Fishers medics want to help prevent opioid addiction by using laughing gas instead

John Tuohy | IndyStar

Show Caption Hide Caption What is fentanyl? Quick facts on the killer opioid Fentanyl, a synthetic opioid, is quickly becoming the most dangerous drug in America. Here are the basics.

Fishers paramedics will begin providing laughing gas instead of a powerful opioid to patients in pain, the first department in the state to make the switch.

The move to nitrous oxide is expected to reduce the amount of fentanyl administered to injured patients by about two-thirds, reducing the risk of addiction and eliminating harmful side effects, said Fishers Fire Capt. John Mehling.

“We feel if we can prevent someone from getting an opioid we are ahead of the game,” Mehling said.

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The nitrous oxide, commonly used in dentists’ offices and hospitals, will be used by EMS workers only for certain injuries, like broken bones, Mehling said.

Paramedics will still give fentanyl to patients with abdominal pain, head injuries and collapsed lungs.

Fentanyl is a heavy and addictive pain medication that is about 100 times more potent than morphine and 50 times more powerful than heroin. The music star Prince died of an overdose of the synthetic opioid in April 2016, in suburban Minneapolis.

Mehling said the fire department consulted doctors at St. Vincent Hospital and other experts before concluding nitrous oxide was safer.

“If it hurts a little, why give a lot?” Mehling said. ‘If you are going squirrel hunting, don’t bring an elephant gun.”

A report in May in the Journal of the American Medical Association found that 46 percent of the 42,249 opioid-related overdose deaths in 2016 involved fentanyl, while heroin was used in 37 percent.

The drug has also gained popularity in Indianapolis. In 2013, fentanyl was found in 14 percent of opioid-related deaths but rose to nearly 50 percent by 2017, according to the Marion County Coroner’s Office and the U.S. Drug Enforcement Agency.

In the past four years, EMS agencies in at least 30 states have begun purchasing laughing gas for use in ambulances, the Associated Press reported.

Fire Chief Steve Orusa said patients must be alert enough to administer the laughing gas to themselves through a breathing mask or tube. It will take effect within 2 to 3 minutes, and when a proper dose has been given, the patient will naturally drop the mask. The pain relief lasts 3 to 5 minutes and the gas can be applied again when the numbing wears off.

Another advantage to the gas, Mehling said, is that patients can give a more accurate description of how much pain they are in when they roll into the hospital.

"With opioids kicking in, the pain level is probably going to be low at that point," Mehling said.

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