In this series, Yahoo News takes a closer look at the current opioid epidemic, its roots and demographics, the increasing acceptance of medication-assisted treatment as a supplement to 12-step programs and the remaining obstacles to combating widespread addiction. This series also highlights ways in which the current crisis is unexpectedly forcing a larger shift toward treating addiction more like other chronic illnesses.
This month, rapper DMX became the latest person to survive a near-fatal overdose thanks to a lifesaving drug called Narcan.
The 45-year-old New Yorker, whose real name is Earl Simmons, collapsed in the parking lot of a Ramada Inn in Yonkers, N.Y., Monday evening, February 9. According to the New York Post’s Page Six, which first reported the incident, by the time police arrived on the scene, Simmons was without a pulse and had stopped breathing.
A medic injected the rapper with Narcan, and he was reportedly brought back to semi-consciousness before being taken to a nearby hospital, where he stayed overnight.
Narcan, the brand name for the medication naloxone, is essentially an antidote to heroin and other opioid drugs. A full opioid antagonist, naloxone directly reverses the effects of opioids, such as respiratory depression. An overdose of opioids can result in complete cessation of breathing. When injected, naloxone can stop an opioid overdose in its tracks.
Though a spokesperson attributed the collapse to an asthma attack, a friend who’d witnessed the incident reportedly told Yonkers police that Simmons had passed out after taking some sort of “powdered drug.” It’s unclear what, exactly, Simmons might have consumed, but Narcan reacts only with opioids, meaning it would not successfully revive an unconscious person unless he had opiates in his system.
In the current heroin and prescription opioid epidemic, which has seen a 200 percent increase in the rate of opioid-related deaths since 2000, Narcan has emerged as a lifesaver.
Since it was first approved by the FDA in 1971, naloxone has become ubiquitous in hospitals and emergency rooms, and increasingly in ambulances and first-responder kits. Naloxone is included on the World Health Organization’s list of Essential Medicines needed for basic health care systems.
In recent years, many states have passed laws to expand access to Narcan as an overdose prevention measure. In order to encourage nonmedical professionals to act fast when a friend or loved one is experiencing an opioid overdose, many of these laws guarantee legal immunity for those who call 911 or administer naloxone themselves. (Absent such protection, someone who was with a drug user at the time could be arrested in connection with the overdose, or prosecuted or sued for administering unauthorized medical treatment.) According to the Network for Public Health Law, as a result of these so-called Good Samaritan laws “over 150,000 laypeople had received training and naloxone kits as of 2014, and naloxone program participants reported reversing 26,000 overdoses."
Nine states passed laws expanding access to naloxone in 2015, and as of September, all but seven states had passed their own Good Samaritan laws.
Around the same time, pharmaceutical chain CVS announced that naloxone would now be available without a prescription to CVS customers in 14 states, including Massachusetts and California. In March, that number will increase with the addition of Ohio.
And on Tuesday, Walgreens announced that it too would begin selling naloxone without a prescription at pharmacies in 35 states.
Schools in New York, Vermont, Delaware and Massachusetts have also begun stocking nurses’ offices with Narcan kits.
Dr. Elizabeth Drew is the medical director at Summit Behavioral Health, an addiction treatment center with locations in New Jersey, Massachusetts and Pennsylvania. Drew told Yahoo News that she thinks anyone who uses opiates, even by prescription, should also be supplied with Narcan.
“Even if you are prescribed an opiate and use it responsibly,” she said, there’s always a chance it could fall into the wrong hands and become deadly — especially if the person with the prescription lives with children or teens.
“Anybody who has opiates prescribed in the home should probably have this medication in the home,” she said.
This month, President Obama proposed $1.1 billion in federal funding to address the nation’s opioid epidemic. About $500 million of that would be dedicated to furthering existing efforts by the Department of Justice and the Department of Health and Human Services to implement overdose prevention programs at the state level, including expanding access to naloxone.
According to the White House fact sheet outlining Obama’s budget proposal, in the past year a toolkit released by the DOJ’s Bureau of Justice Assistance to help law enforcement agencies implement their own naloxone programs has been downloaded more than 2,200 times. The U.S. Department of Defense has committed to providing Narcan kits and training to all first responders on military bases, and the Substance Abuse and Mental Health Administration is dedicating $12 million in 2016 for states to “purchase naloxone, equip first responders with naloxone, and provide training on other overdose death prevention strategies.”
Drew noted that while increased access to Narcan is crucial to curbing the number of casualties caused by this epidemic, in terms of ending widespread heroin and opioid abuse, Narcan is “the equivalent of CPR.”
It may save lives, but Narcan cannot cure opioid addiction, nor can it prevent a second overdose. Drew said “open access to all types of care” — including abstinence-based support groups and medication-assisted treatment — is the key to overcoming the opioid epidemic.
But, she added, increasing access to Narcan nationwide is essential not only to save users from dying of an overdose, but also to raise awareness that heroin and opioid abuse “is a predominant problem in every one of our communities.”
“Now we can see this isn’t someone else’s problem,” Drew said. “It is all of our problem.”
Read more from this series:
—How buprenorphine, or ‘bupe,’ changed opioid addiction treatment
—Abstinence vs. medication-assisted treatment: Traditional 12-step programs embrace a new model
—It’s easier to get a prescription for drugs that cause opioid addiction than those proven to treat it
—The menace in the medicine cabinet: The opioid epidemic’s pharmaceutical roots
—Why the new face of opioid addiction calls for a new approach to treatment