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54% of Michigan pharmacies
give Narcan unprescribed,
UMich study finds
54% of pharmacies in Michigan
offer naloxone without a prescription,
according to a recent study by University
of Michigan researchers. This study,
published in The American Journal
of Drug and Alcohol Abuse, surveyed
pharmacies in eight counties across
Michigan to study naloxone availability.
Naloxone, also known as Narcan,
is a drug that can be used to reverse an
opioid overdose. Common signs that
an individual might be experiencing
an overdose include small pupils,
slow breathing, limp body and losing
consciousness. In situations when it is
unclear if someone is experiencing an
overdose, naloxone can be administered
as a nasal spray or an injectable without
risk.
In 2016, the state of Michigan
passed a standing order that allows
any pharmacist to dispense naloxone
without a prescription. This policy
permits concerned family, friends or
community members to obtain naloxone
preventatively, but not all pharmacies
participate.
Derek Frasure, Rackham student and
policy director of Students for Sensible
Drug Policy, spoke with The Michigan
Daily about the importance of increasing
the number of pharmacies dispensing
naloxone. As of 2017, approximately 34%
of Michigan pharmacies are registered
to dispense naloxone under the standing
order.
“The idea is that we want as many
people to have naloxone as possible
so that whenever an overdose occurs,
somebody is around in order to reverse
it,” Frasure said.
Dr. Chin Hwa (Gina) Dahlem, a
clinical associate professor at the U-M
School of Nursing and a family nurse
practitioner at the Delonis Center, shared
her ideas as to why the percentage
of pharmacies in Michigan offering
naloxone may be so low.
“One piece could be the lack of
awareness, but also there is a cost for
pharmacies to stock medications,”
Dahlem said. “So if there is a financial
cost for the pharmacy to stock the
medication, but no one is accessing
or requesting the medication, they
are eating up the cost. That could be a
possible financial barrier.”
Dahlem also said finances can be a
barrier for patients to obtain naloxone.
“The way it works is that once
you go to the pharmacy, they will bill
your insurance to obtain naloxone,
and whatever your copay is for
that medication is what you pay for
naloxone,” Dahlem said. “Depending
on the insurance and their copays, there
could still be a barrier, especially with the
copay, which I have seen ranging from
zero to $149. However, if you do have
Medicaid, it is free.”
In addition to the low percentage of
Michigan pharmacies offering naloxone,
patients may face other non-financial
barriers when trying to obtain the
drug. Dr. Keith Kocher, an emergency
physician at Michigan Medicine, said the
stigma around naloxone can play a large
role in limiting access.
“How we decide to care for these
kinds of patients at risk of overdose is
layered with a lot of stigma,” Kocher said.
“We make assumptions about them,
oftentimes really terrible assumptions.
And that ends up deprioritizing the kinds
of medical care and decisions that we
should be offering for patients.”
Wearable devices can track
COVID-19 disease progression,
UMich study finds
Consumer-grade
wearable
devices, such as smartwatches, can
monitor
COVID-19
progression
remotely through an analysis of
heart rate data, according to a
new University of Michigan study
published on April 19.
The study breaks down heart
rate data into different physiological
features, including basal heart rate
— also referred to as resting heart
rate — and heart rate response to
physical activity. The study also
examines the circadian rhythm in
heart rate by analyzing a circadian
amplitude parameter, or the heart
rate variation over the day, and
a circadian phase parameter, or
the predicted time heart rate is at
a minimum during the 24-hour
circadian cycle. Another parameter
is the autocorrelation parameter,
which refers to the changes in
heart rate due to mechanisms other
than circadian variation, such as
hormone release. These parameters
change around COVID-19 symptom
onset, which can help distinguish
the infectious stage from healthy
periods.
According to the study, basal
heart rate increases at symptom
onset and the day after, which
researchers hypothesized could be
due to fever or heightened stress
and anxiety, and generally starts to
decline a few days after. The study
found that heart rate response to
physical activity increases soon after
the symptom onset, and it increases
more in individuals who experience
coughing.
Caleb Mayer, a doctoral student
in the Mathematics Department
JINGQI ZHU
Daily Staff Reporter
and a co-author of this study, said
the research is unique in the way it
breaks down the single heart rate
into several physiological systems.
“A lot of other work looks at heart
rate as one signal and one system,”
Mayer said. “And we’re really able
to break it down into these different
physiological systems and see how
those differentially change, and they
change in different time periods
with respect to symptom onset.”
The study’s analysis focuses
on a “baseline” period, defined
as anywhere from 8 to 35 days
before COVID-19 symptom onset,
and an “analysis” period, defined
as anywhere from 7 days before
symptom onset to 14 days after.
“All of this analysis happens
on
a
personalized,
individual
level because we know different
individuals respond differently,”
Mayer said. “They have different
physiological systems. We wanted
to break (it) down into a baseline
period to get a sense of their normal
balance of these parameters, and
then an analysis period where we
look more around symptoms when
the disease starts affecting your
physiology.”
The study analyzed participants
from three separate studies that
collected Fitbit and COVID-19
data: the Intern Health Study,
which follows physicians in their
first year of post-medical school
training; a study by Tejaswini
Mishra
and
colleagues,
which
collected smartwatch data from 32
individuals infected with COVID-
19; and the Roadmap college student
(Roadmap-CS) study, which collects
data
from
undergraduate
and
graduate students at the University.
RESEARCH
RESEARCH
Design by Jennie Vang
Design by Abby Schreck
MAANASA BOMMINENI
Daily News Contributor
Read more at michigandaily.com
Read more at michigandaily.com