Tag Archives: annapolis

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 Re​sponse 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.

Telemedicine vs. Office Visits: Which One Do You Need?

By: STEPHANIE MCKENNEY GROFF, D.O.

Since the start of the COVID-19 pandemic, MPCP has expanded our telemedicine services to give more people access to safe, convenient healthcare. Many of our patients have come to appreciate telemedicine as an alternative to office visits, receiving care in the privacy of their homes. The American Academy of Family Physicians supports telemedicine as an appropriate means of improving health. MPCP offers virtual visits during regular office hours, evenings and weekends.

Telemedicine is ideal for many types of medical appointments, but not for all of them. So when should you schedule an online visit and when should you see your doctor in-person? Here are some helpful guidelines.

Telemedicine visits are good for:

● Follow-up visits: If you’ve already seen your doctor about an illness or injury, follow-up visits using telehealth can help them monitor your progress.

● Review of lab work and imaging results: If your doctor ordered blood work or imaging to assess your concerns or symptoms, a telemedicine visit can give you adequate time to review the results and have your questions answered.

● Prescription refills: If you regularly take medication and your health hasn’t changed, your doctor can often refill your prescription after an online visit.

● Monitoring chronic conditions: Your doctor may be able to monitor a chronic health condition, such as diabetes, heart disease or asthma, and help you manage it without seeing you in the office.

● Counseling and other mental health services: Discussions about mental health, including anxiety and depression, are the top reasons people use telemedicine. Your MPCP doctor may be able to help you with these conditions and can refer you to mental health professionals if needed.

In-person visits are better for:

● Your first time seeing a doctor: It’s important to meet your new doctor so you can start building a relationship and feel comfortable with them. Also, seeing you in-person gives your doctor a baseline understanding of your health and what treatments you may need going forward.

● Physical exams: Are you concerned about a lump you found? Have pain in your joints? Doctors are skilled at recognizing signs and symptoms of disease and will understand what follow-up tests or treatment you need.

● Need for blood tests, X-rays and other imaging scans: A visit in the office allows your doctor to perform an exam to figure out which tests will be best to help with your diagnosis.

● You experience a new symptom to an existing condition: If you have a chronic condition like diabetes or heart disease, even if it is under control, your situation can change. If you notice a new symptom, you should schedule a face-to-face with your doctor.

How to schedule a telemedicine visit

To schedule an appointment during regular hours, just call your MPCP office. A medical assistant will call you before your appointment to help you connect and provide instructions on how to access the video platform that will be utilized during your visit. You may also be advised to collect your medication bottles, gather information such as your blood sugar or blood pressure logs. The medical assistant may ask you to take your temperature, weigh yourself, or provide a blood pressure reading prior to your visit.

MPCP also offers evening and weekend telemedicine visits for acute care (illness or injury) to better fit your schedule. Click here for office hours.  Call 410-729-3368 to schedule an after-hours appointment.

 

Dr. McKenney Groff holds her medical degree from Lake Erie College of Osteopathic Medicine and is certified by the American Academy of Family Physicians. She cares for patients in MPCP’s Annapolis office.

 

10 Things Your Doctor Wishes You Would Ask

By: LYN N. DEA, D.O.

Your MPCP healthcare provider is smart and experienced. However, even the most skilled professional may need your help to make sure all of your health concerns are met. Here are 10 questions to ask during appointments to make sure your provider can give you the best care.

1. How can I have better nutrition and get the exercise I need?
Good nutrition and exercise are key to good health, preventing some diseases and helping you maintain a healthy weight. If you want to eat better, your healthcare provider can recommend some guidelines, and they may also suggest that you see a nutritionist. Your exercise needs vary depending on your age and other factors – for example, ‘I have a bad knee, so what exercise can I do to keep my heart healthy?’ Your provider can work with you to create an exercise plan that fits your situation.

2. Can you explain what you said some more?
Providers and patients often understand health issues differently. If your provider tells you something, but you’re not clear about it, ask for an explanation. That will prevent misunderstandings and give your treatment a better outcome.

3. Will this treatment address what matters most to me?
Letting your health professional know what really matters to you – whether it’s a particular problem like joint pain or broader issues — can guide their decisions about your care. And prescribed treatments, such as new medication, may have side effects that impact your lifestyle, so it’s important to discuss it.

4. How worried should I be about these symptoms?
Always tell your provider about symptoms and why you’re concerned about them. For example, if you have headaches, are you worried you may have a brain tumor? Honestly discussing your fears with your provider lets them be addressed head-on, hopefully leading to a solution and giving you peace of mind.

5. What is the purpose of this medication?
Many times, patients accept a provider’s drug recommendation without fully understanding why. Your provider understands why they’re prescribing a medicine, but you’ll feel more confident taking it if you are clear on the dosage, how to take it, potential side effects and possible interactions with other drugs you’re taking.

6. What is the purpose of this test?
If your doctor is running a test or recommending a screening, you should know the reason. Asking will help make sure you’re prepared for the test — for example, some might require fasting beforehand — and will eliminate any surprises.

7. Which internet resources can I trust for medical information?
The internet is full of websites offering medical advice and promoting health products, but not all of them are legitimate or well-informed. Ask your provider about which sites they trust, so when you search medical topics, you can be sure of getting reliable information.

8. Can I try a different medication?
Most medications your provider prescribes work just fine. But there are times when your condition doesn’t improve, or you start experiencing unpleasant side effects. Tell your doctor about your concerns since there may be other options that will work better for you.

9. Is it okay for me to take these vitamins/dietary supplements?
Go online or open a magazine, and you’re likely to see ads for vitamins and other dietary supplements. Some of them make amazing health claims, but don’t be fooled by glowing testimonies. Most people don’t need mega-doses of vitamins, and they can be dangerous. And dietary supplements are not regulated by the FDA, so you don’t know if they really work, could have unhealthy side effects, or might interfere with medicine you’re taking. Ask your provider whether taking these things are helpful to you.

10. How does my family history affect my health risks?
All of us inherit characteristics from our parents. Unfortunately, you may get some genes that put you at higher risk for health issues, such as heart disease and cancer. Tell your provider about your family’s medical history, ask how this history may affect you, and what you can do to stay as healthy as possible. Your doctor may recommend screenings or lifestyle changes to lower your risks and keep you well.

During an office visit, your time with your provider is limited. See this video about getting the most out of appointments.

 

Lyn Dea, M.D.Dr. Dea is a Maryland Primary Care Physicians, LLC partner and is certified by the American Board of Family Medicine. She earned her medical degree at the Philadelphia College of Osteopathic Medicine. Dr. Dea cares for patients in MPCP’s Annapolis office.

 

COVID-19 Update: How It Affects You

By: MEDICAL DIRECTORS FALANA CARTER, MD and JERRY I. LEVINE, MD, PA

COVID-19 continues to spread in Maryland. Individuals who remain unvaccinated are at the greatest risk of contracting and spreading COVID-19 including highly contagious variants resulting in hospitalization and death. The Centers for Disease Control and Prevention’s latest guidance recommends booster vaccines for adults over 65, those with high-risk medical conditions, and individuals at risk for COVID-19 exposure and transmission due their occupation or institutional settings. The Johnson & Johnson/Janssen vaccine has been approved for a booster after two months. The Pfizer vaccine is available for children 12 and older, and soon will be approved for children 5 years and older. Here’s how the latest COVID-19 news affects you.

The Delta variant

Like many other viruses, the coronavirus (SARS-CoV-2) continually changes, producing new strains with features different from the original virus. The Delta variant is the most common form of the virus in the U.S. today and is very dangerous, causing most new COVID-19 infections. Here’s what you should know:

  • The Delta variant is significantly more contagious than previous variants, infecting many more people.
  • The Delta variant appears to cause more severe illness in unvaccinated people than previous variants, leading to more hospitalizations and deaths.
  • COVID-19 vaccines are very effective in preventing Delta infections, and the vast majority of new hospitalizations and deaths are in unvaccinated people.
  • Fully vaccinated people can get “breakthrough” Delta infections, but they are rare and are generally less severe than in unvaccinated people.
  • Fully vaccinated people with Delta breakthrough infections can spread the virus to others, but vaccinated people appear to be contagious for a shorter period of time.

Booster shots

COVID-19 vaccines remain highly effective against the virus months after vaccination, but their effectiveness will decrease over time.  The effectiveness of the vaccine is enhanced by getting a booster shot. Based on CDC recommendations, these groups are eligible for booster vaccines:

  • Adults 65 or older who received two doses of the Pfizer-BioNTech or Moderna vaccine at least six months ago
  • Adults 18-64 with underlying high-risk medical conditions
  • Adults 18-64 who are at increased risk for COVID-19 exposure and transmission due to their work or institutional settings
  • All adults 18 or older who received the single-dose Johnson & Johnson/Janssen vaccine at least two months ago

Also, individuals with compromised immune systems are eligible for a third dose of the Pfizer-BioNTech or Moderna vaccine at least 28 days after the first two doses.

Boosters may be “mixed and matched,” heterologous dosing. While preference remains to obtain the same booster as the primary vaccine, either Moderna or Pfizer can be received as a booster for the Johnson & Johnson/Janssen vaccine. This can be discussed with your primary care provider.

MPCP administers the Moderna and Johnson & Johnson/Janssen vaccines in our offices, and many of our offices will also offer the Pfizer-BioNTech vaccine starting November 1.

Call your MPCP office to schedule an appointment to receive a booster dose. Vaccines are also available at your local pharmacy or health department clinic.

COVID vaccines for children

The CDC is recommending COVID-19 vaccination for children 12+. Here’s the latest:

  • Fewer children have been infected with COVID-19 than adults, but they can still get sick from the virus and spread it to others.
  • CDC recommends everyone 12 years and older should get a vaccination to protect them and help prevent the spread of COVID-19.
  • The two-dose Pfizer-BioNTech vaccine has been shown to be safe and effective for children 12+. As with adults, serious side effects from the vaccine are rare in children, and the benefits of vaccination greatly outweigh the potential risks.

If you have questions about COVID-19 or the vaccine, contact your MPCP doctor or visit Maryland’s covidLINK website.

Dr. Levine is an MPCP partner and is certified by the American Board of Internal Medicine. He serves as MPCP’s Medical Director and Vice President, and sees patients in the Columbia office.

Dr. Carter is an MPCP partner and is certified by the American Board of Family Physicians. She serves as Assistant Medical Director and sees patients in the Arundel Mills office.