How to Administer NARCAN to
Reverse an Opioid Overdose
Photos by Aimee Dilger | Video and Article by Kelly Dessoye
Published December 27, 2021
We’re going to forgo the prose and storytelling this week to give it to you straight.
According to Luzerne County Coroner Frank Hacken, as of 9AM on December 27, 2021 drug overdose deaths in Luzerne County, Pennsylvania sit at 173 confirmed and 35 pending for this calendar year. He estimates that 73-75% of those are fentanyl related and 5-10% are other opioids without fentanyl. An ng/ml range of 3 and above is enough to kill a person, but the opioid fentanyl is so strong and deadly that toxicology reports are coming back with fentanyl ng/ml levels over 100. Specifically in Luzerne County these deaths range from teenagers to the elderly and span all socio-economic brackets.
“Fentanyl doesn’t discriminate. ”
Fentanyl is cheap and pervasive. Hacken uses the analogy “it’s easier to get drugs than a 6-pack of beer,” and oftentimes a person doesn't know whether the drugs they purchased are laced with fentanyl - an opioid increasingly found mixed with heroin, meth, cocaine, and even marijuana. In Pennsylvania fentanyl test strips are illegal and considered drug paraphernalia, although legislation to decriminalize them is sitting in the PA House as of late October 2021.
A box of NARCAN Nasal Spray. Each box contains two 4mg single use doses.
That means right now taking any sort of street drug is a roll of the dice,
and with New Year’s Eve at the end of this week, we stopped by New Roots Recovery Support Center to film an informative step by step video about how to use the drug Naloxone to reverse an opioid related overdose with certified recovery specialist Bubba. For the demo, he used the brand name NARCAN and that’s the brand New Roots has gotten a hold of.
Please watch the video above. Dr. Rachel Levine also filmed a great tutorial video on pa.gov.
Bubba, a CRS at New Roots Recovery and Support Center, takes a cartridge of NARCAN from the box to demonstrate its use
Steps for Administering NARCAN
Call 911
Administer NARCAN
Wait 2 minutes and if a person is still unresponsive, use the second cartridge of NARCAN in the other nostril
Put a person in the “recovery position” by turning them on their side with their head propped up by their bottom arm and their bottom knee acting as a kickstand
Wait for first responders to arrive - you will be protected by the Good Samaritan Provision
How to Spot an Overdose
(ripped from the CDC’s website)
Small, constricted “pinpoint pupils”
Falling asleep or losing consciousness
Slow, weak, or no breathing
Choking or gurgling sounds
Limp body
Cold and/or clammy skin
Discolored skin (especially in lips and nails)
What is NARCAN?
According to pa.gov, Naloxone, or the active drug in the brand name NARCAN, “ blocks the effects of opioids on the brain and restores breathing within two to eight minutes…[it] has only one function: to reverse the effects of opioids on the brain and respiratory system in order to prevent death. Naloxone is safe to use and has no potential for abuse (a person can’t get high or become addicted to it).”
Naloxone works to reverse overdoses from opioids by absorbing into a person's bloodstream, but it ONLY works to reverse opioid related overdoses. Fentanyl is an opioid that often contaminates non-opioid street drugs, causing accidental overdoses and deaths. Use NARCAN if fentanyl use or contamination is suspected. Anyone who is or is a loved one of someone taking prescription opiates or otherwise using opiates should have NARCAN or another form of Naloxone on hand.
NARCAN is 100% legal and comes in two forms - a nasal spray and an auto-injector. According to Kerri Scheitrum - regional director of New Roots - the nasal spray is what New Roots keeps on hand as the auto-injector is a needle which can be triggering for an addict in recovery.
How to Get NARCAN
You can get NARCAN at the pharmacy using a prescription from your doctor or by downloading the PA State Standing Order. This is a general prescription that can be used at any pharmacy in lieu of getting one from your doctor. You can print out the standing order or present it to your pharmacist digitally. Naloxone is also covered by most insurances and is free of charge for people on Medicaid. Use the map to the right to locate a pharmacy.
If you’re in Luzerne County or nearby, call any New Roots location. Here are the numbers:
Wilkes-Barre (570) 763-4073
Hazleton (570) 455-7000
Tamaqua (570) 810-2221
According to Kerri Scheitrum, they have staff all over the county and will get it to you.
Pick NARCAN up from Luzerne County Drug and Alcohol or Wilkes-Barre Department of Health
If you are an organization you can get NARCAN from the Pennsylvania Commission on Crime and Delinquency
NEXTDistro is “an online and mail-based harm reduction service” that will mail NARCAN directly to your house after you watch a training video. Those videos are available in English and Spanish.
Use this interactive map from data.pa.gov to find Naloxone at a pharmacy.
Bubba opens a box of NARCAN Nasal Spray
Kerri Scheitrum explains the Good Samaritan Provision and The Warm Handoff Program
Eliminating the Fear of Repercussion with
the Good Samaritan Provision
Sometimes, the bottleneck between an overdose and saving a life by calling 911 is fear of legal recourse.
“There is a Good Samaritan Law that protects people from the times they do come upon an overdose and need to call 911. If they call 911 and they themselves are in active use, they are protected by the Good Samaritan [Provision],” says Kerri Scheitrum, stressing, “They are able to call 911, stay with the person that has overdosed, and assist them with what they need until 911 gets there without repercussions.”
According to the National Conference of State Legislatures , under the Good Samaritan Provision, a person experiencing an overdose or reporting one is generally immune from arrest, charge or prosecution for certain controlled substance possession and paraphernalia offenses when 911 is called. On a state level, this also goes for individuals in violation of pretrial, probation, parole, protection, or restraining orders.
The Warm Handoff Program
A program that deserves more love is the Warm Handoff. According to Scheitrum, it was organized between hospitals as a pathway to addiction recovery. If a person is brought to the ER and requests “the warm handoff” they will be connected to a certified recovery specialist who will lay out their options - including rehab - and stay at the hospital with the individual until they can find a bed in a rehab facility. The don’t need insurance or proof of ID. But Scheitrum explains that this is a service that must be requested.
“If an individual has overdosed in the community and is brought into the emergency room by the ambulance or anyone else - and comes in with an overdose - they do not automatically inform them about the warm handoff. The only time the warm handoff is given is if that person requests help, so then The Warm Handoff will get the certified recovery specialist at that time.”
Before we hung up this morning Frank Hacken summed it up pretty well.
To paraphrase him - addiction or an opioid crisis can’t be solved by law enforcement. It’s a social issue and needs a social solution.
Over the course of 2022, Focus Journalism will be releasing several reports that tell the story of addiction in Northeastern PA with an aim to better understand addiction and support those who are going through it or seeking recovery. If you have more resources for the community, please reach out to us at scoop@focusjournalism.com and we’ll add your tip to our Resources page.