On a Saturday afternoon at the fire department, a handful of people are learning how to use the now widely available overdose-reversal drug Narcan. It’s one thing to get it into the hands of those who may need it, but it’s another to know how to use it properly.
Tricia Wadleigh, with the Greater Monadnock Public Health Network, runs the training, and demonstrates putting together a Narcan kit for the class.
"You put your thumb on the bottom. It’s got hash marks on the side, so it said half and half in each nostril. You don’t have to be a scientist here. So you’re doing about half in each.”
Wadleigh's holding a clear syringe with an atomizer, which turns the liquid into a spray. People here get a free kit, but the training is also an opportunity for people to ask questions.
"Does it work on suboxone and methadone?" asks Bill Davis, one of the trainees.
"Yes. So they’re overdosing or used too much of those substances, this can help block those receptors in the brain," Wadleigh tells him.
After the training, Davis opens up about his path to heroin addiction. It started with a back injury that required surgery.
“After the operation, I got some pretty serious narcotics. I didn’t do the rehabbing like I should have. Once they cut you off the stuff…I was sick. I had no idea what hit me. I really didn’t know what opiate sickness was.”
Davis is now in clean and in recovery, and while he hopes he never has to use his Narcan kit, he still knows people stuck in that cycle of addiction.
“Like they say, relapse is a part of recovery. Let’s hope they don’t relapse, because if I see somebody in an overdose, I’ll at least be able to give them some of this. I just don’t really want to see anybody die. If I can help, I will.”
The kits being handed out at the training are part of the 5,000 the state dispensed last fall, paid for through a federal grant.
Tricia Wadleigh, the trainer, has handed out more than 300 of those kits in the region since December.
She tells me the people who come out these kinds of trainings are usually dealing with addiction issues in their lives.
"So these are the mothers who are knocking on their daughter’s door three times a night to make sure they’re awake. They’re the wives who are checking on their husbands multiple times during the day. They’re the children who are checking on their parents multiple times a day. The idea was to get the kits to the users, folks struggling with addiction, and then their closest circle.”
She’s done nearly 20 trainings since December, mostly at local businesses, health care organizations, and public schools.
“And maybe we’re not necessarily dispensing kits all the time, but they’re definitely interested in the education. So we’ve had a little bit of uptick from folks who are interested. And we try to meet that need, whether it’s on a Saturday like this, or during the workday or after work hours.”
It’s obvious just how much of a need there is.
First responders with the Keene Fire Department says they’ve used Narcan nearly 60 times this year; compare that to only about 20 times during the same period last year.
“Narcan is nothing new to us. We’ve had it for a long time," says Jim Pearsall, the training lieutenant for the city of Keene. "But what you’re starting to see is what it’s mixed with. OK, you’re getting the heroin. What’s in that? It’s laced with fentanyl. It’s a way to make it cheaper for a better profit margin.”
Pearsall says that dangerous mixture means many overdose victims now need several doses of Narcan to be revived. And they’re seeing the same people over and over again.
Pearsall tells the rest of the class about one of those people they’re seeing frequently; it’s someone he knew growing up.
“I’ve brought him back nine times. Nine times. It kills me every time I see him. This is happening to everybody. It’s affecting everybody. You know somebody that’s affected by this. You’re taking a step here to help people out.”
MAP: Narcan Emergency Reponse Calls in Keene
Data from 2014, 2015, and through mid-may of 2016, courtesy the Keene FD.
The trainees are also learning CPR; first responders say it’s not always enough to have a Narcan kit.
As they're down on the floor practicing chest compressions, a call comes in: there’s a needle on a nearby street. Pearsall says that’s happening virtually every day.
“We need to be policing ourselves, policing our kids, say hey, don’t touch that. If something looks suspicious, call. We’re here.”
This is the second CPR/Narcan training hosted at the fire department this year; both organized in partnership with a local advocacy group: Keene Hates Heroin.
Jessica White founded the group last year, after losing several friends to overdoses.
“Addiction has been in my life, all growing up, I’ve had family that’s addicted in different ways. And some personal experience. So it’s kind of just a natural calling. I think I just realized there’s a lot of gaps in the community. And if you are determined, you can help bridge those gaps.”
The group holds community meetings, where people come together to talk about why people are using and how to support recovery.
She sees Narcan training as one more way to help.
“Narcan is definitely not a solution. But if it’s used as a means to open up that conversation with more people, somebody walks in the door just because they want that training, at least I got them in the door, I got them engaged in conversation, and now they’ve been exposed to a wider mindset.”
And there was plenty of conversation. People share personal stories and hear first responders talk about what’s happening on the ground.
Diane Meagher is also getting trained on Narcan She’s a school nurse in Keene, where officials recently approved stocking Narcan in schools.
"We’ve had incidents of staff, we’ve had incidents of students, we’ve had incidents of parents, so it’s just one more thing in our tool kit. And as our RNs, we’re sort of used to this delivery method.”
And Tricia Wadleigh, the trainer, tells me the sessions are also an opportunity to debunk some myths.
Narcan can’t get you high and she’s seen no evidence to support the argument that making it more available would encourage users to push their limits.
“There’s a lot of misinformation out there. There’s a lot of very personal opinions, very passionate personal opinions that might not be based in any science or logic, but it’s really hard to break those down. So being able to educate folks about a simple option to save a life is a really powerful thing.”
This kind of training is happening all over the state.
The Derry Fire Department is holding a CPR/Narcan training Wednesday night at Barka Elementary School.