NEWS

Kids to be trained in OD reversal drug

A KY group will give kids skills in reversing heroin, opioid overdose.

Terry DeMio
tdemio@enquirer.com
Audrey Stepp, 8, practices administering a life-saving drug to an overdose victim.

In an indication of how entrenched heroin is in families across the nation, a Kentucky group is about to teach children how to reverse an overdose with a life-saving drug.

Audrey Stepp is 8, and she already knows how to do it.

Her big brother, now 25, has struggled with addiction disease her whole life, and their mother leads the community-based Bullitt County Opioid Addiction Team.

"She has heard me all through the day. All through the night, helping people," Jennifer Stepp said. "She said, 'Mom. Why haven't you trained me in naloxone?' "

On Nov. 21, Stepp plans to teach other children how to use the non-narcotic that can restore breathing in those overdosing.

"People will think this is very controversial," Stepp said. "I'm OK with that."

"This is telling them, if you do find a brother, sister, mother, uncle, not breathing, here's something that you can do about it," said Dr. Mina "Mike" Kalfas, a certified addiction expert in Northern Kentucky who has somewhere near 300 heroin-addicted or recovering patients.

"These kids are realizing that drugs can kill them. This is part of an environment where they might find someone dead (due to heroin overdose)," Kalfas said.

Heroin proves a formidable foe in Butler County

A company that makes a naloxone-administering device similar to the Epi-pen has donated kits for Stepp's training. The Evzio kits arrived on Stepp's front porch Wednesday. The FDA approved the treatment in 2014 for reviving those overdosing on heroin or prescription painkillers.

Stepp said she will provide details on her training early in November. It won't be the first time some of the state's children have been trained to use naloxone.

In May 2014, nine kids, age 13 to 17, were trained at Mentoring Plus of Northern Kentucky, a nonprofit that supports high-risk children.

"At Mentoring Plus, we know our kids are living in communities where substance abuse is rampant," said Robin Anderson, program director. The organization provides 10 weeks of lessons about drugs for kids. In May 2014, Jason Merrick, then-chairman of Northern Kentucky People Advocating Recovery, came in and told kids all about drugs and their effects. And he demonstrated the use of naloxone on a dummy.

"For these kids, drug are everywhere –  their neighborhoods, schools, sometimes their homes," Anderson said. "That is their reality, so they need the life skills required to live in and navigate that world: Skills like what to do when their best friend or brother is having an overdose, as most of our kids know someone who has."

Eliza Wheeler, project manager for the pioneering national advocacy organization Harm Reduction Coalition, wasn't aware of other training specifically for children. But she said younger kids with addiction have been trained, and some parents are training their own kids to use naloxone.

Children will use these training kits donated by Evzio, which makes an Epi-pen-like device to administer naloxone. The kits do not have naloxone or needles in them. Parents or guardians will be given the naloxone and needles, said Jennifer Stepp.

Heroin trends up

So how common is it for a child to have a family member hooked on heroin or prescription painkillers?

No one knows, but with the skyrocketing overdose cases – St. Elizabeth Healthcare has had 846 so far this year compared with 745 in all of 2014 – it's evident that many children are feeling the impact of heroin.

A Kentucky Health Issues Poll in 2014 revealed that ​in Northern Kentucky, 26 percent of those surveyed knew someone with a heroin problem. The poll also showed that 28 percent of adults responding said they have family or a friend with problems stemming from prescription pain medicine.

Another sign of heroin's prevalence in children's homes are child protection cases.

Heroin is climbing as a contributing factor in such cases in Ohio. Child Protection Services cases mentioned heroin as a case factor 3,726 times, or 4.9 percent of the 75,430 caseload in 2010. That compares to 6,827, or 8.9 percent, of the 76,283 cases in which heroin was noted as present in 2013. (Job and Family Services cautioned that just because heroin was noted doesn't mean that a parent was using it.)

Kentucky's Department for Community Based Services doesn't specifically track heroin in its Child Protection Services cases. But a spokeswoman said cases in which substance use is a factor in the agency's involvement with children are climbing.

Experts weigh in

Libby Harrison, project manager for needle-exchange service Cincinnati Exchange Project, is supportive of Stepp's endeavor.

"I see nothing but good in this," Harrison said. "Naloxone is so easy to use a kid can do it safely. Doing this also helps a child avoid the lifelong trauma of watching a loved one die."

Dr. Judith Feinberg, an infectious diseases expert and professor of medicine at the University of Cincinnati said she is "sort of pro," as long as children are not traumatized and they know their first step should be to run to an adult, if one is nearby.

Kalfas is steadfast in backing the effort to train kids.

"This is a great message for kids who are 8, 9, 10 years old. Because at 11 years old, these kids are going to be faced with someone who wants them to take drugs," he said. And he added that when naloxone is ingested by someone who hasn't been taking opioids or using heroin, it has no effect.

"The worst thing that can happen is just nothing. So what?"

Jason Merrick trains Cincinnati/Northern Kentucky Airport police how to save a life with a nasally sprayed naloxone.

Kids want to help

Stepp said she "wouldn't dare give a kit" to just any child, and that parents or guardians must attend the training session and approve of it before she'd train a child to use naloxone.

But it appears more children want to help fight the epidemic.

Alexius Rabanus, 17, of Hebron, whose mother now chairs Northern Kentucky People Advocating Recovery, recently asked her mother to be trained.

Kristie Blanchet said she will do it.

Alexius views it this way: "It's important for the community to step up and try to help people. I hate to see people who have the ability to be saved not saved."

Stepp said she expects to have details on the Nov. 21 training by Nov. 1.