Fentanyl Part 5: Narcan
“Narcan is not going to help you if no one is there to give it you.” – Mike Chustz, EBR EMS
On my way to interview Mike Chustz, public service coordinator with East Baton Rouge Parish Emergency Medical Services, I called 911.
I was stopped at a light on North Boulevard and 11th street when I saw a man lying, arms and legs splayed, on the concrete under the interstate, near one of the off-ramps. He looked gaunt and his clothes disheveled. There was a small Styrofoam cup next to him, and I wasn’t sure if he was sleeping or worse, not breathing.
When I spoke with the dispatcher, she asked me if I stopped, and I told her no. I felt guilty that I didn’t stop, but the truth is that I didn’t feel safe. I don’t let fear rule my life, but to be completely transparent, the random crime in Baton Rouge scares me. I am strategic about when I drive, where I drive, who I drive with, and what streets I drive on.
I told Chustz about the call when I arrived at EMS, and he assured me that it’s better not to stop because you never know what state someone is going to be in, especially if there is drug use involved. And then he said he thought he heard the dispatch call in his Harding Boulevard office.
“Was it near LSU?” he asked.
“No, closer to downtown,” I replied.
“Oh, I guess that’s another one.”
His response was neither flippant nor insensitive but matter-of-fact. The impact of overdose calls – many of them opioid related – is vast. And fentanyl seems to be at the heart of many overdose cases, according to the East Baton Rouge Coroner.
I am new to reporting on an issue that many of our city officials and medical personnel have been dealing with for nearly a decade. While it was my first time to interview Chustz at EMS, it was not his first time to talk about this issue. Overdose calls and overdose deaths take a toll on all of those involved, both personally and professionally. I wanted to understand how the rise in fentanyl overdoses affects first responders’ jobs and what can be done to save someone who has overdosed.
Chustz provided some insight. In 2021, the East Baton Rouge call center received more than 350,000 911 calls and 71,407 were EMS related, he said, adding that the frequency of overdose calls have increased.
“Before noon one day, I was looking at the call board, and there were five different ambulances on five different overdose calls at the same time,” Chustz said. “In my 27 years, I have never seen that.”
He said that between 17 and 19 EMS units run during peak times daily. On the particular day that he mentioned above, there were 13 ambulances running. If five of them were tied up with overdose calls, there were only eight available to answer EMS calls in the rest of the parish. That’s a huge strain on their resources, he said.
“We are continuously taking care of people who have overdosed over and over again,” he said. “It ties up our ambulances. It overcrowds the ER. It’s bad and it’s getting worse, and it’s taking a toll on everyone.”
When first responders first arrive to an overdose call, they asses the patient. If the person appears to be unconscious but otherwise healthy and young, Narcan is administered. Each EMS unit carries six pre-filled syringes of Narcan, Chustz said. From Jan. 1 to Aug. 22, there were 929 patients administered Narcan and 775 were documented as opioid overdoses, Chustz said.
According to American Addiction Centers based in Brentwood, Tenn., Narcan is the brand name for a drug called naloxone that blocks opioid receptors, reversing the opioid overdose. The Federal Drug Administration has approved three forms of naloxone – an injectable, which requires professional training, an auto-injectable called Evzio that can be injected quickly into the drug user’s outer thigh, and nasal spray, naloxone HCI, which can be purchased over the country at local pharmacies. It’s interesting to note here that Purdue Pharma, the company that created Oxycontin – the opioid that began the wave of opioid deaths in this country – produces different forms of naloxone – a tablet, an injectable and a nose spray.
While naloxone has proved effective in saving lives, Chustz said it’s important to remember the human beings who administer the drug are the ones who are doing the heavy lifting.
“Narcan is not going to help you if no one is there to give it you,” he said. And he added that people are often disoriented and irritable after being administered Narcan.
“When you wake someone up after giving them Narcan, they are often combative and rejecting our assistance,” Chustz said. “Many people wake up and refuse to go the hospital. It happens daily.”
I was curious about the cost of Narcan so I called a few local pharmacies. The over-the-counter Narcan Nasal Spray, 4 mg, which comes in a two pack retails for about $135 and can only be purchased through a pharmacist. But over the summer, the Mayor’s office distributed 460 units of Narcan through its Summer of Hope Campaign, according to Mark Armstrong, chief communications officer for the Mayor’s Office. I asked him who paid for the Narcan and he said it was funded by private donors.
I asked Chustz who pays for the Narcan and ambulance ride that first responders provide to an overdose patient. It costs between $900 and $1,500 for an ambulance ride, Chutsz said, depending on the services administered.
“We bill the patients for the Narcan and the ambulance ride, but the collection rate on overdose calls is low,” Chutsz said. “Many people don’t have jobs or insurance.”
The sixth part of this series, “The City” will be published Monday, October 24, 2022.
October 17, 2022