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   The Lower East Side                  Harm Reduction Center
dispenses syringes of Narcan®
to addicts and their friends.
 



Photo:  Willie Davis/Veras

Jewels tells his overdose story to anyone who will listen. He still hobbles back and forth along an asphalt pathway in Tompkins Square Park, wearing his old battered cowboy boots and a CBGB T-shirt held together with safety pins.   Friends slouch on a bench nearby, taking turns gulping from a bottle of Colt 45. Only few bother listening; they've already heard this story too many times.  "I OD'd on the same dope," Jewels, 35, says, referring to rumors that a bad batch of heroin might have caused the deaths of six people,  including two college students who died in an apartment six blocks away. "They brought me back [to life] four times. Twice here, once in the ambulance, and once in the hospital.   When I left the hospital, I was still high."

That afternoon started like any other,with Jewels hanging out in Tompkins Square Park. But then he suddenly collapsed.  His friends — many of whom were high or drunk or both — started screaming and crying.  Someone tried to do CPR, but he had Jewels's head position all wrong.  Another person took over. Jewels's friend Shaun grabbed a cell phone and called 911.

"He was blue and gasping for air,"  Shaun says.  "I opened his mouth and he was biting his tongue."   Another friend pulled a syringe filled with Narcan out of his backpack and handed it to Shaun,who grabbed Jewels's arm and stuck the needle in his bicep. That injection may have saved Jewels's life. He opened his eyes and began to tremble, and soon an ambulance arrived.

Narcan, which is also known by the generic name naloxone, can reverse a heroin over-dose by blocking its effect on the brain.   It is routinely used by doctors and paramedics, and it has long been dispensed to heroin addicts in Europe. Last year, needle-exchange programs in New York City started offering a class on how to use Narcan, with a doctor on-site to hand out prescriptions. Each attendee receives two pre-filled syringes.

Ten needle-exchange programs now participate, and so far five-hundred people have  received  Narcan®.  Those who use up their supply can return for a refill. According to the Harm Reduction Coalition, there have been 45  "reversals" —instances in which Narcan® was used to stop an overdose and save a life.   One participant in the course at the  Lower  East  Side  Harm  Reduction Center was Jewels's friend Shaun.

"If anyone is going to help us, it's going to be us," Shaun, 28, says.  --- "I've been using dope since I was 15, so why not learn how to save my friends?" Shaun has been clean for a year,  --- but perhaps one of the reasons he is such a vocal Narcan proponent is because it saved his life, too. Last year, he says, he overdosed in East River Park, then regained consciousness after an acquaintance injected him.

The recent spate of overdose deaths has been a favorite  subject of  debate  among the regulars in this park. Was it tainted heroin—or heroin that's extra pure? Or was it a lethal mix of cocaine and heroin?   Narcan is only effective if a user overdoses on opiates, including heroin, methadone, and OxyContin.  It is not effective if the heroin is laced with poison, and it doesn't help reverse the effects of cocaine.

Jewels has no way of knowing whether his most recent overdose has a connection to the city's highly publicized cluster of drug deaths.But by the time he returned to Tompkins Square Park after leaving the hospital, he had a new tattoo:  four small dots under his left eye, one for each time he regained consciousness.  - He already had a tattoo on his face, but he made a point of showing everybody this latest one.

That's not something to be proud of," says Leila, 32,  -  when she hears her friend telling his OD story yet again. Leila, for one, does not believe Jewels's claim about injecting bad heroin. "With him, it was gluttony, not bad dope," she says. "He gets gluttony in his eyes when he's drunk. He starts trying to live like The Deer Hunter, thinking he's invincible because he's lived through so much.

In recent days the addicts who hang out here have been watching each other more closely.  - - When one nods out, another will check on him, to make sure he's still breathing and not turning blue.  - - Leila counsels Jewels to slow down his heroin intake.  - - -  A young couple  from  Connecticut, who  call  themselves Skywalker  and Sarah, listen to Jewels's tale from a nearby bench.

"There are so many people dropping dead," says Skywalker, -  whose best friend died of an overdose last year. - - "Hopefully we'll be in the right place at the right time." To improve the odds that they and their friends will stay alive, - Skywalker and Sarah plan to attend a class on Narcan soon and to start carrying around their own supply.

Reference:  Jennifer Gonnerman   The Village Voice    25 August 2005


Narcan Description
NALOXONE - INJECTION (nal-OX-own)

Common Narcan Brand Name(s)
Narcan

Narcan Side Effects
Nausea, stomach upset or drowsiness may occur.  - - If these effects continue or become bothersome, inform your doctor.   -  Notify your doctor if you develop vomiting, sweating, tremors, breathing trouble, seizures  or  a rapid, pounding    or irregular heartbeat while taking NARCAN. If you notice other effects not listed above, contact your doctor or pharmacist.

How To Use Narcan
NARCAN:  NARCAN is administered by injection into a vein or muscle.The dose may  be repeated as needed or this may be continuously infused depending on your condition and the purpose it is being used.    -  - -  NARCAN must be used under close medical supervision so the dose can be adjusted to the response.

Narcan Uses
NARCAN is used to prevent or reverse the effects of narcotic pain relievers.

It has also been used in the treatment of shock, alcoholic coma, schizophrenia and Alzheimer's disease.

Narcan Precautions
Tell your doctor if you have any pre-existing heart disease, if you have been taking any type of pain reliever for more than 2 weeks or any allergies.  NARCAN should be used only if clearly needed during pregnancy or while breast-feeding.  Discuss the risks and benefits with your doctor.

Narcan Drug Interactions
Tell your doctor of any over-the-counter or prescription medication you may take including any narcotic pain medication. Do not start or stop any medicine without doctor or pharmacist approval.

Narcan Overdose
If overdose is suspected, do contact your local poison control center or emergency room immediately.

Narcan Notes
NARCAN can cause withdrawal symptoms in persons addicted to narcotic pain relievers.

Missed Narcan Dose
It is important that each dose be taken as needed.   If you miss a dose,  take it as soon as remembered. Skip the missed dose. Do not "double-up" the dose to catch up.

Narcan Storage
Store at room temperature between 59 and 86 degrees F (15 to 30 degrees C) as directed for up to 24 hours. Check the expiration date on the label and properly discard of any unused medication after that time.


  Save  Lives- By Distributing 
  Narcan Syringes
  "It could Be
  Your Child's Life You Save!"
              

Last week, an outreach worker handed out flyers in Tompkins Square Park: "Overdose takes the lives of nearly 1,000 people in New York City each year. Now you can help." The flyer advertises twice-weekly classes on Narcan at the Lower East Side Harm Reduction Center, which was the first place in the city to start distributing it to heroin addicts.

Tom Smith teaches this class, which includes lessons on how to recognize an overdose,  how to provide "rescue breathing,"  and  the necessity of always calling 911. The class ends with a doctor handing out prescriptions and the staff distributing syringes filled with Narcan. "It only lasts about 30 to 40 minutes," Smith says. "It's mostly to keep someone alive while EMS is coming."

Governor George Pataki gave an unintentional boost to programs like this one when he signed a bill on August 2 about "opioid overdose prevention."   - The legislation authorizes the state health commissioner to establish standards for overdose  prevention  programs,  and  it  authorizes the injection of Narcan by "nonprofessionals" in the case of an overdose.

The city health department in San Francisco started giving Narcan to addicts in 2003 despite criticism that this would encourage heroin use.  - - In New Mexico, state health workers have dispensed Narcan. It is also available in Chicago and Baltimore. In New York City, anyone—an addict, a friend of an addict, a family member—can obtain Narcan through a local syringe exchange.

Reference:  Jennifer Gonnerman   The Village Voice    25 August 2005

Harm Reduction Coalition
Call   212-213-6376   
 Make The Call!                         

To find a program near you,contact the Harm Reduction Coalition at 212-213-6376.

We can be reached day or night whether it is an Emergency or maybe you could  use a friend.  If you really are lonely, and  it is  possible in a room full of people, and you just wish you had someone you could share the joy and sorrow of your life with, you do!   There are plenty of compassionate people working with us just waiting for you to contact us and let us know your name, phone number and the best time to call you.  As soon as we hear from you then we will make the call at our own expense, not yours, to talk with you.  We are here and there is nothing at all you need to be ashamed of by asking us to call.   - - Most of us have become really great friends  because we had to ask for help, and others because they were simply lonely, in the end became part of us, helping others. 

Take control of your life today.  You are the master of your fate.  You never have to be lonely again for we have found the key to unlock the door to let others in.  It is a joy  in these troubled times to know you have friends you can count on and to be on top of things.  Send us a message and let's get to know one another. ChangeYourLife@MedicalAssistedTreatment.com  

Compiled and Edited:  Deborah Shrira RPH,CMA           Updated:    March 2008  

 Now what is Narcan used 
 for?
  
If you are without one
in your part of the woods,
contact your Legislators!
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