June brings uptick in New London firefighters' use of Narcan

New London — Firefighters and a resident administered more doses of Narcan last month than in any other month since April 2015, possibly signaling an increase of fentanyl in the local supply.

A person who has ingested fentanyl, an opioid about 50 times stronger than heroin, often requires more than one dose of the overdose-reversal drug.

In June, when 12 doses were administered, three patients accounted for 6 of them. All three overdosed on June 29, fire department data show, and all three showed no signs of improvement after receiving the first dose. One of those doses was administered by a resident before firefighters arrived.

“It’s something we were expecting based on information at the national level — that we would see more fentanyl as we approached the summer,” said Jennifer Muggeo, supervisor of administration, finance and special projects for Ledge Light Health District.

Fentanyl contributed to the deaths of at least two New London residents this spring: Luis Roman, a 17-year-old New London High School student found unresponsive in his home April 23, and Lebro Mei, the 36-year-old whose body was found in a parking lot on the former Edgerton School property May 7.

"This just really emphasizes the need to saturate the community with naloxone," Muggeo said of the possible increase of fentanyl in the area.

Muggeo is active with the city’s Opioid Action Team, which in December received a $135,000 federal grant to streamline access to substance abuse treatment. The group also received $14,750 from the Community Foundation of Eastern Connecticut, which Muggeo said will help purchase up to 100 naloxone kits to hand out.

Walgreens, CVS and other pharmacies offer naloxone without a prescription in Connecticut, but Muggeo said some people are too ashamed to ask for it or don’t have insurance to cover the cost.

“We are working to ... increase access to effective treatment that can help people manage their chronic disease,” Muggeo said. “But in the meantime, and while that work continues ... this is a medication that can save somebody’s life, and that’s why we should be spending money on it.”

Based on the June overdoses, most of which were in homes, the action team also is analyzing how best to deploy its three recovery navigators. The part-time navigators walk and drive throughout New London to help get people into treatment and work with them through the process.

Typically they encourage medication-assisted treatment, or the practice of combining therapy with methadone, Suboxone or Vivitrol, all of which prevent intense withdrawals and cravings.

"I think a number of ODs the first responders responded to recently were in private homes versus public settings," Muggeo said. "How do we assure that people know about the navigators and how to reach them?"

So far, Muggeo said, the navigators have talked to about 60 people and gotten 48 of them into treatment.

"When somebody is receiving appropriate treatment, the rates of management are on par with the rates of management of other chronic diseases," Muggeo said.

"But only 7 percent of people suffering from substance use disorder have access to any type of treatment," she said. "We have a long way to go."

Muggeo said Alliance for Living’s syringe exchange program also has expanded. Once open only on Friday afternoons, it now has hours on Mondays and Thursdays, as well as an employee doing outreach in the community on Wednesdays.

Syringe programs allow those who are injecting drugs to access clean needles to prevent the spread of HIV and hepatitis C.

To reach the navigators, call or text (860) 333-3494 or email nlcares@llhd.org.

More about the data

In addition to seeing more people needing two doses of naloxone, firefighters also are seeing more community members administering a dose before their arrival.

Four residents did so in 2017; three more have this year.

The previous high for doses of Narcan administered was 10 last October. Despite June's spike, the fire department data show a downward trend in doses of naloxone used, from 75 in 2016 to a projected 56 this year. An increase in fentanyl, however, likely would reverse that trend.

The data doesn’t include all overdoses. Some people wake up before firefighters arrive. And some overdose on drugs that don’t necessarily respond to naloxone, such as the synthetic marijuana known as K2 or Spice.

At least 187 doses of naloxone have been administered in New London since April 2015. Fire Chief Henry Kydd said his department has purchased about 300 doses at $50 each since the beginning of 2015. It also received 100 for free from Natchaug Hospital, which got a grant from the local Community Foundation.

l.boyle@theday.com

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