Treating Heroin and Opioid Addiction
Treating Heroin and Opioid Addiction
Governor Wolf and his administration are working to provide real solutions to save lives and help addicted individuals and their families get the treatment they need to live long, productive lives. This guide will connect you with heroin and opioid addiction services.
There are a number of ways to find treatment for those suffering from the disease of addiction.
Call the Hotline 1-800-662-HELP
Are you or someone you know suffering from a prescription drug or heroin problem? We can help. Call 1-800-662-HELP (4357) for information about treatment resources. Your call to 1-800-662-HELP is completely confidential. This hotline, staffed by trained professionals, is available 24 hours a day, seven days a week and is available in both English and Spanish. Call 1-800-662-HELP.
Find a County Single County Authority
There are a wide variety of substance and alcohol abuse services available to Pennsylvanians. Community substance abuse programs are administered through county program offices called Single County Authorities (SCAs.)
The SCA determines a person’s eligibility for service funding, assesses the need for treatment or other services, and makes referrals to appropriate programs to match treatment and/or service needs. More information about county SCAs .
Find your Single County Authority .
Find a Center of Excellence
You can also find treatment by reaching out to a Center of Excellence. Centers of Excellence help ensure that people with opioid-related substance use disorders stay engaged in treatment to receive follow-up care and are supported within their communities. The centers coordinate care for people utilizing a team-based approach that is focused on treating the “whole person,” 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 Care Provider
You can also find help by reaching out directly to care providers near you. A care provider is a place that provides treatment options for those suffering from the disease of addiction.
Find a care provider near you .
What is Naloxone?
Naloxone is a medication that can temporarily reverse an overdose that is caused by an opioid drug (prescription pain medication or heroin). When given during an overdose, naloxone blocks the effects of opioids on the brain and restores breathing within two to eight minutes. Naloxone has been used safely by medical professionals for more than 40 years and has only one function: to reverse the effects of opioids on the brain and respiratory system in order to prevent death. Naloxone has no potential for abuse- a person can’t get high or become addicted to it – and it is safe to use. Naloxone does not work to reverse overdose from other types of substances. Find out how to get Naloxone.
How do I get naloxone?
Family members and friends can access this medication by obtaining a prescription from their family doctor or by using the standing order (a prescription written for the general public, rather than specifically for an individual) issued by Rachel Levine, M.D., PA Physician General. The standing order is kept on file at many pharmacies, or may be downloaded here (PDF) from the Department of Health’s website.
Naloxone prescriptions can be filled at most pharmacies. Although the medication may not be available for same day pick up, it can often be ordered and available within a day or two.
What types of naloxone are available?
Two of the most common ways that naloxone is administered are intranasal (nasal spray) and the auto-injector. Please note, not all pharmacies stock both forms and insurance coverage may 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 particular plan or if your purchase of the medication will be an out-of-pocket cost.
- Intranasal currently 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 epi-pen) and has a recorded message to talk you through giving the medication.
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, and, if so, what form of naloxone is covered, and any cost-sharing amounts that may apply under their policy.
Will Fee-for-Service and the managed care organizations (MCOs) pay for naloxone dispensed under the standing order for Medical Assistance recipients?
Will Medical Assistance require a prescription in order for the pharmacist to fill the naloxone for a Medical Assistance recipient?
Yes, 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 payment 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 MCO 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.
The Magnitude of the Epidemic
This epidemic affects every walk of life. Rich, poor, black, white, young, or old – the opioid crisis is unprejudiced in its reach and devastation. At least ten Pennsylvanians die every day from a drug overdose, with over 3,500 overdose deaths in Pennsylvania in 2015 alone.
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. Below is a brief instructional video that shows how to administer Naloxone.
In addition to watching the video above and talking to your healthcare provider or the pharmacist about how to use naloxone, you are encouraged to take an online training through a Department of Health approved Naloxone resource site: Get Naloxone Now or PA Virtual Training Network .
These easy to understand, brief trainings explain how to recognize the signs and symptoms of an opioid overdose, what to do in the event of an overdose, and instruct on how to give 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.
Could I get in trouble for giving someone naloxone (statutory immunity)?
Good Samaritan: 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 you believed the person was suffering from an opioid overdose (heroin or prescription pain medication) and you called for medical help/911 after giving the medication.
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 he or she is breathing independently.
DO stay with the person and keep him/ her 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 light pinching, he or she 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 drugs that he or she may have swallowed. Choking or inhaling vomit into the lungs can cause a fatal injury.
Where can I get trained to administer naloxone?
For EMS agencies licensed through the Department of Health, and for certified EMS providers, training will be provided through the Department of Health’s Learning Management System.
For law enforcement, fire departments, and other persons not currently licensed by the Department of Health:
- For training of law enforcement officers by law enforcement officers: The PA Virtual Training Network training on naloxone can aid every law enforcement agency and professional in the Commonwealth of Pennsylvania. In order to access PAVTN.net, you must be registered as a member of the site. Typically, officers are registered by their departments to complete courses.
- For friends, family, and all other non-licensed, non-certified fire or EMS agencies and providers: visit getnaloxonenow.org or the PA Virtual Training Network .
- For Chester County Law Enforcement only: Visit Good Fellowship Ambulance and EMS Training Institute .
The Fee-for-Service Program posts information related to billing for naloxone on the DHS Pharmacy Services website . Pharmacies will need to contact each MCO individually to obtain information about their billing procedures.
If you are a pharmacist in Montgomery or Allegheny County, please note that there are also standing orders in your county. In addition, CVS has developed a standing order for their pharmacies nationwide.
You can also take the time to review the Opioid Dispensing Guidelines maintained by the Pennsylvania Department of Health.
If I’m a first responder, what do I need to know for administering naloxone?
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 Emergency Medical Services (EMS) agency. View a sample EMS agreement . 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 .
If I’m a school administrator or official, what resources are available to me?
As outlined in their position statement , the National Association of School Nurses (NASN) believes that the safe and effective management of opioid-related overdose in schools should be incorporated into the school emergency preparedness and response plan.
Soon after, 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 across Pennsylvania.
In order for a public high school to participate in this program and receive a two dose carton of Narcan (naloxone), the public high school must submit an application to the Department of Health .
Drug Take-back Boxes
The Department of Drug and Alcohol Programs, in partnership with the Pennsylvania Commission on Crime and Delinquency (PCCD), the Office of the Attorney General, the National Guard, and the Pennsylvania District Attorneys Association (PDAA), spearheaded a greatly-expanded prescription drug take-back box program to greatly reduce the amount of prescription drugs available for potential misuse and abuse.
Through grants, this program has placed 580 take-back boxes across all 67 counties. In 2016, approximately 124,336 pounds of prescription drugs were collected and destroyed. Since its start in January 2014, approximately 227,857 pounds of prescription drugs have been collected and properly destroyed.
Find a permanent Drug-Take Back Location near you .
Opioid Addiction and the Wolf Administration
The Wolf Administration has made the fight against opioid abuse and heroin use a top priority. Since Governor Wolf took office, he and his administration have worked with the General Assembly to take aggressive steps to combat the disease of addiction, making Pennsylvania a national leader in the fight.
Governor Wolf recently signed a first-of-its-kind statewide disaster declaration to enhance state response, increase access to treatment, and save lives. This disaster declaration will bolster the administration’s existing response by speeding up and expanding access to treatment, improving tools for families, first responders, and others, and further enhancing coordination and data collection to improve state and local response.
Governor Wolf has also provided funding to implement 45 centers of excellence (COE) throughout the commonwealth that will treat nearly 11,000 people with substance use disorder. Governor Wolf also signed legislation that limits the number of opioids a patient can receive at emergency rooms to a seven day supply with no refills, and put the same restriction in place for minors no matter where they get a prescription.
Additional steps the Wolf Administration has taken to combat this crisis include:
– Launching a prescription drug monitoring program that allows prescribers and dispensers to monitor who is obtaining opioids, who prescriptions are being obtained from, and how often they are prescribed.
– Making naloxone available to all Pennsylvanians through a standing order.
– Expanding the use of prescription drug take-back boxes .
– Developing a warm-handoff policy to get those who have overdosed directly into treatment.
– Improving prescribing guidelines for the safe and effective use of opioids, including in sports medicine , for minors , and Pennsylvanians on Medicaid , as well as improving education for medical professionals on opioid prescribing.
– Launching a 24/7 helpline, 1-800-662-HELP, for those who need immediate assistance with drug and alcohol problems.
Every day we lose ten Pennsylvanians to the disease of addiction. This disease does not have compassion, or show regard for status, gender, race, or borders. It affects each and every Pennsylvanian, and threatens entire communities throughout our commonwealth. While this is not the end of our efforts on this crisis, we have made great progress on battling this public health crisis.