The dispatcher over the radio reported an otherwise healthy man in his late 30s who’d taken too many prescription pain pills had begun slipping in and out of consciousness. Just minutes away when he received the call, Mike Chustz, a paramedic with Emergency Medical Services in East Baton Rouge Parish, rushed to the scene to find the man’s breath slowing as the narcotics gradually shut down his respiratory system.
Sticking an IV into the man’s arm, Chustz administered a dose of naloxone — a powerful opioid antagonist widely known by its brand name, Narcan. As the drug started coursing through the patient’s veins, Chustz saw an instant reaction. Within minutes, the man came to, shocked into a sudden withdrawal, but saved from a potentially deadly overdose.
“When I gave him the Narcan, it saved him,” Chustz said. “There’s no doubt in my mind that me getting there as fast as I did and administering that medication quickly saved him.”
Soon, that same life-saving anti-overdose drug, administered for decades by emergency room doctors and paramedics, will be in the hands of a growing number of emergency first responders throughout Louisiana. Last week, the Louisiana Department of Health and Hospitals announced that it was distributing 8,640 auto-injectors of the drug, donated by Virginia drugmaker kaléo, to local agencies across the state.
The move comes amid a continued spike in heroin deaths, part of a national trend that’s hit the capital city particularly hard. Deaths from heroin overdoses in East Baton Rouge Parish numbered in the single digits as recently as 2012. So far this year, Coroner William “Beau” Clark said he’s confirmed 24 deaths from heroin in the parish — with another five suspected cases pending a final toxicology report.
“If all those end up being heroin, we will have already surpassed last year’s number,” when 28 people died of heroin overdoses, Clark said.
Dr. Arlene Magee, the executive director of St. Christopher’s Addiction Wellness Center in Baton Rouge, said she’s seen a dramatic uptick in the number of people seeking treatment for heroin addiction, many of whom began using the drug after becoming hooked on prescription painkillers.
“It is unnerving how many young men who come in here have overdosed themselves, had a friend die or witnessed some overdose,” Magee said. “The number of overdoses are frightening and staggering.”
Police officers, sheriff’s deputies and firefighters across Louisiana who are being equipped with naloxone auto-injectors will receive training on how to administer the drug. Mark Miles, a spokesman for the Baton Rouge Fire Department, said all firefighters with his agency have been trained, but the department is waiting for final approval from a physician before deploying the medication in the field. “Once we receive that, we’ll go ahead and load the trucks with them,” Miles said.
EMS ambulances have carried the drug since the agency was founded in 1982. Since this January, paramedics administered naloxone 444 times, as of Thursday. Over the same time frame in 2014, EMS dispensed 239 doses.
Those who’ve studied or administered naloxone describe it as a nearly miraculous drug, capable of snatching an overdose victim from the verge of death. Once injected or sprayed into the nose, naloxone circulates almost instantly in the blood, reversing the effects of heroin and other opiates within a couple of minutes. For addicts, a dose of the drug can trigger withdrawal symptoms nearly instantaneously — sweating, nausea, a racing heart and sometimes vomiting — but at the same time, it is remarkably effective at yanking victims out of an overdose.
“You give this medication and it’s like turning a light switch,” said Clark, who in his earlier career as an emergency room physician administered naloxone numerous times.
“It’s an extremely effective medication and, if someone hasn’t taken opioids, it has no impact at all,” said Dr. Sharon Stancliff, medical director for the New York-based Harm Reduction Coalition, a New York-based training and advocacy organization that pushes for public health measures for drug users. “It’s extremely safe.”
Naloxone’s effectiveness in preventing overdose deaths has bred some controversy over just how widely to distribute it. Some public health advocates have pushed for widespread distribution of the drug — at least 30 states allow lay people, including drug addicts and their families, to be prescribed naloxone injectors or nasal sprays. The Louisiana Legislature this past spring approved a new law that limits legal liability when the drug is prescribed but doctors aren’t able to examine the person who could receive it, as long as the person administering the drug receives proper training.
Some states go even further, allowing pharmacies to dispense the drug without prescriptions.
Critics, though, worry that widespread distribution of naloxone risks encouraging heroin use by giving drug addicts a false sense of security.
“You’re walking a fine line,” said Clark. “We’re certainly trying to save lives, but at the same time, the question is posed if you’re encouraging heroin use.”
Although at least one activist group in Baton Rouge has worked to distribute naloxone to heroin users, those efforts recently came to a close. No Overdose Baton Rouge, a grass-roots volunteer group that provided naloxone and clean syringes to drug addicts, announced on its Facebook page Sept. 19 that it suspended its operations because of lack of time and money.
Stancliff, whose organization advocates for wider availability of naloxone, said that restricting the availability of the anti-overdose drug to emergency personnel meant victims of overdoses might lose precious time while police or firefighters responded — and also risked the lives of drug users reluctant to dial 911.
“The real first responders are the people that are in the room when the overdose happens,” Stancliff said. “It’s family members, it’s friends, it’s other folks that are actually there at the time.”
Studies in Massachusetts haven’t shown any correlation between the availability of the anti-overdose drug and heroin use, Stancliff said, and the sudden shock of withdrawal makes the experience extremely painful for opiate addicts.
Sam Anderson, a 34-year-old recovered heroin addict, said dying from an overdose never scared him away from shooting up. Though addicts are always aware of the possibility of death, Anderson said, the constant craving for the drug became an absolute and overriding desire.
“I have people in my life that are now recovered who overdosed two, three times and it wasn’t enough to scare the s*** out of them, pardon my language,” Anderson said.
Anderson said that he supports widely distributing naloxone.
“I’ve witnessed (overdoses) with my own eyes and have had friends that didn’t get it in time and passed away,” Anderson said. “I’ve put three people in the ground this year. If somebody lives, that’s a chance for them to recover. If they die, there’s no shot.”