“It’s definitely a lifesaver,” says Joel Meyers of Gorham, who was administered Narcan by emergency responders after he overdosed in the winter of 2020. Meyers says he seized his second chance at living, reconnected with family and has been in recovery ever since. Shawn Patrick Ouellette/Staff Photographer
Joel Meyers wrote down the date in blue marker on the whiteboard hanging in the kitchen of his Gorham apartment.
Feb. 17, 2020. The date his life was saved. His second chance.
Meyers was getting ready for work when he overdosed on heroin , which was likely laced with fentanyl to make it more potent. When he was a few minutes late for work – he was never late to his job as a cook – his boss called a friend to check on him.
His friend found Meyers unconscious in his kitchen.
At the time, he lived near Moosehead Lake, and paramedics arrived shortly after he was discovered. The medics gave him Narcan – the brand name for naloxone – an opioid antidote that revives people who overdose. Meyers said he was later told they had to give him Narcan seven times before he revived. He woke up at Northern Light CA Dean Hospital in Greenville before being transferred to Mercy Hospital in Portland.
Meyers’ story and others similar to it are being repeated most days across Maine. While more people are dying of drug overdoses, more are also getting second chances at life. And some people are getting third, fourth and fifth chances, surviving repeated overdoses because they were given Narcan in time.
While not every overdose would otherwise be fatal, properly administered naloxone – usually given as a nasal spray but also available as an injection – is extremely effective at saving lives and giving people a chance to get into recovery.
Meyers seized his second chance and has been in recovery since surviving the overdose in 2020. He’s reconnected with family and works as a cook in Gorham.
“It’s definitely a life saver,” Meyers said of naloxone. “I said to myself while I was in the hospital that this was my opportunity to stop, accept help, get into a program and stop the madness.”
Meyers, a South Portland native, said the overdose shocked him into changing his life. He had been living in denial for decades, always thinking that overdoses happened to “other people.”
“I was ‘being careful,’ ” Meyers said with a wry smile, aware of the irony.
Meyers said a back injury at a warehouse in 2000 led to two decades of substance use. It started with prescription opioids for his back pain and his usage escalated over time and included other drugs and alcohol. He quit alcohol in 2019 but continued using opioids.
But when he overdosed and nearly died, the close call made him realize how dangerous his substance use disorder was.
“I could see continuing down that road, and that was the road that leads to dying,” Meyers said.
SAVING LIVES
Maine has experienced record numbers of drug overdose deaths – and the state is expected to break another record this year. But behind that grim toll is another trend – the increasing availability and usage of Narcan to save lives.
Naloxone – in its most common, nasal spray form – looks similar to the nasal sprays one might use to control allergies or reduce congestion. The part that you push when administering is marked in bright red, to make it easy to see and use. Naloxone usually works within 2 to 3 minutes of being taken, binding to opioid receptors in the brain, “reversing the effects of opioid drugs,” according to the National Institutes of Health.
The state has increased the supply and access to naloxone. And the number of recorded naloxone reversals (use of the antidote to revive someone who has overdosed) has also climbed.
While the state has only recently started to track these statistics, naloxone reversals increased from 1,511 from July 2020 to June 2021, to 2,329 during the same period in 2021-22. The distribution of naloxone jumped from 43,950 doses in 2020 to 80,486 in 2021 and 93,125 through October of 2022.
“We have greatly increased the availability of naloxone,” said Gordon Smith, director of opioid response for the Mills administration. “Our goal is to saturate the communities with naloxone because it’s one of the few interventions that does work. If we weren’t doing what we are doing, the number of people we would be losing each week (to drug overdose deaths) would be much, much worse.”
Fatal drug overdoses in Maine continue to increase, with a record 636 people dying in 2021, according to state statistics. Maine was on track in 2022 to break that record, with 565 overdose deaths through October. Final numbers are not yet available.
Experts blame the increasing lethality of drugs, a result of opioids or other street drugs like cocaine being laced with fentanyl, a synthetic opioid far more potent than heroin. Fentanyl, either on its own or in combination with other drugs, accounted for about 80% of all fatal overdoses in Maine in 2021 and through October 2022.
About 6.5% of all overdoses in Maine during the past two years resulted in a fatality. But about 21% of overdoses were reversed by administering naloxone. The numbers can’t account for all uses of Narcan. For instance, if someone is revived by Narcan and doesn’t go to a hospital, that may not be counted. Such cases can be recorded if the person who was saved goes to a syringe exchange and receives a refill of the antidote.
Naloxone is just one component of the state’s anti-overdose strategy, which includes expanding access to treatment, prevention programs, needle exchanges and opioid prescribing regulations.
But naloxone is key, Smith said, because people have to be alive to get into treatment.
A Bucksport native who lives in Portland, Claire Valenoti, 44, says Narcan is “the reason why I’m here.” Sober for four years, she now has a stable life and a job she loves. She has even administered naloxone to others who have overdosed, and still carries it in her purse. Ben McCanna/Staff Photographer
SECOND CHANCES
For Claire Valenoti, 44, it took overdosing and being revived by Narcan four times before she finally made the decision to get into a treatment program.
Valenoti said she regrets it now, but she was ungrateful the first three times she was saved by the antidote, and went back to using and selling drugs. She didn’t value her own life at the time and thought of overdosing as a “way out.” She was irritated that she had to experience withdrawal symptoms, including nausea, instead of marveling at getting another lease on life.
“I was pissed that I was given Narcan. Now, I’m super grateful,” Valenoti said. “It’s the reason why I’m here. It gave me a chance.”
A Bucksport native who lives in Portland, she said she now has a stable life and a great job as a regional sales coordinator for a hotel chain, and has reestablished previously strained relationships with her two adult children. She expects to be a grandmother in April.
“I never in a million years thought I would have a job like that,” Valenoti said. “Life is awesome, and before I was just existing.”
The last time Valenoti overdosed was in August 2018. That October she was arrested for selling drugs. She went to prison, got into treatment and has continued in recovery since being released from prison in March 2021.
“It took getting locked up for me to stop,” Valenoti said.
She has also given Narcan to other people who overdosed – she believes nearly 20 times – and still keeps doses in her purse, vehicle and at work. “You never know when someone might need it.”
The use of Narcan is at times stigmatized, including by Gov. Janet Mills’ predecessor and opponent in the November election. Former Gov. Paul LePage, who served from 2011-19, vetoed or dragged his feet on bills to expand access or usage of naloxone.
“Naloxone does not truly save lives; it merely extends them until the next overdose,” LePage wrote in a 2016 veto message.
Valenoti said that mindset she’s heard from LePage and others is wrong.
“I hear people say, ‘Let the junkies die,’ ” Valenoti said. ” That’s BS. Everyone deserves a chance.”
Claire Valenoti, 44, of Portland says she was revived by Narcan four times before she finally made the decision to get into a treatment program. “I was pissed that I was given Narcan,” she says of her initial experiences. “Now, I’m super grateful.” Ben McCanna/Staff Photographer
MORE ACCESS
Mills has taken the opposite path of her predecessor on naloxone by not only increasing supplies, but also making it easier to find the antidote in more places.
Smith – the state’s opioid response director – said there are several initiatives to increase access, including a “leave behind” law passed in 2021 that allows first responders to leave extra doses of naloxone at overdose calls or when otherwise needed.
Smith said the state is also pushing for more naloxone supplies in schools and businesses, and at jails and prisons to be handed out when people are released. He said he hopes to one day see boxes on walls with naloxone in them in most buildings, next to the automatic defibrillators, although currently the “nalox boxes” are only in a few locations.
At the federal level, the Biden administration is on the cusp of making Narcan available as an over-the-counter drug, as opposed to only being available as a prescription medication. While the state is giving away doses, Narcan, which costs about $35, is typically covered by insurance.
“Naloxone is a miracle drug, but it needs to be administered fairly quickly, so we want it everywhere,” Smith said. “We want to keep people alive. People who are dead don’t get a chance at recovery.”
Smith said schools are another good place to give out naloxone, because the students may not only save each other, but also their parents or other relatives or friends. Smith said it costs about $2 million per year for the state to purchase naloxone, using mostly federal dollars, and those doses are then given away for free.
Naloxone is also distributed at syringe exchanges, including Portland Public Health, and several nonprofits such as Maine Access Points, Health Equity Alliance and the Church of Safe Injection.
Claire Valenoti has been revived four times with Narcan and has administered it to about 20 others. She carries this packet of Narcan in her purse in case she needs to give it to someone. Ben McCanna/Staff Photographer
Bridget Rauscher, chronic disease prevention program manager at Portland Public Health, said in addition to the traditional distribution of Narcan to those who receive sterile needles for safe drug use, the city’s public health department is finding new ways to get the antidote into the hands of the wider community. For instance, many downtown businesses have inquired about naloxone, and Portland will provide training and doses. The city also employs a Mobile Medical Outreach that will, among other initiatives such as giving homeless people winter clothing, distribute naloxone or administer the antidote to those who have overdosed.
Rauscher said paramedics and police officers will still give naloxone on emergency calls, but it’s less likely than a few years ago.
“Because of the widespread availability of naloxone, a high percentage of the time a bystander has administered it by the time first responders arrive,” Rauscher said. “A lot of it is word-of-mouth. Word gets out, and we distribute the naloxone to them.”
At Maine Access Points, which has locations in Sanford, Calais, Machias, Rumford and Caribou, Operations Director Whitney Parrish Perry said that Narcan is “just so much more accessible than it ever was.” MAP will even mail doses to those who request it, and also do training sessions on how to use the antidote, as well as overdose prevention.
Parrish Perry said there’s now a lot higher demand for naloxone, and they have the supplies.
“Organizations and people want to have it,” Parrish Perry said. “There’s a lot more education and that has resulted in a reduction of stigma around the drug itself. We are consistently trending up on naloxone use and access.”
Jennifer Sinclair, harm reduction supervisor for Health Equity Alliance, which has locations in Bangor, Ellsworth and Machias, also said demand for Narcan has increased.
“We have been seeing more people asking for it, more professionals and professional organizations reaching out and requesting training. Colleges are asking us to come out,” Sinclair said.
Sinclair said that “as many people as can carry Narcan as possible, that’s what we want. You never know when you are going to need it.”
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