Speakers Ian Stoddart, Chas Carlson, and Eric Miller of Narberth, P.A were invited to speak regarding the medical and legal aspects of overdose deaths. Stoddart, a 30-year paramedic and Carlson, a six year EMT, discussed the minutiae of Narcan, active ingredient Naloxone, which immediately reverses the effects of an opioid overdose when administered correctly. Miller, a police officer with 23 years of experience, described the differences in police response to overdose victims.

An important takeaway from the speakers was how different states regulate laymen assumption of Narcan differently. In Pennsylvania, Delaware, and Maryland, Narcan is available over the counter to anyone. This contrasts with states in the bible belt, some of which also don’t require the police to carry it. Stoddart described the process of Narcan (Naloxone) from the cellular perspective.

“Gabba cells regulate the respiratory rate, everyone who dies of an overdose actually dies from asphyxiation,” Stoddart said. “Opium locks on the Gabba cells so that a person can’t breathe, and the application of Naloxone kicks the opium off the Gabba cells so they can breathe again.” Stoddard highlighted the danger in the high half-life of heroin, however, noting that revival through Narcan is a temporary respite while the Naloxone adheres to the Gabba cells. “The opium is still swimming around, and Naloxone’s half-life is shorter than heroin’s. So when the Naloxone gets tired and falls off the Gabba cells, the opium can still adhere to them, leading to the possibility of another overdose.”

The time frame from application to revival is about three minutes, according to Stoddart and Carlson. What is most crucial to people overdosing, however, is oxygen. “Breathe for them,” Stoddart said. “If I have (bag breath) and a rescue mask, I can keep someone alive all day without administering Narcan.”

Stoddart affirmed that Narcan acts as a benign drug without opioid in the system, and not dangerous to those suffering from other drug overdoses. The standard protocol should then be to administer Narcan instantly when an opioid overdose is suspected, even when not confirmed. Officer Miller highlighted early problems with the widespread use of Narcan. “My boss just wanted to know if we were going to get sued for using it,” Miller said. The Narberth police force carries the nasal spray form of Narcan, while the ambulance force generally administers intravenous Naloxone, although they also keep the nasal spray on hand for problems with revival. Stoddart confirmed that IV Narcan works quicker than the nasal spray, but that the difference was marginal.