Narcan: Saving lives or enabling users?
When a heroin user shoots up heroin, they feel an immediate high. Their body falls into an immense relaxation and they feel no pain. They will be so calm and relaxed that they will typically fall asleep because the drug slows down the central nervous system.
But when a heroin user overdoses, they will slip into a deep sleep and their body will forget to breathe. Their central nervous system will begin to fail, their body will go limp and their skin will turn from pale to bluish gray. Their breathing will slow down until it stops and they will go unconscious.
There is a drug, however, that can reverse all of that within minutes.
Narcan, also known as Nalaxone, is an opioid antagonist. Once injected into the body of an overdosing user, it counters the physiological effects of the overdose, bringing them back to life. If there is someone around to call for help when a user is overdosing, that person can likely be saved by first responders, assuming they make it in time. While many users regard Narcan as a safety net, it is often seen as an issue by the people doing the life saving.
Narcan has saved hundreds of thousands of users from dying, but does it stop them from continuing to use? With heroin use and the number of national overdose deaths skyrocketing, this question remains up for debate, especially amongst the first responders themselves.
“I hate to say that through my experience with Narcan, I believe it enables a majority of addicts,” Officer Dallas Millner of the Millsboro Police Department said. “There have been several cases where I’ve responded to an overdose complaint and learned through either my fellow officers, or EMS personnel that the individual has an overdose history.”
According to a DHSS report, in 2016, 308 people died from overdoses in the state of Delaware alone.
“There’s even been a couple times where I’ve responded to the same addict multiple times in a week,” Millner said. “If it’s their first time, it probably won’t be their last, since most of the overdoses we deal with are so commonly frequent amongst the same people.”
Hospitals originally gave Narcan to post surgery patients in case of an accidental overdose caused by consuming too much pain medication. By the 1990s, Narcan was used as an emergency medication for opiate overdoses, and now, every ambulance and police unit carries it. It can even be prescribed to post-op patients on heavy amounts of pain medication and is becoming more easily accessible — which is no secret to users.
“I’ve had actual users tell me that a lot of addicts will come to Delaware just to use,” Millner said. “Not only because some of the best heroin is dealt here, but because the Good Samaritan bill is passed here.”
The Good Samaritan bill is a law that allows either the user to call for help in case of an overdose, and excuses them from any charges. It is practiced in all 50 states, as well as Washington D.C., but certain states protect individuals from punishments more than others. In Delaware, possession of the drug and/or paraphernalia are excused during an overdose.
“It’s extremely frustrating that people come here knowing they can overdose without any huge repercussions,” Millner continued. “I think it’d be extremely effective to arrest them after they’re saved rather than just throwing them back on the street afterward.”
While Delaware is an extremely popular place to acquire and purchase heroin, Maryland has seen similar increases.
“Even if Narcan were to completely disappear, drug addicts wouldn’t stop using their drugs,” Jennifer Diaz, an Emergency Room nurse at Peninsula Regional Medical Center in Wicomico County, Md., said. “They are so far gone that they don’t know which hit is going to kill them, and frankly, they don’t care.”
Diaz continued, saying, “I had a patient who had a vein burst in her arm from using so much. When she started telling me about her 5 year old daughter, I asked her if she would go to heroin or her daughter first if they were both waiting for her when she was released. She told me ‘the heroin, without a doubt.’”
Diaz, like many other medical professionals, often gets to know the users she deals with on a personal level while she helps them heal.
“Most patients that come through tell me that they really do want to get better,” Diaz said. “They’d choose the heroin over anything else because they’re so addicted to it, but they know it’s wrong. They often feel they are addicted because of things they’ve messed up in their lives. To me it seems like the hopelessness they have towards fixing themselves is the barrier to them quitting.”
For many users, because their perception of where they are in life was what caused them to begin uing, it is commonplace to be indifferent about whether they live or die. A former addict, Joseph Greene, who is now 27 and has been clean for seven years, was able to attest to that.
“I struggled with depression throughout my teenage years,” Greene said. “Kids my age were using pretty much every drug under the sun, but heroin was one of the most popular since it was easy to get and gave such a good high. I started using when I was 18, and absolutely loved how it took me away from everything going wrong in my life. I had no desire to go to college, I was practically failing out of high school — I just felt like a failure and had no motivation to fix it.”
Joseph had his first overdose when he was 19, and after being revived with Narcan the first time, he didn’t feel much of a desire to quit.
“The first overdose was scary, but because the Narcan was such a quick solution and I was still so depressed, quitting wasn’t really a priority,” he said.
A handful of Greene’s friends had also been revived with Narcan, but it wasn’t until he lost a friend to an overdose just weeks after his own that got him to eventually try and quit.
“I was there the night my buddy died, and I saw how much it hurt his family and friends, so I wanted to quit for my loved ones,” Greene said. “But the withdrawal effects were so unbearable that I actually thought dying would be a better option.”
After just one day of attempting to quit, Greene went right back to using, which led to another overdose and yet another revival from Narcan.
“The Narcan obviously saved my life twice and I’m eternally grateful for that, but it’s not what got me to quit,” he explained. “When my girlfriend at the time had our first baby, I finally felt a true purpose to live. But not every addict is that lucky, so something’s gotta be fixed for the people that feel like they’ve got nothing better to do than use.”
Whether a solution to drug addiction can be figured out or not, it is clear that Narcan gives users the opportunity to save themselves; but it is solely up to them to want to quit using.
“In a perfect world, we could get every addict off the street and put them in a rehab center,” Diaz said. “But it would be wrong to make Narcan any less accessible than it is because a life saved is a life saved, and that’s what has to come first.”