Anne Berkal walked into the free training class at Westerville City Hall and explained to the instructor why she was there: Last year, she came upon a man overdosing on heroin in the parking lot of a Powell gas station and was powerless to help him.
She was determined such a scene would never unfold in front of her again.
As a nurse, Berkal already knew about naloxone, the powerful antidote that can pull someone out of an active opioid overdose. But she had never considered carrying the medication with her wherever she goes in case someone needs help.
Now, she does.
“Why wouldn’t I help save someone if I could?” said Berkal, of Westerville.
And that’s exactly the message that Franklin County Public Health hopes spreads through the free, public trainings the agency hosts to help reduce the stigma of naloxone (more commonly known by the brand name Narcan) and get it into the hands of as many people as possible.
“We are seeing less overdose deaths because of folks like you sitting right here,” instructor Tyler Darling, opiate injury prevention liaison with the health department, told the 19 people gathered for the two-hour class in Westerville earlier this month. “If someone is now breathing because of what you do with Narcan, that’s a remarkable thing.”
The health department hosted nine such trainings in 2017, 34 last year, and has already held 32 this year with more planned. The numbers for naloxone doses distributed have grown exponentially, too: In 2017, the department dispensed 540 free kits (each kit has two, 4 mg doses of a nasal spray); 1,687 in 2018; and already 1,483 through Aug. 5 of this year. (In addition, the department in that same time period has provided more than 2,200 doses to first responders to use.) Anyone — service groups, businesses, churches etc. — can ask for a training, said Theresa Seagraves, an assistant health commissioner.
She said that as part of the formal Franklin County Opiate Action Plan that was rolled out in 2017, “We all made a concentrated to get out and distribute naloxone to anyone we could.”
It isn’t without controversy.
“We do get some pushback, which means we just need to work more on educating about how addiction is a brain disease,” Seagraves said. “People are torn about why we should be doing this for individuals they incorrectly perceive as having made a choice. But it isn’t that simple.”
Columbus Public Health also distributes Narcan free, distributing 524 kits in 2018 and almost 700 so far this year.
The National Centers for Disease Control and Prevention says that still isn’t enough. In the center’s most recent “Vital Signs” bulletin, it points out that there were 38 million prescriptions filled nationwide for opioids (with the prescribed painkillers often the catalyst for a deadly heroin or fentanyl addiction) in 2018, yet only 556,000 prescriptions written for naloxone.
Ohio doesn’t require a prescription to get Narcan at a pharmacy but it can be costly — as much as $100 without insurance. With insurance co-pays, it can be purchased for as little as $20.
But the free public distributions are the most convenient, said Steve Roth, a first responder who now works with Mount Carmel’s outreach medicine programs and who helped train those who attended the Westerville meeting.
He reminded people that Ohio law shields a good Samaritan who uses the antidote on someone from any liability. And he dispelled the myth that using the spray unnecessarily can cause harm.
“If you give Narcan to someone who doesn’t need it, who cares?” he said. “It will do absolutely nothing to them.”
Here’s how it works: Opiates cluster on the breathing receptors in the brain, and an overdose stops a person’s breathing. But when the Narcan spray is administered in a nostril, it pushes the opiates off of those receptors and a person can breath again. Sometimes, it takes two to five minutes for that to happen, and it often requires more than one dose. That’s why each kit has two doses. (To see an instructional video, visit www.dispatch.com.)
In Franklin County, opioids accounted for 90% of the 120 drug overdose deaths in the first quarter of 2019. In 2018, drug-overdose deaths in Franklin County totaled 522, and the majority of them (478) resulted from opiates.
At the Westerville meeting, 45-year-old Daryl Irvin, who works as a peer support specialist at Maryhaven’s Addiction Stabilization Center in Merion Village on the South Side, said we all should feel a responsibility to save anyone we can.
“It’s hard to convince somebody to love themselves,” he said, so addiction recovery is difficult and painful. “You can empower them, encourage them and love them, but at the end of the day, the decision to love themselves is on them.”
For those who have overdosed and have been saved, he always reminds them: “You’re here. You deserve to live. You deserve to be free of addiction and find out who you are as a person.”