Hundreds of emergency medical technicians from fire and ambulance services across eastern Connecticut have started the new year with training on the use of naloxone hydrochloride, commonly known as Narcan, a drug used to pull people from the brink of death after a heroin or other opioid overdose.

Dr. Kyle McClaine, the emergency medical services director at The William W. Backus Hospital in Norwich and co-chairman of the Connecticut EMS Medical Advisory Committee, said the decision to allow EMTs to administer Narcan was a response to the explosion in the number of heroin overdose deaths.

Heroin was a contributing factor in 257 accidental overdose deaths in Connecticut in 2013, a jump from 174 in 2012. The Office of the State Medical Examiner said preliminary numbers indicate yet another increase for 2014, though final figures will not be available until next month.

McClaine said more than 1,000 EMTs under direction of the four eastern Connecticut hospitals, including Lawrence + Memorial, now have access to training on how to use Narcan, which is administered by an intramuscular auto injector or intranasal spray. Narcan immediately reverses the effect of an opioid such as heroin.

The victim of a serious opioid overdose can suffer respiratory depression and eventually stop breathing.

Train-the-trainer sessions are completed in many areas with instructors meeting with service providers at local ambulance services and fire departments.

Training is nearly completed in East Lyme where East Lyme Ambulance President Charles Holyfield said about 48 EMTs are trained and Narcan kits were purchased for placement in ambulances operating from the East Lyme and Flanders fire departments.

"It's a no-brainer," Holyfield said of the decision to carry Narcan. "In one weekend last year we had two fatal overdoses. We're trying to get every active EMT involved."

Prior to the change in the scope of practice approved last year, EMTs could help an opioid overdose patient breathe while waiting for a paramedic to arrive with the Narcan. Paramedics have been administering Narcan for decades.

Steven Garvin, president of the Waterford Ambulance Service and member of the Oswegatchie Fire Department, said he's been to several overdose calls and admits some frustration in waiting for a paramedic while breathing for the patient - when it was obvious Narcan is the easiest solution to get them breathing on their own.

He said about 75 EMTs working at the town's five fire departments will be training this month on the nasal spray, and each of the ambulances will eventually be equipped.

Once EMTs are trained, they will evaluated by an organization's sponsor hospital before the Narcan goes into use, said Ron Kersey, EMS coordinator at L+M. He said it is up to the provider to decide if and how to provide the service, but expects that "most services are going to opt to do it."

"I get the sense that 100 percent of the area will be covered at some level. The question is what logistically is the best way to do this," he said.

New London Fire Chief Henry Kydd and Norwich Fire Chief Kenneth Scandariato both said this week they plan to train all of their firefighters, who are also EMTs.

"We believe it's part of our duty to the city," Scandariato said. "If we don't arrive (at the scene of an overdose) first, we're there at the same time. Our goal is to provide the best care and service we possibly can that's allowed by law - 100 percent of the time."

McClaine says he is championing wider use and availability of Narcan, but said equipping EMTs is not the final solution since the causes of addiction and widespread use of drugs is still at the root of the problem.

"The expansion of the use of the opioid reversal drug Narcan has the ability to save more lives, but in truth … we find people who are dead already," he said.

"I don't want the public thinking we've solved the problem by giving EMTs the Narcan. EMTs are finding people dead and beyond saving. Narcan doesn't bring anyone back to life that is already dead. You have a window of opportunity, when someone has stopped breathing but is still alive."

It's during that window that even wider availability of Narcan to nonmedical first responders, such as police, is a good idea, McClaine said.

Both Norwich and New London police departments have not moved to train officers, relying instead on existing medical services in their cities, such as the L+M Paramedic Program in New London and American Ambulance, a private EMT and paramedic service contracted by Norwich and surrounding towns.

State police have already equipped their troopers, and the legislature has passed a law that gives civil and criminal immunity to a lay person who administers Narcan.

Southern Connecticut State University Police Chief Joseph Dooley, who is president of the Connecticut Police Chief's Association, said some municipal police departments are opting for training, but it remains an individual decision.

"Communities are each evaluating their own situations. In some areas it may be a duplication of services," Dooley said. "As (use of Narcan) becomes more prevalent, others may sign on."

McClaine said the use of Narcan by EMTs is "one piece of a huge puzzle that's not going to be solved by EMTs alone."

g.smith@theday.com

Twitter: @SmittyDay