Fatal drug overdoses nationwide topped 100,000 in 2021, and ¾ of them came from opioids. Find out how AHF is helping combat the opioid pandemic and what members of the community can do to keep themselves safe.
Another Kind of Epidemic
How AHF is combating the opioid epidemic nationwide
GUEST BIO:
Vahe Lepedjian is an Advanced Practice Pharmacist at AHF’s Hollywood flagship pharmacy.
Maxie Sabackic is the Western Regional Director of Pharmacy Operations, overseeing all pharmacy operations within the AHF pharmacies served out of California, Washington, and Nevada.
CORE TOPICS + DETAILS:
[2:09] - It Starts with a Text
A simple beginning to a transformative shift
One day, Vahe texted Maxie about wanting to do more to combat the opioid pandemic. This simple instance of acting on a positive impulse led to the involvement of sales, public health, advocacy, and managed care departments and AHF partners to offer fentanyl test strips to countless patients and community members. Lives were potentially saved at the very first event where the strips were given out, after two people back to report they had detected deadly fentanyl in a drug sample. A couple days later, 300 units were gone after a single day of San Diego Pride.
[7:54] - A Higher-Risk Patient Base
What AHF patients should know
AHF patients are at a higher risk of contracting HIV due to IV drug use, something that pharmacists and clinicians at AHF have to be mindful of when treating them. If fentanyl is injected, even if its been cut into other drugs, it can be fatal.
[12:04] - Spreading the Word, Spreading the Help
Getting knowledge and test strips nationwide
Maxie emphasizes the end goal of AHF’s efforts— fighting the opioid epidemic. They’ve obtained a grant with the Naloxone Distribution Project which provides free units of Narcan, allowing them to hand them out to the community for free. They hope to spread this service to as many states as possible to make the largest possible impact— all while educating pharmacists on their role.
[15:45] - If You’re Struggling with Addiction
The first step is the most important
If you’re struggling with opioid addiction, know that you can always find support. When you’re ready to make a change, AHF will be there to help you make it. AHF can provide Narcan and the training to know how to use it.
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The AIDS Healthcare Foundation is the world’s largest HIV/AIDS service organization, operating in 45 countries globally. The mission? Providing cutting-edge medicine and advocacy for everyone, regardless of ability to pay.
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Lauren Hogan is the Associate Director of Communications for the AIDS Healthcare Foundation, and has been working in a series of roles with the Foundation since 2016. She’s passionate about increasing the public visibility of AIDS, the Foundation's critical work, and how everyday people can help join the fight to make cutting-edge medicine, treatment, and support available for anyone who needs it.
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Lauren Hogan:
Get unfiltered lessons from our leaders at AHF as we uncover real raw stories of where we came from and where we are going. Join us for an unscripted look at the connections our senior leadership have to our mission, core values, and hot initiatives. AHF is the world's largest HIV/AIDS service organization operating in 45 countries globally, 16 states domestically, including DC and Puerto Rico. Our mission is to provide cutting edge medicine and advocacy regardless of ability to pay. Hello and welcome to the AHFter Hours Podcast. I'm your host, Lauren Hogan, serving as your liaison to take you through this journey to learn more about AIDS Healthcare Foundation. Before we start the show, please make sure to remember to check out the show notes so you can follow along. Now, let's get started.
Well, hello everyone and welcome back to another episode of the AHFter Hours Podcast. As always, I'm your host, Lauren Hogan, and today we are going to be discussing a very important topic. And I have to say I'm very happy that we are addressing this to provide more information to the community at large. So first I want to introduce our guests, Vahe I'm going to go with you first.
Vahe Lepedjian:
So my name is Vahe Lepedjian. I am an advanced practice pharmacist at our Hollywood flagship pharmacy.
Lauren Hogan:
Maxie?
Maxie Sabackic:
Hi, my name is Maxie Sabackic. I am the western regional director of pharmacy operations. I essentially oversee all of the pharmacy operations within AHF pharmacy serviced out of California, Washington State, and Nevada.
Lauren Hogan:
So today we're going to be talking about the opioid epidemic and basically what AHF is doing to combat this, it's progressively gotten worse. We were also seeing that it was affecting some of the clients that we serve, so we realized that we needed to do something to make sure that we were helping the community. So first question is just how did this initiative begin? What was kind of like the backstory behind it? I know I gave a little bit, but if you guys could delve more into that, that would be appreciated.
Vahe Lepedjian:
So it actually just started off as a text from me to Maxie. It was a Saturday afternoon and I was at home and just kind of thinking about how it's getting progressively worse, as you mentioned, and that I wasn't satisfied with what we were doing. I wanted to do more. So I texted Maxie and I asked, "Can we provide fentanyl test strips to all of our patients? And she was super supportive right from the get go and she's like, "Yeah, give me some info and we'll make this happen." And that's pretty much how this whole initiative started. And eventually we went on into Narcan as well.
Maxie Sabackic:
Yeah. And we got a lot of buzz about it in the beginning. Impulse was very involved. We worked very closely with Jose Ramos, he's our national sales director. So it was honestly quite incredible to see how one small idea brought so many people in, and so many people shared the same values as we did from all across the different departments. We saw it with sales, we saw it with public health, we saw it with advocacy, managed care. So we had just a lot of interest, and that really fueled both Vahe and me to see what else we can do. So it wasn't just about providing fentanyl test strips and Narcan to the community, it became something so much bigger. And I think that that really got us involved a lot more with the community. We started bringing it to community events. Vahe, I think the first event, if you want to tell everyone about it, was in San Diego, Vahe.
Vahe Lepedjian:
So soon after we had the fentanyl test strips and the Narcan, I went down to San Diego Pride, and I was at two different events there. One of them was in conjunction with Impulse. And that day, that was the very first event that I did. And we were giving out fentanyl test strips and we gave them out to a few of the attendees. And a few hours later they came back to our booth, two people, and said that they had tested their substances for fentanyl and it came out positive and they threw it away. So just immediately, the very first event, I was just blown away that, oh my gosh, this is already making a difference.
And then a couple days later, I was at San Diego Pride, I had taken 300 units of Narcan with me thinking, "Oh, this will be plenty for both Saturday and Sunday." And that's all that fit in my car. So I couldn't even take anymore if I wanted to. Before the end of day, Saturday, they were already all gone. There's such a huge demand for Narcan and fentanyl test strips, and it feels so good to be able to meet this really big need of our community.
Lauren Hogan:
So how common is opioid dependence in the communities that we serve?
Maxie Sabackic:
So about 16 million Americans each year abuse prescription drugs, about 57% of those misused prescription opioids. So that is a huge percentage. And even in the LGBTQ+ plus community, LGBTQ+ adults are twice as likely than their heterosexual counterparts to use any sort of illicit drugs, and they're twice as likely to have substance abuse disorders. So these are the communities that we at AHF primarily service and help. So this is a big need, especially amongst the patients that we see at our pharmacies. Vahe, I know handles a lot of mental health, substance abuse. We see a lot of that come through in our Hollywood communities. So there's a very big need for this, and we are very proud to be able to start tackling this issue in-house within AHF so that we can broaden and bring it to wherever it is needed.
Vahe Lepedjian:
To add to that, in the last year, over a hundred thousand people died from drug overdose in the United States alone. And three out of four of those were because of opioid overdose. So these numbers are absolutely alarming and it's been getting worse year after year, which is why it's so important to tackle this head on.
Lauren Hogan:
So I want to ask for somebody who may not know, what is an opioid, one. And then part two of that is, what does an opioid overdose potentially look like, so people know.
Vahe Lepedjian:
Yeah, so opioids are a class of medications or substances that are related to the opium poppy plant. And basically what they do is they block your brain from sending pain signals to the rest of your body. What an opioid overdose looks like is going to be shallow breathing or no breathing, or you might hear faint gurgling sounds. You'll have blue lips, blue nail beds, which signify a lack of oxygenation, and the patient will be unresponsive. So you'll yell out their name, no response, or you can do a sternum rub with your knuckles. And if they're unresponsive, then chances are they're experiencing an overdose.
Lauren Hogan:
Maxie, you want to add anything?
Maxie Sabackic:
Yeah, I think one more thing to note would be that if we're looking at the population that we service at AHF, we do have patients who are at a higher risk of contracting HIV due to IV drug use. So illicit opioids such as heroin are commonly injected intravenously. So this is something for us as pharmacists and clinicians that we have to be mindful that this is a risk, and this is something that we have to make sure that we can educate our patients on.
Vahe Lepedjian:
One more distinction that I'd like to mention is that fentanyl, which we talk about so often, there's actually pharmaceutically manufactured fentanyl, and it does have a place in therapy. If someone is at end of life or experiencing cancer, then fentanyl would be very appropriate. But the fentanyl that is popping up and causing all of these overdoses and deaths for the majority of them is illicitly manufactured fentanyl. So it's important to make that distinction. People are making this in their homes or wherever else and lacing it in other substances. So it's just important to know the difference that there's pharmaceutically manufactured fentanyl, which you can get with a prescription for very severe pain cases. And then the fentanyl that we're talking about here is made illegally.
Lauren Hogan:
And with that being said too, I kind of want to go back to the Narcan and fentanyl strips. So how do people access this? Like Vahe, you said you went to San Diego Pride and there was such a high demand for it. So within our organization, if somebody is seeking these fentanyl strips or they want to get Narcan, what's the accessibility like, and how are we distributing them?
Vahe Lepedjian:
That's a great question. So fentanyl test strips is how this all started, as we mentioned. And I did a Google search for them and they are so difficult to find. And I was shocked. I mean, because if you look at the CDC, FDA, and other organizations that are combating opioid overdose, a lot of them recognize the importance of fentanyl test strips as a tool in our fight against the opioid epidemic. But then they're so hard to find. So we actually contracted with a manufacturer based in Canada, and now they're available on AHF marketplace for any AHF employee or department to order. AHF pharmacies are stocking them across the nation. And we updated the policy and procedure so that AHF pharmacy patients can receive 10 free strips per month. And if they're not an AHF pharmacy patient, then we're selling them at our cost of $1 per strips. And anytime we participate in events, we just give them out.
And as far as Narcan goes, Narcan is a prescription medication, so you do need a prescription for it. However, because this opioid epidemic has grown so out of control, many states have signed legislation that circumvents the traditional process of receiving a prescription medication. So for example, here in California, pharmacists can prescribe for it. And we even have a program that I signed AHF up for that any AHF employee, as long as they receive training in California can distribute Narcan. So they're really eliminating the barriers to get this into the hands of people that need it the most. And many states have similar programs, and Maxie and I are working with colleagues across the nation to develop the opioid overdose prevention program nationwide.
Lauren Hogan:
Maxie, you want to add anything?
Maxie Sabackic:
Yeah, one of the biggest things is the end goal here, which is fighting against the opioid epidemic. So I think for us getting grants, we have a grant with the Naloxone Distribution Project in California, and these grants provide us with completely free units of Narcan, which is excellent because that's where we find the partnerships that we can do with Impulse or other community service leaders, and we can just hand them out completely for free. So I think it's very important that we spread this out to as many states as we can, especially the ones where pharmacists themselves can have an impact. Because I really think that pharmacists being that end of the line for patient care, that's where we're going to make the biggest impact. So it's very important that all of our pharmacists are on top of this, we're educated, and that's the goal of the program that we've developed.
Lauren Hogan:
So Maxie, you actually just really alluded to my next question once again. And my question to you was, what role does an AHF pharmacist play in fighting the opioid epidemic? And you kind of talked about that a little bit, but maybe just specify the importance of what this role is.
Maxie Sabackic:
Yeah, absolutely. So pharmacists, we're the drug experts. So we understand drug-drug interactions. We thoroughly check when opioids are prescribed, especially in conjunction with certain HIV regimens. We're checking for appropriateness of drug therapy. We're making sure that we are doing the community of favor when it comes to any narcotics or opioid prescriptions. So every state has a prescription drug monitoring program, PDMP, where we have to upload any opioid containing prescriptions, and we're essentially ensuring safe use of prescription opioids. So that's kind of the standard part of it. But then there's also the education part of it. So pharmacists are in the front line. We are essentially the last, arguably the last person that a patient talks to before they leave the clinic, before they leave the door. So that is where we can have the biggest impact in making sure that anybody who gets any sort of a prescription opioid is using it correctly and safely, and on top of that, understands what they're taking.
Sometimes it is needed to take it regularly, but other times it's really just something that's temporary, and it's up to us as the clinicians who see the patient to make sure that they are using it as appropriately as possible. So that is where pharmacists can really get involved with the dispensing, and with any consultations that are surrounding these treatments.
Lauren Hogan:
So we are pretty much at time. It goes by so fast, and I think this is such an important conversation. But I do want to ask too, it's kind of a two part question. One is that, those who may be suffering from opioid dependency, what can you do to help them? I know looking in the past when it comes to those who use needles in HIV, we provide fresh needles for them. What can we do for those who might be experiencing opioid dependency? And second part to that is how can people get involved?
Vahe Lepedjian:
So when it comes to people that are struggling with opioid use disorder, the best thing we can do is just provide consistent support. It's very challenging because any big decisions that are made that impact the person's life have to be made by the person themselves. No matter how badly we want it, no matter how much we try a reason with them, or how much love and support we provide, if they don't want to make any changes, unfortunately no changes are going to be made. So I think our best mode of action is to continue just to provide consistent support, make sure that they have the knowledge around everything, make sure that they have Narcan at home and their loved ones know how to use it, and just to be a source of love and support.
Lauren Hogan:
And then how can people get involved to help with this epidemic that we're currently experiencing?
Vahe Lepedjian:
So the response to this has been so incredible. People from so many different departments have expressed interest, and just they've dived in with us. And it's been such a beautiful organic grassroots campaign that was developed, and now it's gotten so big that we need to enlist even more people to keep this thing going. So for those that live in California, definitely get certified so that you can distribute Narcan, email me and I'll walk you through how to do that. And for those in other states, look at what laws that your states allow. And this is something that's really growing nationwide in terms of legislation, and they're really removing the barriers to access Narcan. So find out what is possible in your state and take the lead, make it happen. I love the saying, if it's to be, it's up to me. So adopt that attitude and let's just keep this going.
Lauren Hogan:
Maxie?
Maxie Sabackic:
Yeah. And another thing is all of our AHF pharmacies have access to get fentanyl test strips and Narcan. So if you are looking to get more involved, connect with your local pharmacy manager and we can make it happen. We have marketing materials available that look incredible, shout out to marketing. We have these really lovely and very to the point educational pamphlets that we worked on with our strategic response team that are just above creative. And I think it really shows how much love and dedication we're pouring into this because we've very quickly come together to make the promotional material, make everything available, get the grants so that we can really roll this out and be ready.
So if you're interested in ever hosting an event in your region, we do actually have an email that comes directly to us. It's preventoverdose@aidshealth.org. If you email that email, we'll be able to set you guys up with anything that you need. We can get you access to more supply, we can get you people to help for your community events. We also welcome ideas. So if you can think of any interesting or incredible idea that you really want to try to implement, bring them to us. We'll make it happen. And if it's successful, we'll do it everywhere. Because at the end of the day, the goal is to fight the fight against the opioid epidemic. And that is really where AHF is starting to make a difference.
Vahe Lepedjian:
And also, all of the information that we have about this program is available on our website that our lovely marketing team created for us. It is www.prevent-overdose.com.
Lauren Hogan:
Well, I have to say thank you to the both of you for really leading the charge on this and understanding what the community needed, and just making it happen so quickly. I'm glad that it's successful, and I'm just happy that we're continuing to serve the community at large. So thank you guys so much for the work that you're doing. It's quite amazing.
Vahe Lepedjian:
Thank you, Lauren.
Maxie Sabackic:
Thank you for having us.
Lauren Hogan:
So thank you guys for tuning in, and we will see you next time. Thank you so much for joining us. If you enjoyed this episode and you'd like to help support the show, please subscribe, share it with your friends, like, post about it on social media, or leave a rating and review. Follow us on Instagram @ahfterhours, and see you next time.