Mobile Life’s Steve Helsley demonstrates how Narcan is administered (photo by Phyllis McCabe)
It’s a situation that plays out almost daily in Ulster County — a 911 call reports an unconscious subject. Cops or firefighters arrive to find a person, usually young, barely breathing. Used syringes or empty glassine baggies at the scene may tip off first responders that they’re dealing with an opiate overdose. Other times, the classic sign of opiate intoxication — pinprick pupils — give it away. It’s a situation where minutes make the difference between life and death. Now, in response to near-epidemic levels abuse of heroin and prescription opiates, local first responders are adding a new element to their work gear: safe, easy-to-use doses of Naloxone, a drug that can instantly reverse an opiate overdose if administered in time.
Naoloxone — sold under the brand name Narcan — has been around since the 1960s. An opiate antagonist, Narcan bonds to opioid receptors in the brain and induces instantaneous withdrawal in as little as 45 seconds. The drug quickly counteracts opiates’ depression of central nervous system function, including breathing, which causes death. The drug is generally considered safe with few side effects. If administered to someone who doesn’t have opiates in their system, Narcan has no effect at all.
As a paramedic working in Newburgh and Rockland County in the 1980s, Saugerties Police Chief Joseph Sinagra estimates he administered Naloxone hundreds of times, often with lifesaving results.
“You’d have someone unconscious, unresponsive, you think you’re going to have to [intubate] them,” said Sinagra. “Then you hit them with the Narcan and they pop right out of it.”
Intravenously administered Narcan has long been standard issue for paramedics and other emergency medical workers. Now, there’s a statewide effort to get an easy to administer newer nasal-mist formulation of the drug into the hands of police officers, firefighters and other first responders who aren’t necessarily trained in advanced life-saving measures. In December 2013, the state’s Emergency Medical Advisory Committee approved a new policy that opened the door to handing out internasal Narcan doses to emergency workers trained in basic life support. The state also started a fund to reimburse local agencies for the costs of the drug and related training.
The move comes as overdoses from opiate abuse are soaring around the country, fueled by the popularity of prescription narcotics like oxycodone and, increasingly, heroin. A report issued last year by the state Office of Alcoholism and Substance Abuse Services estimated that an accidental overdose stemming from opiate intoxication occurs once every 19 minutes. Locally, a batch of heroin laced with the powerful synthetic opioid fentanyl was linked to 68 non-fatal overdoses in the City of Poughkeepsie alone in November and December last year.
Scott Woebse, president and CEO of local first responders Mobile Life Ambulance, said his crews were seeing an increase in heroin overdoses in communities around the Hudson Valley. “It’s not just something we see in the urban areas,” said Woebse. “It’s in the suburbs, its out in the country, it’s all over really.”
In Kingston, city firefighters stocked their emergency vehicles with Narcan for the first time on April 7. By April 15, they’d used the internasal kits twice. In both cases, the patients survived. In Saugerties, Sinagra said that he plans to begin issuing Narcan kits to patrol officers as soon as they undergo training. He pointed to two cases this year where town cops were the first on the scene at an overdose and could have used the kits to revive patients before EMS workers arrived.
“We’re in an area where we have limited ambulance resources,” said Sinagra. “If they’re tied up, you could end up waiting and a couple of minutes can really make a difference.”