The good news is opioid deaths are down in Kosciusko County so far this year, according to coroner Tony Ciriello.
The bad news might be the false sense of security Narcan can give illicit drug users.
Ciriello said there were two opioid-related deaths in the county in each of the first three months of 2017, and so far this year there has been just one fatality. He said two deaths are pending toxicology reports and could add to the total.
“It’s a significant decrease, and a lot of that can be attributed to the fact that first responders are carrying Narcan with them, are able to get to the people quicker, and administer it to reverse the effects of the opioid overdose,” he said.
Ciriello attributes the availability of Naloxone, also known as Narcan, and having first responders trained in its application as a leading reason for the decline.
Naloxone has been around long enough for its patent to expire, which brought in competitors and forced the cost down. This enables first responders to carry the drug with them.
Because there are no side effects for someone who doesn’t need it, and it comes in a nasal inhaler rather than an injection, it can be administered by non-medically trained people such as law enforcement officers and firefighters.
“When you don’t know what someone has overdosed on, it’s a good tool to have because it causes no other harm if they didn’t need it,” said Ciriello. “But something people need to understand: While we have our share of opioid overdose deaths, not all overdose deaths are from opioids. There are still deaths related to abuse of prescription medications, methamphetamine, cocaine and other drugs.
“It’s just the biggest concern right now is the opioids because it’s such an epidemic and people are focused on it right now. But opioids aren’t the only drugs people overdose and die from.”
According to the website narcan.com, the medicine is available over the counter, but locally most drug stores have chosen to handle it the same way as nasal decongestants and other common ingredients in meth: keeping it behind the pharmacy counter. At around $70 per dose and sold in two-dose kits, Narcan is a shoplifting risk merchants are choosing not to take.
But the availability of Narcan concerns the coroner. He thinks users may think of Narcan as a sort of safety net that allows them to try using drugs in ways or quantities they might not if Narcan wasn’t around.
“It concerns me for the fact that if it’s readily available to the public, then people have no fear when they’re using,” he said. “It’s like ‘somebody’s going to have it, and if I overdose they’ll give it to me and get me right back,’” he said.
“It’s not always the case; it doesn’t always work that way. Most of the time Narcan works on an opioid overdose, but if they wait too long to administer it, it’s going to be ineffective at times.
“Having it available is going to save lives down the road, but I also think it encourages more (opioid) use.”
Ciriello emphasized that Narcan is only effective with opioid overdoses; it’s not effective at all in reversing overdoses of meth, cocaine or any other illicit substance.
Opioids have two major sources, according to Ciriello.
“The biggest illegal opioid right now is heroin. However, the opioids we’re seeing the majority of deaths come from fentanyl, which is a legally manufactured opioid used to treat pain. It’s legally prescribed to people, but it’s being abused or people are selling it, stealing it and getting high,” he said.
“Like any other drug, you’ll never get as high as the first time you ever use that drug. People take more of it the second or third time around trying to duplicate that euphoria, which leads to the overdoses.
“We saw the same epidemic with meth. It’s trying to achieve that high that leads to the overdose death.”
Opioid abuse been all over the news lately, and justifiably so, Ciriello said.
“I just want people to understand that this stuff is very dangerous. If you had ever had to tell a family they lost a loved one to an overdose that could have been prevented, you’d understand why the push is so hard to combat this problem and save as many lives as we can,” he said.
”Narcan is a miracle drug, but it’s no match for prevention and never starting opioids in the first place.”
