The President’s Commission on Combating Drug Addiction and the Opioid Crisis recently completed a report with recommendations for how we, as a nation, proceed moving forward in addressing the opioid epidemic, now recognized as a public health emergency. One of these recommendations is to continue expanding on an existing program to prevent opioid overdose deaths. More people need to be informed about and trained to use Narcan.
For those not in the know, Narcan is the nasal spray form of the medication Naloxone. It has been used by first responders for the past decade to reverse medical symptoms of an opioid overdose, effectively saving lives. In layman’s terms, opioids (pain medications, heroin and other derivatives) produce euphoria and lower pain sensation by reducing several vital functions, including respiration; when a person uses more than their body can tolerate, death by accidental overdose (respiratory depression) is the resulting consequence.
So wait, there’s a drug that can literally save lives of people who are dying from opioid use? That’s a major affirmative. Narcan has been used for years by medical providers and police. Thanks to the efforts of many grassroots organizations, Narcan trainings have expanded beyond police and emergency medical services to the general public.
[See: On a Scale of 1 to 10: Most Painful Medical Conditions.]
An increasing number of community based trainings have been provided in the past several years with efforts to prevent overdose deaths within local communities. And collectively, we’re seeing positive outcomes. Despite this, the death toll caused by this epidemic remains staggering. But why?
Digging deeper into understanding this predicament leads to an awareness that we need to change more than our accessibility to Narcan trainings.
Earlier this month, speed-walking up 7th Avenue in New York City, I had a moment that brought my professional life as an addictions counselor and my personal life as a human being crashing together in a way I had never imagined. In a completely non work-related setting, I saw what appeared to be an overdose.
I was rushing to a fundraising event, supporting a friend and the work that his organization does. Feeling the evening caffeine lull, I swung into one of the many Starbucks on the 16-or-so block walk. It’s a coffee shop in Manhattan during rush hour — you can’t move 3 feet without accidentally bumping into someone. In the midst of all the commotion (loud conversation, latte orders being shouted out, people texting and taking selfies), I happened to notice a person half folded over in the window.
Approaching the door as I walked out of the shop, the man, who appeared to be in his late 30s or early 40s, was stationed at the bar-height ledge directly in front of the pane glass storefront, for all of 7th Ave to see. At first glance, he looked as though he was bent over looking for something on the floor. However, the way his one hand was clenching his coffee cup on the table ledge while the other was dangling by his side gave warning signs that something wasn’t right.
And indeed, something was definitely wrong. The gears of my assessing mind finally clicked into place when I was outside the store, looking at him through the glass. He hadn’t moved. Certainly if he was looking for something, he would have shifted position by now. Truth be told, he looked like he was slumping further down.
[See: 11 Ways to Cope With Back Pain.]
But nobody was doing anything. Nobody noticed him.
And then the thought dawned on me: I wonder if anyone in this coffee shop even knows what an overdose looks like. Then again, if anyone did notice it, would anyone know how to help him — or care to?
Reflecting on this experience brought up several considerations:
Awareness. Did the bystanders know what a person who is “nodding out” looks like? Do people know what an overdose looks like? For argument’s sake, let’s assume that some individuals who observed this man did not piece together what these symptoms mean.
Stigma. In turn, we’ll also assume that there were also those who were able to piece together what these symptoms meant, and either didn’t want to “deal with it” or had the mindset that the person deserves what he got because he “chose” to get high. Who would care enough about this anonymous man’s life to intervene?
Training. Who would know what to do to help a person who was in this type of crisis? I’ve been to over one dozen trainings; however, I’m a professional in the addictions field. Would I have been encouraged to attend one of these trainings if I was in a different occupation? Likely not.
[See: 7 Health Risks of Binge Drinking You Can’t Ignore.]
This coffeeshop experience was eye-opening on several different levels. In spite of all of the tremendous work being done to educate the public about the opioid epidemic and empower people to prevent further lives from being lost, people continue blindly (or perhaps intentionally) walking past the next victim. Narcan and similar overdose-reversing drugs are a significant asset in addressing this public health emergency, but their effectiveness is limited.
The lay-person — not just those affected by addiction, but the general public — needs to be educated on signs of overdose and trained on the use of Narcan, similar to the way many individuals are educated on how to perform CPR — not just those with a family history of heart attack. When our conversation surrounding addiction changes, our attitudes will surely follow. This is how we increase the effectiveness of Narcan’s ability to save lives. This is how we face the opioid epidemic.
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How the Culture Around Addiction Limits Narcan’s Effectiveness originally appeared on usnews.com
