The what if we’re wrong-a-thon – Narcan edition

Brandon, over at EMS Basics had a great idea; what if some of the more opinionated bloggers out there were to allow themselves the opportunity to change their minds about a topic that they have argued for or against, and try and look at their position in a new light.

I took the bait, and came up with this. I still think that the best way to keep people alive from overdose is by never overdosing in the first place, and have voiced that opinion here and elsewhere, but this is neither the time or place to continue that argument.

Nevertheless, this old tiger changes his stripes more often than he cares to admit, so here it is!

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On the way to his sixth try at rehab he asked his dad to stop at a gas station/convenience store. Dads, being some of the more naive species known to man when it comes to trusting their kids pulled in and let his boy go. Fifteen minutes later he had to go inside to look for him. The girl behind the register told him that a twenty year old guy asked to use the Men’s Room about fifteen minutes ago and didn’t come out yet.
The kid had come to his father that day, saying he needed help. He said he was ready, really ready to put it away this time. The drugs weren’t working anymore, he said, just keeping him normal. They came from a wealthy area, luxury cars, beautiful home, plenty of money. The boy started with Oxycontin, when he couldn’t steal from his parent’s stash he bought them at school, when he couldn’t afford those he went to heroin. The illegal drug is much cheaper and more readily available.
They unlocked the door. It didn’t move when the dad  pushed against it. He pushed harder, finally putting his shoulder into it. The body of his son lay on the other side of the door. The first thing he saw was a lighter, sitting on the sink. Then the spoon. Then the little plastic corner of the baggie that he used to wonder about when he found them in his kids room, or car, or the wastebasket in the bathroom.
The cashier screamed. He told her to call 911. He made his way into the room, pushed the empty syringe out of the way and started CPR. A father doing CPR on his son. I cannot begin to imagine how that felt.
We arrived, took over for the distraught man, got some narcan going, assisted ventilation’s and watched as the color returned to his face, he moved, then started breathing. The dad, a guy about my age was lost. Relief, anxiety, rage and helplessness all in one package. It was probably more powerful that the narcotics.
On the way to the hospital the kid talked about his desire for recovery. I listened, that deep feeling of satisfaction I get when talking to somebody who very well could be dead growing with every word I heard. Most of it was bullshit, that much I knew, but nestled between the lies were bits of truth. Nobody wants to be an addict. Nobody wants their life controlled by a substance that is slowly killing them.

I thought of the things I have written concerning mass distribution of Narcan. I know exactly what is in my head, but did I articulate those thoughts properly? Could anybody with a friend or family member addicted to opiates even begin to hear and understand my logic? Is it any wonder that people with addicts in their lives, dead and alive vociferously disagree with my stance that Narcan belongs in the hands of trained medical professionals and not be available to the general public?

It is difficult maintaining a completely logical argument, in my mind anyway when in the presence of somebody who is alive that would have been dead had it not been for the medication that saved him. Who am I to argue against something that can and likely will save even one life. To the person living that should have been dead all of the theories about Narcan availability being directly related to increased opiate use, and theoretical overdoses mean nothing. All that matters to them is that they have another chance at recovery.

At the end of the day, that is all that really matters.

We brought the kid into the ER. I shook his hand and wished him well, thinking that his chance of recovery was dismal at best. Back in the ambulance, while sitting in the Captain’s seat putting the med box back in order I looked at the vial of Narcan that I had used to draw the 2 mg that had saved the kid. Then I saw some 5 ml syringes, and a 20 gauge needle. There was enough left in the vial for a couple of doses.

The kid’s dad poked his head into the back doors, the look of relief on his face another reward that comes with the job. For a brief moment I thought of how quickly that look might have never been allowed to grow on his face. Without the drug and delivery devices that somehow had found their way from the med box into my hand that look would have been one of immeasurable pain, frustration and sorrow.

He wanted to shake my hand, but my hands were full as I approached him. Our eyes met, and I told him how it works.

 

Check out the rest at the What if We’re Wrong-a-thon here:

http://emsbasics.com/2015/06/01/the-first-ems-what-if-were-wrong-a-thon/

 

3 Comments

  • Shauna says:

    I find that when it comes to addicts in my experience there is way more to it than that! Where I live they used to teach an abusive program that only taught parents how to be abusers not how to have an actual relationship with there child. Or anyone else for that matter. I have had a spouse commit suicide and he had an abusive parent that was sick and actually believed he should support her instead of himself and made it impossible for him to have any kind of relationship with anyone. When he did have one she blamed whatever woman he was with with everything wrong in her life. Changing social programs to not teach abuse may help in the long run!

  • bernie says:

    this is a subject that provokes an ethical debate. i am a long time medic and believe narcan should be available to everyone. we didnt make these people junkies, but I suppose everyone has a right to save themselves or their loved ones. your logic about not doing drugs is sound, BUT! do we still treat cardiac, cancer, and COPD victims despite the fact that they smoke or do other risk factors? At the end of the day, we’re EMS, we clean up societies discretions, if we wanted to cure society, we’d become epidemiologists and work on prevention.

  • Dex says:

    “Available Narcan might increase opiate use by decreasing risk” sounds an awful lot like “Contraceptive education will increase promiscuity”.

    The only downside I can see to Naloxone availability would be mistaken administration. On the other hand, I’m reminded of what a CPR instructor said to us, about breaking ribs: “They’re already dead, their day is not going to get any worse.”

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