SALT LAKE CITY — Dr. Jennifer Plumb and Sam Plumb lost their brother to a heroin overdose in 1996, and for almost twenty years they watched the issue in Utah get worse and worse as other states rolled out programs to distribute naloxone kits and save lives.
On Monday, Utah Naloxone, a nonprofit the siblings co-founded, announced that Utah law enforcement just reported the 500th life saved through the administration of the organization's naloxone kits.
"Reaching this milestone has been reaffirming to me in really polarized times. It's pretty hard to find something that there's pretty close to universal support and acceptance on. It's restored a lot of my faith," said Jennifer Plumb, medical director of Utah Naloxone and associate professor of pediatrics at the University of Utah.
The Lehi City Police Department helped Utah Naloxone reach the milestone with the seventh time the department has been able to save someone from an overdose since they began equipping officers with kits in December 2020.
"We love being the 500th, but it's a sad number. I wish it didn't exist. It's nice to be able to give people who are struggling with addiction or a mistake a second chance, another day to try and get the help they need," said Lt. Kenny Rose of Lehi City Police Department. "I wish the rest of our stock of naloxone would just expire, and we wouldn't need it."
Opioid overdose is the leading cause of injury death in the state of Utah. The number of deaths from overdose went up 8% in Utah and 30% nationally in 2020.
An overdose of opioids slows down breathing until it stops and can cause cardiac arrest because the heart isn't getting enough oxygen to keep going, as well as a collapse of the circulatory system, meaning no blood is getting to the brain.
Naloxone is a safe, legal medication that, if used in time, can reverse a fatal opioid overdose. It is stronger than the opioids and can reverse the respiratory depression if given in time. It is only effective against opioid overdoses, and it has been safely used in ambulances and hospitals for decades, and studies have found that providing naloxone kits does not lead to increased abuse or riskier use of opioids. In fact, it can actually lead to an increase in drug treatment enrollment.
"There's a lot of folks who've lost somebody or who's known somebody that's struggling, and you think 'They're dying! They're dying! And no one's doing anything!'" Plumb said about the decades after her brother's death in which Utah did not have an effective system for delivering naloxone.
In 2015, the Plumb siblings co-founded Utah Naloxone, a community-based nonprofit of prescribers, pharmacists, public health workers, recovery advocates and people who have lost loved ones to the opioid epidemic who are working to address the opioid epidemic. The organization offers free naloxone kits and training. (Narcan is the brand name for a device that delivers naloxone.)
When the Plumbs began offering training through their organization, they said no one really wanted to have a conversation about opioid abuse or overdose. It took them six or seven weeks until they could find a place to do training.
"Then the seal broke. I haven't had anybody turn me down since I don't know when," Plumb said.
Wherever you have opioids, you should have naloxone, just like wherever you have a bike, you should have a helmet. There shouldn't be judgment.
–Dr. Jennifer Plumb, co-founder of Utah Naloxone
The Lehi City Police Department saw a need and partnered with the Plumbs' organization to fill that need.
"What can I do without naloxone?" asked Rose. "We're almost powerless in an overdose situation. Now we can work in tandem with medical to save lives. ... The primary purpose isn't enforcement but life as a priority."
The cases from law enforcement have made up about 10% of cases reported to Utah Naloxone. Reporting is voluntary, but the recent tallied number is 5,682 reversals so far. They have administered around 115,000 kits (230,000 doses).
"Both amazing and terrifying that it has been needed that many times," she said.
At first when Jennifer Plumb started training law enforcement officers, she heard a lot of talking points that concerned her, like dismissive use of terms like "junkies" or saying that the people who were saved from overdosing were just going to do it again later. But now, she's seen a shift, an evolution. She receives calls from officers asking how they can better help members of their community or what more can be done to save lives.
Utah Naloxone trained members of the Lehi City Police Department in December 2020, and the officers began to carry kits on hand immediately after completing training. They had their first reversal within 40 hours.
"I've been proud of how much they've adopted it. Utah County is not always as willing to talk about this. It always has this reluctance to admit that it's a problem, but the data is pretty clear that it is," Dr. Plumb said. "There's a disconnect with how communities want to perceive themselves."
Rose said that the department has also seen a change in that before parents and loved ones of people with drug addictions began to see police as allies instead of being worried about arrests.
"Now they know that if we're carrying it, we can hopefully maybe save their loved one's life," he said.
Plumb wishes that people in Utah would approach naloxone as a type of emergency preparedness, because "that's absolutely what it is." As an ER doctor and professor of pediatrics, she has frequently seen naloxone given to infants and toddlers who have gotten into a medicine cabinet. Just like you would have the number for poison control, you should also have access to a naloxone kit, she said.
"Wherever you have opioids, you should have naloxone, just like wherever you have a bike, you should have a helmet. There shouldn't be judgment," she said, though she admitted that this judgment usually stems from ignorance rather than malice. "Even if you don't think you need it, you should have it," she added.
Within the second quarter of 2021, Utah Naloxone has reported 433 reversals, a 145% increase from quarter one. The number of lives saved is increasing, but the main measure of progress is how we talk about opioid dependence and addiction and the amount of compassion we have, Plumb continued.
"We need to understand, how did people get to this spot where they were trying to escape?" she asked. "How do we become better stewards of mental health? What is it that is leading people into these spaces that are truly going to kill them? Campaigns of 'just say no' or 'lock them up' aren't working."
You can find more information on receiving a naloxone kit and training at the Utah Naloxone website.