By Ashton Pack and Haven Steele
For The Parthenon
Amidst the ongoing opioid epidemic, harm reduction strategies have been essential for reducing the number of deaths by overdose. One of the most important harm reduction strategies is the deployment of Narcan, also referred to as naloxone, an overdose reversal medicine.
Susan Margaret Murphy, president of the West Virginia Drug Intervention Institute, said naloxone is the most effective harm reduction tool available.
“It is a primary harm reduction strategy, because it’s the one tool we have that can reverse death,” Murphy said.
“You can’t recover if you’re dead, and we can’t even talk to you about getting into recovery until you’ve been revived.”
Naloxone works by blocking the brain’s intake of opioids by displacing them. Murphy compared the way naloxone works to an overcrowded parking lot.
“Naloxone is an opioid antagonist. If you think about the receptors in your brain as a parking lot, when you take an opioid, that opioid is parking in those parking spaces in your brain,” Murphy said. “When we administer naloxone, it kicks those cars – or the opioid – out of those parking spots and reverses the overdose.”
Casey Edwards, a peer recovery support specialist at St. Mary’s Medical Center, said he carries Narcan with him everywhere he goes. He said he has had to use it.
“It doesn’t hurt to carry it or to have it on you. For me, I have it in my backpack that I carry everywhere. I have it in my car’s glove box. I have multiple doses at home,” Edwards said. “And I’m glad that I do because I’ve had to pull Narcan from each of those locations and use it on people.”
Edwards said there is no reason for people not to carry Narcan with them.
“If somebody thinks that they don’t need to carry Narcan, honestly, with the opioid epidemic and where it is, and the amount of people that are overdosing these days, in a way, I feel like that’s a selfish way of thinking,” Edwards said.
Narcan does not always work on the first try. Edwards said it varies from person to person.
“One time whenever I used it on someone, I used one four milligram nasal injection and gave it to him and within five seconds his eyes were open and he started to talk. I mean, boom, he was right with it,” Edwards said. “Other times, unfortunately, I used five or even six doses. It took that much to bring him back. And luckily, it did.”
Though there is often a stigma around the stereotype of people who use drugs, Edwards said it could be anyone.
“There’s police officers, there’s medical professionals, there are teachers, there are people you would never suspect to be using opiates and behind the scenes, they are,” Edwards said. “You never know whenever that person could go down in an overdose.”
Murphy said it is very important for people to carry naloxone with them, especially in an area like Huntington, where overdose rates are still high.
“You are living, working and breathing in a city where there were 28 overdoses in one day, I think it was 2017 or 2018,” Murphy said. “There are spikes in Cabell County and in Huntington pretty often.”
Dickie Anderson, a retired Huntington firefighter, said it’s important to carry it because you never know who could need it.
“I don’t know about how many people do it, but carrying Narcan, if it’s the inhaler type, small, convenient, you always have it on you,” Anderson said. “You never know who needs it. People that are hooked on heroin, sometimes you don’t know who they are.”
“It’s just an overwhelming probability that if you see someone down in Huntington, it’s because of heroin,” Anderson said.
Murphy said there is a common misconception that improper naloxone use can result in getting someone high.
“I’ve run across some common misconceptions that naloxone can get you high, which is totally the opposite of what naloxone does,” Murphy said. “It actually kicks you out of that high. It’s a relatively safe medication and it’s now available over-the-counter.”
She said there are no negative effects from using it on someone who has not had an overdose.
“I could give naloxone to myself right now, and the most I might have is a runny nose,” Murphy said.”
Edwards has experienced that firsthand, as he has seen Narcan get deployed on suspected overdoses before when people were found unconscious.
“You can even use Narcan if it’s not an overdose,” Edwards said. “There’s been instances where somebody is unconscious and for some other reason and it’s a suspected overdose, but so Narcan is administered, but it doesn’t do anything to the patient.”
Edwards said the telltale signs of an overdose are shallow breaths, a slumped position, and a loss of color in their skin.
“You could do anything to try to get them to become active again, cause pain, that sort of thing,” Edwards said. “Do a sternal rub. They’re not going to feel it. At that point, you know that they’re in an overdose.”
As with many issues surrounding drug use, there is a stigma around the usage of Narcan. Murphy said a common sentiment she encounters is the idea that Narcan enables drug use. She said that’s a misconception.
“It’s an emergency rescue medicine in the same way that an inhaler is used or an EpiPen is used,” Murphy said.
Though some people view substance use disorder as a moral failing, Murphy said it is not any different from any other disease in that regard.
“I liken it to any other disease,” Murphy said. “We don’t do this with people who have diabetes and they’re drinking three Mountain Dews a day or choosing to hit the Dunkin’ Donuts every day. We don’t say, ‘Well, that’s a moral failing.’”
Murphy said substance use disorder is different because it rewires the brain, causing a chemical dependency.
Anderson said the opioid epidemic in Huntington is still a relatively recent phenomenon. He attributed the rise in opioid deaths to the decline of oxycontin pill usage, a drug he referred to as “hillbilly heroin.”
“In about 2010 or 2011, they passed legislation that cut all the pill mills out of Florida. So as soon as the pill mills stopped, all the oxycontins stopped flowing into the state,” Anderson said. “Waiting in the wings was heroin. Everybody switched immediately from hillbilly heroin to the real heroin.”
Anderson said the number of overdoses was overwhelming during his time as a firefighter.
“We used to run to seven to ten a day. Just my station, my truck. One truck out of a whole city,” Anderson said.
Anderson said he attributes many overdose deaths to other drugs being laced with fentanyl.
“I’ve seen, I personally know of, someone that’s passed away from cocaine laced with fentanyl,” Anderson said. “It’s getting in every drug that you use now. There’s nothing on the street that you can buy that is safe. It was never very safe to begin with.”
Murphy said the number one way to help reduce overdose deaths is to continue to increase naloxone availability and training.
“For me, I think the proximity of naloxone and getting it out here and having robust community distribution programs where students and citizens can get naloxone for free is really important,” Murphy said.
Murphy said the widespread availability of naloxone has helped reduce overdose deaths among most demographics, though there are some where there has not been any reduction. She said college aged men are one of those demographics.
“We’re seeing an increase in overdoses among the college age population,” Murphy said. “It’s not that a bunch of college students decided to do heroin or take fentanyl, but college is oftentimes when you experiment.”
Alongside experimentation and laced party drugs, Murphy said other drugs often used by college students are also being laced with opioids, such as Adderall being used by students trying to stay up late to study. She said this trend means it is especially important for college students to know how to use naloxone.
“Learning how to use naloxone, being willing to carry it, being willing to show other people how to use it,” Murphy said. “Knowing the dangers of counterfeit pills, especially among the college age population, is huge.”
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