Over-the-counter naloxone will help stop overdoses; rural communities in N.Y. report success with involving citizens

Rural places can already provide Narcan rescue boxes. (PBS image)

If you could, would you save someone from a fatal drug overdose? Most people would answer, "Yes." In the coming months, that chance will become a reality. The Food and Drug Administration has cleared the path for the prescription nasal spray naloxone, know by the brand name Narcan, to be sold over the counter. Narcan reverses opioid overdoses and has already made its way to many rural communities. "Overdose epidemic touches every part of the country, but rural areas have special challenges, like fewer providers who treat people with substance-use disorders and long wait times when people call for help after an overdose. That underscores the importance of Narcan," reports William Brangham for PBS NewsHour.

Real-life examples are a scary and vivid. Julia Wilson of  Cato, N.Y, pop. 2,500, retold her experience with Narcan: "My dad comes running in my room, and he's like: 'Something's happening at the neighbor's house. And so I was like, 'Yes, very funny.' He goes: 'No, I'm serious, I think there's an overdose.'. . .I look out the window and see this man lying on the floor in a shed. And I can see two people trying to do CPR on him. . . . I run back into my room, grab my Narcan kit and get in there. And this man, he's just laying there, not responding. . . . I check for a pulse. He didn't have one. I just put one dose in his nose. He still wasn't breathing. . . . I put in the other dose. When I seen him sit up, it was kind of just like a — like, all I could think was just wow."

PBS's William Brangham reports, "Julia learned what to do in a health class called 'Bones, Bodies and Bandages'." Teacher Donna Cappellano told him, "This is a skill. And kids love hands-on things. And so this is just one other avenue to keep yourself healthy or to — or to be able to help a friend. If you know that you can do something to help somebody and you can get the skill, do it because, otherwise, you're going to feel — you're just going to feel bad that you didn't help."

In Auburn, N.Y., Monika Salvage runs "Healing Cayuga," a county program to fight addiction and overdoses. She told Brangham, "Obviously, it's still important for first responders to come and to have that follow-up care. But those few minutes are really important. And it's even more critical in rural areas, where it's not just a few minutes until first responders arrive."

Cayuga County's outreach includes community advocates. "This county's pied piper is Wally Meyers. Going door to door, Meyers preaches and teaches overdose prevention to anyone who will listen," Brangham reports. "Meyers tries to make sure that government buildings and private businesses have Narcan kits on the wall. They're free, available to anyone who opens up the box. . . . Healing Cayuga has put more than 3,000 Narcan kits into the community. At least 113 people here have been revived by bystanders with Narcan. . . . Since 2020, even as fatalities hit new highs all over the country, in this rural county, they are down by a stunning 43 percent."

Randy Smith is also a community mentor who offers peer support. "Smith ended up in jail  after developing a fierce addiction to painkillers. . . He offers moral and practical support to people who are just starting their recovery," Brangham reports. "Now he's leading a women's support group. . . . Nationwide, women in rural areas are more likely to die of an overdose than women in cities. Smith knows the challenge is keeping people alive long enough that they can find their way to a new path. And that takes everybody pitching in."