4.10 Opioid Antagonist Administration Policy and Procedures

STATEMENT OF CONCERN

The Traverse Area District Library (the Library) desires to participate in the administration of Opioid Antagonists as allowed by Michigan Public Act 39 of the Public Acts of 2019, effective September 24 2019, to combat the continuing rise in opioid deaths in Michigan and potentially save the lives of library patrons, volunteers, or staff.

PURPOSE

To establish guidelines and procedures governing the administration and use of an Opioid Antagonist by Employees or Agents of the Library. This document sets forth the policies and procedures necessary for the Library to maintain intranasal naloxone/Narcan on-site for ready and appropriate access to trained Employees or Agents of the Library and for Employees or Agents of the Library to administer an Opioid Antagonist to persons suspected to be experiencing an opioid or opioid related overdose at the Library.

MICHIGAN LEGAL FRAMEWORK 

Michigan Public Act 39 of Public Acts 2019, “Administration of Opioid Antagonists Act,” Approved Jun 26, 2019, effective September 24, 2019 (the “Act”).  

The Act provides both criminal and civil immunity to the Library for purchasing, possessing, or distributing an Opioid Antagonist under the Act and the Employees or Agents of the Library who possess or in good faith administer an Opioid Antagonist in compliance with the Act.

In accordance with the Act, the Traverse Area District Library Board authorizes the Library Director to proceed with instituting a board-sanctioned opioid overdose prevention program following the procedures outlined in this policy. 

The capitalized terms as used in this policy shall have the same meaning as those terms defined in the Act.

 

  1. Provision of Opioid Antagonist. As permitted by the Act, the Library shall provide and maintain on-site at the Library (including any of its branches) Opioid Antagonists to treat a case of suspected Opioid-Related Overdose in the Library or on Library Property.
  2. Provision of Opioid Antagonist. The Library may purchase and possess an Opioid Antagonist for the purpose of implementing the Act.   
  3. Distribution and Administration of Opioid Antagonist. An Employee or Agent may possess an Opioid Antagonist distributed to that Employee or Agent and may administer that Opioid Antagonist to an individual if both of the following apply:
    1. The Employee or Agent has been trained in the proper administration of that Opioid Antagonist; and
    2. The Employee or Agent has reason to believe that the individual is experiencing an Opioid-Related Overdose.
  4. Training of Employees or Agents.
    1. Employees or Agents of the Library who volunteer for training in the proper administration of an Opioid Antagonist shall be trained in the proper administration of an Opioid Antagonist. .
    2. The training shall be conducted by a person or organization that is accredited to train for the administration and use of an Opioid Antagonist.
    3. After the initial training, supplemental or additional training shall occur at least every two years. 
  5. Procurement and Storage of Opioid Antagonist.
    1. Procurement The Library Director or designee is authorized to procure the Opioid Antagonist as allowed by the Act.  
    2. Other Supplies. At minimum, the Library shall have the additional following supplies available for use by an Employee or Agent:
         1. At least 2 doses of the Opioid Antagonist on each floor of the Library open to the public at each branch of the Library.
         2. Gloves.
         3. Face mask.
         4. Step-by-Step Instructions for the administration of the Opioid Antagonist.
         5. Breathing barrier.
    3. StorageThe following shall apply to the storage of Opioid Antagonist.
         a. Opioid Antagonist will be clearly marked and stored in a secure location.
         b. All Employees or Agents trained to administer the Opioid Antagonist shall be informed of the location of the Opioid Antagonist and shall have access to the Opioid Antagonist.
         c. The Library Director or designee will ensure that all other relevant staff are aware of the Opioid Antagonist storage location.
         d. Opioid Antagonist will be stored in accordance with manufacturer’s instructions to avoid extreme cold, heat, and direct sunlight.
         e. Inspection of the Opioid Antagonist shall be conducted regularly, including checking the expiration date found on the box.  Any expired Opioid Antagonist shall be promptly removed and replaced.
  6. Response Procedures.
    1. SIGNS OF POSSIBLE OVERDOSE
    • person will not wake up or respond to voice (this is the #1 sign to look for)
    • snoring or gurgling sounds
    • breathing is very slow, or irregular, or has stopped
    • pupils are pinpoint
    • blue lips and/or nail beds
    • clammy skin
    2. OPIOID ANTAGONISTIC PROTOCOL:
         a. Assess the scene for your own safety. If the situation is unsafe, do not attempt to get to the victim.
         b. Call 911.
         c. If possible, alert other staff to the situation and ask for assistance, especially with crowd control.
         d. Put on gloves and breathing mask.
         e. Put the individual on their back. Do NOT attempt to move them from a chair to the floor.
         f. Administer a dose of Opioid Antagonist: read and follow directions on the box.
         g. If trained in rescue breathing, commence rescue breathing using an appropriate breathing barrier.
         h. If the person is on the floor, put them in the recovery position.
         i. Watch closely, but from a safe distance. Be aware that the effect of Opioid Antagonist is to cause immediate withdrawal from an opioid high. The person might be ill or confused. Offer reassurance and support, but do not compromise your safety. NEVER attempt to restrain the person.
         j. If the person does not respond within 2-3 minutes, administer another dose of Opioid Antagonist in the other nostril.
         k. Once EMS has arrived, take time for self-care. Allow another staff member to continue with crowd control and limiting gossip about the incident.
         l. Fill out the Library’s incident report and submit to the Library Director.  The report is a Library Record as that term is defined in the Library Privacy Act.This protocol will be updated as necessary after additional training.  A copy of any updated protocol will be attached hereto and become a part hereof.
  7. Distribution of Policy.

 

This policy and any updated protocols will be distributed to all trained Employees and Agents and will be available on the Library’s website.

 

New policy adopted February 20, 2020