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Drop in fatal ODs: Is naloxone blurring depth of crisis?

Look, if it were my child, or friend or anyone, I would want someone there in a heartbeat with the antidote.

A kit with naloxone, also known by its

A kit with naloxone, also known by its brand name Narcan, is displayed at the South Jersey AIDS Alliance in Atlantic City, N.J. on Feb. 19, 2014. Photo Credit: AP / Mel Evans

It might be an extreme example, but we know a Great Kills mother who revived her heroin-addicted son close to 20 times with the overdose-reversal medication naloxone.

We’ve also talked to addicts who are now “playing it safe” by actually having the nasal spray on hand when they gather in small groups to use in case someone overdoses.

Overdose deaths on Staten Island are down nearly 50 percent compared to this time last year, due in part to the efforts of family members and friends to carry and use naloxone, which is now readily available without prescriptions at drug store chains and through community organizations.

District Attorney Michael E. McMahon cited the increase in saves when he announced recently that so far this year there have been 17 suspected overdose deaths this year, compared to 30 deaths reported this time last year.

During the same time period, there had been at least 45 saves, including eight by family members or friends, seven by police and 30 by EMTs, according to the D.A.’s office.

The decline in deaths, added Borough Commander Assistant Chief Edward Delatorre, is in part the result of the entire community — from relatives of drug users to emergency responders — getting involved in the war on drugs.

“The significance of this is now with the introduction of fentanyl into the heroin and other drugs out here, we need to get there quicker and quicker, so we’re just happy to see somebody’s winning the race and family is now fully engaged and really helping out,” Delatorre told the Advance.

Officials and community groups have hosted several overdose prevention events across the Island.


The first concern is this: Fewer overdose deaths on Staten Island doesn’t mean there’s significant progress being made in the number of people using hard drugs.

More are being saved and, if fact, there’s legitimate fear that the wide availability of naloxone perhaps has led to even more using heroin and other opioids — because there’s now that safety net.

While we hope this in not the case, it’s not at all uncommon for someone who is revived to go right back to the drug they love so much.

Dr. Harshal Kirane, director of addiction services at Staten Island University Hospital, pointed out that following an overdose rescue, an individual is highly vulnerable to relapse, which could lead to another overdose.

That’s why what happens in the hours following an OD revival can be life saving or potentially deadly.

“The period after overdose rescue opens a precious window for positive change and to engage in treatment,” said Dr. Kirane.

That’s why we are so supportive of the Soft Handoff program being used by Richmond University Medical Center.

The pilot program, which was recently extended three months, staffs the emergency department 24/7 with peer counselors to help persuade patients to seek treatment rather than discharge.

One of the volunteer peer counselors volunteering at RUMC who has been in recovery many years said it best.

“Addicts don’t want to listen to doctors — we feel judged by them, they don’t know what we’re going through. We will listen to other addicts because they know our struggle, they know how bad it is.”

But what about all those other saves — by family members, friends, police and first responders?

How about this:

The naloxone kit and the training that comes with it should include suggestions on steps to be taken next.

When a family member is saved in a Mid-Island basement, coax, plea and cajole that person into speaking with an addiction counselor.

Better yet, if the addiction has set in for real, try this: “I’m taking you to detox or you have to move out.”

“That’s the last time you get saved.”

It might sound cold-hearted, but the results could safe a life.

When it comes to police and other first responders, perhaps they can be equipped with a list of peer counselors and after the patient is stabilized, require they have a talk with someone who has been in their shoes — and survived to live a life of recovery that includes helping others do the same.

Look, if it were my child, or friend or anyone, I would want someone there in a heartbeat with the antidote.

But I’d also like to see that save be the start of a new life, and not just another episode in a self-destructive one.