Last Friday was International Overdose Prevention Day, but if today is like every other day in recent memory, at least one Long Island family will begin making funeral plans for a loved one whose untreated addiction to prescription painkillers, heroin, methadone, cocaine, Xanax or some combination of drugs and alcohol claimed their life. More than 350 Long Islanders lost their lives to accidental overdose last year – about one per day. Nationwide, someone dies of an overdose every 19 minutes and countless others survive, but suffer irreversible brain damage.
Overdose fatalities involving prescription painkillers like OxyContin, Vicodin, Percocet and Fentanyl are three times what they were a decade ago. The misuse of these and a few other medications were responsible for 15,000 US deaths in 2008 and 475,000 emergency department visits in 2009. A whopping 12 million Americans reported using prescription painkillers non-medically in 2010 and an estimated two million more people will join their ranks in 2012.
The National Health Center for Health Statistics recently found that drug overdose has edged out car crashes to become the leading cause of accidental death in the US. If only there were something like say, seatbelts, or airbags or anti-lock brakes that could save someone who is careening through the pitch black tunnel of an overdose death. There is.
It’s a drug called called Naloxone, which is distributed under the brand name “Narcan.” Developed in the late 1960’s, Narcan immediately reverses opiate overdoses by blocking key brain receptors and counteracting life-threatening central nervous system and respiratory depression. The generic drug, which can be administered via a nasal spray or injection is not prone to abuse because it doesn’t get you high (in fact, it does just the opposite) and has no major side effects if administered in error. Addicts in the throes of overdose who get the drug will likely suffer significant withdrawal symptoms and they’re frequently pissed rather than thankful, but they’ll live to see another day.
Emergency departments and emergency medical technicians (EMTs) have dispensed Narcan for decades, but too many folks are dying waiting for an ambulance to arrive and in many cases, the 911 call happens long after the person has expired. Few non-medical people know about Narcan and it’s only available via prescription, though the federal Food and Drug Administration (FDA) held a hearing earlier this year to explore over-the-counter availability. It costs less than $20 per dose.
Community access to Narcan happens now through a limited number of overdose prevention programs that train drug users and their families to recognize the signs of overdose, underscore the importance of immediately calling for medical help and equip them with life-saving Narcan kits. In February, the federal Centers for Disease Control and Prevention (CDC) released results from a survey of 48 such programs nationwide that detailed 10,000 overdose revivals since 1996. The New York State Department of Health has approved about 75 Opioid Overdose Prevention Programs to date, including one run by the Long Island Council on Alcoholism and Drug Dependence (LICADD), which so far has trained in excess of 300 community members, including two dozen residents of the Shinnecock Indian Reservation.
Those efforts got a boost in recent weeks as the Suffolk County Police Department kicked off a pilot program that put Narcan nasal sprays in the hands of 300 cops in the 4th, 6th and 7th Precincts. Sector cars often arrive on the scene well before ambulances and during a medical emergency, every second counts. The early results are mind-blowing: cops have revived three people in as many weeks. Those three people likely got the wake-up call of their lives and their families can arrange drug treatment, rather than a funeral.
Suffolk lawmakers led by Kara Hahn (D-Setauket), who voted unanimously to create the pilot program, should immediately expand it to include every sector car in the county. Nassau should do the same. School nurses across Long Island – particularly those working in high schools where prescription drug abuse is rampant – should be trained and given Narcan kits. Parents of addicted kids need access more than anyone else and drug users should be trained and equipped to help their friends.
Seventy percent of people who abuse prescription painkillers say they get them from family, friends or straight out of the medicine cabinet. Shouldn’t an overdose antidote like Narcan, which is safe, cheap and proven to save lives, be as easy to obtain? Why isn’t Narcan included in every first aid kit distributed across America?
New York has been pretty progressive on this issue. State lawmakers approved a bill in 2006 that allows non-medical folks to administer Narcan and extends good samaritan protections to those who use the drug in good faith. The Legislature also approved a measure last year that provides for limited immunity from prosecution for certain drug offenses when someone calls for help during an overdose.
We’re also beginning see an awakening at a national level. Even Obama’s drug czar, Gil Kerlikowske, who as a former police chief is a law-and-order kind of guy, recently spoke out in favor of increased access to Narcan. “The Administration supports the use of naloxone by public health and law enforcement professionals because we have seen how effective the drug can be,” he told a group in North Carolina last week.
So, with questions about potential liability, safety and costs handily addressed, what’s the hold-up? It’s apathy more than opposition, though a few naysayers have suggested that educating drug users about overdose and giving them Narcan will leave them a false sense of security and encourage them to use more drugs. That’s the same mindset that allowed HIV/AIDS to kill hundreds of thousands of Americans as we bickered about whether a piece of latex would encourage people to become promiscuous. Think about it. We don’t all drive faster because our cars are equipped with airbags, nor do we eat more Ring Dings because there’s an automated external defibrillator (AED) bolted to the wall in our corporate cafeteria.
Potentially avoiding death doesn’t encourage drug use any more than the fear of death stops it. Addiction is an inherently irrational brain disease, but it’s also treatable and needn’t prove fatal. Too many families are losing the race against time as they beg, plead, and try to cajole their loved one into treatment for a disease whose calling card is massive denial. Too many young people never make it through the doors of a treatment center, never come face-to-face with a counselor and never get a shot at experiencing the miracle of recovery.
Given the enormity of the opiate crisis and recent advances in substance abuse prevention and addiction treatment, it’s easy to wonder whether getting an addict breathing again is the best we can do. Nope, but it’s certainly the least we can do.