Naloxone is saving lives in Washington, but what does it mean for long-term treatment?

The first time police officer Randy Jokela was equipped to give aid to someone overdosing on Seattle city streets, he was afraid and nervous when he reached for his naloxone — an opioid antidote known for bringing people back to life.

It’s personal for Jokela. He has family members with addiction, and he sees the same people on the streets every day: he knows who they are and what issues they face.

As he fumbled with the naloxone kit — a nasal spray that stops the overdose — his believed his efforts were better than doing nothing, just waiting for fire department units to respond.

[ >> VIDEO: Body cam video shows naloxone rescue ]

"I am sitting there trying to get the thing on,” he said. “A person, who is an addict, happened to come by, and he looks at me and goes, 'You need to twist it on.’ [I said] ‘Oh that’s right.’ Now, I can do it.”

A couple of minutes later, that person started regaining consciousness.

Bike officers like Jokela have since saved 23 other lives, but with the opioid crisis claiming hundreds of others each year in Washington — naloxone efforts aren’t just within policing agencies. KIRO 7 News took a look at the increasing public access to naloxone. Here’s what we learned.

Local bike cops have a success story, but it may be specific to Seattle

When 60 bike officers started carrying naloxone in 2016, it became quickly apparent that administering this medication was something that needed to become part of the job. In just six months, police saved 11 people found unconscious on city streets.

With the University of Washington working in partnership on SPD's pilot program, the principal research scientist with the UW's Alcohol and Drug Abuse Institute (ADAI), Caleb Banta-Green, conducted an evaluation on police and naloxone. It's the first of its kind in the country and could serve as research for other police departments.

The study found that bike officers can get to certain scenes, like in parks and alleys, faster than other fire and police units. It also found that those 11 lives saved in the first few months were all a result of officers finding these people while on patrol — not being called to a scene far away.

“It's a very specific finding in Seattle, [to give naloxone] to bike cops, who can intervene before fire [department units] can arrive," Banta-Green told KIRO 7.

"But one bike cop down an alley in Pine Square overnight may not see the person, it may be too late. That’s one situation. The opposite is state patrol, in Palouse, Washington, no one is there.”

With the mission of treating addiction like a disorder and not a crime, Seattle Police Chief Carman Best announced on Thursday that with a $5,000 donation from The Police Assisted Addiction and Recovery Initiative, they would expand naloxone to 100 more officers. This covers all bike officers and some patrol vehicles.

“There is still so much to do,” Best said. "This is another step in our commitment to equipping as many patrol officers as possible with naloxone. We want to save lives.”

While administering naloxone is now part of police service, is expanding it to the department at large effective? That's unclear. In cases where officers are called to the scene, rather than stumbling on someone, it could have as much of an impact to conduct rescue breathing until the Seattle Fire Department arrived to provide treatment. This method is also cheaper and it doesn't require restoring naloxone kits or training.

In addition to Thursday's large donation, previous grants have funded most of the naloxone distribution for officers. KIRO 7 News filed a Public Disclosure Request with SPD in December last year, asking if taxpayers dollars were spent on any supplies or training. The department delayed our request three times and still hasn't provided an answer.

A lawsuit filed by King County against Oxycontin maker Purdue Pharma shed some light on the costs for emergency response — through court documents, but not in detailed public statements from county leaders.

The complaint seeks to hold Perdue accountable in the wake of the Seattle-area's crisis. It specified how much was spent on training and EMS paramedics that responded to calls involving naloxone administration. Since 2016, King County has spent more than $1.8 million. That number does not include supplies for Seattle police or fire departments.

Why family and friends are encouraged to get naloxone

When it comes to people using opioids or with drug habits putting them at the risk for overdosing, it’s their family and friends keeping guard in their own homes — not officers. Even for someone who isn’t addicted, a chronic pain patient with a prescription is like a loaded gun sitting on the counter, Banta-Green said.

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In the latest prompt for people to get naloxone education, the U.S. Surgeon General is encouraging anyone who has a family member or friend, or drug users themselves, to get consulted on how to use it.

“Each day we lose 115 Americans to an opioid overdose — that’s one person every 12.5 minutes,” U.S. Surgeon General Dr. Jerome Adams in a statement. “It is time to make sure more people have access to this lifesaving medication because 77 percent of opioid overdose deaths occur outside of a medical setting and more than half occur at home.”

New data is showing that people in Washington state are making an effort to get educated on how to use kits. Banta-Green and ADAI run a five-year program through grants that distribute naloxone and evaluates its effectiveness. These programs dole out kits through needles exchanges in South Sound areas including Pierce County and Grays Harbor.

According to a data sample that they took over eight months in those areas, the ADAI program distributed naloxone to 1,400 lay responders (friends or family of people who use or an addict) compared to just 300 officers. Lay people used it 392 times during those months in their report.

Many of these lay responders are getting access to naloxone, which his sold under the brand name Narcan, for the first time. Just eight years ago there was only one place in Western Washington to get it.

"My son Dylan died at age 24,” said Seattle-area mother Colleen Keefe. "He was far too ashamed to tell anyone he was addicted to heroin after being prescribed pain medication. So ashamed he didn't even tell his girlfriend of five years. He finally admitted his problem and went into rehab.

“He was released and the one time he crossed the line and used again his roommate found him unconscious. His roommate didn't have naloxone, his roommate didn't have naloxone, and the first responders didn't have naloxone. He died in the hospital later that day."

Colleen, who's a registered nurse, started a needle exchange after her son's death. It’s now one of the 100+ places — including public health programs, kit handouts in parks, other needle exchanges, and pharmacies — where you can access naloxone.

In addition to increased access, Washington law provides protection from criminal drug possession charges for anyone who seeks medical aid for themselves or someone else experiencing an overdose. But this doesn’t mean good Samaritans should start administering naloxone to strangers.

“If you encounter a [passed out] stranger, call 911 and if you can, do CPR,” Banta-Green said. "I don’t think that everyone needs to get naloxone, you have to know what an overdose looks like to help a stranger. If you don’t know anything more, check the pulse, do chest compressions, rescue breathing.”

Some question if naloxone perpetuates addiction

A recent economic study by two researchers — Jennifer Doleac, of the University of Virginia, and Anita Mukherjee, of the University of Wisconsin — critically examined what they called the "moral hazard of lifesaving innovations" nationwide. Their widely-shared study wrote, "Access to this lifesaving drug may unintentionally increase opioid abuse by providing a safety net that encourages riskier use."

But another study published a week later discredited the so-called hazard, writing Doleac and Mukherjee's research on naloxone was not supported by methodology. This new study -- published by a medical toxicologist and EMS directors -- believe more research is needed before determining high-risk behavior.

Public health leaders in Washington state already recognizes that Naloxone is not the answer to the opioid epidemic. It’s like a Band-Aid, but one that keeps people alive for a conversation about long-term treatment.

According to another sample taken from Banta-Green's five-year project, of 1,300 people who received these naloxone kits through needle exchanges in the course of just six months, about 18 percent of people came back with a used kit and took a follow-up survey, which includes a conversation about how to get help for an opioid disorder. Find resources stopoverdose.org here.

Long-term treatment is what will significantly reduce opioid deaths; it can include prescribing medication like methadone and morphine. A growth in those prescriptions last year in state coincides with a slight decrease in overdose deaths.

Normalizing naloxone could help in battling the crisis, some say

With the increase in access and resources, KIRO 7 News has reported on a variety of naloxone stories over the last few years on our Facebook page, and on many of those posts people have weighed in about how this death-reversing drug has changed their life.

"Well as an addict of 20 years I'm now in recovery for 26 months, and I believe it to be a good idea," wrote Susie Turner Nardi of Forks, Washington last year.

"I've overdosed multiple times and I'm grateful I was able to be brought bak [sic] every time now. I'm living a life of recovery because I was given a second, third and fourth chance to live from this drug so I think it's a great idea some of us required more help then [sic] others, but bottom line is without that drug I wouldn't be able to be writing this today I am able to be a mom to my kids, I'm a manager of a store, I have a place I pay for on my own with no help from anywhere and totally self sustaining."

For public health leaders and recovery advocates closely following the opioid epidemic, they say it's stories like Nardi's that help chip away at the stigma of being an opioid user. Those stories show how naloxone can help when opioid use is considered a disorder or disease — when naloxone can be treated something like a defibrillator to revive someone suffering cardiac arrest until they can get better help.

But there's a large number of people who still believe drug users don't "deserve" this second chance. It's a sentiment also largely vocalized on the KIRO 7 Facebook page, as well as on other comment threads nationwide.

A Vox reporter who covered the epidemic last year wrote an opinion piece, after getting emails that drug users should pay the price of criminal choices. He concluded that treating addiction as a disorder, over a moral failure, is a big part in averting this crisis.

It's in a statement that largely resonates with public health leaders and recovery advocates. Former Seattle TV news anchor Penny LeGate started a project that works with police on naloxone distribution, to keep her daughter's memory alive. Marah was 19 when she died. The project that shares her name educates people on the complex issue of addiction.

"She used to say to me, 'Mom. we are not throw away people,'" LeGate said. "This sort of movement ... This recognition that we all are coming to ... that this is a disease, it's not a lack of willpower or morality that brings people to substance use."

"Marah would say, 'Mom, tell them not to judge us, tell them to drop the stigma.' If we all recognize the science, it's a disease then the obstacles we set up for treatment and prevention will go away."