Category Archives: Health & Wellness
Naloxone: A Powerful Tool to Fight Opioid Overdose
By: ANDREA C. CUNIFF, M.D.
The opioid crisis continues in Maryland and has gotten worse as the powerful drug fentanyl is increasingly mixed into illegal drugs. From 2022 to 2023, the state saw 2,583 fatal overdoses, and fentanyl was involved in about 81% of those deaths.
In response, there has been a growing use of naloxone (commonly known by the brand name NARCAN®), a medication approved by the Food and Drug Administration that rapidly reverses opioid overdose. It has been used to save lives in Maryland. Healthcare officials encourage its distribution and use by the public.
What is naloxone?
Naloxone is an opioid antagonist: it attaches to opioid receptors in the body, reversing and blocking the effects of opioids, including heroin, morphine and oxycodone. Naloxone can quickly restore normal breathing to a person whose breathing has slowed or stopped because of an opioid overdose. However, it only reverses opioids and will not work on other drugs like cocaine or methamphetamine.
How naloxone is given
Naloxone should be given to any person who shows signs of an opioid overdose. It can be administered as a nasal spray or an injection. Learn how to respond to an overdose with guidelines from the Maryland Department of Health.
Signs of opioid overdose
- The person’s face is extremely pale and/or feels clammy to the touch
- Their body goes limp
- Their fingernails or lips have a purple or blue color
- They start vomiting or making gurgling noises
- They cannot be awakened or are unable to speak
- Their breathing or heartbeat slows or stops
Source: Substance Abuse and Mental Health Administration
Who can give naloxone?
Naloxone is widely used by police officers, emergency medical technicians (EMTs) and non-emergency first responders. In Maryland, anyone can administer naloxone and training is not required, but your healthcare provider or pharmacist can advise you how to use it.
You can buy naloxone at a pharmacy without a prescription. Free naloxone may also be available from Overdose Response Programs located throughout the state.
What to keep in mind
Naloxone works for about 30 to 90 minutes, but many opioids remain in the body longer than that, so a person can still experience the effects of an overdose after naloxone wears off. If you administer naloxone to an overdose victim, you should still call 911 as soon as possible for immediate medical attention.
Side effects from naloxone are rare, but some people might have allergic reactions to it. Overall, naloxone is a safe medicine and has the potential to save many lives.
In the state of Maryland you are protected under the Good Samaritan Law. This means you will not be arrested or prosecuted if you administer naloxone while you are under the influence of alcohol or illicit drugs, or are in possession of illicit drugs at the time of administration.
More about naloxone
Dr. Cuniff treats patients in the Annapolis office. She is certified by the American Board of Family Medicine and earned her medical degree from the University of Maryland School of Medicine.
Colorectal Cancer Screening Awareness
March is Colorectal Cancer Screening Awareness Month
The American Cancer Society recommends regular screening starting at age 45. Even if you have been screened before, you will need to screen again when your healthcare provider recommends. Click here for more information about colorectal cancer screening.
COVID-19 Vaccines: To Get or Not to Get, That Is the Question
By: RAFEENA BACCHUS, M.D., MEDICAL DIRECTOR
Vaccine hesitancy, whether due to vaccine fatigue, misinformation or genuine concern for side effects, is very common these days. Headlines from trusted news sources and even not-so-trusted sources come at us fast and can be misleading. So how do you know if the vaccine is right for you?
First and foremost, know that your concerns are valid and that these concerns should be discussed with your trusted physician. There are many reasons why the vaccine is important for some to receive and other times when the benefits may not outweigh the risks and therefore should be avoided.
So, let’s address some of the common concerns providers have heard.
- Blood Clots
The largest global study recently published by the Global Vaccine Data Network, after just shy of 1 million doses of vaccines given, showed a statistically significant increased risk of a type of blood clot in the brain after immunization with viral-vector vaccines such as the one developed by the University of Oxford and made by AstraZeneca. It showed that these vaccines were linked to a threefold increase in cerebral venous sinus thrombosis, a type of blood clot in the brain; identified in 69 events, compared with an expected 21. This vaccine was never given the U.S. In the same study, mRNA vaccines (Pfizer and Moderna) showed as small increase in observed ration of blood clots related to low platelet counts but not to statistically significant levels.Several smaller studies have investigated the potential link between mRNA COVID-19 vaccines and have also not found any clear associations.
- Heart Conditions
Myocarditis is inflammation of the heart muscle and has been seen with both mRNA and viral-vector vaccines in several studies. Though cases are rare, they are mostly seen in adolescent and young males. The severity of myocarditis can vary; however, most will have resolution of symptoms. The risk of myocarditis is 5-10 per million vaccine doses. The rate of myocarditis with COVID-19 infection is 40-80 cases per million people infected with COVID. - Neurological Disorders
In the same study done by the Global Vaccine Data Network referenced above, Guillain-Barre Syndrome, a syndrome that affects the nerves, was observed to occur at a statistically significant increase in cases with viral vector vaccines. This was NOT observed with mRNA vaccines. However, inflammation and swelling in the brain and spinal cord was observed after both viral-vector and mRNA vaccines. Seven cases of acute disseminated encephalomyelitis after vaccination with the Pfizer mRNA vaccine were observed, versus an expectation of two.
As with any vaccination, there are many potential side effects. However, it is important to note that severe side effects are very rare. In some cases, your provider may recommend against vaccination due to an underlying medical condition. On the other hand, for those in the majority, these vaccines are safe, effective, and lifesaving. Be sure to discuss with your MPCP provider when making these important health care decisions. We are here to support you any way we can.
Article Sources
K. Faksova et al., Vaccine, https://doi.org/10.1016/j.vaccine.2024.01.100
CDC. Clinical Considerations: Myocarditis after COVID 19 Vaccine. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/myocarditis.html. February 24, 2024
Dr. Bacchus is a MPCP partner and is certified by the American Board of Internal Medicine. She sees patients in the Columbia office and serves as MPCP’s Medical Director.
What To Do? Emergency Department vs. Urgent Care vs. Your Doctor’s Office
By: RAFEENA BACCHUS, M.D., MEDICAL DIRECTOR
Having an illness or injury often results in a good deal of anxiety and worry. You want medical attention and relief from your symptoms as quickly as possible. But where should you go to get the best, most appropriate and cost-effective care? The following are the most widely used treatment options and suggestions about when each might be best suited to meet your particular medical needs.
The emergency department
Most emergency departments are part of hospitals, although there are free-standing emergency departments in Bowie and Queenstown. The ED is designed and equipped to handle serious or life-threatening emergencies. It is always open, including nights, weekends and holidays. Patients are seen according to how sick or injured they are. The most serious cases jump to the front of the line, even if they arrive later than everyone else. Physicians in the ED are trained to look for life-threatening conditions, and the tests you will receive in the ED will help them decide if you have any of these.
The emergency department is the right place to go if you have a serious or potentially life-threatening illness or injury: chest pain, sudden weakness on one side of your body, a new seizure, severe headache, persistent heavy bleeding, poisoning, or a large broken bone.
The emergency department is probably not the right place to go if you have a milder illness or a longstanding issue. You are likely to wait longer for treatment. The emergency department doctors do not have access to your medical records. Your visit will be much more expensive — as much as 4-6 times as expensive! Remember, they have to keep all that life-saving equipment available all the time. That’s great if you need it, but it’s just an extra charge if you don’t.
Urgent care centers
There are lots of these in our area. They often have extended hours, including evenings and some weekend hours. They are designed and equipped to handle medical problems that need attention the same day but are not life-threatening. Patients are usually seen in the order they arrive, so your wait will depend on how many other people go to the urgent care center at the same time you do. Many urgent care centers have X-ray and blood testing equipment.
An urgent care center is the right place to go if you have a new illness or injury that occurs when your doctor’s office is closed, such as sprains and strains, painful urination, ear pain, severe cough or wheezing.
An urgent care center is probably not the right place to go if your doctor’s office is open or if you have a serious or life-threatening condition. A visit to an urgent care center is more expensive than a visit for the same condition at your doctor’s office. The provider in the urgent care center does not know you and will not have access to your medical records. Urgent care centers are not equipped with life-saving equipment or providers trained to treat life-threatening illnesses or injuries.
Your doctor’s office
No one knows you like your own doctor. Your doctor is equipped to treat many illnesses and injuries, and can arrange any testing you may need. Your primary care doctor has your medical records and knows your medical history. Patients are seen by appointment. Maryland Primary Care Physician offices reserve appointments for patients who need same-day treatment. Many MPCP offices have evening and/or Saturday hours for your convenience. Call or check our website, www.mpcp.com, for a list of hours at your doctor’s office.
Your doctor’s office is the right place to go if you have a new problem, such as sinus pain, ear pain or flu, cuts or other wounds, sprains or strains, cough, or a flare up of an old problem, such as back pain or migraine headache, or an ongoing problem that may require more testing or treatment, such as persistent stomach problems or joint issues. You will pay the lowest copay at your primary care doctor’s office, and many times you will be able to get an appointment the same day you call. For extra convenience, all MPCP offices offer telemedicine visits after hours, in addition to evening and weekend appointments at some sites.
Your doctor’s office is the wrong place to go if you have a serious or life-threatening condition. If you need care in the next hour, go to the emergency department.
If you’re not sure what to do, call your primary care provider
Even when the office is closed, there is always someone on call who can direct you to the care you need. If you ever need to go to the emergency department or an urgent care center, take a list of all your medications and allergies with you. Let the staff know who your primary care provider is, and schedule a follow up appointment if needed.
Dr. Bacchus is a MPCP partner and is certified by the American Board of Internal Medicine. She sees patients in the Columbia office and serves as MPCP’s Medical Director.
