LOCAL

Columbia health officials want you to carry Narcan. Here's why and how to use it

Charles Dunlap
Columbia Daily Tribune
Guest speakers Tuesday at an emergency community meeting on opioids at Hickman High School, from left, were Mark Kempker, training officer with the Hannibal Fire Department; Lauren, who started her sobriety six months ago; Sgt. Dallas Dollens with the Columbia Police Department; Jim Marshall, of Cody's Gift; and Willie, who started his sobriety a year ago. The panel was moderated by Scott Clardy, Columbia/Boone County Public Health and Human Services assistant director.

After an alarming increase in opioid-related overdose incidents in Columbia, law enforcement and Columbia/Boone County Public Health and Human Services are encouraging residents to carry Narcan. 

Narcan is an anti-opioid medication that can mitigate an overdose while emergency services are called. It is also known as Nalaxone. 

More: Alarming increase in overdose deaths leads to emergency meeting

Columbia has recorded 22 known or suspected overdose deaths from the beginning of the year through Oct. 1. Half of the deaths have occurred since Aug. 1.

The Columbia Police Department has received 200 overdose-related service calls so far this year. Out of those, Narcan was administered 30 times. This number was 50 in 2020 and 19 in 2019. 

An emergency meeting was held Tuesday at Hickman High School about the increase in opioid-related deaths. More meetings are planned, said Scott Clardy, health department assistant director. 

"We did get some requests after the meeting and are waiting to hear from the requesters as to when they would like us to provide the training," Clardy said. 

A majority of the requests were for training on how to use Narcan. The department can offer updates on overdose deaths at these training sessions as well, Clardy said. 

What opioids do to your body; the signs of an overdose

Fentanyl is a synthetic opioid 80 to 100 times stronger than morphine, according to the federal Drug Enforcement Agency. The police department most commonly sees it mixed into methamphetamines or in counterfeit oxycontin pills, said Sgt. Dallas Dollens with the narcotics investigative unit. 

Opioids are a relaxant that can be used as pain relief, possibly with feelings of euphoria. However, they also can cause confusion, drowsiness, dizziness, nausea, vomiting and make it harder to breathe. 

"If you know someone that is using a drug that they did not get from a pharmacy with a prescription, they are at risk," Clardy said. 

The health department has test strips available that can indicate the presence of fentanyl. While it cannot give a person the concentration of fentanyl, it can alert someone to its presence, said Tracey Bathe, department health educator.

There are many ways a person can overdose on opioids, she said. It can happen from other drug interactions or even other physical or mental health factors. The use of shaming language also can affect a person who may be using opioids, Bathe said. 

"If you use language that is shaming, people will hide and not ask to get help. That is not who we are as a community," she said. 

Bathe explained the signs of an overdose. They are: 

  • Breathing will be slow or absent;
  • Person is not moving;
  • Lips or fingernails may be blue;
  • The person may be choking, or you may hear a gurgling sound or snoring;
  • Cold, clammy skin;
  • The person will not wake up; and
  • Tiny pupils

Even if you are not sure a person is having an opioid overdose, it is OK to give a dose of Narcan, Bathe said. 

Guests at the Hickman High School Commons on Tuesday night listen as Sgt. Dallas Dollens with the Columbia Police Department speaks about the deadly impact opioids are having on the community.

How to use Narcan

Narcan is administered similar to other nasal spray medications. Narcan prevents opioids from attaching to brain receptors and negates what is already there.

"It takes about two to three minutes to work, and its effects wear off in about 30 to 90 minutes," Bathe said.

If there is no change three minutes after administering a dose, it may be necessary to administer a second dose, she said.

Narcan causes near-immediate drug withdrawal symptoms, which is why it is important for a person to be put on their side with their head supported, known as the recovery position, Bathe said.

Rescue breaths may be needed after the first dose of Narcan, and tilting a person's chin up to open the airway may be necessary as well, Bathe said. When calling 911, let the dispatcher know a dose of Narcan was administered, she said. 

So how do you administer Narcan? 

  • Remove the foil backing from the package;
  • Place the tip of the nozzle into a nostril, making sure your fingers touch the nose; 
  • Push the plunger to administer the entire dose.

"If you take a box, talk to whoever is in your household, at your workplace," Bathe said Tuesday. "Leave here and be a teacher and give more people this knowledge."

Where to get Narcan

Narcan is available through the health department from 8 a.m. to 5 p.m. Monday through Friday. The department asks three very basic demographic questions before a box is provided, Bathe said.

Those who attended the emergency meeting Tuesday were able to leave with a box of Narcan, which includes two doses. The medicine needs to be kept at room temperature, so it is not recommended to leave it in a car. 

The Narcan supply in Columbia is provided by the Missouri Institute for Mental Health, which has a federal grant to purchase Narcan and distribute it out into communities, Clardy said.

Residents can also talk to neighborhood pharmacies, which likely will have different distribution policies and questions than the health department, Bathe said. 

The health department is working on a way to have Narcan available 24/7, Clardy said.

The department can provide training to businesses, agencies or groups at their request.

Common overdose locations

During a public comment period Tuesday, one audience member said he has overdosed four times and encouraged people to look out for those who appear to be sleeping in their cars in parking lots or in public restrooms. 

The most common location for an overdose to happen, though, is at home.

"Connecting the DOTS: Drug Overdose Trust and Safety," a project of the Missouri Institute of Mental Health at University of Missouri-St. Louis, notes that in 2017 in Boone County, three-quarters of fatal overdoses happened at a residence. 

Of fatal opioid overdoses in 2017, around two-thirds did not have a history of substance abuse.

"Even if you don't know someone or don't think you know someone who might need Narcan, get it anyway," Clardy said. "You could be the person that sees somebody in that bathroom and could save their life.

"(Carrying Narcan) needs to be a norm like carrying an EpiPen."