"Narcan Party" Hysteria Puts a Value on Drug Users' Lives

By Tessie Castillo 11/05/17

The real objection is that Narcan access for laypeople--especially drug users--allows them to save lives without the cessation of drug use as a requirement.

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While the country is obsessing over the idea of “fake news,” let’s talk about some actual fake news: Narcan parties. Increasingly, media outlets are publishing stories with attention-grabbing headlines such as Narcan Parties Becoming Disturbing Trend, Police Say and People Intentionally OD to be Revived at ‘Narcan Parties.’ The stories usually involve grave reports that the increasing availability of Narcan (naloxone), a medicine that reverses opioid overdose, is causing people to overdose on purpose because they know that Narcan can be used to save them. The reports often originate from paramedics and law enforcement responding to overdose-related 911 calls, though most harm reductionists and drug users vehemently deny the existence of so-called Narcan parties. So who is telling the truth?

As with many controversial issues, the story of “Narcan parties” starts with a truth, which then becomes distorted. Here’s what’s real: Yes, people often use drugs in groups or at parties. That’s not new. Drug use at parties has been happening long before Narcan became easily accessible. What is new is that Narcan is increasingly available to the public and used by laypeople to reverse an overdose. So when first responders arrive at the scene of an overdose they might see a party and they might see that Narcan was administered to the overdose victim, hence the term “Narcan party.”

But from there, facts get twisted.

First, some articles claim that “people are overdosing in houses or public places, knowing responders are nearby with Narcan.” I admit I have trouble keeping a straight face when I hear this. There are two things most drug users avoid at all costs: withdrawal and police. Overdosing and having first responders show up to administer Narcan summons both. Narcan blocks the effects of opioids, provoking the rapid onset of withdrawal symptoms such as pain, vomiting, diarrhea, muscle cramping, hypertension, and anxiety. That’s not an experience anyone would invite on purpose. Plus, the relationship between most illicit drug users and law enforcement isn’t exactly chummy. Neither is the relationship with many paramedics. Under the best-case overdose scenario, an opioid user could wake up in agony and possibly handcuffs. Under the worst case, they could die. So no, people aren’t overdosing on purpose because paramedics and police might be nearby with Narcan.

No one engages in risky behaviors just because first responders are a phone call away. People don’t leave their doors unlocked thinking that if someone tries to rob their home while they’re away, neighbors can call the police. People don’t light fires in their fireplaces in the winter believing that if their house goes up in flames, someone will call the fire department. People leave their doors unlocked and light fires because they believe nothing bad will happen. And in most cases, they’re right.

The same logic applies to drug use. Except in cases of suicide, people who take drugs do not think anything bad will happen. Yes, they know there is a risk of death if they overdose. Yes, they may have overdosed in the past. Yes, they may know someone who died of an overdose. But before you start thinking that drug users are irrational and deserve what they get, consider your own thought process every time you step into a car. You know car accidents are one of the leading causes of unintentional death. You may have had an accident in the past. You probably have known of someone who died in a car accident. Yet you still drive because it’s convenient and because you feel sure that nothing bad will happen—not because you feel comforted that if you do have an accident, nearby paramedics might pull you from the twisted wreckage of your car.

Because of stigma and misinformation, people inflate the risks associated with taking drugs and consider drug users more reckless than non-drug users, who also take deadly risks every day. Eliza Wheeler, Director of the DOPE Project of the Harm Reduction Coalition in Oakland, California, points out that no one claims that EpiPens cause people with nut allergies to gorge on peanuts. She explains, “The concept of ‘Narcan parties’ became distorted because drugs are involved and so everyone immediately thinks something bad must be happening. Instead of EMTs saying, ‘Hey, we responded to a call today and someone else had already saved a life with Narcan. That’s great!’ they think, ‘Oh, we responded to a call today and someone had overdosed on purpose because they had Narcan.’”

Another media claim distorted by stigma is that during “Narcan parties,” a designated person is standing by to revive people who overdose, thus allowing party-goers to engage in riskier drug use, knowing a friend will save them. This claim is false. The rumors originate from the concept of a designated driver, a person whose presence may indeed encourage some people at parties to drink more alcohol, knowing they will not have to drive home. But there is a major difference between driving someone home and giving them Narcan. As mentioned above, Narcan induces agonizing opioid withdrawal, something that opioid users avoid at all costs. Drinkers do not fear the consequences of being driven home by a sober friend after a fun night of drinking.

People are not overdosing on purpose to be revived with Narcan, although, yes, more drug users carry Narcan now and may use it if an accidental overdose occurs. But guess what? That’s a good thing!

Lee Hertel, Director of Lee’s Rig Hub, a syringe exchange program in Minneapolis, Minnesota, explains, “People who have Narcan on hand when using in groups are doing exactly what they should be doing. The golden rule of harm reduction is to never use alone and to have Narcan around if you use opiates. People who keep Narcan on them are looking out for each other and saving lives. Isn’t that the whole point of making Narcan available in the first place?”

Yes, having a life-saving antidote on hand in case of an accidental overdose is the entire point of making Narcan available to laypeople. But the controversy surrounding “Narcan parties” persists due to fears and misconceptions that drug users will take anything and misuse it. For example, the media peddles stories of drug dealers selling Narcan and dope as a package deal. In fact, many drug dealers do sell Narcan along with heroin or other opiates—but how is that any different from physicians co-prescribing Narcan with opioid pain relievers? In both cases, the goal is to prevent patients or customers from dying of an accidental overdose. But while physicians are actively encouraged to co-prescribe Narcan, when drug dealers do the same, the story is twisted to sound sinister.

I admit that as a harm reductionist, I sometimes feel a sense of fatigue that derives from constantly having to point out the obvious: Drug users make decisions based on perceived risk and reward, as we all do. It is the unique stigma against drugs and people who use them that causes drug-related decisions to be viewed as irrational and fundamentally different from the ways in which non-drug users engage in other risky behaviors every day.

I think the real pushback against the widespread availability of Narcan is not about whether it encourages riskier drug use. Empirical studies have disproven that theory time and time again. The real concern is that Narcan access for laypeople--especially drug users--allows them to save lives without the cessation of drug use as a requirement. It means we believe in saving the lives of people who might use drugs again. And again. And again. To many people, this outcome is unacceptable, so they propose policies like limits to the number of times Narcan can be administered to the same person, or forcing people into treatment after an overdose and other measures that imply that only a person who does not use drugs (or will stop immediately) deserves to be saved.

There is certainly a place for compassionate, voluntary intervention after an overdose, and evidence-based treatment options such as medication-assisted treatment should be more affordable and more available. But no one is arguing against that. The real disagreement is over whether or not drug users have the right to make their own choices about what they put in their bodies. Spreading false stories about parties where people overdose on purpose is exactly the kind of news that can whip up anger against harm reduction and create public support for punitive policies that once again show drug users that their lives are considered less valuable than those of non-drug users.

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Tessie Castillo is a writer and drug policy advocate in Raleigh, North Carolina. Her articles explore topics such as criminal justice reform, drug policy, and harm reduction. Castillo previously served as the Advocacy and Communications Coordinator for the North Carolina Harm Reduction Coalition (NCHRC), a statewide nonprofit that advances drug policy and criminal justice reform. During that time, she played a pivotal role in helping to legalize syringe exchange programs and expand access to naloxone, a medicine that reverses opioid overdose. Find Tessie at her website or on Facebook, TwitterInstagram, and LinkedIn.