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ROCKVILLE, Md. – For Renee, a mother of three, it was a delight to have her eldest son in town last December to celebrate the New Year at her home in Rockville, Maryland.
For months, Alex had been staying at a sober-living facility in Connecticut, but the 28-year-old recovering heroin addict felt he had enough control over his life to spend a few days with his family, ringing in 2015.
Mom and son watched movies, stashed away the Christmas decorations and made plans to hit the gym together.
“He was clean, sober, and happy,” she said.
As far as she knew, the last time he had used heroin was July.
“The next thing I know,” Renee said, " ... one of the neighbor boys was screaming for me to wake up – that Alex stopped breathing.”
Her first-born had overdosed in her basement.
The number of heroin-related deaths in the U.S. nearly tripled between 2010 and 2013, according to a March report released by the CDC. One antidote for fighting the surge in heroin-related deaths is the generic drug naloxone. Many refer to it by an old brand name, Narcan.
When it is administered in a timely manner, the so-called miracle medication works to reverse the effects of an opioid overdose.
It’s an alternate outcome that haunts Renee to this day: What if she had naloxone? What if his friend had the antidote?
Although naloxone has existed for years and has often been administered with a needle, Maryland law enforcement officers and relatives of heroin addicts are increasingly receiving special training on how to give the drug nasally, to help combat the growing heroin-death epidemic sweeping the country.
The FDA said it has not approved a nasal spray version of the drug and considers it to be an “off-label” use.
According to the Maryland Department of Health and Mental Hygiene, more than 5,000 people, including more than 2,300 law enforcement officials, have been trained in the last year to use the life-saving antidote as part of the Overdose Response Program. Trained individuals receive certificates and a prescription to carry the drug.
In Montgomery County, where Alex died, training for law enforcement officers started weeks after he died.
More than two-dozen officers have since received a kit, containing the drug and an atomizer that converts the liquid into a nasal mist.
Scott Davis, a Montgomery County police officer, said he hopes it can save lives.
“If we get to the scene first, we can administer it. We have standing orders to do so,” he said. “At this point when they’re overdosing, seconds count. We’ve got to get it to them as soon as we can.”
Although Montgomery County has a purchasing contract with a pharmacy, some Congressional leaders are concerned the rising price of naloxone may be hindering the fight against heroin overdoses elsewhere.
In a March letter to the CEO of the company that markets naloxone for sale in a needleless syringe form, Rep. Elijah Cummings (D-Md.), and Sen. Bernie Sanders (I-Vt.), expressed concern.
“The rapid increase in the cost of this lifesaving medication in such a short time frame is a significant public health concern,” they wrote, demanding financial records from Amphastar, including total gross revenues for the sales of the drug.
In the letter, they cited a November 2014 New York Times article, suggesting that police officials in Georgia are now paying $40 for a naloxone kit compared to the previous price of $22.
“Over the past several months, police departments, law enforcement agencies, and public health officials across the country have warned about the increasing price of naloxone,” they wrote.
They continued: “Some have suggested that these price increases coincide with an increasing number of large city police departments deciding to supply their officers with the drug.”
Although Amphastar did not return repeated phone calls from America Tonight, Cummings’ office said Amphastar is currently working on a response.
The FDA did approve an auto-injector version of naloxone last year called Evzio. According to the manufacturer, Kaleo, "it is the only naloxone product approved for immediate administration as emergency treatment for opioid overdoses in settings where opioids may be present, such as in a home where most overdoses occur."
The product uses visual and voice instructions to teach a person how to successfully inject naloxone into the overdose victim. The needle is hidden.
Law enforcement agencies in 18 states are using the product, according to Fiona Phillips, a spokesperson for the company.
Phillips said the out-of-pocket cost for most consumers with insurance and a prescription would be approximately $30.
Renee said she plans to receive training offered in her county on how to use the nasal version of naloxone. Although nothing can be done now to help Alex, it might help his younger brother, Michael, who also has fallen into heroin’s grips.
“It’s a daily struggle,” he said. “I’m not clean right now. I always, for some reason, resort back to them. They control me. They control everything and they make me hurt the people I love the most.”
Renee said it is important for her to have naloxone close by in case her other son goes too far.
“When you live with an addict, every minute of every day is a potential time for them to overdose,” she said. “[Naloxone] would allow you to have some peace of mind and comfort that should an emergency come like this, you could help.”
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