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Many in U.S. push to share heroin overdose antidote with civilians

By Scott Malone

QUINCY Mass. (Reuters) - Health worker Warren Nicoli got the call late one February night, from a Massachusetts dad who had just seen police revive his 19-year-old daughter from the death-like state of a severe heroin overdose.

Police told the man that he could get the anti-overdose drug they had used, naloxone, from Manet Community Health Center in Quincy, Massachusetts.

"He was just amazed at the stuff," said Nicoli, a prevention specialist at Manet. "He came in the next day and I trained him and sent him home with naloxone."

Manet is one of 19 medical sites around Massachusetts that dispenses the life-saving drug to family members of substance abusers, community outreach workers and even addicts themselves.

The program is part of a state initiative to take on what U.S. Attorney General Eric Holder has called an "urgent and growing public health crisis" of abuse of heroin and other opioid drugs, a class that includes many prescription painkillers.

Quincy, Massachusetts, in 2010 became the first U.S. city to make the drug standard equipment for its police officers, who have used it to reverse some 275 overdoses, a significant number in a city of 93,000 people. Police forces nationwide are starting to follow suit.

The state program has now moved far beyond police, training some 25,747 people in Massachusetts how to recognize the signs of opioid drug overdoses and administer naloxone.

Those people have collectively reversed 2,982 overdoses since the state in 2008 started small trials of the "bystander" program, providing civilians with training and naloxone.

The version of the drug used in Massachusetts comes in a small dispenser the size of a Magic Marker. A dose has no effect on a person whose system contains no opioids. But the results are dramatic for someone whose breathing has almost stopped due to an overdose.

"It's surreal," said Detective Lieutenant Patrick Glynn of the Quincy Police Department, seen as the driving force behind the city's program. "You go from dealing with someone who is dead. They're not breathing, they're not responsive. And in 30 seconds, 90 seconds, they're up and talking to you.”

'MODEL FOR OTHER STATES'

Police forces across the United States are following Quincy's lead. New York State Governor Andrew Cuomo last week said he would provide naloxone to first responders statewide.

"It is certainly a model for other states and is being embraced across the country," said Jeff Levi, executive director of Trust for America's Health, a nonpartisan research group.

Nationwide, more than 50,000 concerned citizens have been trained by 188 community groups, and have collectively reversed 10,000 overdoses, according to the trust.

The advantage to the program is a simple matter of speed, said Hilary Jacobs, director of substance abuse services at the Massachusetts Department of Public Health.

"We wanted to issue naloxone to people who were using or were likely to witness an overdose, the people who were going to be first on the scene," Jacobs said.

Massachusetts recorded 668 deaths from accidental overdoses of opioid drugs in 2012, the highest number on record. Preliminary data show the state headed for another high in 2013.

Massachusetts Governor Deval Patrick on Tuesday will convene a summit on the issue with four other New England governors: Vermont's Peter Shumlin, Connecticut's Dannel Malloy, Rhode Island's Lincoln Chafee and New Hampshire's Maggie Hassan.

The region's one Republican governor, Paul LePage of Maine, will not be attending. A spokeswoman cited a scheduling conflict, but LePage has said the antidote provides drug users an "excuse to stay addicted" and had threatened to veto a bill expanding naloxone access.

He relented in April, allowing the bill to go into effect without his signature.

A bigger worry for advocates is supply. A handful of U.S. companies produce naloxone, including privately held kaleo Inc, whose cellphone-size device for administering the drug received Food and Drug Administration approval in April and Amphastar Pharmaceuticals Inc, which in May filed initial paperwork to sell stock to the public.

Britain's Reckitt Benckiser Group last month said it plans to develop a nasal version of the drug.

Alexander Walley, an associate professor of medicine at Boston University's School of Medicine who also serves as medical director of the state's opioid overdose prevention program, said supply was a concern.

"We've had a couple of periods where we have been worried about supply. It hasn't been rationed but it's a generic drug and there's only a few suppliers," he said.

(Reporting by Scott Malone; Editing by David Gregorio)

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