There has been a lot of talk recently in social media and the news about leaving Narcan behind after a reversal of an Opioid overdose.
A new voluntary program in Pittsburgh, PA allows the state to pay for Narcan atomizers that EMS can leave with friends and family of overdose (OD) patients. The media buzz revolves around the idea that we are enabling this cycle of addiction. “There is some push-back that maybe you’re enabling the problem a little bit, but at least in the short term, reduce the chances that person is going to die and you create more opportunities to get them into treatment,” said Mark Pinchalk, Patient Care Coordinator for Pittsburgh EMS. I agree with Mr. Pinchalk that as an EMS provider we are not there to judge, we are there to render aid.
One of my early instructors told me:
“Scott, your purpose is to leave the patient better than the way you found them.”
I have taken that long-ago statement to heart ever since, whether that I do this medically, as in a diabetic whose blood glucose I raise from 20mg/dl to 130mg/dl, or simply give the person a ride to the hospital. EMS is about providing care. When we use our own judgments or opinions on our patients, it impedes or influences the care we provide.
These cases seem to bring out strong opinions surrounding a delicate issue. Thousands of people die every year from Opioid overdoses. A healthy percentage of them get their start on prescription pain killers. So where do we help? How do we not judge going to the same address three or four times a week to treat the same person in the same situation? These are just some of the tough questions providers and services face every day in America. Although we are trying to hold back the tide with a broom, it is up to us to provide the same level of care each time, regardless of the person or situation.
Will leaving Narcan at the scene save lives? Yes, I believe so. Will it encourage more drug use? I can’t be sure. Time will tell. In comparison, studies show making birth control available to teens reduces sexual activity and reported pregnancies. Consider 2017 data that shows “Among adolescent females aged 15 to 19, 42 percent report having sex at least once. For males, that number was 44 percent. The numbers have gradually dropped since 1988, when 51 percent of female and 60 percent of male teens reported having had sex.”
Personally, I encourage the opportunity, as the law allows, to provide Narcan, knowing it doesn’t make the problem go away. I also look forward to EMS impacting this youthful epidemic. How? Community Para-medicine are the resource to embrace. Just like any other frequent patient, community paramedics will help those experiencing an Opioid overdose get the services they need including the much-needed follow up care.