Unified Command orders opioid reversal trainings, medication at severe weather shelters

Multnomah County opened severe weather shelters for one night Wednesday, Feb. 14, serving 197 people at four different sites. To prepare our community to save lives impacted by the fentanyl crisis, the Multnomah County Health Department also offered on-site training on administering nasal naloxone (Narcan), the opioid overdose-reversing medication. Thirty-five severe weather shelter staff and volunteers across two sites received the training.

The Health Department, with support from the County’s Department of Community Justice and Portland Fire & Rescue, also delivered over 960 doses of naloxone to the four emergency shelters — enough for two doses for each available severe weather bed. When the shelters closed Thursday morning, each departing shelter guest was offered a naloxone kit, each containing two doses; 82 guests took a kit. No overdoses were reported in the severe weather shelters during the one-night activation.

The County’s Emergency Medical Services team received direction from the Unified Command team leading the multi-jurisdictional 90-day fentanyl emergency response to establish a practice of rapidly deploying naloxone at severe weather shelters that open during an emergency activation. Providing on-site trainings to workers prepares them to respond to opioid-related incidents that could occur in or around the shelters.

“Every dose of naloxone that we can hand out and every person we can train to administer the medication is a potential life saved,” said County Health Officer Dr. Richard Bruno, who also served as a member of the Medical Reserve Corps during the shelter activation.

While the County has traditionally provided an online training on administering naloxone to all shelter workers, the Health Department has begun to provide some in-person trainings at shelters given the continued dangers fentanyl poses to people experiencing homelessness.

Bruno explained that the overdose prevention trainings prepare volunteers to go through a mock overdose response, which included assessing signs of an overdose, calling 9-1-1, and administering naloxone along with breathing resuscitation efforts.

“The dual emergencies of fentanyl and severe weather provided the opportunity to find new pathways to train people on how to respond to an overdose and distribute naloxone to the community,” said Bruno.

The County plans to continue providing in-person naloxone trainings at severe weather shelters, as it gives volunteers and staff opportunities to practice and ask questions, Bruno said.

Although pharmacists in Oregon are able to prescribe and dispense naloxone, anyone can request naloxone at their local retail pharmacy. Most insurance will cover the cost of naloxone for people who request a prescription. Bruno said the GoodRx website also offers discounts for people without insurance who need to pay out-of-pocket for naloxone. People can also apply for a limited supply of free naloxone (intranasal and intramuscular) in the mail from NEXT Distro and Project Red.

Health Officer Dr. Richard Bruno training volunteers to administer Naloxone at a severe weather shelter
Health Officer Dr. Richard Bruno (center) training volunteers to administer Naloxone at a severe weather shelter