Narcan credited with dramatic drop in heroin deaths
Despite a probable increase in heroin use, officials say heroin-related deaths have seen a steep decline
By Steven Elbow
The Capital Times
MADISON, Wis. — After a record year of fatal heroin overdoses in 2011, Dane County has seen a dramatic drop in the number of deaths, possibly due to the increased use of an antidote handed out to drug users.
By about mid-September last year, 17 people in Dane County had died from heroin overdoses, and by the end of the year heroin had claimed 23 lives. So far this year, only two people have died. At the same time, says Sgt. Tony Fleres of the Dane County Narcotics and Gang Task Force, there's no indication that heroin use is declining - indeed, it's more likely increasing.
He credits the drug Narcan with the dramatic turnaround in deaths.
"I'd say probably the big story right now is that Narcan is saving lives," he says. "This stuff really brings them back right away. We've had people that have come very, very close to death, literally stopped breathing, turning purple and everything. They give them Narcan and bring them back."
The decrease in heroin deaths has not yet been reported to local health officials.
"Wow, that's amazing," says Mary Jo Hussey, who coordinates AIDS education for the Public Health Department of Madison and Dane County, including a needle exchange.
Last year, Hussey was skeptical that Narcan alone was making a dent in the numbers of people dying from overdoses. But now she's changing her tune.
"I don't know of any other reason why it would drop," she says. "It certainly would seem that Narcan would at least be in part responsible for that."
Although Narcan - generic name naloxone - has been around for years, its distribution hasn't kept pace with the increase in new drug users and the proliferation of cheap, high-grade heroin hitting the streets. That might be changing.
"We've definitely been doing a lot more training lately," says Scott Stokes, director of prevention services for the AIDS Resource Center of Wisconsin, the only group currently distributing Narcan in Dane County. The stepped-up training efforts are taking place in all nine of the Resource Center's service areas in the state. In the Madison area, as well as in Janesville and Beloit, most of that training is done by the center's Jimi Reinke, who has been keeping addicts alive with the drug since 2005.
Stokes says there were 100 people in the Madison area trained to use the drug as of July 31 - the vast majority of them heroin users. That's on pace to more than double the 86 people trained in all of 2011. (Paramedics also carry and administer Narcan.)
Narcan blocks opiate receptors in the brain, countering the effects of a heroin overdose almost immediately. And it's fairly easy to administer - nothing like the gut-wrenching scene in the 1994 film "Pulp Fiction," which featured John Travolta stabbing Uma Thurman in the chest with a heart needle.
"All you need is a 1-inch needle and a muscle," says Stokes.
Apparently a lot of people are being brought back from the brink of death with a quick injection.
It's difficult to say just how often Narcan is used. But the Resource Center runs an informal tally of people who call to say they've used it to save a fellow heroin user - 79 so far this year.
"Those are just the ones that call and tell us," he says. "We know there are many more that occur that we don't hear about."
The rate of heroin overdose deaths the last few years has been one of the most alarming local statistics in public health, going from three in 2005 to 17 in 2010 then to last year's record-breaking number of 23. (The total number of drug overdose deaths last year was 28, up from 27 in 2010.)
The epidemic has been fueled by a combination of increasing numbers of people addicted to prescription opiates and a flood of cheap heroin on the streets. People who become addicted to drugs like Oxycontin, prescribed by physicians or obtained illegally, soon find they can't afford the habit and switch to the cheaper illicit alternative of heroin.
City and county officials, community groups and health care workers last year mounted an assault on the prescription drug epidemic by reducing access, stepping up available drug-abuse treatment and other measures.
Fleres hopes that those efforts will result in fewer people becoming addicted in the first place. But for those who have already moved from pills to shooting up heroin, saving lives is the priority. And that's where Narcan comes in.
"A lot of times when we make a drug arrest we'll find Narcan on people," he says. "A lot of these folks are pre-loading their syringes so that if they do have a reaction it's all pre-loaded and ready to go."
The AIDS Resource Center's distribution program grew out of the center's original mission to curtail the spread of AIDS with its needle exchange program. Stokes says the center began handing out Narcan in the mid-2000s after a rash of deaths nationwide from heroin laced with the powerful synthetic opiate fentanyl.
"It just made perfect sense," he says. "We had access to the population and they trusted us."
The center and a number of other groups are currently working on legislation to provide immunity to drug users who call authorities to report an overdose. The proposal, dubbed the 911 Good Samaritan Law, has been passed in 11 states.
"What we're trying to do is make sure that people who have overdosed are getting the proper treatment they need instead of just administering naloxone and running because they're scared of arrest," Stokes says.
Calling medical personnel, he says, could help get more people into treatment.
You'd think having a near-death experience might be enough. But according to Fleres, some people just don't get the message.
"You tell them, 'You were dead, basically, and we brought you back,'" he says. "It still doesn't faze them. They go back and use again."
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