“More should carry Narcan antidote to counter opioid overdoses”

By Chivis Martinez for Borderland Beat

Thursday morning, the U.S. Surgeon General, while speaking at the National Rx Drug Abuse and Heroin Summit in Atlanta,  urged those at risk, to keep the Narcan antidote on hand.

Further, he recommends family and friends learn how to use the antidote, saying you don’t have to be a first responder to save a life.  Adams says more than half of all overdoses occur at home.

Using Naloxone (Narcan) can reestablish a breathing after it is injected or even sprayed in the nostrils, bringing overdose victims back from the brink of death.

An naloxone shot, available without a prescription for untrained people, works much like the EpiPen, or sprayed in the nostrils swiftly  restores breathing and usually out of danger.

Overdoses have jumped in numbers, many can be attributed to Fentanyl being widely sold on the streets and also infused in heroin.   According to estimates from the Centers for Disease Control 91 Americans die from an opioid overdose each day.

While once prescription only, Walgreens eventually began selling over the counter and now  the drug, which is often referred to by the brand names Narcan or Evzio, is available over the counter in most states and is regularly used by first responders across the country.

Although more expensive,  Narcan nasal spray is preferred over the injectable Naloxone version.  Narcan spray is apx 80 dollars a dose. 

Adams states that for those uninsured persons, the antidote is available at no or low cost but emphasizes that soon;

 “Costs should not and in the future will not be a barrier to accessing Naloxone for anyone in America.”   He is seeking additional federal help in increasing access.

One of the most outspoken Maine’s opponents of the request for federal help is Republican Gov. Paul LePage.  His argument is that the antidote does not treat addiction and actually discourages people from seeking addiction treatment by addicts having a safe guard when faced with overdosing.

However, lives and funds will be saved.  Naloxone, does not draw people to addiction and would be a small part of the overall problem.  Funds and time spent by first responders would be saved. So, if the practical side of the proposal is not impressive, one would hope saving lives should? 

As Adams said, Naloxone will not single-handedly solve the opioid crisis and will be used "in conjunction with expanded access to evidence-based treatment."

"There are people out there who think Naloxone doesn't make a difference: you're just going to go on and misuse substances again," Adams said. "That would be like me saying I'm not going to do CPR on someone having a heart attack because if we save them, they're just going to go out there and eat fast food and be back here all over again."

A personal story: 

My only brother who I will refer to as “T” was an accomplished jazz musician, artist and followed our father into the profession of Heliarc welding.  

He also was a heroin addict.   

His passion was boxing, Golden Gloves,  and was a sparring partner of a world champion.  A man who he met when they were both teen addicts.  The champion became clean in order pursue his dream.  At “T’s” funeral he spoke, saying “T” was his toughest, most talented sparring partner he ever knew of and in his opinion a better boxer than himself  because of his natural talent and instincts.

We were incredibly close; he was loving, funny, compassionate, talented and smart. And he was so loved by all of his family. But strictly speaking on topic, I witnessed his addiction up close and personal when I was a Jr high schooler forward.  In those days there were no treatment centers, as are today.  

“Kicking drugs” meant cold turkey.  Withdrawal meant nausea, vomiting, thrashing, freezing, shaking, sweats, etc.  my mother and I helped him through.  I was 13.  Withdrawal continues for about 3 days with another 3 days or so to feel somewhat normal.  “T” made us promise not to call an ambulance during a withdrawal or O.D.  Because in those days that would end with a trip to jail, a place he would avoid even if there was a chance it could mean his life. 

Witnessing an overdose is most frightening. I saw it once.  “T” was in the bathroom when my mother and I heard a loud thud. I was clueless to the origin of the sound but my mother knew immediately what was happening.  She raced to the bathroom and banged on the door shouting “T’s” name… no response.  She ran to her desk drawer and retrieved a small Philips screwdriver, then manipulated the lock and gained entry.  “T” was slumped sideways on the john, his head resting on a wall. He was wearing a tee shirt and summer shorts, a syringe was still inserted in his thigh. My mother tried in vain to awaken him.  The two of us attempted to get him on his feet, at 110 pounds I was the “bigger” of the two of us, so it was not happening, his body fell to the floor.  Too much for a 15 year old.  I was shaking, crying, praying, screaming “Is he dead? Is he dead?” 

My mother broke her promise to “T” and called for an ambulance.  The hospital was only 5 blocks away.  His life was saved.  And he was then taken to jail.  His “crime” was being an addict. Naloxone was available during that time, but only through a medical facility.  The antidote was invented in 1961.  FDA approved a few years later. 

The pivoting point in my brother’s life is when he met a beautiful, wonderful girl who he turned his life around for.  She would not marry “T” unless he could become clean.  He became clean, had a relapse, clean again for good. He married and had a daughter, who he thought was the most amazing thing on earth.  He was 26 when she was born. 

And he was 26 when he died, three months later. 

No, not by drugs, he was murdered.  After the journey he traveled, it wasn’t heroin that killed him, it was a bad guy. My father and I identified his body at the county coroner’s office.  It was the first time I ever saw my father cry.  He felt like such a failure.   He wasn’t.  I could not imagine a better father.  His entire life and joy was his family, I don’t know a person who had a better childhood than I did, because of my parents.This can and does happen in the best of families, who do the best they are able to. It can happen in any family. 

Adding insult to injury, his killer was acquitted when two witnesses were scared to testify.  My brother’s daughter was only 3 months old.  She never knew her father, but I did my best to see that she knew him through me.  She became a federal agent. She married a DEA agent and they spent a few years in Mexico City fighting the fight against drugs. 

My brother left me a gift.  He loved me very much and continually lecturing me on drugs. Using himself as an example, and sharing horrific stories. It was effective; I never experimented with any illegal drug, not even marijuana.  Oh, for sure many around me in school smoked, and in the 80s cocaine was passed around at parties, but I was never tempted.  I was scared straight so to speak. 

He was an addict.  He also had value. Those two things are not mutually exclusive.  “T” was loved by all who knew him, especially his family, and after all these years that have passed, his memory remains fresh, and his absence still matters.  For those who think his life did not matter because he was an addict, I am here to say, you are wrong.

Read Dr Adams full JAMA article using this link

Below is an excellent documentary "Anatomy of an Overdose" Anatomy of an Overdose explores both the science and the human toll of heroin overdoses.  From the St Louis Heroin Project.  Featuring on; what and why the uptick in overdoses.  Includes the introduction of Fentanyl to heroin [cutting heroin] and an introduction to the Howard and Joyce Wood simulation center where physicians are trained using human-like electro-mechanical mannequins, which remarkably simulate overdoses.  Addicts speak about their addiction and overdosing.  21 minute film.