Naloxone, commonly known as Narcan, a nasal spray being used by the Quincy, Massachusetts Police Department to reverse the effects of opiate overdoses.
As Boston celebrated its World Series victory last fall with a grand parade through downtown, a distraught young man burst through the crowd in search of police. But he didn't want Boston police. He wanted an officer from Quincy, a Boston suburb.
The man's girlfriend had overdosed on heroin. He had heard Quincy police carry naloxone, a drug that can reverse an opiate overdose instantly. Quincy officers, helping with security at the parade, administered the drug, reversed the overdose and saved the 20-year-old woman.
Since Quincy officers began carrying a nasal form of the drug, known commonly by its trade name, Narcan, in October 2010, they have administered the drug 221 times and reversed 211 overdoses, say Lt. Detective Patrick Glynn, commander of the narcotics unit and special investigations at the Quincy Police Department.
As opiate overdoses have soared nationwide, more police departments are taking a hard look at equipping their police officers and other first responders with naloxone instead of waiting for paramedics to arrive. Police are often the first to arrive at the scene, and experts say those early minutes can be the key to saving a life.
The public safety department in Espanola Valley, New Mexico in early 2013 became the first police agency in the southwest to equip its police and first responders with naloxone, says Chief Eric Garcia, director of public safety.
"It's a great tool to add to our arsenal," Garcia said. "It's not only weapons that we need to have. The bottom line for law enforcement is that we are there to protect and serve the public, to preserve life and property."
In Ocean County, N.J. when overdose deaths doubled from 53 in 2013 to 112 in 2013, Ocean County Prosecutor Joseph Coronato "looked at every option to address the problem," including tougher law enforcement, encouraging private companies to build rehab facilities and equipping officers with naloxone, spokesman Al Della Fave said.
The county will pay for the $25 nasal naloxone kits with money from the county's drug forfeiture fund, he said. "It'll e the drug dealers who will be paying for this," Della Fave said.
Ocean County will begin training its police officers in all 31 local departments to use naloxone in Febuary, Della Fave said. "The officers don't want to be standing their helpless waiting for EMS," he said.
An overdose of heroin or other opiates such as oxycodone or hydrocodone can depress breathing and leave the user unconscious. Untreated, the user can die.
Naloxone binds to the opioid receptors in the brain, displacing other drugs and reversing the effects, says Dr. Alexander Walley, an internist and addiction medicine specialist at the Boston University School of Medicine. Naloxone can be administered by injection into a muscle or as a nasal spray and lasts 30 to 90 minutes, he said. It won't reverse the effects of other types of drugs, such as cocaine or methamphetamine.
"There is zero risk. It's so safe I can squirt it up my nose right now and it won't do a thing to me," says Dr. Ken Lavelle, an emergency room physician and EMS medical director for departments in Pennsylvania and New Jersey. "There is very little downside to it for police and other first responders."
In Massachusetts, the Department of Public Health established a pilot program to distribute naloxone to friends and families of opiate addicts in 2007. By 2009, police and fire departments asked to participate.
Five departments now equip first responders with naloxone and many more have expressed interest, says Hilary Jacobs, director of the Bureau of Substance Abuse Services.
"Often they were the first people on the scene and they wanted to be able to do something that was effective," Jacobs said.
Police and first responders have reversed more than 300 overdoses statewide, Jacobs said. The department doesn't track whether some people have been reversed multiple times.
The toughest problem, Glynn says, was persuading drug users, their friends and family that they wouldn't get arrested if they call 911 to get help for an overdose. Massachusetts and most other states have Good Samaritan laws that protect people in medical situations.
Now drug users often flag down officers for help rather than running from them, Glynn said.
To be rescued by a police officer instead of being arrested "is a powerful thing," Jacobs said.
"We didn't anticipate how it would change the relationship between the police and the community, including the drug using community," Jacobs said. "There's a lot of compassion and a lot more respect going both ways. "
Heroin overdoses became an issue in the Quincy mayoral election seven years ago. In 18 months, 99 people had overdosed and died in Quincy and two neighboring communities.
"We needed to acknowledge the problem and come together as a community to deal with it," said Mayor Thomas Koch, who created a task force.
Koch first learned of Narcan during his campaign, when the parents of a young heroin addict recounted the terror of their son's overdose. Police arrived, but without the drug, they could only wait helplessly until the ambulance arrived. The paramedics arrived with naloxone and reversed the overdose.
Equipping police with naloxone made sense since they usually get to the scene first, Koch said.
"It's easy for the cynical person to say, 'Oh, they're druggies, they're junkies, let them die. But when you put a name and a face and a family to that, then it's a different story," Koch said. "Some people who go down this road will never come back, but if we can bring them back, there's always hope."