Nurses on Front Lines in Opioid Epidemic

Community Service Board nurses provide life-saving care, advice.

When someone she recognizes returns to the Fairfax Detoxification Center, Community Service Board (CSB) nurse Rosaline Nankam doesn’t judge. Instead she smiles encouragingly and says, “Welcome back! We’re glad you’re here!”

In her 14 years working at Detox, Nankam has seen people come back again and again, year after year, struggling to overcome their opioid dependence and the terrible toll it takes on their bodies and minds. More than 80 percent of the individuals treated at Detox are homeless; many have lost contact with their loved ones. Nankam is determined not to give up on them.

Nankam says one of her most memorable patients was a man who came to Detox repeatedly for over 10 years. His need for heroin was so acute that he was injecting it directly into an open wound. One day something clicked, and he agreed to enter a CSB residential treatment program. He brought others to Detox for help and stayed drug-free for the rest of his life.

“Detox is the entry point for people with many complex issues,” Nankam explains. “We have to listen closely, to know who we’re dealing with. Clients we serve have many other comorbidities and do not take care of themselves out there in the community.

“Besides their substance abuse issues, we also deal with medical issues such as diabetes, hypertension and other issues. These need to be addressed at the same time as the substance abuse issues, to increase their chances of remaining sober,” Nankam says.

Wanda Orr, who also works at Detox, says that nurses there teach every opioid patient how to recognize the signs of overdose, what to do, what not to do, and how to administer Narcan, the life-saving medication that reverses opioid overdose effects. Orr also gives public presentations to educate the community about opioid abuse and how to get help.

Nurses throughout the CSB – at Detox, residential treatment programs, outpatient services, clinics and at the jail – provide medication assisted treatment and associated case management for individuals who have opioid dependence. CSB Nursing Director Louella Meachem explains that medications such as Suboxone and Vivitrol reduce the craving for the opioid, so that the individual can remain opioid-free and focus on other aspects of their recovery.

Jennifer Hansbrough, a nurse with CSB’s Addiction Medicine clinic at the Merrifield Center, provides medical assessments and triage, case management, prescription monitoring, and follow-up treatment referrals for approximately 80 - 90 individuals receiving medication assisted treatment on an outpatient basis. Hansbrough has spent the past six years working with people with substance use disorders, a population she describes as having been historically underserved and stigmatized.

“I love what I do,” explains Hansbrough. “These are remarkable, resilient people in the midst of surviving an epidemic. To be the person that someone reaches out to, after they have lost so much, experienced so much trauma… it’s a huge thing. They keep trying, keep coming back. It’s a life and death struggle.”

Hansbrough continues: “The biggest thing we want people to know is that we’re here, judgment free. Whatever stigma there is, it ends at the door.”

Nankam, Orr, Meachem, and Hansbrough, with nurse colleagues throughout the CSB and Fairfax County, were honored by the Board of Supervisors on April 10, with a proclamation naming the week of May 6 – 12 as Nurses’ Week in Fairfax County. This year’s proclamation emphasizes the critical role of nurses in combating the opioid epidemic in our community.

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