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Advocates for addiction treatment say Narcan should be made available everywhere

LEILA FADEL, HOST:

Not long ago, in Montgomery County, Md., a teenager used Narcan to save the life of another teen found unconscious from an overdose in a McDonald's restroom. It's what passes for a positive outcome in the opioid epidemic that's gripping the U.S. Our colleague Michel Martin saw that story and decided to talk to people in Montgomery County who are coping with the crisis firsthand.

MICHEL MARTIN, BYLINE: The school year is almost over in most of the country, and there have been many milestones. But some of them, unfortunately, have been tragic ones.

WILL JAWANDO: We already, this school year, lost five young people to overdose deaths. Ninety percent of the overdoses that happen are happening in bathrooms in schools.

MARTIN: That's Will Jawando, a council member in Montgomery County, Md., which is just outside the nation's capital. He's been hosting public forums on fentanyl and other opioids that are now at the center of the worst drug crisis in U.S. history. That's one reason the U.S. Food and Drug Administration has now decided that naloxone, commonly known as Narcan, can be sold over the counter. Jawando says Narcan should be available everywhere.

JAWANDO: It makes sense, as a public safety measure, to have all of our public security guards carry Narcan, but also to have it available at various places for teachers to access. There's a big discussion now of whether students should be carrying it as well.

MARTIN: I wanted to know firsthand about the experience, so I called Greg Hill (ph), who has both received and administered lifesaving doses of Narcan. We also spoke with his mother, Laura Mitchell. She co-founded the group Montgomery Goes Purple to try to intervene in this epidemic of injury and death caused by substance abuse. She says opioids are more dangerous now than ever before because they include a higher content of unknown substances in the mix.

LAURA MITCHELL: We've seen a rise from about 20% of discarded materials from people who use substances containing xylazine to - now it's 80% in two years. It doesn't respond to naloxone. So if you overdose with it - and it can kill you - naloxone's not going to help.

MARTIN: Greg, do you mind if I ask you about your story?

GREG HILL: My first drug use was 12 or 13. My first opiate use was at 15. It just progressed over time. At the end, I was using alone. I didn't have any friends. Nobody trusted me. Nobody wanted me around. And it was miserable.

MARTIN: How did you get them?

HILL: Meeting people on the street. My first drug dealer was a doctor.

MARTIN: Really?

HILL: I got injured when I was 15 and was prescribed opiate medication for the pain. That became a habit by itself.

MARTIN: How did you realize you had a problem?

HILL: It became very apparent to me by not being able to hold down work, not being able to show up for family commitments, not being able to be trusted by family members. Because, you know, at a point, I started getting my next one by any means necessary. I was trapped, and I felt like I needed it. But I didn't know how to stop.

MARTIN: And, Laura, what about you? How did you realize that Greg had a problem?

MITCHELL: I remember the moment like I remember 9/11. Greg was watching the "War On Drugs" series on the History Channel. They talked about naloxone and symptoms of overdosing on opiates and the nodding off - like, sitting there having a conversation, and their head just drops and they seem to, like, have a micro nap. I recognized that. It was very frequent. And I was like, oh, my gosh. It started clicking. And I thought, it's July; he's wearing long sleeves. Where are my spoons going? Why do I keep finding pen barrels without the pen in them?

MARTIN: How old was he then?

MITCHELL: Oh, probably 19.

MARTIN: Did you have any close calls where you thought you might die?

HILL: Oh, yes, several. I actually have been administered Narcan before. I owe my life to that drug 'cause it brought me back.

MARTIN: Who administered it when it happened?

HILL: I was using with another using buddy of mine and put it in me. And he said I didn't even take two steps, and I just fell flat on my face. And he freaked out and called our friend that was a couple of houses down. And she administered two doses of Narcan to me.

MARTIN: Wow.

HILL: And the second one brought me back, but I was still experiencing the high from it, which leads me to believe, like, it may have been fentanyl or something that was in it because it was nearly overpowering the Narcan after two doses.

MARTIN: Some people aren't coming back from this. And I'm just wondering, how long has this been a thing?

HILL: If an addict hears, hey, so-and-so just copped something from over there and it killed him, he OD'd, he died, the addict mind says, man, that must be really good. Let me go get that. I just won't use as much as he did, and I'll be OK. But it'll get me where I want to be. If you made a car that the brakes didn't work on, you kill somebody, like, that car is not going to sell very good. But if you make a drug that kills somebody, it sells more. That's the insanity of addiction.

MARTIN: I understand that you've been sober now for about 7 1/2 years. How did you get a hold of it?

HILL: The jail system, even though I am opposed to it. I had been in and out of jail a few times because of my use. And, you know, having the time away gave me the time that I needed to get everything out of my system and to have a clear mind and be able to decide for myself and not have the drug decide for me or the court systems or my family or anybody. But for me, what do I want to do with my life? You have to be ready to quit. You have to want to quit.

MARTIN: Laura, what's your take on this?

MITCHELL: He's spot on. Obviously, he lived it, so he sees it. We don't have the treatment facilities that operate the way they need to. We still don't. We certainly didn't then. You might get seven or 10 days from the insurance in a treatment facility, and that's not enough. It takes two years for the brain to heal from opioids and what they do to it.

MARTIN: What do you think would make a difference in addressing this?

MITCHELL: We have to go back upstream, focus more on the mental health, identifying and dealing with trauma as kids, especially. If we mitigate those adverse childhood events, we will reduce the substance use and worsening mental health conditions that often lead to self-medicating and numbing.

MARTIN: That is Laura Mitchell. She's the co-founder of Montgomery Goes Purple. That's a coalition that seeks to minimize the harm from substance abuse disorder. And we also talked to her son, Greg Hill, who has personal experience with this. Thank you both so much for talking with us today.

MITCHELL: Thank you.

HILL: Thank you.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.