The Antidote to Heroin Overdose: Who is Allowed to Carry it? Overdose 101

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overdoseAs deaths from heroin and painkillers only continue to skyrocket nationwide, governments and clinics across the country are working to put a drug that can reverse an opiate overdose into the hands of more paramedics, police officers and also the people, who advocates of the drug say are the most important. Why? Because they are the people who are abusing the drugs, their friends and their families. 

Supporters of the lifesaving drug say the opportunity to save potentially thousands of lives outweighs the fears that critics have of a nearby antidote only encouraging drug abuse. 

At least 17 states as of right now, as well as the District of Columbia allow naloxone, which you may know as Narcan, to to be distributed to the public. And at least 10 of these states allow for third parties, or family members and friends of an intravenous drug user, to be prescribed it. 

New Jersey

Among these states is New Jersey, which just passed a law last year, allowing members of the public to carry naloxone, administered through a nasal spray or an injection into a muscle, after getting training. 

About 20 people, most of them related to overdose victims or people who currently abuse heroin, crowded into a clinic in February in Camden, to learn about the antidote. 

Massachusetts

Naloxone,is regarded within the medical community as highly effective when used properly. In fact, a study conducted during a state supported pilot of naloxone distribution and overdose education in Mass showed that it was 98% effective in attempts to rescue a person who overdosed. The police in Quincy, Mass., have been carrying naloxone nasal spray since 2010 and they said in July 2013, that they had used naloxone 179 times, reversing 170 of the overdoses–that is a 95% success rate. 

Nationally

According to the White House Office of National Drug Control Policy, the number of overdose deaths involving prescription drugs increased 21% from 2006 to 2010. And the number of overdose deaths involving heroin increased 45%. In March, US Attorney General Eric Holder called the increase in heroin-related deaths an “urgent and growing public health crisis” and said first responders should carry Narcan with them at all times. 

There are bills pending in AT LEAST seven states right now in order to increase access to naloxone. In Tennessee and Utah, doctors would be allowed to prescribe it and civil liability for those who administer it would be dropped. A Wisconsin bill seeks to widen access to naloxone and, as New Jersey does, provide immunity to drug users who report an overdose. 

Marty Walsh: Boston, Mass–Indianapolis–Ocean County, NJ

Marty Walsh who is the new mayor of Boston, called for all first responders to carry naloxone. Police in Indianapolis, where heroin overdose deaths have doubled since 2011, are starting a program to have officers carry the drug. In Ocean County, NJ police are being trained in how to use it. 

The White House drug policy is backing these states up. It is urging all first responders to have naloxone on hand. And just this past Thursday, the US FDA approved an easy to use device that automatically injects the right dose of naloxone before an ambulance arrives. Doctors could prescribe this to family members, caregivers and friends to keep on hand, in their pocket, or in a medicine cabinet. It would be much like an epi-pen. 

Across the Globe

Naloxone as of right now, is only available via a prescription in the UK, but an advisory council has called for over the counter distribution of the drug. Prescription take home programs are in place in Australia, Canada, Estonia, and Russia. Norway plans to begin distributing the nasal spray kits to drug users in its two largest cities. 

The Downside–The Critics

In Maine, where heroin overdoses are increasing steadily, and have increased fourfold from 2011 to 2012, Governor Paul LePage, is opposed to a bill that would allow health care professionals to prescribe it to family members and caregivers of addicts and allow more emergency responders to carry the drug. 

His reasoning is that it creates a “false sense of security that abusers are somehow safe from overdose if they have a prescription nearby.”

“This bill would make it easier for those who have substance abuse problems to push themselves to the edge, or beyond,” LePage wrote in a letter last year explaining why he vetoed a similar bill. “Offering temporary relief without medical or treatment oversight will not combat drug use.”

Dr. Marcus Romanello, the chief of the emergency room at Fort Hamilton Hospital in Hamilton, Ohio, said he believe that police should carry naloxone but is wary of giving it to the public. 

But he did say that there is no disputing that naloxone works. “They are pulled back from the jaws of death, as we say, by the Narcan,” he said.

The Mechanics of Overdose

An overdose on any kind of opiate is a kind of slowing down of the body. Basically the body forgets to breathe. Naloxone works by blocking the brain receptors that opiates latch onto and it helps the body to remember once again to take in air. The antidote’s effects wear off in about half-hour and multiple doses may be needed, depending on the extent of the heroin use and how many times the body needs to be “reminded.” 

The advocates for naloxone say that it is absolutely essential to train relatives, friends and family members of addicts because the person overdosing is likely sick or unconscious or unable to administer the drug themselves. It also has to be given during a certain time window–usually within a half-hour to three hours after injecting too much of a drug such as heroin.

Naloxone probably wouldn’t have helped someone such as Philip Seymour Hoffman, because he was alone and was already dead when discovered. But for those who are found in time, it is a miracle, lifesaving drug. 

Signs of an Overdose

Overdose signs usually include raspy breathing, a blue face, anything that signals a loss of oxygen. Individuals should always a keep a close eye on people who “nod off” after using and try to wake them up. If they do not rouse, place them on a floor or other hard surface, give rescue breaths every 10 seconds and administer naloxone. Call 911!

The most important thing is to call 911 and wait with the person who has overdosed, don’t leave them. And remember it is just buying time and is not a cure.