One of the more effective drugs used in the immediate treatment of a heroin overdose is Narcan.
Widely sold under its generic name, Naloxone, Narcan counteracts the effects of heroin and powerful painkillers and has been routinely used by ambulance crews and emergency rooms in the United States for decades to treat overdose cases, according to the Associated Press.
Narcan has been used by first responders in Columbiana County communities such as East Palestine and Columbiana, although basic-level first responders have only recently been authorized to administer the drug as a result of changes at the state level.
East Palestine fire Chief Brett Todd said the department recently held protocol training to meet the change. Until then, only paramedics and advanced EMTs could use Narcan on patients.
Their basic-level EMTs began being allowed to use the drug on June 1.
"We have carried it for a long time. It actually works quite well," he said.
The department has already used the drug so far this year, and uses it about a dozen times during the course of a year, for various reasons, he added.
It can be administered on anyone displaying any signs of opioid impairment, or who are unresponsive, or disoriented.
Todd said there are no adverse side effects and the reaction time is fairly quick.
"It's a big change in the patient's conscious level within a few minutes of giving the Narcan," he said.
Heroin use has been "highly suspected" in some of the cases where Narcan was administered, but unless evidence shows the patient was actually using, there is no way to tell, he added.
Columbiana EMS Director Tom Farley said his department uses Narcan for suspected heroin or morphine patch overdoses, or even if their own first responders administer too much morphine on a patient.
"If we give morphine to a patient and it's too much, we can reverse it. Thankfully, Columbiana does not use it all that often. It is a multi-use drug for us," he said of Narcan.
When first responders find a patient unresponsive, they can administer the drug to determine if someone lost consciousness due to a narcotic, he added.
"If it is not responsive, it tells us they did not," he said.
Narcan counteracts the side effects of opiates and, if none are present, it has no other effect on the body, he said.
"We call it the miracle drug because it almost brings it out right away," he said.
The drug costs anywhere from $5 to $15 per filled syringe and Columbiana ambulances are stocked with 12 doses.
Narcan hasn't been used so far this year in the city, he said.
Salem police Lt. Donn Beeson said, at this point, the department does not use Narcan, but plans are in the works to have officers trained to use the Naloxone nasal spray that's becoming available. A recent house bill signed into law this spring gives immunity to first responders and police officers using the heroin overdose antidote.
"The benefit of administering it far outweighs the liability of being sued for doing it," Beeson said.
The Salem Fire Department has a first responder program for medical calls, but does not transport patients. It's currently not permitted to carry Narcan, but fire Chief Jeff Hughes said that will change with the nasal spray.
"This fall, we'll have it on board and be able to use it," he said.
The firefighters will need to complete a class and the protocol for the first responder program will have to be updated.
Salem fire Capt. Shawn Mesler has seen Narcan used by paramedics and said, "It's amazing how it works."
Many first responders in Trumbull County have been using Narcan, or Naloxone, to counteract heroin overdoses for years.
However, most local police departments still rely on paramedics to carry and administer the drug.
Now the area is seeing an increased interest among law enforcement agencies to also train police and other first responders to administer the drug.
Joe Robinson, owner of Med Star Ambulance in Warren, said all of his paramedics carry Naloxone. He said expanding its use to law enforcement can't hurt because it's a fast-acting drug with no harmful side effects. He said first responders have had success using the drug.
"I think it's a sad state of the world we live in where we've gotten to that point, but unfortunately, because heroin is so common, so popular and easy to get, it's a reality we face," he said.
Ernie Cook, Trumbull County 911 director, said getting as many first responders as possible trained to administer Naloxone is a move in the right direction.
"This will save lives and that's what we need to focus us. The chances of saving a life are that much greater when the first person or people on the scene have a drug available with them that they can use to counteract the heroin. If having it and knowing how to use it can make the difference between whether someone lives or dies then training as many people as we can to administer it is a plus," he said.
Capt. Jeff Orr of the Trumbull Ashtabula Group Law Enforcement Task Force and Trumbull County Sheriff's Office, said plans are under way for the sheriff's office to become a distributor of Naloxone. Once the office acquires its permit from the Ohio Board of Pharmacy, the sheriff's office can purchase the opioid antagonist and put it in the hands of those, including deputies, trained to use it.
"We'll be developing or adopting a policy and from there determine who will be trained and who be able to administer it," he explained.
Orr said the goal is to get as many law enforcement agencies using the drug as possible.
"Times are changing. It's about saving lives regardless of whether a person is addicted or using drugs. First and foremost, you concentrate on saving someone's life. Then you work on how to help them with their addiction," Orr said.
Paramedics throughout West Virginia carry doses of Narcan.
"When it works properly and we get to the person in time, the person comes out of it in 30 seconds," said Deszi Polgar, director of operations for the Chester/Newell Ambulance Service.
It is so powerful, in fact, that Polgar said it must be administered cautiously, otherwise the person may react violently when they regain consciousness.
"If we don't know, but we suspect (an OD), then we do it because it's in our protocols and that's what we do just to try to figure out what's going to help," he said.
"We've been using it quite a bit here lately," he said. "We use it throughout the month on a weekly basis - once a week, twice a week."
In his observation, the need to use Narcan on OD victims has been growing steadily over the last three to four years
He mentioned moves by state legislatures to require police officers to carry nasal doses of the drug on them, since they often respond to ODs more quickly than fire or EMS personnel.
"That's how much of an increase of drug use there has been, that they're trying to come up with different means to correct the problem," he said.