With a huge spike in opiate overdoses in Massachusetts and across the country, government agencies and health clinics are working to provide an anti-overdose drug to as many people as possible.
Health and safety officials are distributing Narcan, the nasal spray form of the drug, to first responders in many Massachusetts communities. It's also available for addiction treatment centers and relatives of drug addicts.
Fire officials in several Massachusetts communities say overdose calls are increasingly common. In just a six-day stretch this month, the Revere Fire Department responded to 16 overdose calls. Revere is one of five communities participating in a state pilot program in which emergency responders nasally administer the drug naloxone, or Narcan, to reverse the effects of an opioid overdose.
"It's just incredible, it's like magic," said Michael Viviano, Revere's deputy fire chief. "There's somebody who's on the ground, who's literally dead. Sometimes they're blue, sometimes they're black. And you administer this stuff and sometimes in a minute or two or three they're actually up and talking to you."
Since Massachusetts began the pilot program seven years ago, there have been more than 2,500 reported overdose reversals. But overdose deaths continue.
Exact numbers are not available, but figures compiled by Massachusetts State Police show that in the past four months, at least 185 people in the state have died from heroin overdoses. That's probably much lower than the actual number of overdose deaths, because the state police tally does not include either prescription drug overdoses or overdose numbers from the state's three largest cities, where heroin is a known problem.
Dr. Alex Walley, medical director for the Massachusetts Narcan pilot program, says prescription drug users often switch to heroin because it's cheaper and easier to get.
"What really happened in the last year is there is a realization that these are not two separate epidemics with prescription opioids and heroin users being different populations or different people," Walley said. "What we're seeing now is that the final common pathway for people who have opioid addiction is to use heroin."
In Boston, Mayor Marty Walsh is trying to get Narcan to anyone who wants it. He's directed city health workers to offer Narcan training to police and fire officials and anyone interested.
Earlier this month at the first of five community Narcan training sessions, Boston Health Commission worker Berto Sanchez conducted a 45-minute training session. Most of it involved how to recognize an overdose. It took about two minutes to demonstrate how to put a small vial of liquid Narcan onto a nasal sprayer.
"The two yellow pieces on each end, they come right out," Sanchez explained. "Just take that out, grab the atomizer, and put that on the other end. You're ready to administer now."
Auta Almida listened intently. She was there to get Narcan because a relative overdosed.
"I have [an] extended family [member] who actually has OD'd in the past year," Almida said. "I want more information also to educate my family."
At these sessions, Narcan is handed out free of charge. But the cost of the drug has increased. Seven years ago Massachusetts paid $22 for a Narcan kit. Today that kit costs $42. The Boston Public Health Commission's Rita Nieves attributes that to demand.
"They doubled the price because they know what they have in their hands — a life-saving tool that everybody wants to use now," Nieves said.
Only one pharmaceutical company manufactures Narcan in the dosage that's used as a nasal spray. The company, Amphastar Pharmaceuticals, says it is not able to discuss its pricing history for competitive reasons.
The cost is one negative cited by Narcan critics. They also argue that Narcan encourages drug use by eliminating overdose fears.
But emergency workers like Revere Fire Capt. Jay Picarello say it's their job to do whatever it takes to save lives.
"Someone loves that person who overdosed," Picarello said. "It's valuable for that reason. We're bringing back a son back to a mother."
Massachusetts U.S. Sen Edward Markey is promising to try to get help from the federal government so Narcan can be more widely distributed. It's now used in 17 states.
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