Left: Naloxone, commonly referred to as Narcan, is an antidote for opioid overdose. Right: A man in Upper Darby is caught on a bus surveillance tape shooting heroin and overdosing. Police arrived moments later and revived him after administering Narcan.

Left: Naloxone, commonly referred to as Narcan, is an antidote for opioid overdose. Right: A man in Upper Darby is caught on a bus surveillance tape shooting heroin and overdosing. Police arrived moments later and revived him after administering Narcan.

Left: Flickr Right: Screenshot via Upper Darby Police

Narcan 101: A life-saving heroin antidote carried by just 15 percent of Philly police

You might have seen a video of 25-year-old Michael Meeney shooting up heroin on your Facebook feed this week. He was the subject of a dramatic video captured via surveillance on a SEPTA bus traveling through Upper Darby. In it, Meeney can be clearly seen injecting the drug into his veins on the bus in broad daylight.

His head rolls back and his hands contract. He collapses to the floor as some of the dozen or so passengers react. Minutes later, Officer Matt Rugh arrives and administers naloxone, a heroin overdose antidote commonly referred to as Narcan. In seconds, Meeney wakes up and is helped off the bus by the officer and paramedics. He was later arrested for drug possession, a controversial move officers made after he was rescued and cared for.

Still, Meeney is one of 185 Narcan “saves” made in Delaware County since local officials doled out the remedy to its 42 police departments after state officials made it legal in 2014 for police officers to carry the drug that was once administered only through a prescription. Some 400 squad cars across Delaware County have doses on-hand for when police encounter an overdose victim.

That’s not the case here in Philly. Though officials said for a year that officers would be equipped with doses of Narcan for calls of opioid overdose, just 1,005 police officers in the city have it, representing about 15 percent of the overall police force. Those officers are concentrated in the city’s east and northeast police divisions, and have made 125 saves since they first started carrying Narcan. Officials say 110 of those saves came in the east division where some of the city’s most notorious drug corners are.

“Officers see the great advantages and tremendous impact they’re having, especially for the families,” Delaware County District Attorney Jack Whelan said about the success of the program there, “because one of the worst things for an officer is to go to a house and tell someone their family member died.”

The rapidly growing problem

Public health officials and police roundly agree: We’re in the middle of a growing heroin epidemic similar to the stranglehold crack cocaine had on cities in the ’80s.

According to a report by the Drug Enforcement Agency, the abuse of heroin and cocaine as well as opioids like fentanyl and oxycodone has caused a spike in drug-related deaths in the city over the last decade, with a 43 percent increase since 2009. There was a 33 percent increase in drug-related overdose deaths in Philadelphia between 2013 and 2014 alone.

This chart from the DEA shows the drugs that were in the systems of people in Philadelphia who died from drug overdoses in 2013 and 2014:

Screen Shot 2016-02-24 at 5.44.52 PM
Via Drug Enforcement Agency

Statewide, Philadelphia had the highest drug-related death rate per 100,000 people, with 655 deaths in 2014. Heroin was present in 349 of those deaths. Susquehanna, Cambria, Fayette and Wayne counties round out the top five counties in the state where the drug overdose problem is most acute. But the entire state of Pennsylvania is seeing an increase in heroin use over the last two to three years.

The Keystone State leads the nation in the number of young men who die from a drug overdose. And when it comes to the number of people who die in Pennsylvania each year, drug overdoses recently surpassed car accidents.

So under Gov. Tom Wolf, not only were state police equipped with a drug meant to reverse overdoses, but Physician General Rachel Levine issued a rare standing order for Narcan, which essentially signed a prescription for all Pennsylvanians to go to a pharmacy to get the remedy if they want it.

What Narcan does and how it works

Narcan is a medication that, when administered either intravenously or through a nasal spray, blocks the receptors in the brain that are affected by opioids and effectively reverses the overdose. Unlike methadone, Narcan isn’t used to stimulate the brain and it won’t do anything to someone who hasn’t used an opiate.

Philadelphia Police spokeswoman Tanya Little said officers in the east and northeast divisions — that’s the 2nd, 7th, 8th, 15th, 24th, 25th and 26th districts —  are the only police carrying Narcan from the Philadelphia Police Department at this point. That swath covered with officers who carry the antidote includes everything beginning at 10th and Poplar streets all the up through the Northeast, including Fishtown, Kensington, Port Richmond, Fairhill and Frankford, stretching to the corners of the city in Bustleton and Somerton.

These are the areas that need it the most. According to statistics kept by emergency medical personnel (so not the police), Narcan was administered 253 times by EMS in the first six months of last year in just one zip code: 19134, a zip code covering parts of Kensington where highly-trafficked drug corridors sit square in the middle.

The areas of the city with the next highest number of overdoses treated with Narcan were nowhere close to the volume seen in 19134. During the same time period, 92 Narcan saves were made in both 19124 and 19133, areas that include Frankford and West Kensington.

Administration of Narcan by EMS officials in the first half of 2015.

Administration of Narcan by EMS officials in the first half of 2015.

Delaware Valley Intelligence Center

All the top five zip codes for Narcan use by EMS are also in the same part of the city where police officers now have Narcan available. Little said the east and northeast divisions are where the program is getting rolling, as those areas are where the problem is the worst. Once more funding comes in to purchase the drugs and provide the training, it’s likely more police will be equipped.

“If there’s a rise in another division, which we’re hoping there isn’t,” she said, “that’s where the next batch will go.”

SEPTA Police Chief Thomas Nestel said 22 SEPTA police officers stationed at the 69th Street Station are equipped to administer Narcan and, since August 2015, have made nine saves with 100 percent success. But he says the problem is most severe in the area of Kensington Avenue near the Somerset Station, where his officers concentrate and frequently run into drug dealers, along with drug users from other parts of town looking to get high.

“They’re down there for one reason,” Nestel said, “and when they get high, hopefully it’s in a public location so when there’s medical distress we can provide help.”

The Narcan the officers use at 69th Street was paid for by Whelan’s office because of its proximity to Delaware County, but other SEPTA police officers haven’t been equipped. Many counties are using drug forfeiture money to pay for the distribution of Narcan, but that’s not the case citywide here in Philly.

Cameron Kline, a spokesman for District Attorney Seth Williams, said the Office of the District Attorney isn’t responsible for raising the funds necessary to get Narcan into the hands of police, though he said it’s “certainly something we’ve thought about and looked at.”

That’s the big problem here. Cash. In Delaware County, federal grants from a drug-free communities program helped pay for the Narcan. Drug forfeiture dollars are picking up where that leaves off, but as The Daily News reported earlier this month, that’s getting harder as pharmaceutical companies are rapidly raising their prices — sometimes to as much as nearly $200 per dose.

What happens after it’s used?

As cities, small towns and rural areas across the country are grappling with the heroin problem, they’re also trying out new ways to deal with addicts. Some argue throwing an addict in jail isn’t the best way to get the person help. Others think it’s the only option to get them off the streets and into a life without drugs.

The mayor of Ithaca, N.Y. recently proposed creating a safe drug-use facility for drug users to come and be administered their illegal drug of choice by a medical professional with a clean needle and overdose training. Look across the country, and Seattle is seen as one of the most progressive cities in fighting addiction, and its officers will not arrest drug users, but instead enter them into a diversionary program that gets them treatment.

Typically in Philadelphia, addicts aren’t arrested if they’ve recently used, only if they’re carrying more dope on them they plan to sell to others. They can be diverted to other programs and stay out of jail, but that’s post-arrest. Seattle’s sophisticated — and albeit expensive — Law-Enforcement Assisted Diversion, or Lead Program, diverts users to social services before arrest.

Nestel said SEPTA police won’t arrest a person simply for using drugs, largely because officers can’t be certain what drug was consumed or why the person may have had the reaction they did. It could also be that the person has a mental health issue or overdosed on legitimately prescribed drugs.

“We have officers that have gotten folks into rehabilitation and they fail,” he said. “And it’s just the nature of the addiction is that most people fail multiple times. When they go to get help, it’s a cycle.”

Whelan said in Delaware County, after a person is helped by police following a drug overdose, EMS takes over and they’re transported to the emergency room for treatment where medical professionals give them information about where to get help and how to follow up. Problem is, that’s leaving it up to the addict to follow up themselves. Most won’t do that.

But a grant will be implemented over the next month in the county that funds caseworkers who will identify individuals who have been saved by Narcan and check in on them to make sure they’re getting treatment. That’s something Whelan’s excited about.

What’s more troubling is this: Despite officers making nearly 200 saves from Narcan since the fall of 2014, the drug overdose death number in Delaware County is still rising. Last year, the county saw about 100 deaths. We’re not even through the first two months of 2016, and more than 20 people in Delaware County have died of an overdose.

“We’re not seeing a reduction of the death rate,” he said. “What we’re seeing is a real concern over this epidemic.”

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