- What can we do as Americans to help fight what is now an epidemic in the United States?
- My Story.
- Opioids are the great lie.
- What you need to know about Narcan.
- How does Narcan work?
- Opioid withdrawals are a living hell and potentially deadly!
- Narcan is available without a prescription – Where to find Narcan.
- The Narcan Finder from the National Harm Reduction.
- Additional facts to be aware of about Narcan.
- Here is what you should do if you suspect an overdose.
- What else can you do to fight the opioid overdose epidemic?
- Who should get trained and carry Narcan?
- My Story Continued.
According to the Center for Disease Control, more than 108,000 people died of drug overdose over a 12-month period ending in 2022. The estimates for 2023 are equally grim, and likely much worse. Our young, old, black and white, rich and poor, gay and straight, white collar and blue collar, statistics show that addiction doesn’t discriminate. We are in this fight together.Products – Vital Statistics Rapid Release – Provisional Drug Overdose Data
What can we do as Americans to help fight what is now an epidemic in the United States?
Charlie and I met decades ago in grade school. Regardless of living thousands of miles apart at different times over the years, we’ve remained the best of friends since—if only with an occasional phone call or text. When I would travel home on leave from the Marine Corps, once or twice a year, Charlie’s apartment was always my first stop.
One January day, under blizzard conditions, I drove 8 hours from Washington, D.C. to Schenectady, NY to meet up with some old friends, and to surprise Charlie on his birthday. As I parked in front of his place, a strange feeling came over me. Something was wrong. I walked into Charlie’s apartment and found him face down on his kitchen floor. He was cold and blue. There was little doubt in my mind that this was an overdose.
My memories of us growing up sped through my mind—playing baseball, chasing girls, long, strange, acid trips, chasing girls, concerts, running from authority, chasing girls, crashing my dad’s “borrowed” car into the Hospice House of Schenectady, New York at 2:00 in the morning—all the wild times that constituted our kinship went flashing by. Looking back, almost everything we did, somehow involved alcohol or weed. As we got older, we both moved into harder drugs as a form of entertainment, recreational, I guess you could say.
I turned from Charlie’s lifeless body and ran out the door, down the stairs, frantically dialing 911, giving Charlie’s address as I went. I made it to my car, digging through the glove box, until I found the Narcan kit from a recent training in New York City.
I bounded up the stairs, ran over to Charlie—still not breathing—ripped open the box of Narcan, put my thumb on the plunger, pushed it into Charlie’s nose, and pressed. I shook Charlie for a couple seconds desperately hoping he would breathe. “Come on, Charlie!” I yelled, “Come on man, breathe!” BREATHE! Nothing. I let Charlie’s limp body fall back to the floor. Memories flooded my mind again; I couldn’t move my body.
We took separate paths on life’s journey. I got the hell out of the small city where we were raised, did a tour in the service, then college, then law school.
Charlie, was an “old soul”, philosopher-type—stayed local. Our differences were many, but one thing we had in common; we always ventured to the edge of the existential abyss; we always moved at one hundred miles an hour.
I now suspect we were both mentally running from something. Maybe we were fleeing boredom or perhaps trying to deal with depression, anxiety—who knows—but we ultimately both somehow found our way to opioids, the powerful “no feel, no deal” drug.
When my doctor first prescribed Percocet—a strong opioid for pain—following an injury I suffered in the Marines, I thought I had reached the holy land. A couple “percs” and a few beers later, I was on a completely different plane. All negative feelings went away. No depression, no anxiety, no feelings of not being good enough. No imposter syndrome.
Charlie on the other hand, injured his neck slinging packages at UPS. He was given Oxycontin—which we now know is little more than heroin in a pill—and despite big pharma’s claim, Oxycontin is profoundly addictive. Charlie and me. Two wild, crazy, young guys with injuries and scripts for opioids, innocently on our way to a life of hell.
Opioids are the great lie
Opioids tell you that “everything will be ok” so long as you continue using opioids, continue lying, continue cheating, continue stealing, and by any means necessary, keep using. That is, until you’re face down in misery.
But I had heard that Charlie was starting to get his life back together, that he was clean, going to treatment. He was back with his girlfriend who had said he was doing better.
Standing over Charlie’s lifeless body now. I snapped myself out of my inertia by yelling in frustration louder than I ever had. I ran back down to my car, rifling through boxes, files, clothes, and miraculously found another Narcan kit that I didn’t know I had. I bolted back up the stairs, got down next to Charlie—who was still cold and blue—and injected the second dose up his nose. I watched and waited, listening for sirens, but there was nothing but ear pounding silence. A tear ran down my face.
Countless people become physically dependent on powerful opioids when they are treated for legitimate physical injuries. Some prescribers fail to properly taper a patient from their therapeutic dose of opioid pain medicine, and instead cut them off “cold turkey” by not refilling their prescription. Doctors who do this are risking the lives of their patients.
Abruptly stopping opioids can cause excruciating withdrawal symptoms, such as violent nausea and vomiting, painful muscle spasms, hot and cold flashes, insomnia, auditory and visual hallucinations, diarrhea, dehydration, headaches, and mental anguish. These symptoms can last for days and even weeks.
After college and law school, I became a Marine Corps officer and Judge Advocate General. My passion was courtroom litigation and the Marine Corps was the perfect place to cut my teeth. But the best part of the Marines is the actual training. Ten weeks of Officer Candidate School followed by 6 months of The Basic School, and then finally 14 weeks of the Naval Justice School. If you want to know more about these experiences, then you’re going to have to buy my book.
Life was good and my career was on a strong trajectory. Marine Corps, Justice Department, prestigious law firm.
What you need to know about Narcan
Narcan is the brand name of a medication called naloxone. It quickly reverses the life-threatening effects of an opioid overdose by restoring an individual’s normal respiratory function (breathing).
How does Narcan work?
Our brains have what are known as opioid receptors. When a person uses opioids such as fentanyl, heroin, Oxycontin, hydrocodone, or other drugs mixed with these opioids, they attach to the opioid receptors resulting in a “high”. The opioids slow down our respiratory system to dangerous levels, sometimes to such a degree that our hearts stop beating. This is a fatal overdose.
To learn more, click the following link: How does Narcan work in an overdose?
Because Narcan is an opioid antagonist, if given in time, it can reverse the overdose by wiping clean the brain’s opioid receptors and temporarily block opioids from entering our systems. This allows the respiratory function to start pumping oxygen back into our systems.
- Narcan is a safe medicine, is not addictive, and will not hurt someone who does not have opioids in their system.
- Most people usually wake up within 1 to 3 minutes of receiving Narcan. However, Narcan only reverses an opioid (narcotic) overdose and will not reverse overdoses from other drugs like cocaine or methamphetamine.
Opioid withdrawals are a living hell and potentially deadly!
Another demographic where we see many overdoses are people—who struggled with addiction—are released from jail or prison. Most often these folks, reentering society, did not receive proper Substance Use Disorder treatment while incarcerated. They are released with no treatment resources. Back home and running the streets, they often go right back to using drugs, including opioids. Because their systems are “clean” and no longer used to the dose of the opioid they used to use (whatever tolerance level they may have developed prior to entering incarceration is gone) their systems cannot handle the amount of opioid and they overdose.
Narcan is available without a prescription – Where to find Narcan
All fifty states allow individuals to buy Narcan at the pharmacy without a prescription. Many state and local governments or non-profit organizations offer Narcan for free, following a short training session.
To find Narcan kits in your area see: National Community Based NARCAN Finder Google My Maps
The Narcan Finder from the National Harm Reduction
The Narcan Finder from the National Harm Reduction site is intended for people who use drugs to access Narcan in their community. The Narcan Finder provides a map to help target Narcan and other harm reduction resources in your local community.
You can access this map at: Harm Reduction Resources Near You | National Harm Reduction Coalition
Additional facts to be aware of about Narcan
More than one dose of Narcan may be required when stronger opioids like fentanyl are involved. It is not unusual for people during an overdose to need 5 or more doses of Narcan to restore their breathing and bring them back to consciousness. The amount of Narcan required will vary from person to person. In many cases one dose will be enough, but don’t count on it. Also, it is important to note that the reversal only lasts between 30 and 90 minutes.
Also, however many doses are given, it may only reverse the overdose for so long. I have spoken to several first responders, including EMT and police officers, who have told me that they were able to save a person from overdose on the scene, but have them again lose consciousness before reaching the hospital, sometimes just minutes away.
Therefore, it is critical that you first call 911 if you suspect someone has overdosed, before doing anything else. Make sure medical professionals are on their way before administering the Narcan. More than one person has told me they were feeling so panicked that they administered the Narcan first, and forgot to call 911 after.
Remember, Narcan won’t harm someone if they’re overdosing on drugs other than opioids, so it’s always best to use it if you think someone is overdosing.
If you give someone Narcan, stay with them until emergency help arrives—you will not get in trouble with the police.
Good Samaritan laws are in place in most states to protect those who are overdosing and anyone assisting them in an emergency from criminal charges.
Here is what you should do if you suspect an overdose
The Center for Disease Control (CDC) provides the following guidance if you suspect an opioid overdose:
- Call 911 immediately.
- Give Narcan as quickly as possible, if available. Do not wait for emergency workers to arrive before giving Narcan.
- Try to keep the person awake and breathing.
- Lay the person on their side to prevent them from choking.
- Stay with the person until emergency workers arrive.
- Narcan is a temporary treatment. More than one dose might be needed under some circumstances, especially if an overdose event involves illicitly manufactured fentanyl and fentanyl-related substances.
- Watch the person closely.
- If the person does not respond by waking up, to voice or touch, or breathing normally another dose may be given. Narcan Nasal Spray may be dosed every 2 to 3 minutes, if available.
- Repeat Steps 2 through 6 using a new Narcan Nasal Spray to give another dose in the other nostril.
If additional Narcan Nasal Sprays are available, Steps 2 through 6 may be repeated every 2 to 3 minutes until the person responds or emergency medical help is received.
What else can you do to fight the opioid overdose epidemic?
Help End the Stigma.
Some people still envision the addicted person as dirty, deviant, and degenerate, living in a cardboard box under a bridge. This old intellectually lazy way of thinking creates the stigma that dissuades people from asking for help. After all, few people want to ask for help if they believe people will think they’re the dregs of society. We must work to end this stigma because if people are too embarrassed or ashamed to seek help, they are on the fast track to death.
Addiction doesn’t read resumes. It doesn’t matter if you’re rich or poor, black, white, or brown. In fact, as a prosecutor for the U.S. Department of Justice I knew a few attorneys and judges who struggled with addiction. Alcohol Use Disorder is common in the legal field, but so is the misuse of powerful opioid pain medications such as Oxycontin and fentanyl transdermal patches, typically prescribed for pain.
Who should get trained and carry Narcan?
Short answer? Everyone.
It’s highly recommended that active opioid users, their family members or caregivers should seek Narcan training either in-person or on-line. Please note, that administering Narcan is not difficult to do, and Narcan kits come with instructions. However, proper Narcan training will help to give you confidence if the time comes when you must use it. Being comfortable with the process can save time and lives.
My Story Continued:
After I left the Justice Department, my addiction worsened and ultimately led to profound depression, hopelessness, and the loss of my two sons after a custody proceeding. The emotional and physical toll ultimately played a role in me doing what I thought was impossible for me. Separation, divorce, custody battle, family court, loss after loss, pain med addiction, heroin addiction, and six bank robberies. I’m not a criminal, I don’t even jaywalk.
But I am one of the lucky ones. I survived and now live a life of recovery from Opioid Use Disorder. Never in a million years did I ever think I would get addicted to legitimate pain medication and ultimately start using heroin. I’m not your typical heroin addicted-person, right? Wrong. There’s no such thing as typical when it comes to addiction. We can all fall prey.
Charlie is alive and clean and sober today. He survived that overdose and never looked back. Married, working, and inspiring others to choose happiness over pain and death, Charlie still talks about the overdose. He tells the story about when he was lying there dying, he saw a vision of his mother. She had sadness in her eyes because she had lost her only son to this awful disease of addiction. Carry Narcan and be ready to use it in an emergency. Don’t judge others because you never know what they might be going through. Choose kindness because it’s the right thing, and frankly it requires less energy than being mean. If you ever need to talk, reach out to me or someone else to talk to.
And most importantly, if you or a loved one is struggling with addiction, ask for help. You are not alone.