Narcan distribution prevents some opiate overdose deaths

ST. ALBANS — “Has anyone here witnessed an overdose or administered Narcan before?” asked Turning Point of Franklin County staff member Melinda Lussier, before equipping residents with free kits of Narcan, a drug used to reverse an opiate overdose, one Friday morning.
Part of the Vermont Department of Health’s Opioid Overdose Prevention Pilot Program, the recovery services center in St. Albans City is the only site in Franklin County that offers free Narcan nasal spray to residents after a quick training session.
A young man in the room attending the training raised his hand and shared his story.
He said heroin took the lives of two people he loved. The first time, it was his younger sibling. They shot up together. He survived; his sibling was not so fortunate. The sibling didn’t make it.
Months later, the young man was back at it again, this time shooting heroin with a parent. He survived; his parent didn’t.
Narcan was administered multiple times in one of these instances, but it wasn’t enough to reverse the overdose and save the person’s life.
The young man told Lussier it was these events that drove him to seek treatment. Currently in outpatient treatment for heroin addiction, the young man said he wants a Narcan kit on hand just in case he ever encounters someone overdosing again.
Lussier said it’s this very reason why she is so passionate about the Narcan pilot program.
“I myself am in recovery,” she said. “There was a time in my life that if people would isolate what I looked like or what my lifestyle was, they would absolutely think, ‘Yeah if that girl (overdoses), she should die.’
“However, I was very blessed and graced with having my life spared,” Lussier said. “Now I use that as motivation to be a force for good.
“Somebody who’s struggled with addiction and basically been pronounced dead … when they recover from that, they have a totally different perspective on the value of life,” she said. “Not only are they driven more than the average person to keep themselves healthy and focused and a force for good, but they will go to the ends of the earth to be a trooper to help save other people who are struggling with addiction.”
According to St. Albans Police Chief Gary Taylor, there were 16 opiate overdoses in St. Albans City and Town in the 12 months preceding July 2016. “It’s kind of startling,” he said.
Men overdosed more than women at a ratio of 10:6, according to the data. The age range was “all over the gambit,” Taylor said, ranging from 16 to 49 years old.
“I’m not shocked that older people are dabbling with heroin,” he said. “But that means they have been doing it for a long time.”
“I thought we had all gotten smarter along the way,” Taylor said.
Of the 16 overdoses, seven were fatal.
Taylor said two of the fatalities were friends. When one of the young men overdosed in the car, the other, who was also shooting up heroin, watched his friend die and then be successfully resuscitated him with Narcan.
At a later date, the second young man went on to overdose and be successfully revived with Narcan as well. “This is a testament to the success of Narcan,” Taylor said.
Although the opiate reversal drug saved both of their lives the first time, the men did not survive their second overdoses months later, the chief said.
Lussier said she personally knows seven individuals that went back to actively using again after overdosing.
“It wasn’t a big deal for them and that kind of stuff is scary,” she said. “We can only do so much. If they come for help, we get them connected with treatment, but if it’s somebody that’s still just not ready for recovery, you can’t force it on somebody.”
 “I saw other people dying around me of addiction; that didn’t motivate me to get clean,” Lussier recalled of the time she struggled with addiction. “It’s when I looked in the mirror and I saw myself dying that I said, ‘OK, it’s time.’”
The chief said he is often asked why St. Albans police tries to save people that relapse, even after overdosing or treatment. “I say to them, ‘What happens when it’s your son?’” Taylor said. “Don’t you want everybody to do every thing they can to save (him)?
“This seems to touch everyone,” he said. “This isn’t just bad people. This crosses all socio-economic lines.”
“I get asked all the time, ‘How do I know if I need a kit?’” Lussier said. “I tell people if you leave your house and if you go anywhere in public, you should have a kit on you.
“Grocery stores, outdoor events … there are overdoses all over and you never know when you’re going to need a kit. It’s better to have a kit and not need it than to need a kit and not have it,” said Lussier.
From 9:30 to 11:30 a.m. on Fridays, Lussier offers trainings on the Narcan kits and hands them out for free to anyone interested. Dependent on her schedule, Lussier said she’s also available during the rest of week to train people.
The Narcan kit trainings are not a long, intensive process. “If somebody just wants to kind of come in, get a kit and be able to leave quickly and not use up a lot of their day, they can do that in five minutes, seven minutes tops,” Lussier said.
During a training, Lussier first explains how to identify a person that has overdosed. One should look to see if the person has completely stopped breathing or if their breath is really shallow. The person might be purplish around the lips and eyes. To check if the person is responsive, rub one’s knuckles on their breastplate or put a finger between their upper lip and nose, Lussier instructed.
If they don’t respond, call 9-1-1. Anyone who calls the police, even if they are using opiates themselves, is protected from criminal charges under a Good Samaritan Law.
Taylor confirmed this. The one avenue St. Albans police will pursue is trying to identify the supplier of the drug. “We want people to call for help,” he said. “We don’t want you to die.”
Lussier said calling 9-1-1 is an important step because administering one kit of Narcan might not be enough to save the person’s life. “If you give the Narcan and the person goes back into an overdose and you don’t have any more Narcan, then the person might still die and all those efforts are for nothing,” she said. “But if you have the medics on the way, they’ll have more.”
Lussier said the most common cases of overdose and where more than one kit is typically needed is with people who use after being incarcerated or in treatment. Many people are also overdosing because of fentanyl-laced heroin, recently referred to in the media as “Game of Thrones” heroin or purple dope, she said.
According to Taylor, the fentanyl-heroin mix has made its way to Franklin County.
“It’s not the heroin itself that is making people go into an overdose as much as the fentanyl that it’s laced with,” Lussier explained. The heroin is often just mixed with fentanyl in a bowl.
“There’s no chemistry going on to figure out, ‘Well does this baggie have 10 pinpricks of fentanyl or 2 pinpricks?’” she said. “Ten can put someone back into an overdose multiple times.”
“To people who aren’t using, we think that’s something to be wary of,” Lussier said. “To somebody who’s still actively using, they want to find that stuff because it’s good and powerful … That’s the scary thing because it’s almost advertising for the drug dealers.”
Taylor said he’s heard from the Vermont Drug Task Force that some drug dealers hand out Narcan kits along with the fentanyl laced heroin because the drug is so powerful. “It makes a hell of a statement about how potent your product is,” he said.
The third step is to administer the Narcan. Lussier received new kits a few weeks ago, which have a simpler design and higher dosage of four milligrams of Narcan instead of two. Lussier said the new design “saves money from all the pieces. It saves time from the training, but it also saves time for the person getting the Narcan.”
She also emphasized that the kits are safe for the person getting the Narcan and the person administering it. There are no needles involved, just a spray. And if someone, say a child, ingests the Narcan, nothing negative will happen to him or her, according to Lussier. All they will feel is liquid running down the back of their throat.
“If I had my way, I wish I could just give out kits, boxes of kits,” she said. One of the prerequisites of the pilot program though is collecting the age, race and gender of the person who applies for the kit. The person is given a unique identifier or client identification instead of using their name.
“The Health Department’s collecting that information to learn the trends, to try and understand who wants these and why,” she said.
Therefore, Lussier can only hand out one kit at a time, but people can come back in and fill out a refill form to get another one. When the person fills out the form, they can check off whether the Narcan was used, lost, stolen or given away.
Lussier said sometimes kits are given away to active users because they are too uncomfortable to come into Turning Point themselves. Since she received the new kits, Lussier estimated that she has easily handed out 60 kits.
“At the end of the day, there’s a need,” Lussier said. “No matter what we try to dress it up with, there’s a need for treatment. There’s a need for recovery. So as long as we try to hide that and not have treatment available, then the people who need it are going to continue stealing.”
“They’re going to continue robbing and cheating and lying,” she said. “Crime is not going to get any better because they’re desperate. And its almost like, ‘OK, well if I can’t get help to get out of this hole, then I’m going to just keep on digging and doing what it takes, in this day, to get my next fix.”
“It’s painful,” Lussier said. “I see a lot of people die … However, there’s no price tag on seeing somebody come through the doors who was completely shattered and all of a sudden, a week later, they’re doing a little better.”

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