Antidote to overdose
<p>Albertsons Safeway announced Monday that Narcan Naloxone Hydrochloride Nasal Spray is now available without a prescription in the stores' North Idaho pharmacies. Narcan is the only FDA-approved nasal spray for emergency treatment of opioid-fentanyl- and heroin- related overdoses.</p>
<p>Naloxone hydrochloride with a nasal spray attachment is seen in the medical kit of a Coeur d'Alene Fire Department emergency medical technician.</p>
COEUR d'ALENE — Post Falls Police Chief Scot Haug said he frequently encounters parents whose children are hooked on heroin and just don't know what to do.
He said it’s an epidemic in the community. Just Sunday night, his officers responded to a likely drug overdose in Post Falls.
"If there are things we can do to save someone's life, even just one life, those things are worth pursuing,” Haug said.
On Monday, Haug met with other local law enforcement leaders to discuss the possibility of having officers carry Narcan nasal spray — an FDA-approved spray for the emergency treatment of opiod-, fentanyl- and heroin-related overdose — with them on patrol. The meeting comes in conjunction with a Monday announcement from Albertsons Companies that all Albertsons and Safeway pharmacies in North Idaho will begin dispensing Narcan, the brand name for naloxone, without a prescription.
Available as a ready-to-use, needle-free spray, Narcan contains a 4 milligram concentrated dose of naloxone that reverses the effects of an overdose by blocking the opioids for up to 90 minutes, which reverses the respiratory depression that would otherwise lead to death.
According to the U.S. Center for Disease Control and Prevention, the anti-overdose drug has saved 26,463 lives nationwide over the past 20 years. In 2015, Idaho lawmakers passed House Bill 108 allowing those suffering from drug use disorders, and their friends and family members, to obtain naloxone.
Coeur d'Alene Police Chief Lee White, along with Kootenai County Sheriff Ben Wolfinger, was part of Monday’s discussion with Haug on the use of Narcan.
White said agencies across the United States have carried similar drugs for some time, but he still has some questions about the product.
"There's a cost [about $150 each] associated with it and just storing these kits is kind of an issue for us," White said. "Our patrol cars are frequently turned off and parked in front of someone's house or sometimes in our back lot. The Narcan needs to be kept between 59 and 86 degrees. That presents a little bit of a problem for us here during the winter in Coeur d'Alene."
White said, with how quickly technology and medicine is advancing, he is hopeful the price of Narcan will go down and the storage issue will be addressed sometime in the near future.
"If we could save even one life, it would be worth the cost," White said.
In addition to monetary and storage concerns, White said the city's fire department has a fantastic response time and is often just seconds behind law enforcement when responding to incidents. The possibility must be considered, he said, that having officers carry Narcan would be duplicating emergency medical service efforts.
"Giving this drug just a couple seconds quicker than the fire department would, I don't know if that's the best course of action," White added. "I trust our EMS folks implicitly — they're the people that deal with this every day."
According to both Haug and White, Narcan can save lives and could be a valuable resource for the community as a whole. However, both cautioned the general public on the use of Narcan by untrained individuals.
"Sometimes you don't administer a dose to completely bring them out of their opioid-induced state," White said. "If you just inject them with this stuff willy-nilly, people come out of their stupor oftentimes extremely violent. If you do it wrong, you're playing Wrestlemania with these people and that's the biggest concern for us when it comes to a regular person administering this stuff. I would hope that they would call us and have the medical professionals deal with this."
Coeur d'Alene Fire Department Deputy Chief Thomas Greif echoed White's warning regarding the use of Narcan. With any medication, Greif said you are only addressing one piece of a much larger puzzle.
When trained EMS personnel administer Narcan, Greif said they often use just a minimal amount to support the respiratory system of someone experiencing an overdose. There could be other side effects along with the overdose, Greif said, such as cardiac issues, blood pressure spikes, and hypertension.
The minimal amount of the nasal spray, Greif added, can get the breathing rate and volume to manageable, safe, levels, without waking the overdosed patient.
"With a chronic user in particular, you're going to see violent behavior when they come out of that state," Greif said. "We are blessed that when we administer this we have a team of five or six people on hand to deal with it. It is concerning that there might only be one person around administering it who isn't prepared to handle with the other effects. We just ask that they please also call 911 immediately and get us on the way because we can manage the other things that will come with it."