- Associated Press - Sunday, April 10, 2016

URBANA, Ill. (AP) - Like a lot of longtime law enforcement officers, Sgt. Dan Coile has seen his share of heroin overdoses and, sometimes, the fatal consequences.

The breathing of someone overdosing on heroin sounds like a loud snore, he said, with long pauses between breaths, “like they’re trying to suck in air.”

Since the Champaign County sheriff’s office armed him and others in his department with an emergency antidote for heroin and other opioid drug overdoses called naloxone, he’s administered it once himself, he’s been on a few more calls where deputies did it, and he’s seen the treatment bring people back from the edge of death.

The sheriff’s office carries a form of naloxone that is administered nasally. Coile recalls one recent occasion when a deputy treated a man who had overdosed on heroin, who had already turned blue when they arrived and gave him the first dose.

Paramedics arrived and gave the man a second dose, and “he just jumped up, and it was like, whoa,” Coile marveled.

That’s what naloxone can do when a heroin overdose victim gets it on time, he said, and it makes a big difference when treatment is started even a few minutes ahead of the ambulance’s arrival.

“You look at a person and you think, that person is dead, or that person is going to die, and all of a sudden that person is looking at you,” Coile said.

Naloxone, often known by the common brand name Narcan, is in a class of drugs called opioid antagonists. It works by blocking opioid receptors, or the effects of opioid drugs, which include heroin and a variety of opioid pain medications, such as OxyContin, Vicodin and Percocet.

Several police agencies and emergency responders in this area - among them Arrow and Pro ambulance services and the Champaign and Urbana fire departments - already carry the remedy, and many more are about to, under terms of the Heroin Crisis Act (Public Act 099-0480). The state law, which went into effect last September, requires, in part, all emergency responders to have training and access to opioid antagonists and for all schools to train qualified staff members to be able to administer the treatment.

Among the police departments in the area getting ready for the change are Urbana, Champaign and the University of Illinois.

Naloxone will also be coming to Danville police, Public Safety Director Larry Thomason said, but not until some issues are worked out on obtaining a naloxone prescription, training and storage.

“It’s susceptible to temperature changes, so how do you dispense it?” Thomason said. “You can’t just put one in a car with the officers.”

Urbana police sergeants were trained recently by the Champaign-Urbana Public Health District to use and carry naloxone, but not all of them are comfortable administering the intramuscular injection form of the drug they were trained to use, according to Urbana Deputy Chief Sylvia Morgan.

“We do have a small number of sergeants already carrying Narcan in the needle and vial form because they were comfortable with administering it in this manner,” she said in an email. “We are working to get the nasal spray Narcan, so that all of our sergeants will feel comfortable carrying and administering the medication.”

Champaign police will start naloxone training for just sergeants on patrol at the end of April, and is in the midst of working on a naloxone policy, Deputy Chief Joe Gallo said.

Depending on the training, the cost of the drug and obtaining supply, he said, the sergeants will likely begin carrying it after that, with one sergeant equipped to provide it per shift.

UI police are still working on how to handle naloxone training, cost and storage issues, spokesman Pat Wade said.

“I think the reality is, it’s an important drug and it saves lives,” Wade said. “But all the EMS around Champaign-Urbana carries it, and if there’s a call, they’ll be there before us.”

The Champaign-Urbana Public Health District, which has had a naloxone program in place since 2009, uses the intramuscular injection form of the drug because it’s the least expensive with the longest shelf life, according to Joe Trotter, the prevention lead agent for a 17-county area based at the health district. It’s also the form of naloxone the health district gets supplies of through the Chicago Recovery Alliance, he said.

The public health district also supplies naloxone to anyone over 18 who has someone nearby at risk of a heroin/opioid drug overdose, Trotter said.

It’s not available on a grab-and-go basis to the public, though. Anybody picking up naloxone from the health district has to undergo training on how to use it, Trotter said.

Behind the new state law is a heroin use crisis showing no signs of slowing down, though some East Central Illinois counties seem to have more of a heroin problem than others.

Heroin overdose-related treatments doubled last year at Carle Foundation Hospital’s emergency room over the year before, according to numbers provided by the hospital.

“Like everywhere else, it’s gone to an epidemic proportion,” Thomason said about the heroin issues he sees in Danville and Vermilion County.

Vermilion County had seven heroin overdose deaths last year, but already this year there have been seven more, plus a possible three more, pending final confirmations, according to Coroner Peggy Johnson.

“I wish I had a magic wand, truly, to make all that go away,” she said. “It causes a lot of pain.”

There were 16 heroin-related overdose deaths in Champaign County last year, four fewer than the year before, possibly thanks to the county sheriff’s office starting to carry Narcan in mid-2015, according to county Coroner Duane Northrup.

The Champaign County sheriff’s office partnered with Carle to train and carry Narcan starting last July, because its officers can often reach an overdose victim before a firefighter or paramedic can. Carle’s Arrow Ambulance is also suppling nasal Narcan to the sheriff’s office.

Champaign County Sheriff’s Lt. Brian Mennenga said there’s definitely still a lot of heroin use in the local area, though he wouldn’t call it the county’s No. 1 illegal drug issue. He’d rank it third, after marijuana and cocaine.

Still, Mennenga said, the amount of heroin addiction in the area “doesn’t seem to be getting any better.”

“We’ve actually used our Narcan three times already this year,” he said.

Ambulance crews have used it more. Arrow, which responds in a 1,550-square-mile area from its Champaign base, has used naloxone for heroin or opioid overdoses 90 times in the past six months, according to Operations Manager John Sollars.

Sometimes, ambulance crews are dispatched on heroin overdose calls and assist more than one overdose victim at the same address, said Sollars and Justin Stalter, Carle’s regional EMS system coordinator. Once last year, Sollars said, naloxone treatments were needed for three people at once at the same home.

The treatment works well, he and Stalter said, but the effects only last so long and sometimes people need repeat doses. Sometimes, too, people run out of luck, they said.

Recently, Sollars said, Arrow responded to a heroin overdose call involving a patient who had already been treated with naloxone on two other previous ambulance runs. The third time they came to help this man, he was dead when they got there.

“That’s not an isolated incident,” Sollars said.

For many who use heroin long enough, there comes a time when a rescue call won’t be made fast enough, he said.

“Someone won’t be there sometime, or find them on time,” Sollars said.

Tim Compton, director of Pro Ambulance, said Narcan use fluctuates for Pro, but “here in the last few months, we have definitely see an increase in the number of times we’ve used it.”

Like Coile, he’s seen amazing results with treatment, arriving to find a heroin overdose patient looking “absolutely terrible. They’re pale, sweaty, unconscious. Some are semi-conscious,” he said.

Some are turning blue, depending on how long they haven’t been breathing, because that’s what a heroin overdose does - it ultimately wipes out the drive to breathe, he said.

Then naloxone is injected, Compton said, “and it’s like you flip a switch. They’re awake now. The know where they are. They’re completely coherent.”

The next obstacle sometimes is trying to persuade a heroin overdose victim to go to the hospital, he said.

The effects of a naloxone treatment can wear off before all the effects of heroin does, or a mix of heroin and another drug someone may have taken and doesn’t remember, and a relapse can occur after the ambulance crew leaves, Compton said.

“We don’t allow them to not go to the hospital,” he said.

Piatt County Sheriff David Hunt said his department is looking at making naloxone available, probably for all deputies, and has had some meetings about that. But heroin hasn’t been a big issue in that county recently.

“We’re not seeing much of it this year,” he said. “I’ve talked to other sheriffs who have seen an increase of it in their counties.”

About seven officers at the Douglas County sheriff’s office have been trained to use it, but haven’t had any heroin overdose calls to use it yet, according to Lt. Clint Howard.

While there is heroin use going on in Douglas, Howard said, the county is seeing more of a swing toward methamphetamine drug use.

“I know it’s out there,” he said of heroin. “But a lot of people we know or suspected are involved in it are pushing to Champaign.”

The East Central Illinois Task Force, a drug task force covering Coles and Douglas counties, made 16 heroin-related arrests in 2014 and 14 in 2015. The task force’s commander, state police Master Sgt. Ryan Starrick, said heroin is the No. 2 drug issue behind crystal meth in those two counties, with a lot of the heroin users who live there traveling to Champaign and Decatur for supplies.

Champaign police Sgt. Matt Henson, who supervises the Champaign County Street Crimes Task Force, said he’s seen a significant increase in heroin in the area over the last four or five years.

Some users start out with heroin, Henson and others said. Some progressed to heroin from opioid pain medications.

“I’ve talked to several people who are heroin addicts who did start with prescription narcotics, and they get to the point that they can’t get a prescription any more,” Henson said.

Addiction to opioid painkillers is the strongest risk factor for heroin addiction, according to report last year by the Centers for Disease Control and Prevention. Someone addicted to opioid painkillers is 40 times more likely to become addicted to heroin.

Champaign County launched a pilot program in April 2015 in hope of making a dent in local heroin addiction.

Carle, the Prairie Center addictions treatment agency and Champaign County Drug Court got together on a partnership in which a selected group of heroin addicts sentenced to drug court are being given monthly injections of a pricey drug, Vivitrol, which reduces cravings and blocks the pleasure effects of heroin and other opioids.

Carle kicked in $81,300 to help cover the medication and lab costs and the drug maker agreed to provide the drug for up to 30 participants at a reduced cost, but the voluntary program hasn’t gotten as many participants as its partners wanted, said Champaign Country Judge Jeff Ford, who heads the drug court.

About six to seven heroin addicts have been involved, he said, but two more are about to take it, and “we have three on right now who are doing fantastic.”

Ford said the first two people in the program stopped it early, and both started using heroin again. But nobody who has been in the program has used while they were in it, he said, and that’s been verified by drug-testing.

“We’re starting to get people in there who are doing well,” he said. They really like it. Things are just starting to settle down. … The good news is, we’ve had some good people in there.”

Ford said the program looks promising, “but we’re going to need to see more of a population in there, for sure.”


Source: The (Champaign) News-Gazette, https://bit.ly/1ZxRx4w


Information from: The News-Gazette, https://www.news-gazette.com

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