In rehab from an opioid addiction, Kyle Cummings, who not long ago had been homeless and living in his car, is in a good place now. Yet there are many people in his life who are not. That’s why he was happy to receive the latest edition of the opioid antidote, Narcan, in a nasal spray variety— to keep in his pocket, just in case.
Linda Guttierez smokes a synthetic cannabinoid known as K2 or Spice, a bad batch of which which sent approximately 47 people, including Guttierez, to the hospital for a total of over 100 times in a couple of days last month.
As she copes with addiction, she said she now feels more secure to have received several packets of specialized fentanyl detection strips to dip into the K2. With a little water, you insert the strip and see if it’s positive or negative, just like in a pregnancy test.
Their stories of addiction — how to do it without killing yourself, as well as the struggle to get clean and not relapse — emerged this past Thursday afternoon as the Cornell Scott Hill Health Center, along with other organizations dealing with addiction and homeless services, marked the third annual National Overdose Day on the Green.
The idea was to raise awareness of drug overdose, reduce stigma, and spread the word about prevention.
The latter took the form of writing “scrips,” as the professionals call prescriptions, for Narcan not only for users of opioids but for anyone who would like to have it handy to save a life if necessary.
“On a bus, a train, in schools, no one’s immune from a place where someone might overdose,” said Melissa Zuppardi, an assistant program director for the Cornell Scott Hill Health Center.
“That’s why we need to get the word out.”
In the first hour of the 10 a.m.-2 p.m. event, Zuppardi and the pharmacist sitting beside her wrote Narcan prescriptions for 15 people.
“It gives parents a measure of control,” she said. “I’ve heard from parents. They hear gurgling from behind the door of the room. Their kid’s overdosing.”
Now, with the Narcan, which she taught people at her table how to use, they can save their kid’s life.
Workers from Cornell Scott, the Yale University School of Medicine’s Community Health Van, the city’s emergency operations center, and the volunteers from SWAN (Sex Workers Alliance Network), all of whom were busy demonstrating the nasal spray, and injection Narcan, would distribute about 150 kits altogether, estimated Phil Costello, Cornell Scott’s clinical director of homeless care.
Sally Graveline, a volunteer with SWAN, said Narcan has saved her life and she has used it to save others’ lives.
“Every urban dweller should be required to carry one,” she said.
Yale School of Medicine Department of Infectious Diseases nurse Sharon Joslin, on duty with the community van, put it this way: “We’re losing 200 people a day to overdose. My goal is to get people the care they need, as if they had diabetes.”
“Some people believe we are encouarging addiction” through distribution of the Narcan, and the methadone and Suboxone which she also had on hand, Joslin said. “I respect that position but I don’t agree. My belief is we need to help because substance abuse is a disease like diabetes. I don’t believe we should just let people die. Everyone should be treated equally. Not just people who can afford to go to the Betty Ford Clinic.”
While injection Narcan obviously requires a needle (big enough to go through clothing), the latest version of the nasal Narcan, as demonstrated by Zuppardi and others, is easy to administer.
Here’s what you do, said Zuppardi, if you come across someone who is having an opiod overdose: First you call 911, because each dose of Narcan lasts only from 20 to 90 minutes. Then you open the package, put the cone in one nostril and press. You wait for two or three minutes for the person to arouse. If the person doesn’t, you do it again in the other nostril.
The Narcan being distributed comes two to a box, with a portion of four milligrams to each, which is twice the strength of the previous version, said city emergency management chief Rick Fontana.
Narcan wouldn’t have helped the vast majority of K2 overdose victims in mid-August, because that batch turned out not to be laced with fentanyl.
That’s why part of the focus Thursday was to get the word out about K2, for which there is, at this point, no antidote, said Costello.
“I feel marijuana users will see it as ‘synthetic’ marijuana, which it is not,” he added. “It’s harmful,” and cheap, which is why he fears people may be switching over to it.
As he was helping to supervise the event, several people called out to Costello, aka “Dr. Phil.” Costello is not a doc but an advanced practice registered nurse—actually a guy who was a mechanical engineer for 20 years, before he retrained to do what he loves.
“They call me Dr. Phil, from what they see on TV,” he said.
Between checking one guy’s heart and repairing, with iodine, gauze, and bandages on a bad gash on the heel of another homeless man who approached him, Costello reflected on the larger picture:
“The Narcan is just to keep people alive until they can get into recovery. But a lot of these people relapse and self-medicate. They have had terrible problems in their youth or as children. When they stop using, PTSD or bipolar returns and can devastate them. What’s little known is that relapse is a part of the recovery process.”
His solution? It’s double-pronged, he said: Starting in school there has to be far more of a concerted education campaign about drugs. Ultimately that is the only way to “close the barn door.” In addition, there has to be a long-term wholistic approach with enough mental health services to do the job.
Yale Medical School’s community health care van, a mobile clinic, will be parked in front of Trinity Church on the Green every Tuesday from 8 a.m. to noon for the immediate future while the city pursues longer-term actions, like opening a walk-in center a block or so from the Green.