Mayor Marty Walsh Wants First Responders to Carry an Overdose Reversal Medication

This past summer, the New York Times wrote, “Heroin, which has long flourished in the nation’s big urban centers, has been making an alarming comeback in the smaller cities and towns of New England.” And it’s no secret that Massachusetts has had its share of drug problems for a long time.

In 2011, Greater Boston was ranked No. 1 in the nation for drug-related emergency room visits, according to the Massachusetts Health Council. The region was also four times (!!!) higher than the national average among metropolitan regions for emergency room visits involving heroin. In addition, the South Shore saw high reports of overdoses in 2011, with one person dying from an overdose every eight days. Not-to-mention our neighbor to the north, the beautiful state of Vermont, which is reported to be in the midst of a “full-blown heroin crisis.” Between 2010 and 2012, unintentional drug overdoses increased by 39 percent in the city of Boston. When it comes to heroin, there was a 76 percent increase in the rate of heroin overdoses between 2010 and 2012, higher than the rate of increase for all other substances.

Due to all of these factors, Mayor Marty Walsh has called for all first responders in Boston to carry the opiate overdose reversal medication called naloxone, commonly known by its brand name, Narcan. According to city representatives, all EMTs and paramedics from Boston EMS, a bureau of the Boston Public Health Commission (BPHC), already carry the medication and have used it to successfully reverse countless overdoses. Under the new plan, this would expand to all members of the Boston Police and Fire Departments. 

Dr. Alexander Walley, a Boston University School of Medicine assistant professor of medicine and the medical director of the Massachusetts Department of Public Health’s Opioid Overdose Prevention Pilot Program, has already seen the benefits of this kind of action. Through the program, the state distributes free naloxone kits to people likely to witness an overdose, and teaches them how to administer the drug, which is a vital part of a program like this. “Now they have this tool that they can use to literally bring people back to life, and that is a powerful experience,” Walley says. “It represents something that’s much bigger than just the medication.”

Walley says that overdose education and naloxone distribution (OEND) appears to reduce the rate of opiate overdose deaths and is a cost effective way to treat heroin users. “It’s a promising, scalable, and affordable tool to address the public health issue of fatal opioid overdose. First responders can be trained and equipped with naloxone rescue kits, which has potential to improve both the overdose response times and the relationship between first responders and people who use heroin and prescription opioids,” he says.

As of early February, Boston EMS had administered Narcan 52 times since the beginning of the year compared to 41 times between the same time period in 2013. The Massachusetts legislature has also enacted the “Good Samaritan” law which aims to help prevent overdoses. The legislation offers protection from drug possession charges for people who call 911 to seek emergency medical attention if they are experiencing an overdose or witness someone experiencing an overdose.

In 2012, Walley published a study in the journal, BMJ which showed that in Mass. communities with high numbers of opioid overdose deaths, OEND implementation was associated with a significant reduction in opioid overdose death rates. “As a primary care doctor and addiction medicine provider, I have seen the benefits first hand of my patients who have survived overdoses due to naloxone rescue kits and come into treatment,” he says. “Similarly, many of my patients have reported to me saving, rescuing others with naloxone kits. I believe in overdose prevention education and putting lifesaving tools directly into the hands of the people best able to reduce overdoses.”

The BPHC is organizing five community workshops that will begin in February and take place in South Boston, East Boston, the South End, Dorchester, and Allston-Brighton. The events will provide interested residents with overdose prevention training, information on how to access Narcan, an overview of the substance abuse system of care in Boston, assistance with accessing services, and the opportunity to meet with neighborhood substance abuse coalitions.

“Training programs like OEND help educate people on how to prevent, recognize, and respond to an overdose,” Walley says. “When used by people with proper training, naloxone, which can be administered by injection or by nasal spray, is a safe and effective antidote that reverses the life-threatening effects of an opioid overdose. The Massachusetts training programs have been implemented successfully in diverse settings including needle exchanges, detox programs, addiction treatment, community meetings, family support groups and among first responders.”

There are 11 police stations around the city that are equipped with MedReturn drug collection kiosks. The kiosks, a partnership between the BPHC, Boston Police, and the Massachusetts Department of Public Health, allow residents to anonymously dispose of unused or expired medication that could be misused or abused. Disposal of medications is free, confidential, and accessible 24 hours a day, seven days a week. More information and a map of kiosk locations can be found at bphc.org/drugtakeback.