If there’s one thing Clinton resident Riley Rayner wanted for his older brother Dylan, it was a second chance at life. He died from an accidental opiate overdose in June while attending college in Oakland.
Naloxone, an opiate overdose antidote, could have provided that. The only problem is many emergency responders don’t carry it as standard equipment, and that includes those in Island County.
Riley Rayner’s change.org petition, “Combat Island County’s Opiate Epidemic: Naloxone for All First Responders” aims to change that, putting the life-saving drug in the hands of first responders, such as law enforcement, emergency medical technicians (EMTs), drivers with Island Transit and other public employees.
Naloxone, also known as Narcan, is a nasal spray that blocks opiate receptors and quickly reverses the physical affects of heroin or other opiates.
While WhidbeyHealth ambulances have carried the drug for years, Dylan’s mother, Colleen Keefe, who is also an Island County Public Health nurse, said that minutes spent waiting for the paramedics to arrive can be the difference between life or death. Riley Rayner also believes that if first responders in Oakland were equipped with Narcan when they found his brother unconscious, he may still be alive. Dylan Rayner was a month shy of turning 25 years old.
Where it began
After attending International Overdose Awareness Day in Seattle, where he first learned about Naloxone, Riley Rayner looked at the website stopoverdose.org to see if Island County was among the counties in Washington that funded the drug.
It was not.
“Honestly, I just assumed all first responders carried it,” Riley Rayner said. “It seemed like a no-brainer that you would carry something as simple as a nasal spray to save someone’s life immediately.”
Though the drug does not cure addiction, Riley Rayner said it could be the first step among many in treating and preventing the problem. If a person has a near-death experience, it may lead them down a different path, and away from opiates or drugs in general, he said. He also wants it known that Narcan can be purchased as an over-the-counter drug at pharmacies like Island Drug in Clinton.
“I felt obligated to do something because if I could just save one person’s life, it will make this whole thing worthwhile,” Riley Rayner said. “I could be content knowing that it spared someone else the feeling of losing a brother or a son or a friend.”
The petition is addressed to 24 decision-makers, entities and departments, including Governor Jay Inslee, state lawmakers, all three Island County commissioners, Island County Sheriff Mark Brown, South Whidbey Fire/EMS and the City of Langley. It had 1,259 supporters as of Tuesday morning, around 250 shy of the petitions’ goal of 1,500.
Narcan came at the recommendation of two Seattle Police Department officials. Bike officers have carried Narcan since March and have administered 12 “opioid reversals,” according Police Safety Officer Steven Redmond and Senior Police Counsel Rebecca Boatright. Redmond said every department should look at supplying their officers with Narcan, or at the very least train them on how to deal with an opiate overdose.
Boatright said the department is also looking into providing all of its patrol officers with the “critical life-saving tool.
“The heroin epidemic is one of the biggest issues facing many law enforcement agencies,” Boatright said. “…It’s a drug with no known side effects. There’s no side effect of using it on somebody who may not be experiencing an overdose on an opiate.”
An agency decision
Whether Narcan is carried and administered by first responders is up to each individual district, department or board, said Island County commissioners Helen Price Johnson and Rick Hannold. For example, commissioners can only recommend the Sheriff’s Office carry the drug. She said the county has been addressing the rise in opioid abuse in Island County by conducting public meetings to raise awareness in the community about the impacts of opioids; the creation of a substance abuse task force, studies into substance abuse in the county, investments in mental health services and the creation of an opioid outreach program that will allow the department to meet with those afflicted by addiction and draw them into treatment.
Price Johnson was in favor of the drug and wants the county to take a look at what it would cost, its need and how many times first responders could have used it.
“I do think that this is another tool in the toolbox,” Price Johnson said.
Brown said the sheriff’s office will “absolutely” consider using Narcan. He said his only reservations were how to train his folks to administer the drug, how to deploy it and how much it would cost.
”I think we need to think over how we can best serve our community,” Brown said. “Certainly Narcan is one way in an emergency system.”
Boatright said none of the 12 people revived showed signs of aggression and that no other agency she knows about has dealt with it. She said people gradually revive.
The Langley Police Department is also on board with the drug.
In an Oct. 11 email, Langley Police Chief David Marks said the department purchased Naloxone kits for each of its four officers to carry. In doing so, the department becomes the first law enforcement agency in Island County “that trains and equips their officers to deal with opioid overdoses.”
South Whidbey Fire/EMS Chief Rusty Palmer said there would be some legal steps to jump through before it could provide its first responders with Narcan, including getting approval from the state and WhidbeyHealth Medical Program Director Paul Zaveruha, who oversees ambulance systems in Island County. Once approved, the district would then look at how to train its staff to use it and put it into effect. Fire/EMS does not administer drugs to patients, including over-the-counter drugs like aspirin. Palmer added that he would like to see more studies done on the effectiveness of Narcan’s typical dosage, which is 4 milligrams, and that it would aid in a decision on the drug.
“It totally depends on how it comes in,” Palmer said. “We have to look at the program and make sure it’s appropriate for our folks to use and carry.”
“We’ll always consider anything like that,” he added.
A 2012 study by the University of Washington published by the Annals of Internal Medicine found that Naxolone is a cost-effective way to prevent overdose deaths and save lives. The university’s Alchohol and Drug Abuse Institute is currently evaluating the feasibility and potential impacts for Seattle’s police officers to carry and administer Naloxone for opioioid overdose reversal.
Susan Kingston of the institute’s Center for Opioid Safety Education said she’s had conversations with a few people on the island, including Theresa Avery of Island Drug, in regard to their interest in Naloxone. She said her office can provide technical assistance at community meetings and be available for presentations and dialogue.
In addition to providing a life-saving drug, Riley Rayner hopes it will raise awareness that addiction to opiates is a chronic illness of the brain and that it should be treated no differently than diabetes or heart disease. He said it affects people indiscriminately and that people tend to stigmatize and even dehumanize addicts. In turn, users can sometimes feel ashamed of their drug abuse as well as how society views them.
Addiction to opiates can also stem from prescribed painkillers after surgeries. This was true for her son, Keefe said, who had major surgery for a throat abscess and was later prescribed an opioid medicine. Dylan Rayner’s drug use eventually spiraled into heroin. He later went to a treatment center for rehab.
Riley Rayner said when Dylan came out of treatment in March, he looked healthy and was back in college.
“Everything seemed fine,” said Riley Rayner, who last saw his brother at his graduation from Saint Mary’s College of California in May. “He seemed like his normal self.”
“Two weeks later, he died. It’s hard to know for sure what’s going on,” he added.
Keefe said she spoke with the U.S. Surgeon General in August, who was in Seattle evaluating the Seattle Police Department’s progressive approach to combating opioids. He later reported back to President Barack Obama, which lends credence to the fact that it has reached a large scale of impact, Keefe said. Like her son, she could no longer keep quiet about the issue and that she too wants to see Narcan used by first responders and more awareness raised about addictions to opiates.
“It’s not going to go away,” Keefe said. “This is something that’s here and we need to start addressing the issue.”
In an effort to prevent pill abuse and theft in homes, the county and the Drug Enforcement Administration (DEA) will give the public a chance to bring pills for disposal at Take Back Day from 10 a.m. to 2 p.m. on Oct. 22 at 5521 East Harbor Road. The service is free, anonymous and no questions are asked.