A Public Overdose. An Antidote at Hand. Would Passers-By Use It?
A Public Overdose. An Antidote at Hand. Would Passers-By Use It?, Across the country, someone dies of an opioid overdose every 24 minutes. In Massachusetts, the death toll is five people a day.
In the face of this epidemic, Cambridge could become the first city to take a step that until recently might have seemed unthinkable: It might place lockboxes on street corners to give the public easy access to Narcan, the brand name for naloxone, a medication that can rapidly revive people who have overdosed.
The idea is in its earliest stages, and any concrete plan for the city, and residents, to consider seems at least a year away. But several days ago, the city police and area doctors who support the boxes conducted an experiment here, asking people who walked by if they would help a stranger who had overdosed.
The officials placed a dummy on the ground on a brick plaza along busy Massachusetts Avenue in Central Square, between two of this city’s most drug-infested areas. Passers-by were asked to pretend they had just found an unconscious person. They were handed a cellphone, which was connected to someone acting as an emergency dispatcher.
The dispatcher directed them to a nearby lockbox, gave them a code to open it and then explained how to administer Narcan, a nasal spray. Doctors say Narcan is safe; if given to someone who has not overdosed, it does no harm. It is not addictive and cannot be abused.
“We want to see if regular people walking down the street would be willing to help someone who appeared to be overdosing,” said Dr. Scott Goldberg, director of emergency services at Brigham and Women’s Hospital, who oversaw the experiment. “And if they were willing to help, would they be able to help?”
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| A Public Overdose. An Antidote at Hand. Would Passers-By Use It? |
As it turned out, dozens of people agreed to participate in the experiment. This is what some of them and others around Central Square said afterward:
‘I did it with a baby strapped to me’
Shirley Poyau | Doctoral student in clinical psychology, who walked by and joined the experiment even though Lucy, her 7-month-old daughter, was strapped to her chest
“I’m not a vigilante, and I’m not some hero, but if someone looks unresponsive on the street, I always make sure, at a minimum, to call 911. I’m not the type of person who ever just walks by. Sure, I would be concerned about mouth to mouth. But using Narcan, there was nothing complicated about it. I did it with a baby strapped to me. It’s how I eat and even shower — you have to do it all with a baby strapped to you.”
‘It allows us to acknowledge the truth about the opioid epidemic’
Barb Cohen | Infertility technology entrepreneur, who was walking by and tried administering Narcan
“I’m in favor of it because it allows us to acknowledge the truth about the opioid epidemic and it empowers the people who have the capability to help their neighbors. People are so much at the mercy of the drug to which they’re addicted, but I would hope that if they were helped, they might realize, in a more sober moment, the value of their own life and the importance of trying to get clean and stop using. And they certainly won’t have that option if they’re dead.”
‘People may be freaked out about the transfer of fluids’
Cathie Zusy | President of the Cambridgeport Neighborhood Association, who said she was speaking only for herself
“I wonder if these boxes are necessary,” she said, noting that the police respond quickly and that Central Square has a needle exchange equipped with Narcan. “I would want more info about whether we’re losing people right here. If so, why not install a trial box? But I also wonder whether passers-by would feel comfortable putting a nasal spray in a passed-out person’s nose. I think they’re more likely to call 911. I have. With concerns about H.I.V. and hepatitis C, people may be freaked out about the transfer of fluids or liability issues. Training people to administer Narcan would require tremendous public education.”
‘We can’t arrest our way out of this’
Sgt. Louis F. Cherubino Jr. | Supervisor of the Cambridge Police Department’s special investigations unit for drugs and vice crimes
“This is a crisis of epidemic proportions. It’s worse now because of the advent of the fentanyl, which is much faster acting than heroin and has a greater propensity for overdose and death. We’ve learned we can’t arrest our way out of this, like the cliché says. But do you let people just fall and succumb to the illness, or do you help them? If we can save one life, we’ve done our job. This box would provide a quicker response before police or E.M.S. could get on the scene, so I think it’s a positive step.”
‘I don’t want the box’
Sharon Walsh | Store manager at Supreme Liquors in Central Square
“The police should do their job and police the street. If people are nodding off, we’ll call an ambulance. But I don’t want the box. It’s an encouragement for people. And it would be stigmatizing to the store. That’s not what people want to see when they enter our business. Cambridge is too liberal. They put this bench outside where people are supposed to be able to recharge their phones. But you don’t see normal people there. You see poor, old drunks waiting for someone to buy them something.”
‘Surprisingly easy to administer’
Josh Gerber | Owner of 1369 Coffee House in Central Square
“I quite like the proposal to put Narcan boxes in public areas, for a couple of reasons. Narcan is surprisingly easy to administer, and it can save a person’s life nearly instantaneously. I also really like the public nature of the boxes, as I think they would bring some awareness to the severity of the crisis.”
‘It only encourages the users’
Gary Mello | Former candidate for Cambridge City Council
“I would be wholly opposed to such an idea. We have an outstanding 911 response, so it’s just not necessary. And I don’t like the idea of handing it to untrained civilians. Beyond that, it only encourages the users. If they feel they’ll be saved by Narcan, they’ll just keep doing it. If you’re going to solve this problem, you make the drugs harder to get and you hassle them when you know they’re using. You can’t fix them. It’s just a problem that doesn’t stop.”
‘The potential of saving lives’
Louis A. DePasquale | Cambridge city manager
“Like so many communities in Massachusetts, Cambridge is experiencing and actively responding to the opioid crisis. Because the prototype boxes would allow bystanders to administer lifesaving Narcan to overdose victims before the arrival of EMS, they have the potential of saving lives.”
