Nicole O’Donnell got a pretty good birthday gift this year — she saved a life.
On the day she turned 40, O’Donnell was in Philadelphia’s Kensington neighborhood doing what for her has become second nature, and her life’s calling: As a Certified Recovery Specialist (CRS), O’Donnell and her colleagues counsel people dealing with opioid addiction and recovery. While CRSs usually see people who’ve been brought to the emergency department or other treatment facilities following an overdose, as the use of opioids has steadily turned into what is now a full-blown national crisis, a major part of their job is community outreach.
“We were driving around that day, trying to engage the community to see if we could provide treatment services to people in the neighborhood who are actively using,” O’Donnell recalls. There’s an area behind a building where we know a lot of people go when they’re using. It’s not uncommon for people to overdose there. So, as part of our community outreach, we went back there to make sure everyone was okay, and that’s when we heard the screaming.”
A man was running down the street, screaming for anyone who might have Narcan, a medication that is sprayed into the nose — similar to a nasal spray — that is used to counter the effects of an opioid overdose. O’Donnell and her colleagues, who have Narcan on them at all times, sprang into action, following the man to where his friend was lying.
“Typically, when someone overdoses, they turn white, or blue. This man was gray… very gray. His color was the worst I’ve ever seen,” O’Donnell said. “I really didn’t think he was going to make it.”
O’Donnell administered two doses of Narcan and rescue breaths, and waited.
“It was the longest three minutes of my life, waiting for him to start breathing,” she said.
O’Donnell also noted the face of the man in his early 20s was familiar. She had seen him before, talked to him, and tried to get him into treatment.
After minutes that seemed to last for hours, the man started breathing, and slowly color returned to his face. O’Donnell and her colleagues took him to a nearby hospital where he was referred to treatment.
O’Donnell has a lot of stories like the one she tells of that summer day in Kensington. The misuse of opioid prescription medications has devastated communities nationwide, including Philadelphia, where more than 1,100 people died from an overdose in 2018 alone. In October 2018, Philadelphia’s Mayor Jim Kenney established an emergency response to the city’s epidemic, with particular emphasis on Kensington.
Sadly, research shows that 10 percent of people who receive Narcan will have a fatal overdose in the next two years, making O’Donnell’s community outreach and other efforts to provide resources and connections to treatment all the more important. If there’s good news to be had, though, it’s that according to a recent report, overdose deaths in Pennsylvania went down by 18 percent from 2017 to 2018.
“The biggest impact in the recent decrease in opioid deaths is thought due to the increase in Narcan use,” says Jeanmarie Perrone, MD, a professor of Emergency Medicine and director of Addiction Medicine Initiatives at Penn Medicine. “It’s definitely becoming more prevalent. People who are using have it. They carry it all the time.”
Part of the reason for the increasing familiarity is the commitment to the effort at the state level. Last year Pennsylvania allocated $5 million to a two-year distribution program where Narcan will be given away free of charge at designated locations across the state. Philadelphia is hosting several of those giveaways — with training on how to properly administer the medication — throughout the year. Narcan is also available without a prescription at most retail pharmacies in the city.
In the past two months alone O’Donnell says she and her colleagues have administered the life-saving Narcan at least four or five times. And it’s not just Certified Recovery Specialists intentionally going to areas known for drug use who are called upon to help. Lots of people have Narcan stories. For instance, last month, an article in the Philadelphia Inquirer detailed Perrone’s own story of how she and a group of strangers came together to save the life of a man suffering from an overdose while riding the subway in Center City. And earlier this summer, a Penn undergraduate administered Narcan to a stranger after receiving training on how to do it at an opioid town hall at Penn Presbyterian Medical Center.
Later this month, O’Donnell, Perrone, and other leaders from Penn Medicine’s Center for Opioid Recovery and Engagement (CORE) program will host a Narcan Story Slam where members of the public will have an opportunity to share their own Narcan stories. The event will be held in honor of Penn anesthesiologist Bonnie Milas’s tragic experience losing both of her sons to overdoses. In collaboration with the College of Physicians, the Penn team hopes the event will highlight Dr. Milas’s efforts to train people on proper administration of Narcan and her advocacy for getting Narcan into the homes of families affected by Opioid Use Disorder.
“Bystanders are saving the lives of people who overdose every day,” Perrone said. “Much like CPR, where anyone with the proper training could save the life of someone suffering a cardiac arrest, understanding how to administer Narcan is quickly becoming an important need for the public at large. These stories are happening in our own backyards, and we can’t turn away. We all have the ability and opportunity to save a life — no prescription needed.”