Heroin overdose antidote promises fewer deaths but raises questions over who should carry it

The Associated Press

A kit with naloxone, also known by its brand name Narcan, is displayed at the South Jersey AIDS Alliance in Atlantic City, N.J. on Wednesday, Feb. 19, 2014. An overdose of opiates essentially makes the body forget to breathe. Naloxone works by blocking the brain receptors that opiates latch onto and helping the body "remember" to take in air. (AP Photo/Mel Evans)

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By KATIE ZEZIMA, Associated Press

CAMDEN, N.J. (AP) — As deaths from heroin and powerful painkillers skyrocket nationwide, governments and clinics are working to put a drug that can reverse an opiate overdose into the hands of more paramedics, police officers and the people advocates say are the most critical group — people who abuse drugs, and their friends and families.

Supporters say the opportunity to save potentially thousands of lives outweighs any fears by critics that the promise of a nearby antidote would only encourage drug abuse.

At least 17 states and the District of Columbia allow naloxone — commonly known by the brand name Narcan — to be distributed to the public, said Jeffrey Levi, executive director of Trust for America's Health, a national nonprofit that focuses on preventive health care. And at least 10 of those states allow for third parties, such as a family member or friend of an intravenous drug user, to be prescribed it.

Among them is New Jersey, which passed a law last year that allows members of the public to carry naloxone — administered through a nasal spray or injection into a muscle — after getting training.

About 20 people, most of them related to overdose victims or people who currently abuse heroin, crowded into a clinic last weekend in Camden, a drug-plagued city across the Delaware River from Philadelphia, to learn about the antidote. Jane Stiuv, whose daughter survived a heroin overdose in 2011, listened as a nurse described the signs of an overdose and when to administer naloxone.

Stiuv, who found her daughter slumped over the side of a bathtub with a needle in her arm hours after her release from prison, said she wanted to learn how to reverse an overdose should it happen again. Each attendee received a kit containing two syringes, a small vial of naloxone, alcohol swabs and a face shield for rescue breathing.

"I was a little shaky. It brings me back to the times she overdosed," Stiuv said of the training. "But it makes me feel better that it can help her and do something about overdose prevention."

Naloxone is regarded within the medical community as highly effective when used properly. A study conducted during a state-supported pilot of naloxone distribution and overdose education in Massachusetts showed it was 98 percent effective in attempts to rescue a person who overdosed.

Police in Quincy, Mass., have been carrying naloxone nasal spray since 2010 and said in July 2013 that they used naloxone 179 times, reversing 170 of those overdoses — a 95 percent success rate.

According to the White House Office of National Drug Control Policy, the number of overdose deaths involving prescription drugs increased 21 percent from 2006 to 2010; the number of overdose deaths involving heroin increased 45 percent.

Bills are pending in at least seven states to increase access to naloxone. In Tennessee and Utah, doctors would be allowed to prescribe it, and civil liability for those who administer it would be dropped. A Wisconsin bill seeks to broaden access to naloxone and, as New Jersey also does, provide legal immunity to drug users reporting an overdose.

Marty Walsh, the new mayor of Boston, this month called for all first responders to carry naloxone. Police in Indianapolis, where heroin overdose deaths have doubled since 2011, have started a pilot program to have officers carry the drug. In Ocean County, N.J., police are being trained in how to use it.

The White House drug policy office is also urging all first responders to have naloxone on hand. In 2012, the Food and Drug Administration held hearings on making naloxone available over the counter, but it has not yet done so.

Naloxone is available by prescription in the United Kingdom, but an advisory council has called for over-the-counter distribution. Prescription take-home programs are in place in Australia, Canada, Estonia and Russia. Norway plans to distribute nasal spray kits to drug users in its two largest cities.