Opioid Epidemic & Narcan’s Unintended Consequences

In 2017, the U.S. Department of Health and Human Services declared a public health emergency related to the opioid crisis. Indeed, overdoses and deaths from opioids have skyrocketed over the past decade. In 2017, deaths from opioids were six times higher than in 1999. Opioids impact the quality of life and longevity, as well as have tremendous social and economic impacts on communities throughout the United States. The Centers for Disease Control and Prevention has stated that the total economic burden of prescription opioid misuse costs over $78 billion per year.

In addition to the financial toll, deaths from opioids have been increasing steadily and have overtaken deaths due to motor vehicle crashes. Approximately 130 Americans die each day from an opioid overdose and around 68% of drug overdose deaths in 2017 were opioid related.

Communities have been actively looking at ways to reduce the impact of opioids and curb these upward trends. One solution that several jurisdictions have embraced is providing Narcan (naloxone) to members of the public. Narcan is an opioid antagonist and, when administered, it can cause the complete or partial reversal of an opioid overdose.

Although emergency medical services (EMS) agencies have been giving Narcan for years, the introduction of this drug to untrained citizens is a relatively new approach. Experienced EMS providers understand that administering Narcan is certainly not without risk. Individuals suffering from an overdose that are treated with Narcan undergo rapid withdrawal, which can lead to erratic behavior and violence.

Sadly, a recent example of this danger occurred in Appleton, Wisconsin – where a firefighter was killed and a police officer shot after an unconscious individual suffering from an opioid overdose was treated with Narcan. After administering two doses of Narcan, the man regained consciousness. EMS crews attempted to persuade the man to be transported to the hospital for follow-up treatment and evaluation. The man became agitated and pulled out a 380-caliber handgun from concealment. This incident serves as a stark reminder of the dangers faced by first responders each day, and has caused some departments to rethink or institute policies regarding searching unconscious victims prior to Narcan administration.

This podcast, recorded on 24 September 2019, includes EMS professionals with decades of experience. This podcast explores the issues surrounding the opioid epidemic, explains how EMS is handling this new public health crisis, and discusses the possible unintended consequences of making Narcan available to citizens.

Andrew R. Roszak

Andrew Roszak, JD, MPA, EMT-P, serves as the executive director for the Institute for Childhood Preparedness and as an advisor for the Domestic Preparedness Journal. He is the author of the Preparing for the Unexpected Series of books, which includes “Preschool Preparedness for an Active Shooter.” He has spent over 20 years working on emergency preparedness, response, and recovery issues. He is admitted to the Illinois and District of Columbia Bars and is admitted to the Bar of the U.S. Supreme Court. Find him on Twitter: @AndyRoszak.



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