When first responders respond to opioid overdoses, time is critical in helping a patient to regain consciousness and stabilize. With synthetic opioid use on the rise, their strong potency stands as a threat to both responders and users alike. Although the San Marino Fire Department has long been equipped to use the drug Naloxone—which reverses opioid overdoses—the agency recently took steps to equip the San Marino Police Department as well.
Naloxone, sold under the brand name Narcan among others, is a medication used to block the effects of opioids, especially in overdose. More than 70,000 drug overdose deaths occurred in the United States in 2017 with opioids involved in 67 percent of the cases, according to the Centers for Disease Control and Prevention. Opioids, used as painkillers, are a class of drugs naturally found in the opium poppy plant. Some are made from the plant directly while synthetic versions are created by scientists in labs using the same chemical structure.
San Marino Firefighter/Paramedic Jeff Tsai noted that use of synthetic opioids fentanyl and carfentanyl are increasingly being seen by first responders across the Los Angeles region and the country. Many drug dealers mix these synthetic opioids with other drugs, such as heroin, cocaine, methamphetamine and MDMA, to increase their potency which then in turn increases the chance for overdose, according to the Drug Enforcement Administration (DEA). Many of the users don’t know about the synthetic additions. The threat to first responders comes when these synthetic opioids are present in the air, where they could be inhaled, such as an area they may enter where pills are being produced.
Fentanyl is 80 to 100 times stronger than morphine. Pharmaceutical fentanyl was created for pain management treatment of cancer patients, applied through a patch on the skin, according to the DEA. Carfentanyl is 10,000 times stronger than morphine and 100 times stronger than fentanyl and has a similar chemical composition, according to the DEA. It was originally produced as a large animal tranquilizer.
“These are all central nervous system depressants,” said Tsai. “So they slow your breathing down. They pretty much make you unconscious. Mainly it starts with the respiratory depression that will lead to respiratory arrest and pretty much death after that.”
In San Marino, the police department recently acquired Narcan for free through the Naloxone Distribution Project, an organization funded by the U.S. Department of Health and Human Services and administered by the Department of Health Care Services (DHCS) to combat opioid overdose-related deaths throughout California. Officers are currently working with the fire department to ensure proper procedures so that officers can administer it to patients if they arrive before paramedics with the fire department are on scene.
Tsai noted that Narcan is “extremely safe” and there are no side effects so even if a person is not suffering from an opioid overdose, there will be no negative repercussions.