ROBERT SIEGEL, HOST:
People on the frontlines of the opioid battle are increasingly turning to Narcan to revive those who've overdosed. Police, school nurses, family members, drug users all commonly carry the drug. But being saved from an overdose is not a guarantee that someone will stop using drugs. A hospital in Massachusetts finds that 10 percent of the patients it treats with Narcan have been revived at least three times. Deborah Becker of member station WBUR has this report.
DEBORAH BECKER, BYLINE: This is an increasingly common scene for Boston emergency workers speeding to respond to an opioid overdose. Boston Emergency Medical Services deputy superintendent Edmund Hassan estimates that his workers use the overdose reversal drug naloxone, more widely known as Narcan, at least three times during a typical eight-hour shift. At a single-family home in South Boston, the workers find a middle-aged man unconscious in the basement. The crew rushes to administer Narcan, squirting it into the man's nose. Hassan starts asking questions.
EDMUND HASSAN: So he's getting some Narcan now.
UNIDENTIFIED WOMAN #1: Yep.
HASSAN: You just found him here. Do you know him - Husband, OK.
BECKER: A woman tearfully tells Hassan the man is her husband. Her son found him in the basement. We're not identifying the man because of medical privacy concerns. Hassan leads the medical team while trying to reassure the man's family.
HASSAN: We gave him Narcan probably about three or four minutes ago, and he's got good vitals.
UNIDENTIFIED MAN: All right.
HASSAN: So I think if we - maybe if we give this a few more minutes...
BECKER: The emergency workers massage the man's chest, clap their hands in front of his face and repeatedly yell his name as they adjust a ventilator. After more than five minutes, the man's eyes, and he groans.
HASSAN: Come on.
UNIDENTIFIED WOMAN #2: Did he say anything?
HASSAN: Do you want to try and get up?
BECKER: The man is taken to an ambulance, and Deputy Hassan says the emergency room will take over from here.
HASSAN: As EMS providers, this call's a success.
BECKER: But Hassan says that does not mean that this man will stop using drugs.
HASSAN: For it to be a total success in terms of health care would be that he'd get into a rehab program and never do heroin again.
BECKER: Even though more and more agencies and laypeople have Narcan, Hassan and his workers used it 40 percent more times this year than last. And Hassan says the man he just revived may need it again.
HASSAN: I'll bet if we researched it out, at some point, we probably took care of him before.
BECKER: Boston Medical Center has looked at its Narcan use and finds that many of its overdose patients have been treated before. About 30 percent of those revived with Narcan at Boston medical have been revived more than once - about 10 percent, more than three times. Dr. Ed Bernstein, an emergency physician at Boston Medical, says even though doctors can save someone from an overdose, that doesn't mean they can save them from addiction.
ED BERNSTEIN: Well, you do feel helpless, especially since we're trying our best and we have all these different tools now. We have to basically work on one day at a time, one step at a time, one life at a time.
BECKER: The problem, Bernstein says, is that it's tough to get long-term addiction treatment either because there are not enough beds or because the patient doesn't have the money or the insurance. He says less than half of those revived with Narcan at Boston Medical go on to get further treatment. So most patients are discharged after just a few hours, and many go right back to using.
JOSEPH: I've been revived by Narcan about four to five times in my life. I've overdosed many more times than that.
BECKER: Thirty-one-year-old Joseph, who didn't want his last name disclosed because of the stigma of substance use, says he was often so sick after being revived he felt he needed heroin.
JOSEPH: There's times I got out and I still had more dope at my house and I went and shot more dope. It's just a vicious, vicious cycle.
BECKER: But Joseph now hopes to break that cycle. After struggling with opioid use for 15 years, he's been in treatment for more than a year. Narcan, he says, has been just one step on his journey to recovery. Boston EMS's Ed Hassan says the bottom line is Narcan saves lives so people like Joseph and the man revived at the beginning of our story can one day save themselves.
HASSAN: Our job, really, as EMTs and paramedics - we're dealing with the immediate crisis. We've got them breathing again. I guess that's one small battle in a very big war.
BECKER: Hassan may never know if the man whose revival we witnessed will win his battle. We left him at the doors of the ER, where his son walked up to his stretcher, took his father's hand and said, I'm glad you're alive, Dad. For NPR News, I'm Deborah Becker in Boston.
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