Pubdate: Sat, 09 Aug 2014
Source: Courier-Post (Cherry Hill, NJ)
Copyright: 2014 Courier-Post
Contact:  http://www.courierpostonline.com/
Details: http://www.mapinc.org/media/826
Author: Andy McNeil

CAMDEN EMT SUPERVISORS WILL CARRY HEROIN ANTIDOTE

Despite being lawfully permitted to carry the heroin antidote Narcan
since late March, emergency medical technicians in Camden still are
not equipped with the drug.

It's a startling reality that's caught the attention of law
enforcement in the city.

"EMTs have expressed frustration to officers on overdose scenes of
their lack of Narcan and the inability to save a person's life," a
Camden County Police supervisor, who asked to remain anonymous, told
the Courier-Post.

"It just doesn't make sense to either cops or EMTs when law
enforcement has medicine and medical professionals don't."

In response to a call Friday, a representative of Camden's EMTs said
supervisors will begin carrying Narcan in two or three weeks.

Camden County's police department was one of more than 30 agencies
across the county that began carrying naloxone - known widely under
the brand name Narcan - in May. The move came a month before Gov.
Chris Christie announced a statewide expansion of a pilot program in
Ocean and Monmouth counties.

Christie's administration already had issued a waiver in March to more
than 28,000 certified EMTs statewide that would let them administer
the drug.

"When the person's breathing and heartbeat slows to a stop, every
second matters," said Camden County Police Chief Scott Thomson.
"Whether they live or die no longer needs to hinge upon an ambulance
racing through the city streets to the emergency room to receive Narcan.

"Since May, we've been honored with the opportunity to prevent over 28
premature funerals," he said.

So far this year, Camden has seen 267 overdoses, with most of those
victims being from the suburbs, according to officials. The number of
fatal overdoses as of Friday remains tied with the city's homicide
count at 22.

Given this stark figure, advocates aren't happy about the delay in
getting the antidote into the hands of EMTs.

"It's not acceptable," said Patty DiRenzo, who lost her son to a
heroin overdose in 2010 and championed the Overdose Prevention Act
signed into law last year. "They should have it."

The law the Blackwood resident fought for shields those who call 911
during an overdose situation from being prosecuted for drug possession
and allows doctors to prescribe naloxone for use by the general public.

"This is the epicenter of where we are having the most of our
overdoses," DiRenzo said of Camden. "This is where our kids are going
to buy and use."

Kathleen "Kass" Foster, whose son lost his battle with heroin
addiction in 1997, agreed.

"It's a disgrace that they aren't carrying it," said Foster, a
co-founder of Parent-To-Parent, a Marlton support group for parents of
adult children battling drug addiction. "How many lives are we going
to lose while they're dragging their feet?"

Both DiRenzo and Foster insisted they'd accept no excuse for the delay
and mulled taking the matter up with officials themselves.

Change is on the way, according to John Grembowiec, EMS director at
University Hospital in Newark.

The Essex County hospital took over EMT services in Camden from an
ambulance provider in 1986. Voorhees-based Virtua oversees the city's
paramedic units.

Grembowiec said the hospital employs about 60 EMTs in Camden and has
between two and four ambulances on the streets depending on the time
of day.

The antidote will be carried in separate supervisor vehicles - a
decision he said was made within the last month. He added officials
plan to evaluate the approach in six months and consider whether the
effort needs to be expanded to all EMTs.

"We believe that we have been able to manage overdoses effectively
without it all these years," Grembowiec said. "It wasn't, for us, as
pressing an issue to get (naloxone) on the trucks immediately as it is
in maybe Ocean County."

Ocean County made headlines as it saw the number of overdose deaths
more than double from 2012 to 2013 when 112 people died of overdoses.
Meanwhile, Camden County had 159 drug-related deaths last year.

Grembowiec, who has been a paramedic since 1981, said it's important
to keep in mind the primary objective of EMTs in an overdose situation
is to get the victim breathing adequately.

"The most important tools are really the oxygen and the adjunct
breathing equipment that we use," he said.

Dr. Ryan Sexton, associate EMS medical director at Cooper University
Hospital, agreed that supporting respiration is the first and foremost
concern.

The EMT, he said, "has the training and skills to provide ventilation
and oxygenation ... until they can get to the hospital or until a
higher level of care, like a paramedic, is there to administer the
medication."

(Paramedics differ from EMTs in that they are trained in advanced life
support and have been able to use naloxone for decades.)

Naloxone works by blocking opiates from attaching to receptors in the
brain that tell the respiratory system how to function. The antidote
does not make the overdose go away, but rather buys time, making it
crucial to call 911 immediately.

Grembowiec believes the legislation was intended to make a greater
impact in suburban and rural towns, where response times may be slower
than in urban areas.

He also pointed out fully reviving a patient before reaching the
hospital isn't always a plus, noting victims often awaken agitated
about losing their high and may be combative.

"The other thing you don't want to have happen is wake them up and now
they don't want to go to the hospital and want to walk away," he said.

Sexton said the drug should be given as promptly as possible if the
option is available and the EMT or officer is appropriately trained,
explaining they need understand how to handle potential adverse effects.

"Personally, I think that if we can get this medication (administered)
sooner we may do some good and we certainly will decrease stress on
the emergency departments," he said.

Through Cooper, Sexton's department oversees 20 or so local EMT
agencies, including Gloucester County EMTs. He said roughly half of
the agencies are trained to use naloxone.

He theorized some agencies may not yet be carrying the antidote due to
a number of barriers, such as a lack of medical oversight and training
or funding issues. Reliance on police and paramedics for the drug may
be another reason, he added.

Meanwhile, DiRenzo maintains the decision for EMTs to carry the drug
became a "no-brainer" when the governor issued the waiver.

"As soon as that happened, it should've been automatic with EMTs
across the board."
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MAP posted-by: Matt