Jose Olivares/Nevada Sagebrush
A prefilled syringe of Naloxone hydrochloride, a drug used to reverse the effects of opioids, lies inside of Change Point’s pharmacy on Friday, March 27. The highly concentrated dose pictured above is intended for use by medical professionals only and is not distributed to laypeople. However Senate Bill 459, if passed, would allow friends and family of at-risk opioid users greater access to smaller doses of Naloxone.

By Jose Olivares

In 2003, Joshua Livingroom, an opioid dependent, was with his friends in California when something traumatizing and horrific happened.

“We were in this house doing Xanax and heroin. We got out to the car and I was actually overdosing,” Livingroom said. “I was just not coming back. [My friends] dug around in my kit and found the Naloxone. They jammed it right into my leg. I came to right away and I was pretty confused.”

Immediately after the injection, Livingroom became sick. When Naloxone is administered, it immediately puts people in withdrawals from the opioid they are so heavily dependent on.

Livingroom, now an outreach worker with the Public Health Alliance for Safety Access, has been saved by Naloxone three separate times. Livingroom was dependent on heroin and is on a path toward recovery. His story is not uncommon.

On March 23, Gov. Brian Sandoval presented Senate Bill 459. The bill, if passed, would establish an opioid overdose prevention policy in Nevada and a 911 Good Samaritan Provision. The policy would allow for greater access to Naloxone, a life-saving drug that stops opioid overdoses, to friends, family members and loved ones to know someone at risk of an opiate overdose.

On Wednesday, April 1, Livingroom and other advocates will present their testimonies in favor of SB 459 to the Committee on Health and Human Services.

Opioids are common drugs that are typically used to relieve pain. Opioids are both prescription pharmaceuticals and illicit street drugs. Common opioids are Vicodin, Oxycodone, morphine and heroin.

Dr. Karla Wagner, a community health science assistant professor at the University of Nevada, Reno, has done extensive research on the topic of opioids and Naloxone. According to Wagner, opioids have pain relieving, euphoric and respiratory depression effects. Opioids can slow and eventually stop someone’s breathing. Wagner said that these effects make opioid usage dangerous, especially because it is easy to become psychologically and physically addicted to it.

“It doesn’t matter if it’s a legal opioid prescribed for pain or [if it is] an illegal drug bought on the street,” Wagner said. “They all have those effects.”

In recent years, overdose related deaths from opioid drug use have been steadily rising. The Center for Disease Control and Prevention reported that in 2013, there were 16,235 deaths involving prescription opioids in the U.S.

Change Point, a harm reduction center in Reno, has been actively trying to help with the opioid epidemic. According to Abigail Polus, a harm reduction and outreach coordinator at Northern Nevada HOPES, over 270 of 1,500 clients at Change Point are 24 years of age and younger.

Even though opioid overdoses can be deadly, Wagner says that Naloxone can negate the effects of opioids and save people’s lives by removing the opioid from the receptors and restoring a person’s breathing.

Medical personnel and certain first-responders use Naloxone in emergency situations. According to Polus, the problem is that there can be a delay in their response time; once they arrive at a scene, it may be too late to save a person’s life. Currently in Nevada, small doses of Naloxone can only be prescribed to people for their own personal use. It is not allowed for someone else to administer a person’s prescribed Naloxone.

“How am I going to administer Naloxone to myself when I am overdosing?” Livingroom said in response to these limits.

SB 459 would expand pharmacists’ permission to distribute Naloxone and would also allow doctors to write standing orders to programs to distribute the life-saving drug.

State Sen. Ben Kieckhefer, R-Reno, introduced a similar bill (SB 309) seven days before Sandoval introduced SB 549. They are both being reviewed by the Committee on Health and Human Services.

SB 459 and SB 309 also include the “Good Samaritan Drug Overdose Act” which allows for immunity from criminal discipline if emergency personnel are called to a scene of a drug or alcohol overdose. Nevada currently has no Good Samaritan provisions.

“We actively, at our drop-in center, every day hear stories about someone passing away that was overdosing and no one called for help because there are no Good Samaritan Provisions,” Polus said. “There is nothing sadder than hearing that they spent so long cleaning up the dope and waited to call for help, [so] that by the time help got there, they were dead.”

There has been opposition to bills that advocate for Naloxone’s accessibility. In 2014, Maine attempted to pass a bill similar to SB 459, which Governor Paul LePage vetoed. He claimed that broader access to Naloxone would encourage drug use and provide a sense of “invincibility” to substance users.

“In the research that I’ve done, we actually saw that three months after people participated in the [Naloxone] program, 53 percent said their drug use had gone down,” Wagner said. “By not providing people the opportunity to learn about the risks, to have access to the tools that can keep them safe, I think we’re doing an injustice to our fellow citizens.”

Livingroom’s firsthand experience with Naloxone has given him insight that helps advocate the spread of the lifesaving drug.

“The thing I say over and over is that dead people never recover,” Livingroom said. “Once you’re dead, you don’t get a chance to rehabilitate and become a contributing member of society. If I had died, if I had not had that Naloxone back in 2003, or whenever that was, I wouldn’t be taking care of my kid, I wouldn’t be taking care of my job.”

Jose Olivares can be reached at rhernandez@sagebrush.unr.edu and on Twitter @TheSagebrush.