You may have heard a lot lately about Narcan, brand name of the drug naloxone. The drug, which quickly blocks the effects of opioids and can be administered by injection or nasal spray, is available in hospitals and ambulances around the country, but many have pushed to also get it directly into the hands of addicts and people who may be around them to help prevent opioid overdoses from becoming fatal. In recent months, Narcan has been shown to help save lives on the A&E shows Nightwatch and Live PD.
But is it really a "miracle drug" that can cure addicts? We spoke to Ken Seeley, a certified addiction-treatment counselor and interventionist—a mental health professional who helps plan and execute an intervention, the process by which an addict's loved ones persuade him or her to seek treatment—from A&E's Intervention on what the addiction-treatment community thinks about Narcan and why there isn't a nationwide system for tracking prescription-drug use.
In your line of work are you seeing more opioid users than you have in the past?
Absolutely. It's doubled in the last three years.
Why do you think it's increased?
All the 'doctor pill mills' (doctors who overprescribe without medical justification) made it so easy to get you pills back in the day. Now they're trying to shut them down in different states, so [addicts] are grasping for anything. They're getting things illegally. And they're getting [the pills] mixed with fentanyl—an extremely potent, and inexpensive, synthetic opioid that works quickly and for short periods of time—and all kinds of different cocktails. That's why we're having so many more people overdose and die.
Is it still easy to get pills, even though it may be a little harder to "doctor-shop," or find multiple doctors who will give you a prescription?
Absolutely. They're finding different ways to get them, even though a lot of the doctor's offices and the pain clinics are getting shut down. People are [using] other types of drugs like heroin mixed with fentanyl and all different types of things that are getting young adults to overdose and end up dying.
Where are they getting them? Online? On the street?
Dealers get them all over the country—or the world. They get them online and then they're bringing them into the country and then they're selling them on the street. [The dealers] are probably getting them online but the kids are getting them on the street.
Do you think social media has helped or hurt addicts?
It's a double-edged sword. Before it was hard to get drugs and now they're able to go on social media and find other people that are getting high and meeting up with them. But at the same time, they're online getting help for treatment and resources to get off of drugs.
As of July 2017, all states now have a PDMP (Prescription Drug Monitoring Program, a data-collection system that collects, analyzes and monitors prescriptions and how they are dispensed). Why is there no nationwide system? Why are states not talking to each other?
Physicians are licensed within their state, so I think that's the same thing they're doing with the prescriptions—they're not taking [the PDMP] out on a federal level, which is creating more harm. [Some addicts] are just going to the next state and getting their drugs. People with resources are flying to other states and getting drugs. It really needs to be a national effort because it's a national crisis.
Even with PDMPs, is it still easy to find a doctor to give you a prescription?
Absolutely! I could go to my doctor and tell them 'On Friday I'll be 28 years sober and in recovery and I can't take pills, but my back really hurts'—and I can get a doctor to write me a prescription today. But then you might need to start going to a different doctor, and then then you may need to start paying cash and look around until you find a doctor that will give you [another prescription]. And it keeps going until you just can't afford them anymore. That's when you go to the streets and get heroin.
Are privacy concerns part of the issue?
I believe more people die under that HIPAA law than are saved. The law, part of the Health Insurance Portability and Accountability Act of 1996, which provides privacy and safeguards for medical information, was designed to protect your rights if you have a disease. But when you're dealing with addiction, it's killing more people. Yeah, you don't want everyone to know you have a disease, but when you have an addiction everybody should know because you need to be able to protect yourself and other people need to be able to protect themselves so that they don't give [addicts] the drugs that are going to kill them.
The last time I bought cold medicine, I was asked for my ID. It seems like some pharmacies are tracking some medications more vigilantly than doctors are tracking opioid prescriptions.
I love that. Drug stores are doing their part to help with this epidemic. It just doesn't make sense when you get to that next level—the doctor who believes they could write a script for anything. People are dying from this and it's created the horrible epidemic of heroin mixed with fentanyl. [It started] because [addicts] couldn't get pills anymore.These poor people go to a doctor for a back injury and if they have the gene of addiction, now they're addicted and they've got to get their drugs somewhere. Heroin with fentanyl gives you an even better high, and that's what's killing people. A lot of the addicts that I'm seeing started their addictions from getting over-prescribed from a doctor.
So they were over-prescribed pain pills and then that led to them looking for a mix of heroin and fentanyl on the street?
Prescription drugs were the worst thing going on about two or three years ago. Then Florida, which was one of the first states that started doing raids, was busting these pill mills and shutting them down. But even though some of them got shut down, it didn't stop the addiction. It didn't get people into rehab where they could get help. So the next thing you know, they're on street trying to get pills. But getting pills on the street is so expensive— the average person just can't afford it—so they go for something cheaper, heroin and fentanyl.
What does the addiction-treatment community think about Narcan?
It's a great drug and it's helped a ton of people who could have died. It is an amazing tool to use. But we're missing the big picture. We need to be intervening on that person—like we see on the show—with the family system and getting that person into a treatment facility. I realize a lot of them don't have families to build them up, to pay for treatment, but there's a lot of free treatment out there and places that will help people.
I hear addicts are even keeping Narcan on hand to see how high they would get. That's what's going on out there: 'Let's see how high we can get before we overdose and then we have something to bring us down.' If used appropriately, it's a great drug, but it's being abused.
Do you know people who have been saved from an overdose with Narcan? Did it push them to get help?
Once they get to the point of needing Narcan, they go to the emergency room and they overdose and they're brought back. That isn't really rock bottom to them. They do care if they die, but they really don't care. When they walk out of the emergency room or come to, the thing they're looking for is drugs. It's not really working to get people sober, but it's a great warning sign that we need to do something serious to save that person's life. If they don't want to go to treatment, okay. Then let's create consequences around them where they finally want to go to treatment.