Opiate antidote: Cops, EMS lean on naloxone to fight drug overdoses

Three of the men overdosed in their homes. One was found unconscious, his face gray, on the floor of a bathroom at the Westfield Trumbull Mall. Another was found in the parking lot.

Since July, Trumbull police officers have saved five people — three between Oct. 18 and Nov. 9 — from potentially fatal heroin overdoses using naloxone, a medication that reverses the lethal effects of this drug in users.

In each of these instances, police officers were the first responders who administered the drug before EMS arrived to take the victims to nearby hospitals. The victims might not have survived without early intervention by Trumbull officers, who are among the first police officers in the state to carry the lifesaving medication.

Naloxone is commonly known by its brand name, Narcan. Acting as an opiate antidote, it helps a person who has overdosed on heroin or prescription painkillers resume normal breathing. Opiate overdoses are characterized by shallow or halted breathing, drowsiness, slowed heartbeat, and pinpoint pupils.

Trumbull EMS paramedics have administered naloxone for years, but new laws in response to a sweeping nationwide heroin epidemic have expanded access to the drug for those not licensed to administer prescription drugs.

As first responders, Trumbull police officers often arrive at emergencies before fire or EMS, so being able to treat people in situations where time is of the essence — such as an overdose or cardiac arrest — is crucial.

“The sooner you get to somebody and the sooner you can administer the drug, the more likely it is you’ll save that person,” said police Chief Michael Lombardo, whose officers starting carrying naloxone in May. “We’re already in the field, so we wanted to equip our officers with it.”

Critics of naloxone argue it enables addicts to continue using without addressing their disease, but advocates believe it keeps people alive so they can seek treatment.

Experts also stress that the decades-old drug is meant for emergencies, not to treat addiction. Naloxone doesn’t produce a high and won’t have an effect on someone unless that person has taken an opiate. The effects of one dose — administered by injection or sprayed in the nose — may last only a few minutes, so immediate medical treatment at a hospital usually follows.

Legislation that saves lives

The Trumbull Police Department — and other police departments throughout the region, including Redding and New Canaan — began carrying naloxone after 2014 state legislation cleared the way for third parties to administer the drug without the risk of liability or prosecution. Doctors have been able to dispense the drug to family members of addicts under the same protection since 2012.

Third-party protection is necessary since users aren't prescribed, nor do they administer, the drug. The legislation is designed to make naloxone more accessible.

Connecticut is one of 37 states with laws that address naloxone accessibility, according to the Prescription Drug Abuse Policy System, and one of 24 with third-party protection.

Mary Kate Mason, a spokesman for the Connecticut Department of Mental Health and Addiction Services, said her department supports broad access to naloxone.

“It literally means the difference between life and death,” Mason said, noting that heroin addiction has become a nationwide “public health crisis” largely attributed to it being cheaper than the prescription painkillers that often initially hook users.

Heroin-related overdose deaths throughout the country nearly quadrupled between 2002 and 2013, according to the Centers for Disease Control and Prevention. Heroin-related overdoses killed more than 8,200 people in 2013, the most recent year for which this data is available.

Connecticut mirrors that national trend. According to the office of the medical examiner, heroin played a role in 308 fatal overdoses in 2014 — a dramatic increase from 222 overdose deaths in 2013 and 100 in 2012, as reported by the Hartford Courant.

And the state is on track to meet or exceed 2014’s deaths this year. By June 2015, there were already 155 heroin-related deaths in Connecticut.

In most cases, overdoses are triggered by more than one drug. Heroin, an opiate derived from the poppy plant, is often used in combination with synthetic opiates called opioids. This class of drug includes painkillers such as morphine, oxycodone and extremely potent fentanyl.

Heroin in Trumbull

After a death involving opioid painkillers in 2014, Trumbull has not reported another overdose death this year — at least geographically.

“There have been Trumbull young adults that have died from heroin overdoses, even in the last six months,” Chief Lombardo said. “They just haven’t occurred in Trumbull — they occurred in neighboring communities … but it’s still affecting our Trumbull community.”

Addiction increases crimes in town, Lombardo said, such as larceny, burglary and domestic violence.

“That taxes our services,” Lombardo said. “It’s not like the only person affected from the use of substance, when it gets to that point, is the user.”

Overdoses in Trumbull are nothing new, according to Lombardo. What’s new are the steps the town has taken to address addiction, such as naloxone training for police officers and a drug prevention task force, led by First Selectman Tim Herbst.

“We’re not going to put our heads in the sand and pretend it’s not happening,” Herbst said at a July press conference for the task force, which draws members from schools and law enforcement.

“We have to acknowledge it and tackle it head on,” he said.

Trumbull EMS Chief Joseph Laucella said having police officers able to administer naloxone helps the community and EMS, which this year is expected to respond to 4,300 calls, only a small fraction of them overdoses.

“It’s a huge benefit,” Laucella said, adding that Trumbull EMTs, who have less training than paramedics, started administering naloxone in May alongside police officers.

“I’m very grateful that the town has a first responder program,” he said. “Not only with Narcan, but with everyday life-threatening calls, our first responders are able to get on-scene and provide a level of care before the ambulance arrives to take over and complete the rest of the call.”

Overdose trends

Most overdoses in the state occur outside Fairfield County — in Hartford, New London and New Haven counties. Of the heroin-related overdose deaths reported in 2014, only 46 were in southwestern Connecticut.

That includes 17 deaths in Bridgeport, nine in Danbury, six in Norwalk, and five in Stamford; Stratford, Bethel and Fairfield each had two; and Greenwich, Shelton and Newtown had one.

But death locations can be misleading. The state medical examiner records where people die, not what town they’re from. People die at hospitals and motels, as well as at their homes.

A majority of statewide overdose deaths are non-Hispanic white males. The five people saved in Trumbull with naloxone were all white males in their 20s.

Four are from Trumbull, one is from Pound Ridge, N.Y.

In each of these cases, the users were unresponsive and barely breathing, slumped in a seat or on the ground. Signs of heroin use surrounded them.

Police officers administered a dose of naloxone and seconds later the user gasped a huge breath, returning to life.