Narcan saves opioid overdose victims, but many keep using
Administered in recent years by first responders, it’s credited with saving thousands of lives in a region that continues to grapple with an opioid epidemic
By Jo Napolitano
FRANKLIN SQUARE, N.Y. — It saved their lives, but it didn’t end their addiction.
That’s the experience of many drug users who have been revived with Naloxone, commonly known by its brand name Narcan, the now widely available one-shot treatment for opioid overdose.
Delivered by injection or nasal spray, Narcan reawakens the brain’s breathing reflex center after heroin or other, similar drugs, put it to sleep.
Administered in recent years by first responders and ordinary Long Islanders alike, it’s credited with saving thousands of lives in a region that continues to grapple with an opioid epidemic — one that killed 442 people in Nassau and Suffolk last year alone.
Those rescued by Narcan have awakened in their mom’s house, in a friend’s kitchen, on the side of the road, or in a KFC restroom after emergency responders kicked in the door.
Tatiana Green, 27, of Franklin Square, was at home with family when she was revived.
“I remember being in the bathroom and my mother coming in,” she said. “I was in and out of consciousness. They said I stopped breathing.”
A 24-year-old Lake Grove man who asked not to be named likened his Narcan save to waking up at his own funeral.
“I was out for seven minutes and they brought me back,” he said.
Some people emerge swinging, startled by the strangers staring down at them. A fire chief from West Babylon suffered a concussion in April after bringing a neighbor back to life.
Some are rescued by Narcan just once. Others are saved multiple times; many continue using.
“One would think that a near-death experience would make the person want to run to treatment, but the psychological and physiological effects don’t always result in that outcome,” said John Venza, vice president of Adolescent Services for Outreach Development Corp., a residential drug rehab center that treats 125 teens annually.
Half of the patients he serves each year have used opioids, and a quarter are addicted, he said.
Dr. Michael Delman, assistant professor of medicine at Hofstra and president-elect of The New York State Society of Addiction Medicine, said he is not surprised that people keep using after such a scare.
“Naloxone . . . doesn’t have any anti-craving effect,” he said.
An addicted person’s brain is altered by drug use over time, said Dr. Constantine Ioannou, director of residency training at Stony Brook University Hospital and a clinical assistant professor of psychiatry.
“There are changes in the brain that don’t allow them to stop: The accelerator is pushed down, but the brakes don’t work anymore,” he said.
Those brakes are normally moderated by consequences.
“But the addict brain is rewired — for some reason, when the brain is hijacked by drugs, the memory of consequences becomes impaired,” he said.
Some boast about the number of times they have been revived.
“I remember running groups of young people who were proud to have flatlined,” Ioannou said. “They hadn’t hit bottom yet.”
Those ready to make a change act far differently.
“They look completely beaten down by the addiction,” he said, adding that they suddenly realize the full weight of their dependence. “They are focused on recovery. They want to move forward.”
Narcan buys them time, he said.
The drug can indeed be a game-changer, said Samuel A. Ball, president and CEO of the National Center on Addiction and Substance Abuse and a professor of psychiatry at Yale University.
“It keeps people alive,” he said. “It gives them and their families a second or third chance to get some help.”
Rescue workers, grateful for the treatment, say they are sometimes frustrated by showing up at the same house where they have saved someone before.
“More has to be done with getting to the root of the problem,” said Mark Klahn, 61, an EMT at Community Ambulance Company in Sayville. His company recently committed to on-the-spot or next-day Narcan training for families whose loved ones were revived.
Police and police ambulances on Long Island have used Narcan more than 1,500 times since 2012. They and other groups host training seminars across the region so the drug can be administered by parents of addicted children and users who can save each other.
A recent training in Holbrook brought out a father helping his son stay clean and a gaggle of young nursing students looking to bolster their skills.
Jillian Rinaldi, 23, also was in attendance. She said she was just 11 when her brother Joseph died of a heroin overdose in September 2005.
“He never missed a family function,” she recalled. “He always made sure I was out doing something. He took me bowling, mini-golfing, go-carting — anything but let me stay at home on the couch.”
Rinaldi has wanted to work in the field of addiction ever since her brother’s death. She was thrilled to learn of the Narcan class and even happier to see how easy the treatment is to administer.
She wishes it was available years ago.
“Anyone can do it,” she said. “Even an 11-year-old.”
And while educating the public remains key to saving lives, doctors are trying to better understand the addicted mind. Research shows heroin’s effect on young people is worse than on adults: Opioids physically change their still-forming brains.
Ioannou said many of those now caught up in heroin addiction were first turned on to the drug after they experimented with their parents’ or grandparents’ prescription medications.
He said the trend started 10 to 15 years ago when the medical community began focusing on pain management. High-potency painkillers became available in millions of American households.
Heroin addicts who spoke with Newsday support his assertion.
Nicholas Garbarini, 30, of Bellport, said he started smoking pot at 12 and moved on to his father’s Vicodin by 16.
“Any kind of social anxiety was lifted,” he said. “It put me in a state where everything was OK.”
Garbarini, who was treated with Narcan on three occasions, eventually underwent drug treatment and said he has been clean since 2014.
The biggest problem with opioids, Ioannou said, is that their pull is so strong.
“The only thing more addictive is meth,” he said.
Suzanne Segovia, a senior probation officer assigned to the specialized addiction unit of Suffolk County, has been working exclusively with heroin addicts for six years.
She currently has 39 probationers. Her typical client, she said, is white, 24, middle class — mostly men, but some women.
All are addicted or in recovery, she said.
“Nobody comes in and says, ‘I love being a heroin addict,’ ” Segovia said. “It’s a curse. It’s a lot of work. They have to use drugs to maintain a normal life. It’s not about getting high. They are just trying to not be sick.”
She wishes families weren’t shamed into isolation.
“It shocks me that there is not more help available,” she said. “I think probation is the greatest thing for a heroin addict. At least in that case, someone can help them navigate treatment.”
Copyright 2016 Newsday