Dr. Carlton Heine, an emergency room physician at Bartlett Regional Hospital, talks about the increased used of heroin in the community.

Dr. Carlton Heine, an emergency room physician at Bartlett Regional Hospital, talks about the increased used of heroin in the community.

Ellis: Narcan bill means ‘life or death’

Editor’s note: This is part of a series of stories on heroin, with the next installments to be published Monday.

Anchorage Sen. Johnny Ellis says his bill is different from the ones usually heard in the Capitol.

“A lot of the legislation we deal with in the Legislature is not life or death,” he said in a phone interview this week. “This bill is life or death.”

Senate Bill 23 deals directly with increasing access to a life-saving heroin antidote called Naxolone, better known by its brand name Narcan. It can instantly reverse an opiod overdose if administered during the overdose.

SB23 has garnered huge amounts of support from local politicians, health officials and community activists — all of whom are looking toward Narcan to help stem the recent spike of heroin-related fatalities in the capital city. Six people have died of heroin overdoses in Juneau since February.

“We need to arm our community with this,” said Michele Stuart Morgan, a 53-year-old Juneau resident who started a grass-roots group, “Juneau – Stop Heroin, Start Talking,” to raise awareness about heroin use in Juneau.

She’s urging her group’s members to support SB23 and is collecting signatures for support. “We have to be proactive,” she said.

Meanwhile, the Juneau Police Department is contemplating having its patrol officers carry Narcan, following in the footsteps of police departments on the East Coast that are also combating skyrocketing heroin-related deaths.

“They’re using Narcan in their police departments,” JPD Chief Bryce Johnson said of a presentation he recently attended about the Quincy, Massachusetts, police department. “… We’re missing a couple of pieces on the model they’re using back there, but we’re looking at them.”

There’s no quick-fix for reducing or eliminating drug addiction, but putting Narcan into more hands in the community appears to be one of the most immediate and effective steps to take to physically prevent heroin deaths. The Centers for Disease Control and Prevention in 2010 estimated Naxolone was responsible for preventing 10,000 heroin overdose deaths.

It’s been a staple for EMTs and hospitals for decades. In Juneau, Capital City Fire/Rescue EMTs have saved seven people from heroin overdoses so far this year by administering Narcan, CCFR Chief Richard Etheridge said. He said CCFR has delivered Narcan 22 times this year, a slight increase over last year’s 17.

“Most people normally, when it’s given (properly), they just slowly start waking up a little bit and start breathing a little bit better on their own,” Etheridge said of how people react to Narcan.

Narcan is non-addictive and does not have any serious side effects, but it should be administered slowly when injected (there’s also a nasal spray form of Narcan). Etheridge said if a high dose is given all at once, the patient can become combative.

“It instantly reverses the high that they had, so a lot of times patients will come up swinging,” he said. “They’re very upset and agitated.”


Pushing Narcan

Large swaths of the country are grappling with a crippling and deadly heroin epidemic — the rate of heroin-related deaths has nearly quadrupled in the U.S. — as the result of it becoming cheaper and easy to get than the over-prescribed pain killer OxyContin. More than 8,200 people died of heroin in 2013, the CDC says, leading to more people advocating for Narcan to become more widely available.

In West Virginia, school nurses are being trained on how to administer Narcan to students. Drug users in Baltimore are being trained in court how to deliver it, should one of their friends overdose. Police officers in Massachusetts are carrying Narcan with them on patrol.

There have been 853 confirmed rescues using Narcan out of 924 attempts in Massachusetts so far in 2015, according to the 23 police and fire departments there reporting to the state’s Department of Public Health.

Sen. Ellis, D-Anchorage, said he wants it to be more available to Alaskan families. His bill protects Alaskan doctors from civil liability for prescribing Naloxone.

“We’re trying to make it over the counter, so a doctor could prescribe this and a Juneau family who might have a family member who’s a heroin addict could have this in their family home,” he said.

Ellis introduced the bill last session, where it passed the Senate floor with a 19-1 vote. It’s currently in the House Health and Social Services Committee and would need to clear a House vote next legislative session. Then it would only take the signature of Gov. Bill Walker to become law.

“About 29 other states have passed similar legislation, and I want Alaska to join,” Ellis said.


Legislative support

Alaska’s Department of Health and Social Services said in a July report that 72 people died from heroin between 2008 and 2012, and the number of heroin-associated deaths more than tripled during 2008-2013. One of the report’s recommendations to curb the death rate was to broaden access to Naloxone for acute heroin overdose reversal.

Dr. Carl Heine, an Emergency Room doctor at Bartlett Regional Hospital, told the Empire that Narcan works by blocking the receptors receiving the opiods in the brain. Every drug has side effects, including Narcan, he said, with nausea and diarrhea among them.

“I’m an ER doctor, I’m all about saving lives,” Heine said with a smile when asked if he supported the bill.

He expressed concerns, though, that heroin users would become overconfident in thinking that they can be saved.

Etheridge, too, said he would support the bill but he thinks there should be an education component to it, so people know how to administer it. One risk of the medication is that if the person receiving Narcan does not receive emergency care afterward and the Narcan wears off, the person will go right back into the heroin overdose and could die.

Among the bill’s supporters are the Alaska State Medical Association, which stated in a letter that Alaska ranks 29th among states for the highest drug overdose mortality rate, and the Alaska Mental Health Trust Authority. The Haven House, which provides housing and support for formerly incarcerated addicts in Juneau, also voiced support.

SB23 has nine co-sponsors, including Sen. Dennis Egan, D-Juneau, who said he decided to cosponsor the bill after hearing about the legislation and talking with Ellis.

“If we save even one user from an overdose, it’s well worth it,” Egan said in an email, adding that heroin is “getting way out of hand and in a horrible way. We need to at least try to add more teeth to provide another way to fix it.”

Ellis described the bill as a “small piece of the puzzle” and not the “end-all, be-all,” but that it will help prevent heroin related deaths. He said he was optimistic it would pass when the Legislature reconvenes in January.

“We want to get this drug more widely available, and it will save lives,” he said.

• If you’d like to be a part of the Empire’s coverage highlighting heroin addiction in Juneau, contact reporter Emily Russo Miller at 523-2263 or emily.miller@juneauempire.com.

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