Narcan: Save a life

By Dean Shipley

May 9, 2014

London police officers are receiving training to carry naloxone, a drug which can reverse the side effects of an opiate overdose.

The drug, commonly known by its brand name, Narcan, will be kept in officers’ cruisers and be used on an as needed basis.

EMS chief Robert Olwin conducted a training session with London Police Department on Thursday. Another training session will be given to third-shift officers soon.

London police officers are often the first to respond to calls coming in through 911 of a person being unresponsive. With the rise of heroin use in the county, that first-responding law enforcement officer may suspect the unresponsive person is a victim of heroin overdose. If so, the officer may choose to administer Narcan, Olwin said.

The drug can reverse the effects of an overdose by blocking the brain’s receptors that opiates latch onto and helping the body “remember” to take in air. The antidote’s effects wear off in about a half hour, and multiple doses may be needed.

However, before it’s administered, the first responder follows a protocol, Olwin said. It includes the following:

• Check patient for responsiveness and adequate respirations, which should be six to eight times per minute.

• If patient is unresponsive, but breathing adequately, monitor patient and await arrival of EMS.

• If the patient is not breathing adequately, assess position of head and neck and reposition to make clear the airway.

• If this procedure does not improve breathing, consider the administration of Narcan and supporting respirations with rescue breathing.

• Administer Narcan as needed.

Olwin said if the patient is only breathing twice per minute, the goal of the drug is to elevate breaths to between six to eight.

The drug is contained in a small syringe holding a 2 mg quantity. The syringe is equipped with a conical-shaped tip called a mucosal atomizer device (MAD).

Olwin demonstrated the procedure on a medical dummy during the training session. The syringe is placed up to the patient’s nose and the MAD gently inserted. Because of its conical shape, it does not entirely enter a patient’s nostril.

The syringe is marked in .5 mg increments. Olwin advises injecting one .5 mg dose in each nostril and then monitoring the response. If the person is under an opiate overdose — it could be from any number of legal opiates — the patient will “come out of it” and the danger of death is almost immediately averted.

Olwin said when the patient comes out of the apparent overdose, “they’ll come up agitated.”

The patient could become combative, suffer a seizure or vomit. Olwin said he has experienced all of the above.

One officer asked if the patient could be handcuffed prior to administering the drug. Olwin said that could be an option, but it would be the officer’s call.

The officers were cautioned not to rapidly administer the full dose of Narcan, “as serious complications can occur from rapid administration of the drug.” If the unresponsive person is not amidst an opiate overdose, the administering of Narcan is harmless.

Each officer will be assigned a kit marked with their name. There will also be a list of all officers to whom the kit has been issued. Officers are responsible for the security and tracking of the drug, since they will be operating under the license of the EMS.

The officers will have to report when the drug is used on a patient to the county emergency medical district as soon as possible after administering it. When Narcan is administered, the officer administering must fill out a drug usage sheet provided by the emergency medical district.

Narcan 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 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.

Among them is New Jersey, which passed a law last year that allows members of the public to carry nasal-administered naloxone after getting training.

In Ohio, the drug is only available to authorized personnel.

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. In 2012, the Food and Drug Administration held hearings on making naloxone available over the counter, but it has not yet done so.

The Associated Press contributed to this report. Dean Shipley can be reached at (740) 852-1616, ext. 17 or via Twitter @DeanAShipley.