Henry “Skip” Gates was teaching a math class at Lawrence High School in Fairfield in 2009 when he was summoned to the office for a phone call.
“I heard the sentence, the worst sentence any parent can ever hear: â€˜We regret to inform you your son has been found deceased,’ ” Gates recalled. “I felt like the floor opened and I started to fall. And I’m still falling.”
Will Gates, 21, a championship skier from Skowhegan who was studying molecular genetics at the University of Vermont, had died of a heroin overdose. He wasn’t an addict, but had decided to snort the drug.
The growing problem of heroin gained renewed national attention on Sunday, when police in New York reported that Academy Award-winning actor Philip Seymour Hoffman had been found dead in his apartment, the apparent victim of a heroin overdose.
As the number of overdose deaths from opiates such as heroin has been on the rise in Maine and nationally, the public health community has been working to expand access to the drug Narcan, which has been credited with reducing overdose deaths in parts of the Northeast.
“Deaths from overdoses on heroin or opioids in general are quite high relative to our population,” said state Rep. Sara Gideon, D-Freeport, referring to heroin and similar synthetic drugs like methadone and oxycodone. Gideon is sponsoring a bill to give police, volunteer firefighters, drug users and their family members access to Narcan, also known by its generic name naloxone, to administer when someone is in the often-fatal respiratory distress that happens during an overdose.
The Legislature’s Health and Human Services Committee is scheduled to hold a public hearing on the bill at 9 a.m. Wednesday.
Gates doesn’t know if Narcan, which instantly reverses the effects of an overdose, would have saved his son’s life. He knows only that his son’s body was still warm when his roommates found him.
CHANCE TO TURN LIVES AROUND?
Statistics released last month by the Maine Attorney General’s Office showed that the number of opiate overdose deaths in the state rose from 156 in 2011 to 163 in 2012 — almost the same number of people who died in traffic crashes that year.
The number of overdoses attributed to heroin jumped from seven in 2011 to 28 in 2012, the last year for which figures are available. The state medical examiner expects the total for 2013 to be higher still.
Police say people who are accustomed to prescription painkillers are now turning to heroin because it is less expensive and more available.
Gideon’s bill, L.D. 1686, would allow physicians to prescribe — and pharmacists to provide — Narcan to people besides those who would need the drug for themselves, such as police officers or family members. The goal is not only to save lives, but to give people a chance to get treatment, Gideon said.
“Is there any way we can use this as an opportunity to basically alter someone’s path and get them to a healthier lifestyle?” she said.
Narcan has become the primary drug for treating overdoses from heroin, methadone or prescription painkillers like OxyContin.
It works by attaching to the same receptors in the brain that opiates do, blocking the opiates from getting through and preventing their impact on the respiratory and nervous systems. The sudden withdrawal, however, can be violent, which is one reason some people oppose its widespread distribution.
Narcan already is available in about 85 percent of rescue calls, said Jay Bradshaw, director of Maine Emergency Medical Services, the state agency that sets guidelines for rescue service in the state. Rescue workers who are trained in advanced life support are authorized to administer the drug, but basic EMTs are not.
Portland firefighters have carried Narcan on all their fire trucks and ambulances since 2002, when a rash of methadone overdose deaths swept the city. In 2011, firefighters administered 60 doses of Narcan. That number climbed to 65 in 2012 and up to 93 in 2013, said Deputy Chief Terry Walsh.
The drug is not without consequences. In addition to violent reactions to withdrawal it also can cause vomiting which can dangerously block the airway in a patient who already is having problems breathing.
Gideon’s bill is similar to one submitted in the last legislative session by Rep. Ann Dorney, D-Norridgewock, who is a doctor. That bill, which included a provision to protect someone who reports an overdose from prosecution, passed but was vetoed by Gov. Paul LePage, who said the key to reducing drug abuse is to keep drugs away from users.
“This bill would make it easier for those with substance abuse problems to push themselves to the edge, or beyond,” LePage said in his veto letter. “It provides a false sense of security that abusers are somehow safe from overdose if they have a prescription nearby.”
DEATHS REDUCED IN MASSACHUSETTS
The evidence in states that have expanded access to Narcan, including Massachusetts and Rhode Island, does not show that people are more likely to use heroin if they know Narcan is available, said Gordon Smith, executive vice president of the Maine Medical Association.
“We do not believe having naloxone around the state is going to increase” heroin use, he said. “What it will do is save lives and help get people into treatment so they can be law-abiding and productive citizens.
“In our opinion, it is the single most significant act the Legislature could do to save lives in this arena,” Smith said.
In Quincy, Mass., the city’s police department led the effort to expand access to Narcan.
“We arrested generation after generation, the same people over and over,” said Lt. Detective Patrick Glynn of the department’s narcotics unit and special investigations. “We all realized we cannot arrest our way out of this problem.”
The initiative was a response to a surge in overdose deaths in 2009 and 2010. Over 18 months, Quincy and neighboring Braintree and Weymouth — an area with about 100,000 residents — had 99 accidental overdose deaths from opiates, 47 of them in Quincy.
“We reduced the death rate by 66 percent in the first 18 months” after expanding access to Narcan in October 2010, Glynn said, noting that the number of overdose deaths in Quincy fell to 31.
The department administered 225 doses of nasal Narcan, which reversed the overdose effects in 214 of those cases. Seven people were not affected or were already dead, and four were unaffected because they were not overdosing on an opiate, he said.
When the drug’s effects are reversed, the person still must go to the hospital for treatment, or the effects will resume.
Nasal Narcan costs $22 per dose and is administered much like a nasal antihistamine, Glynn said.
He said there is no evidence that drug users will take more chances if Narcan is available. “I haven’t found any type of person with a substance abuse disorder that wants their high taken away” as they go through a sudden and painful withdrawal, he said.
He also said that Narcan has not solved the addiction problem.
“Not everyone is going to go into treatment,” he said. “I’d like to give them the option to choose (rehabilitation). They have to be alive in order to make the choice.”
SUPPORT FOR MAINE LEGISLATION
Gideon, the bill’s sponsor, was encouraged to renew the effort to expand Narcan access by a constituent, Neil Fishman of Freeport, whose stepbrother, Jonathan Stampler, died of a drug overdose about 10 years ago in New York.
Fishman’s father, Jack Fishman, was a biochemist who helped invent Narcan. Fishman said he wished Narcan had been available when his stepbrother relapsed.
“If this drug is administered in time, it saves lives,” he said. “It has saved literally thousands and thousands and thousands of lives. The trick is, it has to be administered in time.”
Gates, who speaks to high school students about his son’s death in 2009, said he plans to testify in favor of the bill Wednesday, even though it’s too late for his son.
“My mission is to get the word out, to tell kids the truth about these poisons, maybe convince a kid to have second thoughts before he pops that first pill or snorts a line — something I can do to maybe help some other family not walk down this path,” he said.
“It’s hard for me, because he wasn’t just my son. He was my best friend,” Gates said. “We’d call each other two or three time a week. I still reach out for my cellphone.”
For more about Will Gates’ death and opiate abuse, go to: http://vimeo.com/41741770.
David Hench can be contacted at 791-6327 or at:firstname.lastname@example.org