New data on heroin overdose deaths in Connecticut released by the chief medical examiner show an increase of nearly 87 percent from 2012 to 2014. This finding underlines the importance of developing strategies to tackle heroin abuse and implementing potential solutions to reducing overdose deaths, including increased use of the heroin overdose “antidote” Narcan, which is set to be made more widely available in 2015.
Heroin Epidemic: The Basics
The rising trend of heroin overdose deaths can ultimately be traced back to the rising abuse of prescription opiate medications like OxyContin. These substances are effectively medicinal forms of heroin, and although extended-release formulas were intended to reduce the risk of addiction, this restriction was easy to circumvent. It wasn’t until OxyContin and similar medicines like Opana were made abuse-resistant—preventing users from crushing the pills or preparing them into solutions for injection—that those addicted to opiates could no longer get high through medications. This led many to switch to a more accessible and drastically more affordable substance: heroin. The impact of this change is seen in heroin and prescription drug overdose rates, with the steady climb in prescription drug deaths between 2000 and 2010 leveling off just as heroin overdose rates shot up dramatically. The abuse-resistant formulation of OxyContin was released in 2010, about the time of the large-scale shift to heroin.
Heroin Overdose in Connecticut
In 2012, there were 174 drug overdose deaths where heroin was involved, and this increased by about 48 percent to 257 in 2013. The growth was smaller from 2013 to 2014, with a 26-percent increase to 325 deaths, with heroin accounting for 58 percent of the 558 accidental drug overdoses in the state last year. Running the numbers, the increase from 2012 to 2014 is 86.7 percent—meaning there were roughly 87 percent more heroin-related deaths than two years earlier. It’s important to note that many of these deaths—in fact, the majority from 2012 to 2014—involved multiple substances, such as fentanyl (another opiate), cocaine, alcohol and methadone (used to help heroin abusers minimize withdrawal symptoms and reduce their dependence). One hundred fifteen of the 325 deaths in 2014 involved heroin alone, 37 were in combination with fentanyl, 73 in combination with cocaine and 100 in combination with other substances such as alcohol and methadone. The most common cause of a death from heroin abuse is respiratory depression, a side effect of the drug. The user falls asleep and his or her body “forgets” to keep breathing. The fact that respiratory depression is a side effect of heavy drinking is one reason deaths in combination with other substances are so common.
Is Narcan the Solution?
Narcan is a brand name for naloxone, a medicine that reverses the effects of opioid overdose. Opiates like heroin create their effects by the interaction they have with the opioid receptors in the brain, where they mimic the function of the body’s natural endorphins. Narcan works by jostling these molecules from their position and occupying the receptors instead, but doing so without producing the same effects. Somebody suffering respiratory depression from heroin use can be saved by a dose of the drug, which allows normal breathing to return. Previously in Connecticut, only paramedics were legally allowed to administer Narcan, but legislative changes taking place last year—like the “Good Samaritan law”—mean that medical technicians and emergency responders, including police and firefighters, will be able to administer the drug. It’s literally a life-saving medication, and getting it into more responders’ hands is a promising strategy for bringing down overdose rates. In addition, the new law means that anybody using Narcan to save the life of someone overdosing on opioids is immune from civil and criminal punishment. Of course, this is a “last resort” when it comes to reducing overdose rates. The true goal in Connecticut and around the country is to help these people before overdose occurs, helping them find treatment and overcome their addictions. Nurse Karen Butterworth is spearheading a group aiming to do just that in Connecticut, working with police, fire departments, emergency care centers, psychiatric services and the state Department of Children and Families to tackle the epidemic. Alongside using the “last resort” to reduce the numbers of deaths, families, friends, law enforcers, paramedics and healthcare professionals need to encourage anybody in need to seek treatment for addiction. The more people we get into recovery, the less we’ll need to opt for the last resort and pull addicts back from the brink of death, and the smaller the number of overdose deaths will get.