N.Y. Pilot Program Allows EMTs to Administer Naloxone

May 19--The breathing slows of someone overdosing on oxycodone or heroin.

The pupils shrink to pinpoints. Eventually, the victim may stop breathing completely and die.

An antidote drug called naloxone can reverse an overdose of the opioids, but until now, emergency medical technicians were not licensed to administer it.

A pilot project launched by the state Department of Health this spring allows basic EMTs to give the antidote in overdose cases involving heroin, hydrocodone, oxycodone, fentanyland and other opioids.

"It can really be a lifesaver," said Mitch Levinn, chief of Hoags Corners Ambulance, which handles medical emergencies for most of Nassau in Rensselaer County.

In some areas of the nation overwhelmed by overdose cases, such as New Mexico, EMTs and even police officers administer the drug through a nasal spray.

Several states, including New York, allow family and friends of drug addicts to give the spray to a loved one during an overdose. The drug has been used 470 times from 2006 to 2011 under the family and friend program, the health department said.

The pilot project permits 39,000 basic EMTs in the state administer the drug, also known as Narcan. Previously, a paramedic on an ambulance crew could administer it, but the state has only 7,000 paramedics, and many rural areas like Hoags Corners do not have enough ambulance calls to support hiring a paramedic.

Hoags Corners Ambulance has one ambulance and about 20 EMTs on its volunteer crew.

"We stabilize and transport," Levinn said. "There are not a lot of medications we can't administer."

In life-threatening situations, the Hoags Corners ambulance tries to pick up a paramedic along the route to the hospital. Sometimes they grab one from Sand Lake, North Greenbush or East Greenbush, or intercept an ambulance from one of the large ambulance companies operating in the county. More often than not, the meets-ups fail.

The all-volunteer ambulance department gets 250 to 300 calls a year, Levinn said. A handful are overdoses of some type.

"The Narcan solution gives us access to this lifesaving medicine that previously could have been as much as a half-hour away," he said.

The pilot program is a collaboration between the Regional Emergency Medical Organization, Albany Medical Center, DOH's Bureau of Emergency Medical Services and the AIDS Institute. Urban areas like Albany, Schenectady and Troy are not taking part in the project because their fire departments have a high ratio of paramedics already using the opioid antidote.

Naloxone works by blocking the effects of opioids, said Dr. Michael Dailey, professor of emergency medicine at Albany Medical Center, who advocated for allowing EMTs to use it. It is administered through a simple nasal spray and absorbed through the mucus membrane, and can potentially improve a person's respiratory rate within minutes.

"The goal is to get them back and breathing on their own," Dailey said.

The treatment is harmless if it is given in error to someone not having an opioid overdose.

"Narcan has very little that can go wrong and a lot that can go right," Levinn said.

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