Many in U.S. push to share heroin overdose antidote with civilians

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White House Urges Naloxone Access To Prevent Overdose Deaths


By Scott Malone

(Reuters) - Health worker Warren Nicoli got the call late one February night, from a Massachusetts dad who had just seen police revive his 19-year-old daughter from the death-like state of a severe heroin overdose.

Police told the man that he could get the anti-overdose drug they had used, naloxone, from Manet Community Health Center in Quincy, Massachusetts.

"He was just amazed at the stuff," said Nicoli, a prevention specialist at Manet. "He came in the next day and I trained him and sent him home with naloxone."

Manet is one of 19 medical sites around Massachusetts that dispenses the life-saving drug to family members of substance abusers, community outreach workers and even addicts themselves.

The program is part of a state initiative to take on what U.S. Attorney General Eric Holder has called an "urgent and growing public health crisis" of abuse of heroin and other opioid drugs, a class that includes many prescription painkillers.

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Naloxone/Narcan Heroin antidote
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Many in U.S. push to share heroin overdose antidote with civilians
DENVER, CO - NOVEMBER 18: Denver Fire Department started carrying naloxone, a heroin antidote, in their cars and fire trucks in July, November, 18, 2015. Denver firefighters have administered the drug 87 times while Denver police have given it to people five times.(Photo by RJ Sangosti/The Denver Post via Getty Images)
AURORA, CO - JULY 11: Dawn O'Keefe, an ER nurse at University of Colorado Hospital, has saved lives administering naloxone. Public health officials are promoting the use of the drug naloxone to help save people from opioid overdoses, a life-saving measure few know about in the midst of what health officials are calling an opioid epidemic. (Photo by Kathryn Scott Osler/The Denver Post via Getty Images)
Staff Photo by Jack Milton, Wednesday, June 5, 2002: Naloxone hydrochloride, the generic form of Narcan, used in treating opiate overdose. (Photo by Jack Milton/Portland Press Herald via Getty Images)
This photo taken on Wednesday February 5, 2014 shows a emergency opiate overdose kit at the MaineGeneral Harm Reduction program office in Augusta. -- The cone-shaped adapter is placed in the victim리s nose to turn the liquid naloxone into a spray that helps the person start breathing again. (Photo by Joe Phelan/Portland Press Herald via Getty Images)
This photo taken on Wednesday February 5, 2014 shows a emergency opiate overdose kit at the MaineGeneral Harm Reduction program office in Augusta. -- The cone-shaped adapter is placed in the victim리s nose to turn the liquid naloxone into a spray that helps the person start breathing again. (Photo by Joe Phelan/Portland Press Herald via Getty Images)
NEW YORK, NY - MAY 27: New York State Attorney General Eric Schneiderman speaks at a press conference about a new community prevention program for heroin overdoses in which New York City police officers will carry kits with Naloxone, an heroin antidote that can reverse the effects of an opioid overdose, on May 27, 2014 in New York City. The New York Police Department is being provided 19,500 kits for officers; the program will begin after officers recieve training. The Naloxone is administered nasally. (Photo by Andrew Burton/Getty Images)
GEORGETOWN, ON - JULY 25 - Betty_Lou is an advocate for the distribution of Naloxone kits (seen here) that can help save a person who has taken an overdose. Betty-Lou Kristy is seen in her Georgetown home with photos of her late son, Pete. Betty-Lou has lost a son and two sisters to prescription drug overdoses. She has since been heavily involved in securing quality addictions treatment. (Richard Lautens/Toronto Star via Getty Images)
WASHINGTON, DC - APRIL 16: United States Attorney General Eric Holder addresses the Police Executive Research Forum's National Summit at the Mayflower Hotel April 16, 2014 in Washington, DC. Holder cited the rising number of overdose deaths from heroin and other dangerous opioids while talking about the Justice Department's effort to fight the crisis, including expanding first responders' access to the overdose-reversal drug naloxone. (Photo by Chip Somodevilla/Getty Images)
NEW YORK, NY - MAY 27: New York State Attorney General Eric Schneiderman (C) and New York Police Commissioner Bill Bratton (L) speak at a press conference about a new community prevention program for heroin overdoses in which New York police officers will carry kits with Naloxone, an heroin antidote that can reverse the effects of an opioid overdose, on May 27, 2014 in New York City. The New York Police Department is being provided 19,500 kits for officers; the program will begin after officers receive training. The Naloxone is administered nasally. (Photo by Andrew Burton/Getty Images)
Registered Nurse Babette Richter, with the South Jersey AIDS Alliance takes a break in Camden, N.J. on Saturday, Feb. 22, 2014. after she addressed a gathering on the technique for administering the heroin overdose antidote, naloxone, also known by its brand name Narcan. A study conducted during a state-supported pilot of naloxone distribution and overdose education in Massachusetts showed that it was 98 percent effective in attempts to rescue a person who overdosed. (AP Photo/Mel Evans)
In this Thursday, April 12, 2012 photo, inmate Steve Wohlen pauses while speaking during an Associated Press interview in a state prison, in Bridgewater, Mass. Wohlen was saved from a life-threatening heroin overdose in 2010 by his mother when she applied two quick sprays of Narcan, a drug that blocks opioid receptors in the brain to reverse overdoses of opiates. The drug, widely sold under its generic name, naloxone, counteracts the effects of heroin, OxyContin and other powerful painkillers and has been routinely used by ambulance crews and emergency rooms in the U.S. and other countries for decades. But in the past few years, public health officials across the nation have been distributing it free to addicts and their loved ones, as well as to some police and firefighters. Wohlen is serving a 5- to 7-year sentence for an armed robbery he committed to support his heroin habit. (AP Photo/Steven Senne)
Avi and Peggy Farah, of Jersey City, N.J., answer a question in Camden, N.J. on Saturday, Feb. 22, 2014. during a demonstration on the technique for administering the heroin overdose antidote, naloxone, also known by its brand name Narcan. The Farahs started the BTF Movement, named after their son, to raise awareness after Benjamin Tofik Farah died of an overdose of Phencyclidine (PCP) and heroin. (AP Photo/Mel Evans)
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Quincy, Massachusetts, in 2010 became the first U.S. city to make the drug standard equipment for its police officers, who have used it to reverse some 275 overdoses, a significant number in a city of 93,000 people. Police forces nationwide are starting to follow suit.

The state program has now moved far beyond police, training some 25,747 people in Massachusetts how to recognize the signs of opioid drug overdoses and administer naloxone.

Those people have collectively reversed 2,982 overdoses since the state in 2008 started small trials of the "bystander" program, providing civilians with training and naloxone.

The version of the drug used in Massachusetts comes in a small dispenser the size of a Magic Marker. A dose has no effect on a person whose system contains no opioids. But the results are dramatic for someone whose breathing has almost stopped due to an overdose.

"It's surreal," said Detective Lieutenant Patrick Glynn of the Quincy Police Department, seen as the driving force behind the city's program. "You go from dealing with someone who is dead. They're not breathing, they're not responsive. And in 30 seconds, 90 seconds, they're up and talking to you."

'MODEL FOR OTHER STATES'

Police forces across the United States are following Quincy's lead. New York State Governor Andrew Cuomo last week said he would provide naloxone to first responders statewide.

"It is certainly a model for other states and is being embraced across the country," said Jeff Levi, executive director of Trust for America's Health, a nonpartisan research group.

Nationwide, more than 50,000 concerned citizens have been trained by 188 community groups, and have collectively reversed 10,000 overdoses, according to the trust.

The advantage to the program is a simple matter of speed, said Hilary Jacobs, director of substance abuse services at the Massachusetts Department of Public Health.

"We wanted to issue naloxone to people who were using or were likely to witness an overdose, the people who were going to be first on the scene," Jacobs said.

Massachusetts recorded 668 deaths from accidental overdoses of opioid drugs in 2012, the highest number on record. Preliminary data show the state headed for another high in 2013.

Massachusetts Governor Deval Patrick on Tuesday will convene a summit on the issue with four other New England governors: Vermont's Peter Shumlin, Connecticut's Dannel Malloy, Rhode Island's Lincoln Chafee and New Hampshire's Maggie Hassan.

The region's one Republican governor, Paul LePage of Maine, will not be attending. A spokeswoman cited a scheduling conflict, but LePage has said the antidote provides drug users an "excuse to stay addicted" and had threatened to veto a bill expanding naloxone access.

He relented in April, allowing the bill to go into effect without his signature.

A bigger worry for advocates is supply. A handful of U.S. companies produce naloxone, including privately held kaleo Inc, whose cellphone-size device for administering the drug received Food and Drug Administration approval in April and Amphastar Pharmaceuticals Inc, which in May filed initial paperwork to sell stock to the public.

Britain's Reckitt Benckiser Group last month said it plans to develop a nasal version of the drug.

Alexander Walley, an associate professor of medicine at Boston University's School of Medicine who also serves as medical director of the state's opioid overdose prevention program, said supply was a concern.

"We've had a couple of periods where we have been worried about supply. It hasn't been rationed but it's a generic drug and there's only a few suppliers," he said.

(Reporting by Scott Malone; Editing by David Gregorio)

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