Narcan takes center stage in battle against opioids

As the heroin and opioid epidemic continues, police and paramedics are often the first line of support when it comes to saving users from deaths.

Nalaxone, more commonly known as Narcan, is currently the main and most effective drug used to revive those in the midst of an overdose of heroin. The drug acts by blocking the opioid receptors in the brain, effectively prohibiting the drug from continuing its effect on the user.

Narcan is able to administered in multiple ways, with paramedics having the training to administer it though and IV, intranasally or in a syringe, while police training limits them to intranasally.

Firefighter/paramedic with Kent Fire and EMS, Caleb Schjeldahl, has been carrying and using Narcan for over 10 years now. He says that in recent years, as heroin use has become more common, his distribution rate of Narcan has also been on the rise.

“I’ve been a paramedic since 2006, and it’s always been here,” Schjeldahl said. “The prevalence of its use has never been what it has been in the past two or three years. I can count on one hand how many times I gave it from 2006-2014.”

He also praises its effectiveness, and the necessity to have it on hand.

“That drug does an amazing job of reversing immediate life threats,” Schjeldahl said. “It’s a necessary thing that we have on there, it’s a great tool for what it’s used for. It does exactly what we need it to do.”

While Narcan is a crucial tool to giving addicts a second chance and the opportunity to seek help, the drugs it works on are limited.

“There’s certain things it won’t work on; carfentanil being one of them,” Administrative Lieutenant for Kent PD, Michael Lewis, said. “Just because that drug is so powerful, it won’t have an effect. Carfentanil is (at least) 100 times more potent than regular fentanyl, and [10,000] times more powerful than morphine.”It is these other powerful substances that are leading to so many overdose deaths.

According to the Portage County Coroner’s Office, of the 47 drug deaths seen in the county, three were caused by heroin alone, six were from a combination of heroin and fentanyl, 17 were from fentanyl alone, seven were from carfentanil and one was from the drug 3-methylfentanyl.

This year, Lewis says Kent PD have already responded to four overdoses cases, with one being fatal.

Not only is Narcan carried by paramedics and law enforcement, but can now also be obtained by civilians.

“There was just recently a training opportunity that was given out at Northeast Ohio Medical University (NEOMED) in Rootstown, and anybody who went to that training could receive free Narcan,” Lewis said. “The same service is offered in Kent through the Mental Health and Recovery Board. It’s very important, it’s about saving lives.”

The distribution to the public though, is not something Becky Doherty, Judge of the Portage County Common Pleas Court, is necessarily in favor of.

“I personally think that Narcan should be used be medical personnel (and) law enforcement,” Doherty said. “Because the concerns that I had about Narcan being available to people over the counter, is that it gets in the hands of the addicts. What I’ve learned recently is that heroin dealers will sell Narcan at the same time and that’s really terrifying. It’s not like the news isn’t out there, the word isn’t out there that you can overdose on this stuff. But, in order to prevent that, the dealers are providing narcan along with it.”

Narcan, while effective, still does not, and will not, prevent someone getting addicted to heroin. Both Schjeldahl and Lewis attested to what a powerful drug it can be.

“The thing about Heroin is, it’s so addictive that after a short period of use, you’re not using it recreationally,” Schjeldahl said. “You’re almost using it to stop being sick. So they have to use, otherwise they get violently ill. If they’re not under medical care they withdraw, and it’s dangerous to them”

Lewis talked about how this drug often causes people to do things they would never imagine doing.

“This is such an addictive and powerful drug, that it hooks you the first time you use it,” Lewis said. “And then you just crave it. Where one hit used to do it, now you need two, three, four, and it just goes on from there. You become such an addict you end up burning out the veins in your arms. Next thing you know you’re shooting up in between your fingers, underneath your fingernails, in between your toes, underneath your toenails. This drug really takes hold of you and doesn’t let go until it kills you.”

This past June, Ohio Governor John Kasich signed Ohio House Bill 110. The “Good Samaritan” Bill, which went into effect in September, “provides immunity from prosecution for a minor drug possession offense if the person is seeking or obtaining medical assistance for a drug overdose, provided that, within thirty days of seeking or obtaining the assistance, the person obtains a screening and referral for a drug screening and treatment,” and that “no person shall be granted such immunity more than two times.”

In short, this new bill provides immunity from being criminally charged for drug possession, so long as the offender is seeking or receiving treatment.

“The reason for that is they didn’t want to discourage people from contacting life-saving efforts for fear of being charged,” Lewis said. “Now, there’s some caveats to that. If you are found in possession, you’re going to have 30 days to get involved in some sort of drug treatment program. If you don’t, then you can be charged.”

Moving forward, there remains more questions than answers about how to properly address the matter of heroin addiction, beyond reviving them with Narcan.

“This is a systemic sickness for the family, for the healthcare system, for law enforcement,” Schjeldahl said. “So Narcan helps that immediate problem. We want to save people, that’s why we’re here. What happens after that is the bigger picture. We give ‘em the Narcan, we take ‘em to the hospital, and that’s it. It’s a much bigger issue than just giving somebody Narcan on the street. It’s this big systemic issue that really needs to be addressed.”

Lewis suggests the way to go about that is through education and forced treatment.

“Is Narcan going to solve everything? No, absolutely not,” Lewis said. “It’s only purpose is to reverse the effect of opiates. It’s not going to solve that person of their drug addiction. So really the only way to stop it is through education. Education and forced treatment is going to be absolutely necessary.”