Throughout the 2010s, Ohio has been hard hit by a growing opioid addiction crisis. Thousands of Ohioans have become addicted to prescription painkillers, heroin, and other opioids. The crisis is statewide: it has harmed people in large cities, in small towns, and in rural Ohio.
As Ohio’s opioid epidemic has grown in scale, it has also become more lethal. Thousands of people die from opioid overdoses every year in Ohio. The 2016 Ohio Drug Overdose Data: General Findings reported that 3,495 people were killed by opioid overdoses in 2016.
3,495 people were killed by opioid overdoses in 2016.
As overdoses have increased, so has the use of naloxone. The drug, which is also known by the brand name Narcan, can revive someone overdosing on opioids. It is administered as a nasal spray or an injection.
Naloxone is controversial. Some public officials have even suggested that it has made the opioid epidemic worse.
Most naloxone is administered by emergency workers. First responders throughout the United States and across Ohio now carry naloxone with them.
Naloxone is also available without a prescription to anyone in Ohio who has been certified to administer it. The certifying course is open to everyone.
Naloxone has saved thousands of lives in Ohio, according to the state Department of Mental Health & Addiction Services: “Approximately 74,000 naloxone administrations occurred from 2003 to 2012. The number of naloxone administrations per year grew every year from 4,010 in 2003 to 10,589 in 2012 (164%).”
In 2013, the department estimated that opioid overdoses cost Ohio $3.5 billion, and required $4.9 million in medical spending.
One overdose survivor, a Zanesville man named Brandon, has been revived more than once with naloxone. He is now in recovery, but it took him a long time to be ready.
“I went to rehab a couple times, went to jail a few times, I was still getting high,” Brandon said. “In August (2016) I went to jail again. I went back to Pickaway to rehab. I’m in Hope Court now. I feel great. I’m doing great.”
Naloxone is also used to revive caregivers and first responders who have been exposed to powerful opioids like fentanyl and carfentanil. Those drugs can cause an overdose if they come into accidental contact with someone’s eyes, nose, or skin. Three nurses at a hospital in Massillon had to be revived with naloxone after they were exposed to opioids in the course of treating an overdose patient.
Administering naloxone is a component of harm reduction, a controversial approach to fighting drug epidemics.
Harm reduction is based on the idea that the best way to help people suffering from drug addiction is to keep them as healthy as possible. The aim of harm reduction is to keep drug users alive, and minimize the damage that drug use does to communities. Other harm reduction tactics include needle exchanges, methadone clinics and safe consumption sites.
Studies about naloxone administration show that it “does not encourage opiate users to increase their drug consumption, nor does it increase the likelihood that they will harm themselves or those around them.”
Harm reduction methods are almost always controversial. Some critics react to harm reduction strategies from a moral standpoint. Such critics believe that enacting harm reduction policies gives the impression that a community approves of or even encourages drug use. Indeed, a number of Ohio incidents have caused national debates and scrutiny of naloxone.
In one incident, East Liverpool police officers took photos of two overdose patients, who appeared to be unconscious, in their car. The police published the photos on Facebook, where they went viral. Controversy and national press coverage ensued. The police say that they were trying to promote awareness of the opioid epidemic.
More controversy erupted in June 2017, when Dan Picard, a city council member in Middletown, proposed limiting the amount of times one person can be revived with naloxone by first responders.
“[An opioid user] obviously doesn’t care much about his life, but he’s expending a lot of resources and we can’t afford it,” Picard said. “I want to send a message to the world that you don’t want to come to Middletown to overdose because someone might not come with Narcan and save your life. We need to put a fear about overdosing in Middletown.”
Picard’s proposal drew media attention, and Ohioans had strong reactions. Some people criticized Picard on Facebook:
“These people need HELP not political nonsense,” wrote one man.
Others took Picard’s side. “Personal responsibility and consequences are the only thing that will save these people. It’s not a disease, it’s a bad decision that became an addiction. Stop coddling and making excuses,” wrote another.
“All we’re doing is reviving them, we’re not curing them.”
For some Ohioans, opioid addiction is a moral failing. To people who hold that position, administering naloxone to opioid users is just sustaining and condoning a dangerous mistake.
Other officials are frustrated with naloxone for similar reasons. Butler County Sheriff Richard Jones expressed his frustration with naloxone when he explained to the press why his deputies don’t carry naloxone.
“I just know what we are doing is not working,” Jones said. “My brother died of cirrhosis of the liver and early in his life he had a drug problem. There isn’t somebody out there who doesn’t know somebody who has a drug issue. I am trying to get the point across that we’re just frustrated.”
Jones also stated that his department works closely with the county’s EMS and fire services to administer medical first responder care. He said that he preferred medical caregivers to administer the drug, even though anyone can be trained to use it.
He said that there is a perception among his officers that reviving someone who is overdosing can be dangerous. But, most of all, he was frustrated that naloxone hasn’t made the problem of mass overdoses any better.
“All we’re doing is reviving them, we’re not curing them,” Jones continued. “One person we know has been revived 20 separate times.”
Jones is referencing an incident in Dayton. There, one person has been revived with naloxone more than twenty times by first responders. A Dayton police officer was asked about Picard’s comments in light of the multiple revival story. The officer, Major Brian Johns, had this to say about Picard’s comments:
“I disagree with it. I know Narcan isn’t the answer. But, as law enforcement, we took an oath to protect life and where do you stop?”
In the end, the only way to end the harm of drug addiction is through treatment. The benefit of naloxone, and other harm reduction strategies, is keeping drug users alive long enough to get there.