GRANBY — While emergency responders across Hampshire County rely on Narcan to save people who overdose on opioids, the push is on to train civilians to administer the life-saving drug.
That’s why a small group of women gathered at Granby Free Public Library on Tuesday, learning from an expert on how to spot overdose victims and administer Narcan to reverse the effects of opioids.
Narcan, known generically as naloxone, is a drug that can rapidly reverse the effects of an opioid or heroin overdose.
“Everybody should have it because this is a public health epidemic,” said Kimberly Dion, a clinical assistant professor at the University of Massachusetts Amherst College of Nursing, who works in harm reduction.
The epidemic referenced is the dramatic increase in deaths attributed to opioid overdoses in recent years, both in Massachusetts and across the nation.
Tuesday’s training was a joint effort between Hampshire HOPE, the Northwestern district attorney’s office, the Quaboag Hills Community Coalition and Tapestry.
Cherry Sullivan, executive director of Hampshire HOPE, said the groups have organized training sessions to break down barriers to getting Narcan. They also want to ensure people understand what opioids are, how they affect the body and how Narcan prevents deaths. At some sessions, attendees are given Narcan to take home. At others, they receive a voucher for a free dose from a local pharmacy.
“This is coming out of the idea (that) we want to continue to let the public know the importance of having Narcan on hand to save lives and the importance of calling 911,” Sullivan said. “As we continue to see the number of deaths increasing, we want to make sure people really understand the value Narcan has and how to get Narcan.”
The length of time an opioid stays in the body makes a difference when Narcan is used, according to Dion.
No matter the dosage, Narcan remains in the system for 30 to 90 minutes. An opioid like methadone stays in the body for 24 to 32 hours.
Fentanyl — considered to be about 50 times as powerful as heroin — can remain in the system two to four hours, while heroin lingers six to eight hours.
Because opioids can stay in the body longer than Narcan lasts, victims can remain at risk of succumbing to an overdose. Often, multiple doses of Narcan are needed.
The number of opioid related deaths in Massachusetts slowly increased from 2000 before spiking dramatically in 2014. In 2016, a total of 1,979 people died of confirmed or estimated overdoses, according to data published by the Massachusetts Department of Public Health this month.
In the past, the transition from users ingesting or snorting pills to using opioids intravenously has taken about four years, according to Dion. Now the period is much shorter, occurring often in only a matter of weeks or months, Dion said.
“The path has been much quicker,” she said. “This is a concern for us.”
Dion gave those attending the training tips on how to determine if someone has overdosed or is really high.
Signs of an overdose include deep snoring or gurgling, very infrequent or no breathing, and pale and clammy skin. Overdose victims also are unresponsive to stimulation, she said.
One way to check the response to stimulation is to inflict pain, Dion said. There are two specific tests: using one’s knuckles to rub hard up-and-down a person’s sternum or side-to-side under their nose.
If the person doesn’t react, she needs help, she said.
“I’m not going to wait for her to turn completely blue,” Dion said. “We can really save a life.”
Once a person is determined to have overdosed, the next step is to call 911, Dion said.
“You will not be able to manage this yourself,” she said.
Dion said people are occasionally hesitant to call emergency responders because they are afraid of getting themselves or a loved one in legal trouble. With the state’s Good Samaritan Law, a person who, in good faith, calls for medical assistance “shall not” be charged or prosecuted for possession of a controlled substance
“Calling 911 allows the best chance to get someone to come to your house and help your loved one,” she said.
Dion shared a story about an acquaintance who gave her son Narcan, but didn’t want to get him in trouble. The woman’s son woke up, said he was fine and went to bed.
“She woke up to a dead child because she didn’t know he took methadone,” Dion said.
After calling 911, Dion recommends giving a few rescue breaths to get oxygen into an overdose victim’s body. This is done by taking a deep breath, placing one’s mouth over the other person’s and pushing your air into their mouth while plugging their nose.
After a few breaths, Dion said, the naloxone or Narcan should be administered. How exactly naloxone is delivered depends on the type at hand. With a single-step version, one spray in a nostril does the trick. The multi-step version requires the nasal injector to first be set up before administering a spray in each nostril. A third method involves a hand-held automatic injector that is administered in the thigh, like an EpiPen.
The overdose victim then should be placed in the rescue position, which leaves them propped up on their side and prevents them from rolling over.
Narcan takes about three to five minutes to work. A second dose can be administered after the same amount of time, according to Dion.
Narcan is harmless if a person isn’t overdosing or if the overdose does not stem from opioid use, Dion said.
More trainings are scheduled for Amherst and South Hadley. Information about future sessions can be found on Hampshire HOPE’s website at www.hampshirehope.org.
Emily Cutts can be reached at ecutts@gazettenet.com.