More responders using `wonder drug` Narcan to treat overdose victims

Dec. 21--While Connecticut state troopers were recently trained and equipped with a drug that medical professionals have used for decades as an antidote to narcotic overdoses, some local emergency services departments have been more reluctant than others to carry the medicine.

The Bridgeport police are considering implementing a program that would make naloxone hydrochloride, commonly known as Narcan, available in its squad cars, said William Kaempffer, Bridgeport's public safety spokesman.

"We see a benefit for public safety and have done extensive research nationwide on whether it is feasible to implement in Bridgeport," Kaempffer said.

Several members of the Bridgeport Police Department already have completed training and the department is examining policies and procedures at other departments.

Nearby Stratford, on the other hand, does not have plans to carry the drug, said Lt. Frank Eannotti.

Neither do the Shelton police department or Shelton's Echo Hose Ambulance Corps.

"We don't administer it," said Patrick Lahaza, the educational and paramedic coordinator for Echo Hose. "We get medics to the scene much quicker than most areas. I think you'll find more rural departments administering it."

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

Skyrocketing death rates

Overdose deaths due to opioids in the state rose from 195 in 2012 to 284 in 2013. Of those fatalities, heroin was blamed for 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.

Narcan could reduce those numbers, Cassavechia said, noting Danbury firefighters, who are trained EMTs, know how to spot opioid overdoses and often begin resuscitation before medics arrive.

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

He said some consideration has been given to obtaining 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.

Dr. Eric Collins of Silver Hill Hospital and Dr. Jim Brubaker of Norwalk Hospital have trained local police departments, including New Canaan, on identifying an opiate overdose and administering the antidote.

"This is what you'd call the last step of preventing the fatal consequences of an overdose," Collins said of the training. "If someone stops breathing, it only takes four minutes, maybe five or six sometimes, before brain damage can occur. So having our police, who respond (to emergencies) often very quickly, recognize the signs of an opioid overdose and then having them have Naloxone available can save a life."

Naloxone reverses the effects of an overdose within a few minutes and lasts for 30 to 90 minutes, enough time for an ambulance to arrive. The most common types of Naloxone are injections and intranasal mists.

Greenwich Emergency Medical Services Deputy Director Art Romano said Greenwich paramedics have been carrying Narcan for 28 years with excellent success.

From Jan. 1 to Nov. 1, Narcan was administered to 26 overdose victims. Responders have been 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 and lungs.

He said Stamford Hospital deals with 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 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.

Narcan appears to have 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.