As of January, 2023, Mahoning County ranks amongst the top nationally in overdose death rates, with a rate of 68.3 per 100,000 residents,¹ which is more than double the rate of the national average. Between February 2022 and January 2023, 154 drug overdoses were recorded in the county, and 5,142 in the state of Ohio.
What is Narcan?
Narcan is a brand name for the generic drug Naloxone, an effective overdose-reversal drug that can be administered intranasally or intramuscularly to stop the effects of an overdose and save someone's life. As of 2015, at least 27,000 lives have been saved from opioid overdoses by Narcan as published by Center for Disease Control and Prevention's Morbidity and Mortality Weekly Report.²
Naloxone is an opioid antagonist, meaning it binds to opioid receptors and can reverse and block the effects of other opioids, such as Oxycodone, Morphine, Heroin, and Fentanyl. Its effects are temporary and do not last long, but long enough to obtain medical intervention that can save a person's life.
Jonathan Goyer's Story
10 years ago, in 2013, Jonathan Goyer collapsed on the floor of a group home he was staying in and lost consciousness. He had injected himself with heroin during a relapse, and because he was in recovery, his tolerance was lower to the powerful drug than what he was used to. Jonathan was overdosing, and the drug was about to kill him.
That's when Goyer's roommate injected him with Naloxone, or Narcan, seven times until he was finally revived.
An addict of ten years, Jonathan had stayed in over 30 different treatment facilities trying to get clean. Often, his friends and loved ones admitted him, sometimes against his will. But it wasn't until that fateful day in 2013 than Jonathan had ever overdosed before, and his near-death experience was exactly the breaking point he needed to take getting clean seriously.
"I had never heard of Naloxone, not in 2004, not in 2009... I had only heard about it in 2013, when it was used on me. Being somebody who struggled with addiction for 10+ years, who has been to over 30 treatment facilities, I was never educated on Naloxone or how to use it."
Now, Jonathan is considered a national leader on the front lines of the epidemic as an expert advisor to Rhode Island's Overdose Prevention Taskforce. He's also implemented and managed the first ever peer-led outreach program Anchor MORE. He has been sober for ten years this year.
He credits Naloxone with keeping him alive long enough to want to live.
The Lasting Effects of Being Revived by Naloxone
A common myth about access to Naloxone is that drug-users will view it as a "safety net" to their habits and partake in something called compensatory drug-use—taking even more drugs than they would without it. The reality is, addicts aren't living in a world of that kind of rationale and careful planning when they choose to abuse substances. On the subject of compensatory drug use, Jonathan Goyer stated:³
“Why would anyone want to get high to the point where they have to take Narcan and immediately sober up? The problem is that there's many addicts who don't care if they live or die.”
Goyer argues that people choose powerful drugs like heroin and other opioids as an escape from intense emotional pain—it's not about having "fun" and calculating how to get the best "high," the ability to see the future and its consequences is out of reach in place of the urge to escape pain. They aren't engaging in risky behavior because of access to Naloxone—they're engaging in it regardless because they are addicts, Naloxone or not. The concept of compensatory drug use when given Naloxone was studied in 2016 by New York State Psychiatric Institute, when a group of 61 heroin users were trained in administering Naloxone and given take-home supplies and interviewed over the course of 3 months. Their analysis showed no evidence of compensatory drug use following Naloxone/overdose training in heroin users,⁴ and additional findings actually showed an overall decrease in the amount of heroin used in those 3 months. A similar study was conducted in 2009 amongst users in the skid-row area of Los Angeles, with 53% of participants reporting decreased drug-use at their follow-up interviews after receiving take-home Naloxone.⁵
How does Naloxone Help Recovery? Zach's Story
Another issue people fail to see properly is how not everyone's recovery story is cut-and-dry like Jonathan's. A common misconception involving the use of Narcan by first responders is that it is administered to the same people over and over again. Although the use of heroin and other schedule I substances are illegal, officers cannot typically arrest someone who is overdosing due to good samaritan laws. The narrative gets pushed that first responders are reviving the same people over and over again with Naloxone, only lengthening their cycle of abuse, but studies have shown that this phenomena is greatly over-exaggerated. A massive study published in 2013 that studied nearly 3,000 people who had a non-fatal opioid overdoses found that as little as seven percent of patients had a repeated opioid overdose after one year.⁶
But still, repeat revivals do happen on the streets. But having multiple overdoses and being revived by Naloxone can still lead to recovery. After all, how is someone supposed to seek treatment if they're dead? Near-death experiences do often serve as a catalyst for seeking treatment, just like in Goyer's case. Or in the case of Zach Nielson. Zach flatlined from an overdose of heroin, and was revived by Naloxone.⁷
Only Zach didn't seek recovery right away.
Angry, addicted, and seeking to escape the emotional pain of everyday life, Zach continued to use heroin and overdosed five more times. It wasn't until his sixth overdose that a girlfriend brought Zach to a treatment center where he was treated for two weeks. It was after those two weeks that Zach began to see glimmers of his old self and realized he could seek recovery, after all. Zach's story is a bit different from Goyer's; while Goyer may seem like the poster-child for having a near-death experience and awakening with new hope, and a shock to the system for the life he wanted, most people's route to recovery is messier and grittier than that.
They still deserve every chance.
Written and edited by Mary Dippolito
1. Jung, Yoohyun, and Christian Leonard. “Drug Overdose Deaths: Tracking Devastating Toll of U.S. Crisis.” The San Francisco Chronicle, September 7, 2023. https://www.sfchronicle.com/projects/us-drug-overdose-deaths/?fips=39099.
2. Wheeler, Eliza, and Stephen Jones. “Opioid Overdose Prevention Programs Providing Naloxone to Laypersons - United States, 2014.” Centers for Disease Control and Prevention, June 19, 2015. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6423a2.htm?s_cid=mm6423a2_e.
3. Stoffers, Carl. “Narcan: It Saves Lives. Does It Enable Addicts?” The Marshall Project, August 14, 2015. https://www.themarshallproject.org/2015/08/14/narcan-it-saves-lives-does-it-enable-addicts.
4. Feelemyer, J.P., J.D. Jones, T.J. Cicero, A.K. Clark, and S. Darke. “No Evidence of Compensatory Drug Use Risk Behavior among Heroin Users after Receiving Take-Home Naloxone.” Addictive Behaviors, March 9, 2017. https://www.sciencedirect.com/science/article/pii/S0306460317301119?via%3Dihub.
5. Wagner, Karla D, Thomas W Valente, Mark Casanova, Susan M Partovi, Brett M Mendenhall, James H Hundley, Mario Gonzalez, and Jennifer B Unger. “Evaluation of an Overdose Prevention and Response Training Programme for Injection Drug Users in the Skid Row Area of Los Angeles, CA.” The International journal on drug policy, May 2010. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4291458/.
6. Larochelle, Marc, J Frank Wharam, Dennis Ross-Degnan, Fang Zhang, and Jane Leibschutz. “Opioid Prescribing after Nonfatal Overdose and Association with Repeated Overdose: A Cohort Study.” Annals of internal medicine, January 5, 2016. https://pubmed.ncbi.nlm.nih.gov/26720742/.
7. Thomas, Deborah. “Zach N: From near Death to Recovery from Opioid Addiction.” The Walker Center, June 7, 2023. https://www.thewalkercenter.org/blog-posts/zach-n-from-near-death-to-recovery-from-opioid-addiction.
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