Narcan on hand in Pittsfield to address increase in opioid-related overdoses
PITTSFIELD — Pittsfield recently missed out on state grant funding for the anti-overdose medication naloxone, but local officials say the drug already is readily available in the city.
Unfortunately, emergency responders and health officials say, the number of opioid-related overdoses continues to increase with figures never seen here before.
Naloxone, better known by the brand name Narcan, is administered through a nasal spray or by injection and quickly counters the effects for someone after they've used heroin or opioid pain medications. As part of statewide efforts to combat the opioid epidemic, which includes a rising number of fatal overdose cases in Massachusetts, all ambulances are now required to carry naloxone when responding to emergency calls.
"Like everyone else, we are seeing increases, things we have never seen before," said Brian Andrews, president of County Ambulance Service.
He said the service and others — like Action Ambulance Services, which also operates in the Pittsfield area — must by law carry the medication and attendants must be trained to administer it. He said County Ambulance acquires its supply of Narcan through Berkshire Medical Center.
Although some fire and police personnel in the state have begun carrying the drug on calls, that is not the case in Pittsfield. Officials here said that, even without Narcan, the ambulance crews — which typically arrive a few minutes behind fire department first responders — do have the drug.
The average ambulance response time to a scene, Andrews said, is just over 3 minutes. Ambulance crews are dispatched on emergency calls along with other first responders.
He added that all Emergency Medical Technicians on the ambulances can dispense the nasal spray version of Narcan, while paramedics with more advanced training can deliver that type of dose or an injection of the drug.
Crews follow a protocol for determining whether Narcan is required, Andrews said, including the presence of drug paraphernalia or a history of illegal drug or prescription pain medication use. However, he said naloxone is considered safe to administer even if people are not suffering an opioid overdose.
County Ambulance alone has responded to an average of 1.25 calls per week when Narcan was required, Andrews said, but that figure likely has risen in recent months.
According to state Department of Public Health estimates, unintentional fatal opioid overdoses reached close to 1,300 in 2014, including at least 24 in Berkshire County and 13 in Pittsfield.
Those figures also have risen dramatically since the period from 2000 to 2011, when the state total did not top 615 in any one year, and Berkshire County experienced an average of well under nine deaths per year.
And there are many more unintentional opioid overdoses that do not prove fatal but probably require an emergency response. DPH figures for fiscal year 2009 show there were 712 nonfatal, unintentional overdoses in Pittsfield.
Dr. Jennifer Michaels, medical director of the Brien Center, and admitting psychiatrist at Berkshire Medical Center, said family and friends of anyone at risk of an opioid overdose should consider purchasing naloxone, which now is available without a prescription from CVS and possibly other pharmacies.
And she urges those with addiction problems to seek treatment and become involved in a support group, such as Learn to Cope, which meets Tuesday evenings at BMC's Hillcrest campus on Tor Court in Pittsfield.
"It is a treatable disease," she said, "and I would encourage people to seek treatment; it works."
Michaels noted that Gov. Charlie Baker, Attorney General Maura Healey and many other state and local officials are pushing to expand funding prevention and treatment of opioid addiction.
Part of that funding recently included grants to eligible cities to purchase naloxone and provide training for fire and police in its use. Through some confusion in the DPH announcement, Pittsfield was listed as among the cities to receive a share of the funding, but that was a mistake. The list of communities was later said to be those cities eligible to apply for funding, based on the extent of the overdose problem in those communities.
The next area of confusion focused on whether the city had been turned down for a grant or whether the city had simply not applied. DPH spokesman Scott Zoback confirmed that the city was listed inadvertently as a recipient on the initial press release and said the agency had no record of the city applying for the funding, adding that none of the cities submitting applications was rejected.
There could, though, be subsequent grant rounds, he said.
But Pittsfield Fire Chief Robert Czerwinski said that he did, in fact, submit an application in October. "As far as I know, I had applied; it was an online application," he said. "Where the miscommunication was is beyond me."
The chief said he has not received any notifications concerning the grant since applying, but he did keep a screen shot of his application for the grant.
Zoback said later that the DPH would look into the matter.
Czerwinski said that regardless of whether firefighters have the medication on their trucks, the response time for ambulance crews is rapid, typically one to three minutes behind fire personnel.
He said he will evaluate whether funding for naloxone and training in its use should be included in the department's fiscal 2017 budget.
Even without the grant funding this year, said state Rep. Tricia Farley-Bouvier, D-Pittsfield, "the people of Pittsfield should not be worried."
She said that, while some Facebook posts in the wake of the state's press release and reversal asserted otherwise, "Narcan is absolutely available in Pittsfield."
Police Chief Michael Wynn said in an email, "We have examined the deployment of Narcan several times and continue to evaluate it. Both of our ambulance providers have Narcan on all of their equipment. Given the response times from those providers and the relationship that we have with them, at this time we rely on them. This model has been working."
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