The number of unintentional deaths from opiate overdoses in North Carolina has more than tripled from 1999 to 2012, when there were more than 600 reported deaths. Last year, state lawmakers attempted to address the growing problem with legislation that makes it easier for drug users to obtain an overdose-reversal drug called naloxone, or Narcan. WFAE’s Nick de la Canal takes a look at how that drug is being distributed and used to prevent overdose deaths.
Last November, Louise Vincent and Adam Wigglesworth visited some friends in Greensboro.
They knew their friends were planning to get high on heroin that night. So, to be safe, Louise and Adam brought along sterile needles and some Narcan.
The evening got off to a rough start.
“When they did get high, within a few minutes, we noticed they were kind of slumped over and just sort of asleep, snoring, deadweight,” Adam says.
A woman named Liz looked especially bad. Her breathing became shallow. Her lips were turning blue. So the friends decided to administer Narcan.
In a video Louise and Adam captured that night, Louise is seen crouching over a brown sofa giving Liz mouth-to-mouth. Liz’s face is ghostly white, her mouth agape. Despite all this, Louise and Adam don’t seem particularly frightened or concerned. They don’t even bother turning off the loud music in the living room. Adam pulls out a syringe and aims it at Liz’s thigh. He deftly pushes the needle in.
“Come on, Liz. Liz? Liz!” Lousie coaches, “Alright, let’s go ahead and give her some more Narcan.”
“Giving her the rest of this CC,” Adam replies.
He fills the syringe with another dose. Again, he presses the needle into Liz’s leg.
“It looks like the color is coming back, right?” says another friend in the room.
“Looks like the color is coming back,” Louise says, “She was already very tired.”
Suddenly, Liz’s eyes flutter open and her chest fills with breath. Louise holds Liz’s face in her hands.
“Liz... You overdosed,” she says, “Can you sit up for me?”
Liz delicately lifts herself upright and takes a cup of water from Adam. The friends call an ambulance. She survives the overdose.
From The Doctors To The Users
Narcan, also known more generically as naloxone, has been around since the 1960s. It’s on the World Health Organization’s list of essential medicines - right up there with morphine and ibuprofen. Up until last year, only doctors and other medical workers could administer the drug. But that changed last year with the passage of the 911 Good Samaritan law. Now anyone can administer Narcan.
The North Carolina Harm Reduction Coalition has since distributed free drug overdose kits with Narcan to more than 1,700 people.
“We’ve given them out literally all over the state,” says the coalition's director Robert Child. “The most kits have gone out in the Greensboro - High Point area, the triangle of North Carolina, in Charlotte, in Asheville, in Clyde…”
Over the past year, the group has documented 77 times the kits were used to reverse an overdose.
The kits come in plastic sandwich bags. Louise and Adam keep hundreds of them in a large cardboard box in their Greensboro home. They’re also volunteers with the coalition.
The bag has a brochure with information on how to administer Narcan. Just fill up a syringe with about 1 CC of the drug and stick it in a person’s bicep, thigh, or buttock, you don’t even need a vein. And the kit comes with two sterile syringes with large 3 CC needles, which are large enough to go through clothes.
The kit’s centerpiece is in a tiny, brown, zip-lock bag: two miniscule vials of Narcan about the size of your knuckle. Louise and Adam give them out to anyone they know who’s using. They say they visit crack houses or house parties where drugs are used. They’ll even ask drug dealers to distribute the kits to their customers. Plus, they make sure to have it around if they use.
A Second Chance
There are concerns that Narcan is such a good safety net, it will actually encourage people to shoot up more often and at higher doses. But Robert Martin, director of substance abuse services at Carolina’s Medical Center’s Mercy Hospital doesn’t buy that.
“Most clinicians believe that people are going to use anyway,” he says, “Just having naloxone in the house is not going to make someone use more drugs than they normally would.”
That’s what many politicians and health officials are beginning to believe too. Seventeen states and the District of Columbia have adopted laws that allow everyday people to administer Narcan. Maine was set to be the 19th, but its governor issued a veto last year.
The legislation that was passed in North Carolina last year also allows doctors and licensed medical workers to prescribe bottles of Narcan to their patients. Martin says that increased availability is a good thing. If someone overdoses and is saved, he says, that may be the defining moment that that person decides to get treatment.
And in the case of Liz, the young woman who overdosed, that’s what happened. She got a second chance from Narcan, and few days later, used that chance to check herself into rehab.
