Narcan Stops Fatal Overdoses, Heroin Users Choose What To Do From There

The drug  Naloxone , also known as Narcan, is a short term fix in a long term fight against heroin addiction. The injection or nasal mist can almost always stop an overdose from becoming fatal. U.S. Attorney General Eric Holder has called for equipping police and firefighters with the drug. In some places, like Maine there’s still resistance. But in Massachusetts and Connecticut, Narcan is moving forward, and it’s not only first responders who are administering the life saving drug.

Liz Whynott from Tapestry Health, based in Northampton, Mass., says its tremendous that more people have access to Narcan. As someone who advocates for people with AIDS, STDs, and heroin addiction, she says because Narcan is so immediately effective it’s is her “favorite intervention.”

And while of course more lives are saved, she says, it’s not as straight forward as that.

“It’s a little controversial. What I’ve heard from law enforcement is that you’re not arresting them anymore. You’re just enabling them.”

But Whynott says the other side of the coin, “It gives people another day to live,” she says, and “to make the decision to stay clean, or get clean.”

She adds, “If they choose to do so.”

At a recent training in Greenfield, Massachusetts, Whynott stands in front of about 25 men and women who for their own personal reasons want to learn how to administer a dose of Narcan nasal mist. Holding up a kit, Whynott explains how to assemble the device.

“A lot of people, the first time [they do this ] the mist sprays out.” And she kids, “that’s the initiation part.”

She points to the atomizer and says “that’s what you put up the person’s nose.”

Getting the mist up someone’s nose is one thing, But as Whynott explains, rescue breathing is still necessary, and because Narcan is only effective for about an hour, it’s critical to get the user  to the hospital. That means calling 911, and for someone who is also getting high but wants to save a friend’s life, that’s dicey. In the not too distant past consequences came with that call as police usually arrived and anyone using was arrested. That was a clear deterrent and Whynott says, many people died.

But states are developing or expanding their so-called Good Samaritan laws. Last month in Connecticut, Governor Dannel Malloy signed a bill that essentially gave permission for almost anyone to administer Narcan, and protection from the law, with exceptions. That good faith law takes effect in October. Massachusetts changed its law in 2012. Now when people call 911, Whynott tells the group, you won’t automatically get arrested.

“However, she warns, “you can still get arrested if you have a warrant or [are in ] possession [of heroin or other illegal drugs] with intent to distribute.”

A woman in the group asks about whether police could call child welfare officials if kids are in the house. Whynott tells her, they can. Her voice trails off without judgement.

The same is true in other states.

The people in this room today have come for varying reasons. Chris Vincent, a self described addict with a desire to counsel others, lives at a half-way house in the nearby town of Orange, Mass.  He says a few months ago at the house, someone relapsed. He went out and used and died.

“It would be a definite ease of mind to know that we had [Narcan] in the half-way house in case of this situation,” says Vincent.

Greenfield, Mass., resident Betsy Russell came because she found her son’s girlfriend overdosing on heroin. She says she called 911 and paramedics gave the girlfriend Narcan. She survived. But some of her son’s other friends didn’t.

“One came out of rehab a couple of weeks ago. They found him dead,” she says. And she adds, “It’s rampant in this town.”

It’s rampant in many towns, and  in many states, and because of that police and other first responders are beginning to carry Narcan for the first time ever, like they carry oxygen tanks and band-aids.

Back in the snowy days of March 2014, when Massachusetts Governor Deval Patrick declared an opiate abuse public health emergency, he used that power to remove the hurdles  to police and fire fighters carrying the antidote. The union rules, the liability, and most of the the costs of Narcan, at least for now, vanished.

Tapestry Health’s Whynott says for a long time police didn’t want to be the ones administering Narcan. Now requests for trainings from public safety departments are soaring, and she says, she’s seeing a radical shift in law enforcement culture.

“There’s a lot more empathy toward [heroin users] and it’s a kinder response to addiction,” she says.

Hartford, Conn.,Deputy Police Chief Brian Foley says, it’s true.

“Ask cops,” he says. “We’ve all stood over a virtually soon to be dead person who’s just about to overdose, only for an EMT to come over and pump him up with the Narcan and have him sit right up … in a matter of seconds.”

In greater Hartford, Conn., where according to the state’s Chief Medical Examiners office,  overdoses have increased between 80 and 100 percent since last year, Foley says  policy hurdles do remain. The need for trainings and funding the drug , but he says, “there won’t be much resistance to carry Narcan otherwise.”

Foley sees the upcoming expansion of Connecticut’s Good Samaritan law as an acknowledgement of a real heroin problem. But he says in some of Connecticut’s smaller towns, the problem is still swept under the rug. He says he’s even been approached by some towns, asking to keep their name out of any sort of “heroin discussions” [if someone from their town overdoses in Hartford]. Foley wouldn’t name names; he says that’s a political pool he doesn’t want to swim in.

Shawn Lang, a policymaker with AIDS Connecticut says towns won’t be able to keep their head in the sand for too much longer. Her group, working with the state of Connecticut, will soon release comprehensive  overdose data from 2008 to the present.

“We’re going to do some Geo-Mapping with colleagues at Yale’s Interdisciplinary Research on AIDS, to create a map,” Lang. says. “[Then] we can look at accidental opiate overdoses in the state.” And she emphasizes, “per city and town.”

But even just looking at the old data, Lang says there are very few Connecticut towns that haven’t been touched by this crisis.