Distributing `miracle drug' for heroin questioned

City's plan to let addicts give Narcan called unwise

March 10, 2003|By Joe Nawrozki | Joe Nawrozki,SUN STAFF

Racing against the clock on a bitterly cold night, two paramedics scrambled up the stairs of a cluttered Essex rowhouse sometime after midnight.

On the second floor, they found an unconscious man in his underwear, wedged between the wall and a bed, very near death.

The paramedics, Amanda Drasal and Denise Childs, had seen this many times on Baltimore County's east side - a heroin overdose, one of hundreds reported each year in the county. Their patient was in critical shape. He was breathing three times a minute, unresponsive. He had been released from prison that day and celebrated his freedom with a dose of heroin.

Childs started an IV while Drasal pulled a preloaded syringe of Narcan from a medic bag. She injected 2 milligrams into the man's left shoulder.

Within minutes, he was conscious and totally sober.

"You do this so often it becomes almost Godlike, bringing someone back so quickly, so completely, from dying," Drasal, who has been a paramedic six years, said in describing the scene. "But you do it long enough and it gets frustrating because the addicts don't care that they nearly died ... that you save their lives. We see repeat cases - the same faces. It's frustrating."

Narcan, a narcotic antagonist that reverses the effects of acute heroin intoxication, is at the center of a new program just beginning in Baltimore, where addicts will be given the drug and shown how to administer it when they notice another addict suffering an overdose. Baltimore is trying to cut its high heroin mortality rates; more than 1,000 people have died in the past four years.

Baltimore County officials will be closely watching. Last year, the county logged 109 fatal heroin overdoses.

Narcan, generic name naloxone, is manufactured by Endo Pharmaceuticals in Chadd's Ford, Pa., and was approved by the Food and Drug Administration in 1971. Since then, it has been a mainstay in emergency medicine and regular hospital care.

Perhaps no other professionals use Narcan more on a daily basis than paramedics. And perhaps no group appreciates its amazing properties more.

"It's truly a miracle drug," said Lt. Bob Holmes, an emergency medical services supervisor in Dundalk. "You hit them with a shot of Narcan and they come up like rising from the dead."

Sometimes, said Holmes, "they will come up violently, other times in a stupor. In most cases, they are angry that you ruined their high. And in almost every case we have seen, they will return to using heroin because they are repeat performers."

But while many in the medical and treatment field hail Narcan's wonders, others say that distributing the drug to addicts to save lives is a move of desperation, one that sends the wrong message to young people and the addict population.

"The program is a green light for people to try heroin or continue shooting it," said Lt. Richard Lannen, a county emergency service officer with 16 years' experience. "What people should be trying to do is get off narcotics that ruin their lives and everybody who comes in contact with them."

A heroin town

For more than 50 years, Baltimore has been known as a heroin town. At first, the city's romance with heroin was limited to jazz performers and some soldiers who had returned from service in World War II. The rise of the "Beat Generation" in the 1950s made heroin more attractive to the young, but in the 1960s, heroin and stories of addicts committing crimes to support their habits became front-page news.

Perhaps no other heroin fatality shocked Baltimore into the harsh realities of the drug world than the death in 1961 of Eugene "Big Daddy" Lipscomb, a popular defensive lineman for the Baltimore Colts and mainstay on the 1959 championship team. He had been traded to the Pittsburgh Steelers but maintained friendships in Baltimore.

Lipscomb's body was found by police in an apartment in the 400 block of N. Brice St. on the city's west side. A friend tried to revive him by placing ice on his groin and injecting him with salt water to counteract the opiate. Neither worked.

That event marked a time when heroin began to take hold of Baltimore. Sections of once-prosperous Baltimore County were sliding into decay and the dope trade found new takers there as well.

One of them was Michael W. Gimbel, who would later become Baltimore County's drug czar and official spokesman against drugs. In the comfortable suburban world of Pikesville, young Gimbel found heroin.

`I overdosed twice'

"Back in the '70s, I overdosed twice in one weekend and nearly died both times," Gimbel said. "I was revived at the hospital by Narcan, and both times I went right back out and got more of that heroin. It doesn't make much sense to people outside the culture of heroin addiction, but that's reality in the drug addict's world, ... that's how vicious that disease is.

"Distributing Narcan to addicts is foolish," he said. "They are not responsible people." .

Janice Nichols, a paramedic at the Baltimore County Fire Department station in Middle River, wondered, "How far do we go with this?"

"We are a humane people but eventually people have to be accountable for their own actions," she said. "Putting Narcan in the hands of their fellow addicts is just adding another false sense of security. They will just start using more and more.

"And we in this business know. Heroin addicts are some of our biggest customers."

Her husband, Bob Nichols, also a paramedic at the Middle River station, recalled "one guy here in Middle River that I revived five separate times with Narcan after he overdosed."

"On the sixth call, it was too late," Bob Nichols said. "He was dead."

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