a list of naloxone distribution locations.

How do I get naloxone?

Family members and friends can access naloxone by:

  • Obtaining a prescription from their family doctor
  • Using the standing order issued by Rachel Levine, M.D., Secretary of Health and PA Physician General. A standing order is a prescription written for the general public, rather than specifically for an individual.

To use the standing order, print it and take it with you to the pharmacy or have the digital version on your phone. Download the standing order from the Department of Health (PDF).

If you are unable to print it or use the digital version, the standing order is kept on file at many pharmacies. If a pharmacy does not have it on file, they may have the ability to look it up.

Naloxone prescriptions can be filled at most pharmacies. Although the medication might not be available for same-day pickup, it often can be ordered and available within a day or two.

What types of naloxone are available?

Two of the most common ways naloxone is administered are intranasal (nasal spray) and auto-injector.

  • Intranasal has two pieces that are easily assembled: a prefilled medication tube and an atomization device, which is sold separately. The nasal piece may not be stocked at your local pharmacy; however, they may assist in ordering it. Additionally, the nasal atomization device can be ordered from a number of medical supply companies without a prescription.
  • The auto-injector comes in a manufactured dosage form (similar to an EpiPen) and has a recorded message to talk you through giving the medication.

Please note, not all pharmacies have both forms, and insurance coverage can vary depending on the type of medication being purchased and each individual insurance plan. Check your insurance prescription formulary or call your benefits manager to determine if the medication is covered by your plan or if your purchase will be an out-of-pocket cost.

Does insurance cover naloxone?

Insurance companies vary in how they cover naloxone and other drugs used to treat an opioid overdose. Prior to having a naloxone prescription filled with a pharmacy, consumers are encouraged to check with their insurance carriers to find out whether naloxone is a covered benefit under their policy. If so, check to see what form of naloxone is covered, and any cost-sharing amounts that may apply under the policy.

Will fee-for-service and managed care organizations pay for naloxone dispensed under the standing order for Medical Assistance recipients?

Yes.

Will Medical Assistance require a prescription in order for the pharmacist to fill the naloxone for a Medical Assistance recipient?

Per 55 Pa Code, Chapter 1121 — Pharmaceutical Services — §1121.52, pharmacists can treat the standing order as a verbal order for Medical Assistance recipients.

Can a person other than the eligible Medical Assistance recipient (friend or family member) obtain the naloxone at the pharmacy on the recipient's behalf? Will the Medical Assistance Program make payment?

PA Medical Assistance will make payments for naloxone for the eligible Medical Assistance recipient.

Is prior authorization required by Medical Assistance for any of the naloxone products or supplies?

The Evzio auto-injector is covered by Medical Assistance but requires prior authorization. Generic naloxone is covered without the need for prior authorization.

Where can a pharmacy access Medical Assistance billing procedures for naloxone and the nasal actuator?

The fee-for-service program will post information related to billing for naloxone on the DHS Pharmacy Services website. Pharmacies will need to contact each managed care organization individually to obtain information about their billing procedures.

Will copays apply for the naloxone products and nasal actuator?

No, the Medical Assistance copay will not apply.

Is there a limit to the number of times that a Medical Assistance recipient can get naloxone?

No, there is no limit to the number of fills that can be obtained.

How to Use Naloxone

How do I administer naloxone?

When given during an overdose, naloxone blocks the effects of opioids on the brain and restores breathing within two to eight minutes. Here’s how to administer naloxone nasal spray:

Front and back of nasal spray packaging


STEP 1: Peel back the package to remove the device.

Hold plunger up to patient's nose and push.


STEP 2: Hold the device with your thumb on the bottom of the plunger and two fingers on the nozzle.
STEP 3: Place and hold the tip of the nozzle in either nostril, until your fingers touch the bottom of the patient’s nose.
STEP 4: Lastly, press the plunger firmly to release the dose into the patient’s nose.

Want to know more about how to administer naloxone?

While it is not necessary to obtain a training certificate in order to purchase naloxone, learning these important details will help you respond properly in the event of an overdose and also meet the immunity requirements of PA Act 139.

Can I get in trouble for giving someone naloxone?

Through the ‘Good Samaritan’ provision of Act 139, friends, loved ones, and bystanders are encouraged to call 911 for emergency medical services in the event an overdose is witnessed and to stay with the individual until help arrives. The provision offers certain criminal and civil protections to the caller so that they cannot get in trouble for being present, witnessing, and reporting an overdose.

Administering Naloxone: Physicians are permitted to write third-party prescriptions for naloxone, and you are immune from liability for giving naloxone if: 1) you believed the person was suffering from an opioid overdose (heroin or prescription pain medication) and 2) you called for medical help/911 after giving the medication.

What do I do if I am a first responder at the scene of an overdose?

Please view the First Responder Toolkit for details about each of these steps, and review Act 139 training for first responders.

What are the do's and don'ts in responding to an opioid overdose?

DO support the person’s breathing by administering oxygen or performing rescue breathing.
DO administer naloxone.
✓ DO put the person in the “recovery position” — on their side — if they are breathing independently.
DO stay with the person and keep them warm.
DON’T slap or try to forcefully stimulate the person — it will only cause further injury. If you are unable to wake the person by shouting, rubbing your knuckles on the sternum (center of the chest or rib cage), or lightly pinching them, they may be unconscious.
DON’T put the person into a cold bath or shower. This increases the risk of falling, drowning, or going into shock.
DON’T inject the person with any substance (salt water, milk, “speed,” heroin, etc.). The only safe and appropriate treatment is naloxone.
DON’T try to make the person vomit the drugs they may have swallowed. Choking or inhaling vomit into the lungs can cause a fatal injury.

Where can I get trained to administer naloxone?

Dispensing Naloxone

The fee-for-service program posts information related to billing for naloxone on the DHS Pharmacy Services website. Pharmacies will need to contact each managed care organization to obtain information about their billing procedures.

If you are a pharmacist in Montgomery or Allegheny counties, please note that there also are standing orders in your county. In addition, CVS has developed a standing order for their pharmacies nationwide.

Review the Opioid Dispensing Guidelines maintained by the Pennsylvania Department of Health.

I'm a first responder. What do I need to know?

The enactment of Act 139 allows first responder organizations to obtain, carry, and administer naloxone in the event of an opioid overdose. According to Act 139, a non-licensed first responder agency must first enter into a written agreement with an EMS agency. This written agreement is valid only under the consent of the EMS Medical Director or another physician. View the Standing Order Naloxone Prescription for PA Firefighters and Law Enforcement Officers.

The Naloxone for First Responders program is designed to provide naloxone to first responders at no cost.

I’m a school administrator/official. What resources are available to me?

The National Association of School Nurses believes that the safe and effective management of opioid-related overdose in schools should be incorporated into the school emergency preparedness and response plan.

Governor Wolf and the Pennsylvania Departments of Health, Education, State, and Drug and Alcohol Programs announced a statewide partnership with Adapt Pharma to provide a free, two-dose carton of Narcan (naloxone hydrochloride) nasal spray to public high schools in Pennsylvania.

Though the program is no longer accepting new applications, enrolled schools can reorder naloxone from Adapt Pharma.

Drug Take-back Boxes

The Department of Drug and Alcohol Programs, in partnership with the Pennsylvania Commission on Crime and Delinquency, the Office of the Attorney General, the National Guard, and the Pennsylvania District Attorneys Association, spearheaded an expanded prescription drug take-back box program to reduce the amount of prescription drugs available for potential misuse and abuse.

Through grants, this program has placed hundreds of take-back boxes across all 67 counties. Since its start in January 2014, hundreds of tons of prescription drugs have been collected and safely discarded.

Find a drug-take back location near you.

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