For a long time, Gary Carmack of Waynesville watched his 25-year-old son James battle a heroin addiction.
“He would look at me with these big, sad eyes, and he wanted so bad to get off of it,” Carmack said. “Everyone would be saying, ‘you just have to tell him to quit.’ And of course that’s virtually impossible without the right kind of help.”
As a paramedic, Carmack had seen countless overdoses. The family tried desperately to get James into treatment. But in 2013, his son was one of 258 Missourians who died after using heroin that year.
“I’ve seen a lot of human tragedy, I’ve seen a lot of good things too. But this is the hardest thing that I’ve ever endured in my life,” Carmack said. He’s since founded an addiction support organization, The Lime Tree Recovery Group, in honor of James.
In 2014, Missouri’s heroin death toll rose again to 338, a nearly five-fold increase from just eight years prior.
James Carmack’s death also hit home for Missouri Rep. Steve Lynch, R-Waynesville. Lynch and Carmack both grew up in Waynesville, and played football together in high school, Carmack said.
Lynch began filing bills to improve access to naloxone, commonly referred to as Narcan. The antidote, given as an injection or a nasal spray, can reverse the effects of a heroin or opioid drug overdose. In 2014, the Missouri legislature passed a measure to allow first responders to carry Narcan.
“One week after they started carrying it, the (Pulaski County) sheriff called me. They had saved a life with it. Another week went by, they saved another life,” Lynch said.
During the last legislative session, Lynch sponsored a bill to expand naloxone access again by allowing civilians to purchase it and keep rescue kits on hand. The measure passed the House with only one “no” vote, but did not get through the Senate in time due to a filibuster over so-called “right to work” legislation.
“I can’t tell you how disappointed I was,” Lynch said. “Because literally the year’s gone by … and in those states that have the bills like we’re trying to get passed, it’ll save 40 percent, maybe 50 percent of the lives because it works that well.”
Lynch has pre-filed a bill for the 2016 session that will push again for civilian access to naloxone. By allowing parents, friends and other addicts to carry the antidote, a person can be resuscitated from an overdose sooner and potentially save a life, he said. The bill requires people who administer naloxone to immediately contact emergency personnel, which speaks to a concern that civilians would not be equipped to treat other side effects of a heroin overdose.
Carmack rejects another frequently-cited concern, that increased access to naloxone would make people feel freer to use heroin, if an antidote is close by.
“As a paramedic, one of the things we know is whenever we do give Narcan, sometimes the person will get a little bit combative, because, after all, we just ruined their high,” Carmack said. “I just don’t think that’s correct at all.”
Costs for a single-dose rescue kit vary, but appear to be around $28 in states where naloxone is legal, said Brandon Costerison of NCADA St. Louis, an advocacy and support group for people with addictions.
Though Narcan can help in emergency situations, Missouri does have a long way to go in improving access to addiction treatment, Carmack said. Many patients and their families report challenges in finding an available bed, or a physician willing to prescribe suboxone.
The idea of civilian access to Narcan is not new. 20 states, including Kentucky and Minnesota, have laws freeing civilians from criminal and civil liability if they administer naloxone, according to LawAtlas, a research group for state laws. 17 more have at least one law expanding the availability.
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