Last July, Raagini Jawa and Melissa Bachman and their friends sat in a coffee shop near Boston Medical Center and decided they needed to do more than talk about preventing overdose deaths.
With BMC neighboring a ground zero location for the consequences of the opiate epidemic, overdoses in the area – sometimes on the BMC campus, in public bathrooms or even on the sidewalk – have become more common. Most, however, aren’t sure what to do when they see such a thing – from janitors at the hospital to neighbors walking their dogs.
That’s something – at least within BMC – that Jawa and Bachman hoped to change by initiating a volunteer, grass-roots effort to train staff at BMC on how to spot an overdose, administer Narcan (the opiate reversal nasal spray), and carry Narcan with them.
On Monday, the duo had scores of volunteers in one of the medical buildings holding 15-minute trainings on what to do if they spot an overdose on campus, or even in their own communities
“This is really a grass-roots effort started last fall officially by resident physicians and pharmacists at the hospital,” Jawa said. “It really all began last July in a coffee shop. We looked around and we said we had to do something. We wanted to put together a program to teach staff here how to spot and overdose and administer Narcan. People know what Narcan is, but they don’t feel comfortable giving Narcan. We wanted everyone on campus to come – from doctors to secretaries to the janitorial staff to phlebotomists, everyone. This is something that can save a life if you know what you’re doing, and you can’t hurt someone by administering it.”
Those taking the training got lessons in what an overdose looks like, and then also got to use real Narcan kits – both the older two-step kit and the new one-step kit – to practice how to use it correctly. That was followed by a pharmacy setup to help those interested in carrying Narcan to get a prescription that – if filled by the BMC pharmacy – does not have a co-pay. All of that lends to the ease for promoting staff on the BMC campus – where there is an average of one overdose every three days – to carry the lifesaving drug and know how to use it.
“Our message is you carry it and you give it,” said Jawa, a medical doctor and Master of Public Health. “You aren’t going to harm anyone. If it’s an opiate overdose, you’re only going to help them. Even if you aren’t carrying it, if you’re trained, there is enough Narcan around that you can probably walk someone else through it. It’s important for many people, not just doctors and pharmacists, to know how to use this to save lives.”
Dr. Joe Calabrese, dean of students at the Goldman Dental School, said he came to the training because he felt like his job put him in a position where he might likely see an overdose. If he does, he said it was important to him to know what to do.
“I spent a lot of time here after hours and on weekends,” he said. “I park in the garage here and work in this area, and I wanted to have a dose on me just in case. Given the location and the nature of my job and where it brings me at night, I thought it would be a good idea to have it.”
While most of this effort is centered on training civilians at the hospital, many see the next logical step as extending such trainings to the neighborhood to interested neighbors – many of whom see just as many overdoses as those at the hospital.
At the South End Forum’s Opiate Working Group on April 24, that very topic came up.
The Boston Public Health Commission already has a program that trains family members and loved ones of those who have a substance use disorder, but moving to neighbors living at the heart of the epidemic is something that hasn’t yet been considered – but all agree might be worth thinking about.
Meanwhile, back at the BMC training, Public Safety Officer Mikel Panajoti said he has worked on the Bike Unit for several years and sees lots of overdoses. Police at BMC have carried Narcan for four years, and Panajoti has become an unofficial spokesman for the volunteer effort.
“We use it a lot,” he said. “Last year, we used it 107 times, and some of those overdoses were fatal. We see it within our campus and outside the campus…It’s satisfying when you could change somebody’s life by saving it. There are those that appreciate it and those that don’t care, but if you can help to get one person on the right track, that’s good enough.”
At the end of Monday’s training – or at least by 5 p.m. – more than 300 employees had been trained and signed up to carry Narcan.