The opioid epidemic claims 115 American lives every day. Advocates of the overdose antidote naloxone are intent on lowering that number
Bronx native Brian Angel, the 27-year-old canvass director at VOCAL-NY, received training with his colleagues to use the anti-overdose drug naloxone just weeks after he started at the grassroots community nonprofit last August. By late October, he told Moneyish, he had already reversed an overdose.
“(That) goes to show you how important it is,” he said. “I feel like I can actually help people.”
Angel, who’s tasked with recruiting members and donations for the Brooklyn-based organization that helps low-income people affected by homelessness, HIV/AIDS and mass incarceration, says he and his staff saw a man lying outside on the ground with his arms outstretched. As Angel turned the corner, he said, he saw a cop nearby calling for backup. “I think he’s sleeping,” Angel recalled the officer saying. “He’s overdosing!” he said he yelled in response. (Naloxone training typically teaches participants how to recognize an overdose, provide rescue breathing and administer the drug.)
After a coworker helped him locate the naloxone kit in his bag, Angel said, he put on the gloves, held the man’s left nostril and sprayed the first naloxone spray into his right nostril, then started rubbing his chest. The overdosing man “popped right out of it” within a few seconds, he said, and repeated the words, “Thank you, thank you, thank you.” The cop, Angel added, was “speechless.”
Naloxone, available under brands like the intranasal spray Narcan and the auto-injectable Evzio, has gained traction as one harm-reduction strategy against the nationwide opioid epidemic that kills 115 Americans daily. The drug acts to swiftly combat the slow or stopped breathing that results from overdosing on opioids — i.e., prescription painkillers, heroin or the potent synthetic fentanyl — by binding to opioid receptors to reverse the effects.
Though naloxone’s price has climbed in recent years, most insurance plans cover it and most states have made it available without a prescription; local community and public-health organizations have also worked to increase access. A two-dose carton of Narcan costs $125.
Law enforcement and nightclub staff have also invested in naloxone training. Tecla Tesnau, the manager and longtime head bartender at Baltimore’s Ottobar, had her staff of about 25 trained to use the drug in February or March of 2017, she said. With just two new hires to train this year, she decided to open up her training to the community, drawing around 30 people. Based on the positive response, she added, she may even “step up the frequency” to quarterly trainings.
Forty-nine-year-old Tesnau, who says she has had close friends overdose, says the newfound knowledge is “empowering” for her employees. “I don’t think there’s anything quite so alarming as having something tragic … unfold in front of your eyes and not being able to do anything about it,” she said “In the instance that there is an overdose, they know what signs to look for; they know how to handle the situation … they know how to use the product, and also to be prepared for the possible fallout from using the product.”
She also hopes to provide a degree of comfort to clientele, she said, “that if you come in, we have a staff that’s trained and well-versed in ways that can help people — instead of just being your average rock venue.”
Heightened access to the drug has inspired some pushback, with critics arguing it could encourage riskier opioid use: Research published in March suggested that “broadening naloxone access led to more opioid-related emergency room visits and more opioid-related theft, with no reduction in opioid-related mortality.” A 2009 study, meanwhile, pointed out that laypeople were “consistently successful” in deploying the overdose-reversing drug long used by emergency medical personnel. “The peers or family members of overdose victims … are most often the actual first responders and are best positioned to intervene within an hour of the onset of overdose symptoms,” the authors wrote.
To that end, Surgeon General Jerome Adams urged more people to carry the lifesaving antidote in a rare public health advisory last month.
“For patients currently taking high doses of opioids as prescribed for pain, individuals misusing prescription opioids, individuals using illicit opioids such as heroin or fentanyl, health care practitioners, family and friends of people who have an opioid use disorder, and community members who come into contact with people at risk for opioid overdose, knowing how to use naloxone and keeping it within reach can save a life,” he said.
Arielle Mayer, a 32-year-old bartender at Comet Cafe in Milwaukee, learned the scope of the opioid crisis when she dated an ex who struggled with prescription pill dependency. Curious about the liabilities and logistics involved with naloxone, she decided to attend a training in January at Riverwest Public House Cooperative.
“I think it helps me do my job better because I can see signs more clearly of intoxicated people. I know what a drunk person looks like, but now knowing what someone who might be on opiates might look like when they’re using is helpful,” Mayer told Moneyish. “I feel better meeting new people — and feeling like if I walked into a situation that was dangerous, that I have at least a little bit more background knowledge on what to do in case of an emergency.”
Mayer encouraged others — in the service industry and beyond — to get trained up, too. After all, she said, “knowledge is power.”
“Even if you don’t have Narcan at your disposal or you are not particularly interested in being the person who administers it, having the knowledge and being able to walk someone else through it, or being able to even just assess that ‘This is an overdose’ versus ‘This is just a tired person or a drunk person,’ is really important,” she said. “Knowing isn’t going to hurt you.”
West Palm Beach life coach and meditation teacher Brandyce Stephenson sought out that knowledge, attending a naloxone training at Rapid Recovery Florida about six months ago. “Until things drastically improve and get better, it’s going to take all of us,” said Stephenson, who is 11 years sober from alcohol. “It’s an hour of your time and you could literally save someone’s life. That’s just a no-brainer to me.”
Though she initially wondered when she would ever run into someone overdosing on opioids, Stephenson said, she reminded herself that with addiction, “you just never know.” “So it’s better to have the knowledge,” she said. “How would I feel if I didn’t have that training, and someone close to me was overdosing on the couch or in the bathroom?”
Stephenson now drives around South Florida with a naloxone kit in the trunk of her car. “I can be the difference between life or death,” she said. “It makes me feel empowered. It makes me feel like I’m part of the solution and not the problem. And I think if I can be the difference between someone’s last breath and a shot at having another day, then that’s really the important part.”
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