Health

Witness an overdose? Call 911. It may save a life.

Alaska, like many states, has a serious opioid-abuse problem. State laws are catching up, taking it on as a public health epidemic.Heroin, morphine, oxycodone, hydrocodone, fentanyl, Percocet and other prescription and illicit drugs deliver users into a world of diminished pain, and for many, heightened pleasure. Addicts williangly take the plunge, disregarding the knowledge that these substances have the power to kill.

The role of witnesses, friends and family members as crucial front-line life-savers is increasingly evident, whether by calling in medics or by administering an antidote themselves.

In 2015, 54 Alaskans died of opioid painkiller overdoses, and another 34 died of heroin ODs, according to the Alaska Department of Health and Human Services. Twenty-two of the heroin deaths occurred in Anchorage.Six months into 2016, the Anchorage Police Department says people continue to fall victim to the drug's powerful pull. This year, heroin has already claimed nearly a dozen lives.

Although police think they know what killed Darlene Kunayak, a 45-year-old woman who lived homeless in downtown Anchorage, they appear to believe she could've been saved.

Police theorize someone moved Kunayak's body after she'd overdosed on alcohol and heroin. But no one bothered to call for help when her body was shutting down, breathing its last breath.

So Kunayak is now known as No. 11 — the 11th heroin OD death police have investigated this year.

Maybe, it didn't have to be.

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Maybe the people whose names preceded hers on the fatal overdose tally didn't have the be there either.

A powerful drug called Narcan, generically known as naloxone, reverses the effects of opioid overdose and can bring people back from the brink of death. This year the Alaska Legislature passed a law to allow the overdose antidote to get into the hands of more people.
"Any addict, friend or family member can go to a doctor to get a (prescription) for Narcan right now, the doctor can prescribe and dispense Narcan legally," Sarah Evans, a staff member for Sen. Johnny Ellis, who sponsored the bill, said in an email. In time, pharmacists will also be able to prescribe the medicine, making it available over the counter.

Meanwhile, last week, in a statement referencing Kunayak's death, APD urged "citizens who encounter someone in a possible overdose situation to contact medics right away by calling 911."

"A lot of times people in those situations who have been using drugs are afraid to call for help because they are afraid they are going to get into trouble," said police spokesperson Jennifer Castro.

A 911 call for an overdose is first and foremost a medical call, Castro said. Saving a life is the priority.

Additionally, a "make the call" good Samaritan law passed in 2014 shields people from prosecution for possession of illegal drugs.

Last year, medics with the Anchorage Fire Department administered naloxone to 305 people. In 2014, 285 people received the overdose-reversing drug, said AFD Assistant Chief Erich Sheunemann.

The emergency care is given not just for heroin overdose, but for any suspected overdose, or if someone is unconscious and it's unclear why, Sheunemann said.

In its altered state, the body forgets to do the things that keep it alive. Naloxone wakes it back up.

"It is very noticeable when you have someone unconscious and not breathing, and they just come back in very rapid order," Sheunemann said.

Prescription and illicit pain medications and illegal drugs can deliver near instant euphoria, but the superendorphins they engage also suppress a person's heart rate, blood pressure and respiratory system.

"They just overwhelm the system and cause it to shut down," Sheunemann said.

The revival window is narrow, though, making quick intervention essential to prevent brain injury and death.

If someone is overly lethargic, can't be roused from sleep, is unconscious or is barely breathing or breathing irregularly, or if they are turning blue, they are likely overdosed. Unless someone does something to help, the OD victim could die.

According to the U.S. Department of Health and Human Services, more than 28,000 people died from opioid overdose in 2014. Of those deaths, 10,500 were heroin-related, triple the amount seen in 2010.

While the over-the-counter cost of Narcan and naloxone remains an unknown, insurance companies and Medicaid will cover it, Evans said.

Single doses cost the city fire department $30, Sheunemann said.

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However, national demand for Narcan and naloxone has caused price spikes. And it's not entirely clear how willing insurance companies will be to pay for outpatient doses.

In May 2016, the online news site Politico noted prices for "some versions of the drug have risen as much as 17-fold in the past two years."

Politico found an auto-inject version made by Kaleo Pharma "soared from $575 to $3,750 per two-dose package in just two years." Another version made by Amphastar doubled in price to $66 for two syringes. A third option, a generic version made by Hospira, "which cost $1.84 in 2005, shot up to $31.66 by 2014."

While the details of how over-the-counter sales will work in Alaska and how much they will cost are still being worked out, there's no question early intervention saves lives, and people of all ages and backgrounds struggle with addiction.

My younger sister is among those heroin addicts with too many close calls to count and who, now precariously sober, is lucky to be alive. I am grateful for it. If I lived closer to her I'd carry Narcan, just in case.

I hope being at the ready proves to be simple and affordable for all Alaskans in every corner of the state.

As Shannon Hilton, president of the Alaska Nurse Practitioner Association pointed out in a letter to the Legislature urging passage of SB 23: "We do not wait for the house to burn down before we call the fire department. We do not wait for a diabetic to be in (a) hyperglycemic coma to initiate treatment. Addiction is a treatable disease, but the patient needs to be alive to receive treatment."

Jill Burke

Jill Burke is a former writer and columnist for Alaska Dispatch News.

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