Narcan Spray

First responders reversed 159 opioid overdoses from April through the end of 2017.

That’s according to a report issued through a partnership between Mercy Hospital Washington, the Multi-County Narcotics and Violent Crimes Enforcement Unit and fire, EMS and law enforcement agencies with the unit’s coverage area.

According to data prepared by Tom Nuernberger, EMS coordinator at Mercy Hospital Washington, there was a coordinated push beginning in April to get the drug naloxone hydrochloride, known by the brand name Narcan, into the hands of police officers, sheriff’s deputies and firefighters.

Before last year, ambulance personnel were the only first responders which carried Narcan.

Quick use of the drug can reverse the effects of an overdose of both prescription opioid and heroin. Increased availability of the drug has prevented many more fatal overdose cases.

The usage of the drug was reported more than 250 times, but not all agencies reported when Narcan was administered. The actual number of times Narcan was administered could be more than 300.

“This (drug) has made a difference,” Nuernberger said. “Lives have been saved.”

A goal of “Building a Partnership for the Community” was to get Narcan in the hands of more first responders in the case they get to an overdose scene before EMS crews.

“It’s nice that law enforcement and firefighters are able to administer this and get the patient breathing and their blood flowing,” Nuernberger commented.

There were five Narcan training sessions held in 2017 in the areas served by the Multi-County Narcotics and Violent Crimes Enforcement Unit. That includes classes in Washington, East Central College, Union, New Haven, Potosi and Troy.

Franklin County sheriff’s deputies and police departments within the drug task force’s coverage area now carry Narcan.

Varying Doses

According to Nuernberger, the doses of Narcan varies. For example, law enforcement and fire protection agencies carry 4 milligram doses. Half the dose, or 2 milligrams goes into each nostril.

He explained EMS crews carry smaller milligram doses because they have advanced training and more sophisticated equipment to monitor victims of a drug overdose.

“They can monitor the situation much better, but police don’t have that type of equipment,” Nuernberger said.

Narcan has been used diagnostically which accounts for the discrepancy between the number of times the drug has been administered and the number of actual overdoses.

According to Nuernberger there are times that a first responder may not know what is happening to a patient and Narcan could help rule out an overdose. He added the drug does not have any negative side effects.

The decrease in fatal drug overdoses could be attributed, in part, to Narcan.

The task force investigated 39 overdoses in all of 2017. Of those, 13 were fatal. During 2016, the task force investigated 56 overdoses, including 26 that resulted in death.

Cost of Narcan

The cost of each 4 milligram dose of Narcan is $37.50. Based on the number of times the drug has been reported to be have been used, the cost totals $9,600.

Doses of Narcan are being paid for through drug forfeiture funds seized by the Multi-County Narcotics Task Force and supplemented by the county prosecuting attorney’s office.

The task force has provided $10,000 and another $2,000 came from the prosecutor’s office.

Agency Uses

Following is a list of agencies that reported the Narcan usage to Mercy Hospital Washington, the number of victims and the milligrams given:

Gerald EMS — five victims, 8 milligrams;

Meramec EMS — 43 victims, 143.5 milligrams;

New Haven EMS — none;

St. Clair EMS — 35 victims, 100 milligrams;

Union EMS — 37 victims, 80.9 milligrams;

Washington EMS — 19 victims, 46 milligrams;

Lincoln County EMS — 63 victims, 214.9 milligrams;

Washington County EMS — 21 victims, 51.5 milligrams;

Sullivan EMS ­­— none reported;

Beaufort-Leslie Fire — two victims, 8 milligrams;

Boles Fire — three victims, 10 milligrams;

Pacific Fire — two victims, 4 milligrams;

Pacific Police ­— five victims, 24 milligrams;

St. Clair Police ­— three victims, 16 milligrams;

Union Police — six victims, ­24 milligrams;

Washington Police — seven victims, 42 milligrams:

Troy Police — one victim, 4 milligrams;

Sullivan Police — none reported;

Potosi Police — none;

New Haven Police — none;

Franklin County Sheriff’s office — five victims, 24 milligrams;

Washington County Sheriff’s office — none; and

Narcotics Task Force — one, 16 milligrams.

Program Specifics

In 198 incidents, the patient was transported to the hospital. There were 26 times the patient was not transported and one time it is not known if the patient was transported.

A law enforcement officer was present in 166 incidents that Narcan was used last year, and there were no officers nor deputies present 63 times. There were cases when it is unknown if a law enforcement officer was at the scene of the Narcan administration.

The fewest number of uses last year was in April, the first month of the program. Narcan was used 18 times. In May it was used 26 times.

The month that Narcan was administered the most was in June when it was given 33 times.

The drug was used 32 times in July, August and November. In September, Narcan was administered 28 times, in October, 26 times, and 29 times in December.

Narcan was administered to 148 males and 86 females last year. It was used seven times for people under the age of 20; 74 times for victims between the ages of 20 and 29; 53 times for those aged 30 though 39; 29 times for people between the ages of 40 and 49; 32 times for ages 50 through 60; and 38 times for people over the age of 60.

According to Nuernberger, oftentimes the use of Narcan for those over the age of 60 was for diagnostic purposes.

The drug was administered to 227 white victims, 10 black victims and one Hispanic victim, according to the report.

Future plans call for additional training sessions, refresher course and a public education campaign.