Responders Increasingly Using Narcan to Treat Overdose Victims

Nov. 30--Less than a month after Connecticut state troopers were trained and equipped with a "wonder drug" that for decades medical professionals used to save people overdosing on powerful narcotics, other first responders are getting in on the act.

Redding Police Chief Douglas Fuchs said his officers are well on their way to carrying Naloxone Hydrochloride, commonly known as Narcan. Because of the rural environment, Fuchs said his cruisers already carry defibrillators and oxygen and every one of his 17 officers are trained EMTs.

Since the town relies on a volunteer emergency medical staff, his officers often arrive first to medical calls.

"We know this will afford us the opportunity to save a life," Fuchs said.

Fuchs said all his officers were expected to be trained by the end of November, and Narcan will be added to the Redding cruiser inventory.

Danbury Emergency Medical Services Director Mathew Cassavechia said there are no immediate plans to have city police or firefighters carry the opioid antidote that can reverse in a matter of minutes the poisonous effects of drugs such as heroin, morphine, oxycodone, methadone, Percocet and hydrocodone.

Overdose deaths due to opioids in the state rose from 195 in 2012 to 284 in 2013. Of those fatalities, heroin alone was the culprit of 86 deaths in 2012 and 109 deaths in 2013. In Fairfield County, heroin fatalities jumped more than 50 percent from 21 in 2012 to 34 in 2013.

Cassavechia said Danbury firefighters, who are all trained EMTs and know how to spot opioid overdoses, can begin resuscitation before medics arrive.

"We are confident in our first responders that they can deal with any medical emergency prior to the paramedic's arrival," Cassavechia said.

He said there has been some consideration to obtain Narcan for police and firefighters.

"Does it mean Narcan can reduce all overdoses? No, but timing has something to do with that," Cassavechia said.

Each syringe is about $28, and while Danbury does not track the success rate paramedics have with Narcan, Cassavechia said it's worth every penny.

"When we are talking about lives being saved, it's a worthy investment," Cassavechia said.

Narcan use grows

The turning point for first responders catching on to Narcan was the Oct. 1 enactment of the state's so-called Good Samaritan law, which provides civil and criminal immunity to anyone administering a drug such as Narcan to someone experiencing an opioid-related overdose. Only licensed health care practitioners were previously allowed to administer the drug.

While most towns have access to Narcan, not all emergency responders use it.

In New Milford, only paramedics -- not EMTs -- can use the drug, said Drew Loya, a paramedic in Ridgefield and New Milford.

"I've been a paramedic for almost 20 years and it is very successful," Loya said.

If an overdose occurs while the paramedic is not in the ambulance, a regional paramedic needs to be called, Loya said. However, EMTs are going through training to use the drug.

Ridgefield allows firefighters to use Narcan, Loya said. Ridgefield firefighters are cross-trained with EMTs because they transport patients to hospitals from the scene.

Ridgefield police are also considering training to use Narcan.

In Newtown, the Sandy Hook and Hook and Ladder fire departments do not use Narcan and do not have plans to get it any time soon, said Bill Halstead, captain of Sandy Hook.

Dr. Douglas Gallo, the medical director of Stamford Emergency Medical Services, who supervises what medical care firefighters and police can provide on the job, said Stamford firefighters recognized the value of carrying Narcan and he endorsed the idea.

"While the paramedic crew in Stamford are excellent and have been capable of administering Narcan for years, the fact is the faster the drug can be administered the better, and by having first responders acting in advance of medics, they can perform potentially life-saving interventions," he said.

Gallo said in some cases when firefighters arrive before medics, they could begin the treatment that saves lives.

Greenwich Emergency Medical Services Deputy Director Art Romano said paramedics in town have been carrying Narcan for 28 years.

He said Greenwich paramedics have had excellent success rates in resuscitating overdose victims.

From Jan. 1 to Nov. 1, Narcan was administered to 26 overdose victims and they are universally successful in reversing the effects of opiate overdoses, if they get the call in time.

But Romano said in Greenwich, where police respond to every emergency medical call, there are no plans to have officers carry the drug.

"We have had such a high level of success all these years, besides we literally go together on all these calls and we have a very high success rate," Romano said.

'Wonder drug'

Dr. Jason Podber, chairman of Stamford Hospital's Department of Emergency Medicine, said Narcan competes with opiates to attach itself to certain receptors in the central nervous system. Once it is introduced, it keeps the opiate from attaching to the receptors and prevents the opiate response that can stop hearts from beating and lungs from breathing.

He said Stamford Hospital deals with about four to five overdoses per month and most of those are from prescription drug abuse.

Some overdoses occur by accident. He said one patient was recently admitted to the hospital because he put too many Fentanyl patches on his body. Podber said the man actually did not realize he already had one patch on when he administered another. Medics found the man unresponsive, but he was quickly revived with Narcan.

And there appears to be no serious downside. Podber said if someone is given Narcan mistakenly, it does not cause a problem. He said he hasn't seen anyone who didn't need Narcan have an allergic reaction.

"It is a wonder drug for people who make bad decisions," Podber said.

Copyright 2014 - The Stamford Advocate, Conn.