Narcan: How To Save a Life
Melissa Harris-Perry: Thanks for being with us on The Takeaway, I'm MHP.
This weekend in Portland, Oregon, eight people died from overdose as a result of fentanyl poisoning. Were it a gun crime, we'd call it a massacre. Yet it's only a tiny fraction of the mounting death toll from opioid overdoses that continues to wreak havoc in cities, towns, and rural communities across the nation. There's something we can do, and by we, I mean you, me, all of us who with a little planning and training just might make a life-saving difference.
In March, the Food and Drug Administration authorized over-the-counter sales of Narcan. That's the easily administered drug that can reverse the effects of an opioid overdose. It's a decision that could save many lives. For our show's, very last Takeaway reports, producer Katerina Barton set out to learn more.
Katerina Barton: Hi, how are you doing?
Joanna Kaufman: Oh my God, it's so good to see you.
Katerina Barton: Good to see you. It's been so many years.
Joanna Kaufman: I know. It's been so long.
Katerina Barton: This is Joanna Kaufman. We were friends in high school in Santa Fe, New Mexico, but we haven't talked in a few years.
Joanna Kaufman: I'm a nursing student, full-spectrum doula, and priestess in training, living in Santa Fe, New Mexico.
Katerina Barton: We both had younger brothers around the same age.
Joanna Kaufman: Ben was an amazing young man. He was really soft-spoken, really kind, really compassionate. He could never pass somebody on the street without offering something, whether it was like food or some money if somebody was in need. I feel like he really felt the world. He loved animals. He just had a heart of gold.
Katerina Barton: Benjamin died from an opioid overdose in 2019.
Joanna Kaufman: Means a lot to get to share Ben's story in a more public way. Yes, also difficult because I don't want him to be defined by how he died like anybody.
Katerina Barton: Unlike a lot of people who become addicted to or misuse opioids, he started with prescription medications.
Joanna Kaufman: I believe that he first got access to narcotics through my dad's prescription. My dad had cancer and it was painful, and then somehow got access to that and tried it and really liked it. It became his drug of choice.
Katerina Barton: Ben was around 18 years old when he first started using. Joanna says he tried to conceal it from her and the rest of his family, but eventually--
Joanna Kaufman: He overdosed. Once my mom found him, he was unconscious and she did CPR and called 911 and they revived him with Narcan and they saved his life and he went and detoxed at the hospital. Even then was convincing everybody it wasn't a problem. The second time it was fatal. He was with some friends who were probably also using, and they were around his age. Ben had just turned 20. It was a year after my dad died from cancer, and my brother was really struggling with that. He was really close with my dad.
The people who he was with, I'm not sure at what point they noticed that Ben was in respiratory arrest. I think he was vomiting, that's a sign. He was not conscious. It was typical for Ben to take naps at a party. That was how he would fall asleep at parties and that was a running joke with his friends. When they noticed that he was unconscious or not breathing, they maybe did CPR for a minute, they did not call 911 because they were afraid of what the consequences would be for them. They put him in the shower, putting somebody in the shower doesn't revive somebody who has overdosed. Then finally they put him in the car and they drove him to the ER and they dropped him off out front. By that time, it was too late.
Katerina Barton: Over the past two decades, fatal opioid overdoses have been rising. Joanna mentioned her brother was given Narcan during his first overdose. It's the brand name for the drug naloxone. It's a simple nasal spray that can reverse opioid overdoses. It's becoming more and more available and it can save lives.
Joanna Kaufman: I think the question is, how can we best protect the people who we have alive in our lives and see their value. Ben died at age 20. He was such a tremendous light, and when I think about the ways that he could have contributed to the world throughout his life or just like who he would've become, that's the grief and that's the loss when we don't take the steps to be prepared.
Katerina Barton: We're pausing here. Up next, I'll learn some of the simple steps that can save someone from a fatal overdose. This is The Takeaway.
Melissa Harris-Perry: You're back with The Takeaway. I'm Melissa Harris-Perry and we're bringing you a special Takeaway report on the continuing opioid crisis and the harm reduction strategies and tools that can save lives. Here again, is our producer, Katerina Barton.
Katerina Barton: Over the past two decades, the number of people dying from opioid overdoses in New York and across the United States are rising each year. This is from prescription opioids and also because of the massive flow of fentanyl into the American drug trade. More than 81% of the overdose deaths in New York City in 2021 involve fentanyl. It's being found in more and more types of drugs like heroin, meth, and even cocaine.
There is something that public health experts say could help. Narcan is an overdose prevention tool that anyone can use. It's legal and it's pretty quick and easy to learn how to use it and it can reverse an opioid overdose. A CDC study from 2020 found that nearly 40% of overdose deaths occurred while another person was nearby, which means the more people carrying Narcan, the better chance there is of saving a life. After her brother's death in 2019, Joanna got trained to administer Narcan
Joanna Kaufman: I do carry Narcan all the time. Sometimes either on like Ben's birthday or death anniversary, I do encourage my friends to sign up for training. It's free. You get free Narcan. Yes, I feel like people are overdosing all around us and you just never know when and you don't know who.
Katerina Barton: At least in New York City, there are dozens of public trainings online and harm reduction centers that are willing and waiting to train people on how to administer Narcan. One of these places is the After Hours Project, which is nestled between Myrtle and Broadway under the subway tracks in Brooklyn, New York. I went there to meet with Elena Rotov.
Elena Rotov: I am the Narcan coordinator here at After Hours Project, which basically means I do Narcan trainings and I keep track of the Narcan that we have going in and out every month.
Katerina Barton: Narcan is just one of the prevention tools they use.
Elena Rotov: After Hours Project is a nonprofit basically was started 20 years ago to help stop the spread of Hep C and HIV particularly in injection drug users. Getting people clean needles, clean syringes, helping pick up dirty syringes in the community, and then we'd expanded from there.
Katerina Barton: Elena gave me a tour of their office and trained me on how to administer Narcan.
Elena Rotov: When you use it on a person just as a regular nasal spray like you would anything else, it essentially will block the opioid receptors in the person's brain for 30 to 90 minutes. This will stop respiratory depression, which is what overdose is, essentially. The kit that I'm going to give you today has two doses of four milligrams. Basically, if after you use the first dose, the person doesn't wake up after a minute or two, you can go ahead and use a second dose. That's because it's completely legal to use this on anybody at any time because it's completely harmless. Essentially, if you don't have any opioids in your system, it's not going to have any effect on you at all.
Katerina Barton: So first, Elena says that if you think someone might be experiencing an overdose, you'll want to check for respiratory depression, which is when someone's breathing slows way down. You're also going to look to see if a person is responsive.
Elena Rotov: If somebody is non-responsive to shouting or yelling, we recommend doing a sternal rub which is where you make a fist and then rub it on the chest cavity gently. A little hard but not too hard, just enough to be uncomfortable just so that you're not shaking someone's shoulders if they fell and hit their head or something. Just a gentle way to see if that person is responsive to touch.
Katerina Barton: Elena says if the person is still not responding, the first step is to call 911 to get paramedics. EMTs will have extra doses of Narcan and will be able to do CPR if it's needed. It's important to call 911 because Narcan only blocks opioids for 30 to 90 minutes, so it gives time for paramedics to arrive and for someone to get to the hospital to be treated further.
Elena Rotov: It does not remove the opioids from the person's blood. You've ingested the opioids already, you can't get them out. Once it wears off, the person could overdose again. Your body's had a little bit of time to work through the drug, but once the Narcan wears off, it could result in another overdose.
Katerina Barton: After you've called 911 and paramedics are on their way, then she says you can administer the Narcan.
Elena Rotov: Basically, you want to take the Narcan out of the package, and if you can tilt the person's head back a little bit, you can give a glance to the nasal passage just make sure there's nothing obstructing it at which point you will you put the nasal spray inside, either nostril, it doesn't matter and press down on the plunger. You want to make sure that it's fully in there before you press on the plunger because otherwise it will be lost. Each shot is just one dose. Then after a minute or so if there's no response, you can go ahead and use the second dose.
Katerina Barton: If a person still isn't responding then Elena says you can administer CPR if you're trained until paramedics arrive. If you're worried about calling 911 because you have drugs on you or you're worried about getting the other person in trouble, it's good to know that most states have Good Samaritan Laws which will protect you.
Elena Rotov: The Good Samaritan Law will protect you and the person you're calling for. Basically, even if the person has drugs on them or you have drugs on you, you will be protected from prosecution except in the case of open warrants and child welfare cases, and immigration-related issues.
Katerina Barton: Narcan is already pretty readily available, and the good news is, it will become even more widely available later this year. In March, the FDA authorized the drug to be sold over the counter at pharmacies across the US without a prescription. Elena says, the more people who know about Narcan and how to use it and the more accessible it is, it can save lives and eliminate a lot of the stigma that comes with drug use or even carrying around an overdose prevention drug.
Elena Rotov: The stigma surrounding it can be really damaging. That puts a lot of normal people who might have stigma around drug use in their family. It puts their family members at risk when there's heavy stigma surrounding carrying Narcan or when there's assumptions being made about like, "Oh, well, you must use drugs or this and that." The more it becomes normalized to have it, I think overall the safer every public environment and private environment will be.
Katerina Barton: For my friend Joanna, she just wants people to care about the opioid epidemic just as much as any other public health crisis.
Joana Kaufman: We're all masking, right, throughout the pandemic. We're all social distancing, and really policing each other about that, but I think that there's this association around substance use that maybe their lives are worth less or it's their fault or they're putting themselves in harm's way or whatever the story is that makes us feel like we are not responsible for being in community care around them or carrying Narcan. Whatever it is, I would really like to see the same collective and individual responsibility that people felt for the pandemic around the opioid epidemic.
Katerina Barton: For The Takeaway, I'm Katerina Barton.
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