Naloxone Saving Lives During Chicago Tainted Heroin Crisis

Oct. 06--Chris Reed doesn't recall much about slipping into a heroin overdose in 2009. What he does remember, vividly, is how he was saved from it by a medication called naloxone.

"I woke up, and it was like having the wind knocked out of me for two minutes -- just a totally terrifying experience," he said. "It took a little while to figure out what had happened. I remember having a really bad headache. It was just really, really physically intense."

Reed, a Crystal Lake addiction recovery advocate who has been clean for six years, now trains other people how to use naloxone, part of a major push to get the overdose antidote into the hands of those closest to the heroin crisis -- police officers, family members and the users themselves.

The medication was credited with saving dozens of lives in Chicago last week after heroin suspected of being tainted with the powerful painkiller fentanyl produced more than 80 overdoses.

Dr. Steven Aks, the chief of medical toxicology and an emergency room physician at Stroger Hospital, said the wider availability of naloxone appeared to be producing better results than he saw during a similar outbreak a decade ago.

"People have been rallying quickly, and it's been a quicker response," Aks said. "We learned a lot of lessons, and it shows."

Advocates say more work remains to be done. Chicago police officers do not carry the medication, even as many suburban departments have started giving it to their officers. It's still not easily available in pharmacies or at many public health centers. Inmates leaving incarceration, a population highly susceptible to overdose, don't receive it on their way out.

Yet Dan Bigg, whose Chicago Recovery Alliance outreach organization has been handing naloxone to drug users for 18 years, said the efforts to expand the medication's availability are creating a new reality on the street.

"This is what the world would look like if it were well-protected by naloxone: Overdoses would still happen, but there would be a lack of fatalities," he said. "What we're seeing now is really a potentially amazing thing."

The U.S. Drug Enforcement Administration calls Chicago a hub of national heroin distribution, and by some measures, its problems with the drug are the worst in the country. Chicago has far more emergency room visits linked to heroin than any other city, according to federal data, and researchers say about 1 in 5 people arrested in Cook County test positive for the drug.

Overdose deaths have been relatively stable in recent years, averaging 564 annually in Cook and the collar counties. It's not clear how the wider availability of naloxone, also known by the brand name Narcan, has affected those numbers, but anecdotally, people who train others how to use the medication say they've heard about hundreds of overdoses that have been halted.

Chelsea Laliberte, who formed an addiction counseling and education organization called Live4Lali following her brother's heroin death, said her group was aware of 175 overdose reversals in the past year performed by people it trained in naloxone use.

"Naloxone has been around for a long time," she said. "It's because of these programs and the mobilizations that people know about it and can get ahold of it."

The Chicago Recovery Alliance, which distributes naloxone, clean needles and other assistance to drug users, regularly asks its clients if they have used the medication on anyone or had it used on them. Over the years, Bigg said, the group has received more than 6,300 reports of such "peer reversals," with 10 coming on a single day last week.

Police departments have also joined the movement. Numerous suburban and downstate agencies have begun issuing the medication to their officers, and some of them, including Arlington Heights and Deerfield, have already seen officers reverse potentially fatal overdoses.

All 24 officers in the Countryside Police Department were trained to administer naloxone last year. Chief Joseph Ford, who also received the training, said officers are often first to respond to an overdose, and when that happens, time is of the essence.

"When you're talking about an opioid overdose, you're talking about a blocking of the breathing function in the brain," he said.

The Chicago Police Department, however, does not issue the medication to its officers. Spokesman Anthony Guglielmi said the department relies on firefighters and paramedics to supply the medication, since they would likely be on the scene first.

"We're not opposed to having (naloxone)," he said. "We just don't have it yet."

Advocates have said they also want to see more public health clinics carry the medication, and to have jails issue it to inmates with drug problems as they leave incarceration. A spokeswoman for Cook County Sheriff Tom Dart said the department was examining that idea but no action has been taken.

Naloxone is available from pharmacies with a doctor's prescription, but a new Illinois law, following a model already in place in 14 other states, will allow drugstores to dispense it to anyone. But Garth Reynolds, executive director of the Illinois Pharmacists Association, said state officials first must issue a standing order to allow the dispensing to begin.

"I'm hoping we'll have that in the next month or so," Reynolds said.

Authorities have said the tainted heroin responsible for last week's spate of overdoses was so potent that many victims needed more than one dose of naloxone to be revived. Aks, the Stroger emergency room physician, said that intervention can be the first step toward setting an addict on a new path.

"The long-term goal is to get them into recovery, but we want to make sure they don't die as they are going through their addiction," he said.

Tribune reporters Jeremy Gorner and Peter Nickeas contributed.

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