<p>Accurate statistics on the heroin epidemic are difficult to gather, but one thing is clear. The overdose-reversing drug naloxone, often known by the brand name Narcan, is saving lives.</p>
With the stigma of drug addiction still strong, accurate statistics on the heroin epidemic are difficult to gather. But one thing is clear. The overdose-reversing drug naloxone, often known by the brand name Narcan, is saving lives.
According to Martha’s Vineyard Hospital records, nearly once a week, on average, someone arrives at the emergency room in crisis with an opioid overdose. Dr. Karen Casper, the affiliated medical director for EMS at the hospital, said the emergency room staff treated 45 people for opioid overdoses between October 2014 and October 2015. The rate has remained about the same since then, she added.
That figure counts people with a primary diagnosis of drug overdose. It does not include people who are addicted to heroin, but come to the emergency room for a different, though possibly related, medical problem.
“The majority of them are receiving Narcan in the field,” Dr. Casper said. “That time is critical. Many times, with their intervention in the field, our patients are already improving by the time they come to the emergency room.”
An overdose of heroin or other opiates overwhelms nerve receptors in the brain, shutting down involuntary functions, including breathing. Narcan, which can be administered intravenously or by nasal spray, reverses the effect of heroin by knocking the opioids off those receptors, allowing the patient to begin breathing again.
In addition to emergency medical technicians, police officers in Tisbury, Edgartown, Oak Bluffs and Aquinnah now carry Narcan on patrol and are trained to use it.
“A lot of patients actually come in and are doing much, much better,” Dr. Casper said. “Our treatment in the emergency room becomes keeping them breathing, and continuing to try to reverse the opiates, and then check for any signs of damage that occurred when they weren’t breathing.”
For some, however, Narcan comes too late. The difference between surviving a heroin overdose and dying from it can be a matter of seconds.
“The unfortunate people that didn’t get the Narcan soon enough and stopped breathing long enough, they die,” Dr. Casper said. “Then we do cardiac resuscitation, and we do our best. The longer you’re down without breathing, the less likely you are to recover.”
Oak Bluffs fire and ambulance chief John Rose takes every opportunity to get the word out about how important it is to call for help quickly in the event of an overdose. Massachusetts law provides a degree of immunity from prosecution for anyone who calls for medical help to treat an overdose. A person who seeks medical help for themselves or someone else cannot be prosecuted for possession of drugs, if the drugs are found as a result of the call for help.
“We see more and more of it,” Chief Rose said. “Just last week there was the death of a young man, we couldn’t get there soon enough. We can make such a difference if we can get there quickly.”
“We see our police departments can sometimes get to scenes before EMS,”
Dr. Casper said. “If we can get every police department on this Island on board with Narcan, we can save more lives.”
The Edgartown police department has been equipped with Narcan for a little more than a year, and Det. Michael Snowden estimates officers have used the drug five times.
“They used it twice just in the last month and a half,” he said.
According to Lieut. Matt Bradley of Oak Bluffs EMS, medics administered Narcan 12 times in 2014, 11 times in 2015, and four times so far this year. He cautions that since Narcan is safe and has no side effects, a dose is very occasionally administered as a precaution, and very occasionally administered to a patient who is not overdosing, but whose symptoms mimic an overdose.
“We err on the side of caution,” he said.
Tri-Town ambulance chief Ben Retmier reports that his department administered five doses of Narcan in 2014, five in 2015, and one so far this year.
Narcan costs about $20 per dose. On Cape Cod, Narcan is available without a prescription. At a meeting Thursday of the Martha’s Vineyard Youth Task Force,
coordinator Theresa Manning said her organization has begun to approach local pharmacies about carrying Narcan on the Island, and Conroy’s will be the first to do so. Purchasers will be trained in its use by the pharmacist, she said.
Mr. Retmier said as the use of the overdose reversing drug increases, there is concern that addicts may have a false sense of security.
“From the research I’ve seen and read,” Mr. Retmier said, “people say ‘I’ll overdose and get the Narcan and I’ll be fine.’ They don’t realize what the medicine actually does. You’re breathing again, but half an hour later you’re overdosing again because you still have heroin in your system.”
Narcan is effective in blocking opioid overdoses for 60 to 90 minutes. But depending on the strength of the heroin or other opioid, the amount injected, and other factors, it can wear off in as few as 20 minutes, and sometimes a second dose is required in the field or in the emergency room.
The effect of Narcan is so dramatic that in some cases, patients feel relatively normal after receiving it, according to first responders. Dr. Casper is concerned that addicts may refuse further medical treatment after they are revived with Narcan.
“People using these drugs need to realize that you can’t count on one dose of Narcan saving you,” Dr. Casper said. “If you need Narcan, you need medical attention. It may not be enough.”
Medics say in some cases they are called to respond to a patient who was previously treated with Narcan, but overdoses again within a short period of time. In one case, medics responded to a patient who overdosed on two successive evenings.
“I have a lot of compassion for these people,” Dr. Casper said. “It’s such a multi-faceted problem when a person has substance abuse. We all have to try our best to be supportive and try to be understanding.”
Emergency room staff also see a disturbing number of people who have been treated for an opioid overdose before.
“Too many,” Dr. Casper said. “It’s just sad.”

Comments
The Vineyard as we've known
MVY lover New YorkThe Vineyard as we've known it for over 40 years is gone. No more leaving your doors unlocked. No more leaving the car unlocked. Empty houses have become shooting galleries for these desperate kids and they leave behind a wreck. Heroin is delivered weekly by a group of mules who know how to easily get past the law. And the upcoming summer will be worse. Time to face the sad facts--our paradise is lost. The inner city is here and it's here to stay. As long as there are kids with nothing to excite or inspire them and with low level drudgery jobs facing them every day, this won't stop.
Yes MYV lover , nothing is
gina menemsha/nycYes MYV lover , nothing is the like it was 40 yrs ago anywhere..
But can't agree that some teenager shoots up due to their dire future you predict.. There are many opportunities available for self improvement & success in their early life.. The heroin users just prefer to get that "high" No one has a gun to their head to start using.. ..
I believe that's true anywhere.. Users just want to use.. & it crosses many socio economic classes..
I would hardly compare the
Grewuphere Vineyard havenI would hardly compare the island to an inner city...people still leave cars/ homes unlocked and I have yet to see an abandoned building filled with kids shooting up...drugs are definitely a problem just as they are anywhere else but I think ur exaggerations are both offensive and inaccurate
I used to be one of the high
MVI used to be one of the high schoolers shooting up in abandoned buildings. Youre not a drug user so you just don't know what to look for but there are frequently needles in the street and I've now lost two friends to overdoses. It is a very real problem- the island doesn't have to look like the Bronx for there to be a drug issue. It's in people's basements and in the dark at night, that young couple that walked by you on the street today- it's literally everywhere if you know where to look. To a non-user I get how you might think it's an exaggeration but please don't minimize this issue due to your own ignorance.
Knowing the Vineyard - it's
Paul FloridaKnowing the Vineyard - it's difficult for me to believe this story is true. The Island inhabitants must be aware of those who are living under this dark cloud. They need to 'reach out' and help where they can.
Don't put your head in the
Wayne VirginiaDon't put your head in the sand. This is happening all over. While the opinions shown here may well be wrong, the data from the hospital and EMS is not made-up. This is a problem over the entire nation and I am sure the Vineyard is not exempt. I also speak from personal experience driving an ambulance in suburban Virginia.
The heroin epidemic is not
Chris NY/Oak BluffsThe heroin epidemic is not just confined to the Vineyard, rather it is everywhere. No longer is it a minority problem confined to the inner cities, it is in every suburb across this great land. Yes, the Vineyard will change for it, forever. I would not leave my car or home unlocked, not anymore at least. But the real issue is that the Vineyard people need to understand that this is an epidemic, it cant be brushed under the rug. The police have a role, but so do the schools, parents and the community-at-large. Everyone needs to focus on it and make it their business to get involved. These kids (and adults) are hooked, they will steal, they will do what they can to get their drugs, it will only get worse. Tough enforcement and real community interaction may help stem it. I have many (too many) years in law enforcement, believe me once an addict, always an addict. You must stop this now, but know that even if you do, the repercussions will be felt for years. As these addicts get older, they will invariably turn to something else, again and again.
This issue, four comments on
Truthteller CAThis issue, four comments on heroin epidemic, thirty seven on plastic bag use....I guess that shows what we think is most important.
The unrelenting nature of
Juleann West TisburyThe unrelenting nature of addiction and the pervasive access to drugs requires changes in how the problem is addressed. It is a positive step that community leaders are coming together to develop a comprehensive, coordinated approach.
Vineyard taxpayers have been funding the D.A.R.E. (Drug Abuse Resistance Education) program for decades. Has the program demonstrated any measurable results? It is a program that became institutionalized into the budget process without requiring any ongoing evaluation of its effectiveness. It is administered by the Sheriff's Office, but it is unclear where the funding comes from; except that it comes from both public (taxpayer) and private (charitable) sources. What does the program DO? Does the Sheriff report to anyone about their activities or participation rates among students? What does it COST? How much staff time is allocated to the program? Is the message of the program one best delivered by law enforcement?
It is quite likely that D.A.R.E. has outlived its usefulness. And, in the current climate these funds are desperately needed for programs with proven results. I hope elected officials will evaluate whether existing expenditures -- already intended to address drug use and addiction -- are being used effectively and appropriately.
I'm not so sure that most of
Dismayed EastchopI'm not so sure that most of the abusers are kids without anything to do. My research tells me the recent uptick in heroin abuse stems from addiction to pain medication such as Oxytocin. Heroin is cheaper once a person is no longer able to get a legit prescription. Pain meds are often over-prescribed for physical injuries. In an off-season economy run by construction work, farming and other physical hard working jobs, that always seems to be under stress (have you tried to find someone to fix something that wasn't booked for weeks?) it is no wonder that this, sadly, has happened in our Paradise.
These people are Americans
Green Land Oak BluffsThese people are Americans for whatever reason we need to help them. We the people for the people by the people what happened in this country is we are off track is about people NOT money and corporations.
Thank GOD for Lt. Matt
Thank youThank GOD for Lt. Matt Bradley and his dedicated crew! Once a corpsman always a corpsman! Thank you Matt for continuing to serve your country and your island! Semper Fi.
Add new comment