MIAMI COUNTY — In the fight against opiate overdoses, local law enforcement has in recent years been equipped with a not-so-secret weapon.
Narcan (naloxone) is a prescription medicine administered as a nasal spray, used for treatment as an antidote in an opioid-related emergency.
During an overdose, opiates interrupt key parts of the body’s impulse to breathe by overwhelming receptors in the brain. Administering a dose of Narcan helps to relieve these effects and allow breathing to normalize, generally working within three to five minutes. Reversing this process quickly is essential to avoid brain damage or death in the abuser.
Narcan wears off after about 90 minutes, by which time the body has usually processed opioids enough to avoid further respiratory failure.
“We started carrying it in May 2016 for all the staff,” Miami County Sheriff Dave Duchak said. “That’s when we were starting to see the use really increase. It was first used six weeks after we got it. After the first time or two that lives were saved, I think the staff really took it to heart.”
In 2013, the Troy Fire Department logged 40 total Narcan administrations to 34 people. By 2017, the number had risen to 247 total Narcan administrations to 174 people. The Miami County Deputy Sheriff’s Office has logged approximately 17 Narcan administrations in the field and three in the jail since the office began carrying the drug in 2016. Despite a rise in recent years, numbers now seem to be declining.
“We’re through the first quarter, and we’ve only had 22 Narcan administrations, and we’ve had 24 overdoses,” Troy Fire Department Chief Matt Simmons said. “That’s a number that’s usually flip-flopped. Our numbers are way down, and that’s a good thing.”
“The numbers, with respect to opioids, are trending downward in the county, and seem to be throughout the region,” Duchak confirmed.
Despite the positive downturn in overdoses, law enforcement officials insist that opiates, when abused, are still as big a threat as ever to both the individual abuser as well as others in the vicinity.
“At the end of the day, heroin and fentanyl are different from every drug epidemic, because they kill people,” Simmons said. “A narcotic overdose knocks out the respiratory drive. If you’re not breathing, you’re going to die. The time indicator for our EMS to get to the scene is four minutes. That’s our benchmark standard. If people aren’t breathing, you can do the math. That’s why it’s important to get Narcan in the hands of anybody we can.”
“Even a tiny amount of fentanyl can overdose you,” Duchak said. “Sometimes it can get airborne or absorbed through the skin, and first responders have been known to experience overdoses due to that contact. Fortunately, that’s never happened in Miami County, but we could offer immediate treatment if there were accidental exposure, so that’s an added benefit of having Narcan in the field.”
While administrations of Narcan have proven effective, many in the county have voiced concerns about the budgetary effect it could be having on the community, as well as the strain it could be having on those who administer it. Miami County’s law enforcement is largely determined to quell these concerns, as the reward is proving to far outweigh the cost.
“We get asked about cost a lot,” Simmons said. “People often ask, ‘What is this costing our community? How much is Narcan costing our general fund?’ The answer is nothing. We have paid $650 for all of our drug bags, and that price hasn’t gone up in five years. We belong to the Greater EMS Council out of Dayton, which serves 14 counties. They provide us a drug bag that carries any drugs we’d need, whether it’s to treat an overdose or a bee sting. If we use that bag once a year or six times a day, it’s exchanged out regularly at the hospital for the same flat fee.”
“The criticisms I hear from some of the community is that they don’t like to see tax dollars spent on that,” Duchak said. “I understand and respect people’s opinions, but at the end of the day, somebody’s given me a tool that’s not costing us out of the sheriff’s budget. Due to grants through the Ohio Health Department, it doesn’t cost us anything. How can we not use that tool to preserve life?
“Some have said there should be a ‘two-strikes-and-you’re-out’ rule, meaning if we administer Narcan two times, the third time we wouldn’t. Let’s say law enforcement arrives and finds somebody in cardiac arrest. Usually, there’s another user or family member, so there’s lots of stress and emotions are high. The officer has the Narcan, there’s evidence of drug abuse, and let’s say the officer could see in a database that this person has been given the Narcan before. So the officer is expected to just stand by and watch somebody die? That’s not going to happen.
“When you explain it to people, they get it. Your front line personnel are the ones dealing with it, and all of us got into this to help people. I cannot imagine having the ability to do something and not act.”
“We’re in a political season, and at any ‘meet the candidates’ night, it’s a question that gets brought up — ‘What are you going to do about the opioid crisis?’” Simmons said. “I believe now that this is not a ‘crisis. We get crises every day at the fire department. People call 911 because they’re in a crisis. The way I like to define a crisis is ‘I don’t know what to do now. I don’t have the expertise, the equipment, or the training to handle this.’ I would say it’s definitely a challenge for us, but it’s not a crisis.
“The City of Troy has brought what is still a crisis for a lot of other communities to a challenge, and that’s a great thing.”
According to both departments, the drawbacks of Narcan are virtually non-existent.
“It’s very easy to administer,” Simmons said. “There are no serious side effects. It’s not dangerous to have around. It’s not an addictive drug.
“And it’s inexpensive. It costs about 40 cents to produce — 40 cents to administer Narcan and save a life.”
“When we first implemented Narcan, it was an evolution of thinking for a lot of us in law enforcement,” Duchak said. “In society, we have a pre-conceived stigma of what a drug addict is, and this opioid situation proves overdoses can come from anywhere. For us, it’s been a no-brainer.
“Our primary mission is the preservation of life. If there’s a tool or something we can do to save a life, we’re going to do it.”
For more information on Narcan, visit www.narcan.com.