In my five years working on ambulances as an emergency medical technician — both at home and in Rhode Island — only once have I seen a patient come close to dying before my eyes. To my surprise, the cause of almost-death was neither heart attack nor car wreck, nor stroke nor stabbing. Instead, it came neatly packaged in a tiny white pill bearing the name Vicodin.
I found my patient on the floor of his suburban New Jersey home, unconscious, not breathing and with a face as young as my own. Remembering my training, I took a deep breath and then did my best to help him. The patient’s already weak pulse was rapidly deteriorating, and all I could do was continue to ventilate him and wait for paramedics. The second they arrived on scene, they reached into their box of medications and took out an orange capped vial with a clear liquid inside, which they then injected into the patient’s arm. Shortly thereafter, he began to breathe on his own, his face regained its color and we got him to the hospital in better condition than we found him. After my initial sense of relief, I walked away from my closest run-in with death feeling disturbed. What was this mystery medicine, and why did my patient have to wait for a paramedic for it to save his life?
The drug is called naloxone. Our war on drugs is shifting from street corners to pharmacy counters, and naloxone is fighting on the front lines. Prescription drug abuse now steals more American lives than heroin and cocaine combined, and young people are among the most common victims. According to research published in the journal Addictive Behaviors, 50 percent of college students are offered a prescription drug for nonmedical purposes by their sophomore year. Prescription painkillers, or opioids, are rapidly becoming the drug of choice — 12 percent of college students report having misused a prescription opioid in their lifetime. Studies suggest that abuse of prescription opioids is most prevalent among highly selective urban colleges in the Northeast. Does that kind of school sound familiar?
As prescription opioid misuse has become increasingly common, sadly, so have its gravest side effects. Since 1991, fatal overdoses from prescription painkillers have more than tripled, with young people misusing opioids at the highest rates. Naloxone blocks even the most powerful prescription opioids from binding to their receptors, reversing the effects of overdose and saving patients’ lives.
Recognizing the merits of the drug, several states are piloting programs that distribute naloxone to high-risk populations and teach them how and when to use it. The idea is simple. You will never find someone with a severe allergy traveling without an emergency EpiPen, and you should never find someone at risk of overdose without emergency naloxone. In Massachusetts, over 10,000 people have been trained to use naloxone, with 1,200 reported incidents of successfully reversed overdoses. This type of program is a no-brainer.
Yet according to a new report from the Trust for America’s Health, only 17 states have laws expanding access to naloxone. Fortunately, Rhode Island is one of those 17, but students in the remaining 33 are defenseless against the dangers of accidental opioid overdose. We must take steps toward sensible drug policy by expanding access to lifesaving therapies.
Despite naloxone’s miraculous biological properties, it does nothing to address the root causes of prescription drug overdose. Our fastest-growing drug problem will not be resolved by just another drug. We will only overcome our prescription drug addiction if we appreciate it for what it truly is: a preventable epidemic. Drugs like Vicodin may be prescribed by a doctor, but that does not mean they are safe. Every 19 minutes, someone in the United States dies from an overdose. About 72 percent of the time a prescription pill is misused, the person popping the pill acquired it from a friend or family member.
The next time you fill your prescription or share a pill with a friend, consider the dangers within that tiny capsule. By maintaining strict oversight of our prescription drugs, we can stop overdoses before they happen.
But when overdoses do occur, I’d like to know that naloxone is at the ready. Wouldn’t you?
Jonathan Staloff ’14 worked at the Clinton Foundation, an organization working to improve access to naloxone and reduce prescription drug abuse on college campuses.