Within the past two months two suspects in Modesto Police custody became unresponsive shortly after being handcuffed and put in the back of patrol cars.
Their eyes rolled back, breathing slowed and became shallow and their pulses weakened.
In separate but very similar incidents that occurred in May and June, officers Jason Botsch and Robert Weber recognized these symptoms as an opioid overdose.
The officers, recently trained to administer Narcan, gave the suspects the life-saving antidote through a nasal spray, reversing the effects of overdose.
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Both suspects regained consciousness and their breathing normalized within a few minutes.
“I administered the Narcan to him and it was exactly like our training taught us,” Weber said. “He came to and he had a bad nasal drip and he was upset. It immediately detoxes them so they go into withdrawal.”
Even though an ambulance was on the way, the immediacy of Narcan‘s effects is crucial.
“Within five to seven minutes, if someone is not breathing, you are talking about going brain dead or going into cardiac arrest,” said Jonathan Blount, a Stanislaus County Sheriff’s Deputy and former medic. “Minutes are crucial when you are talking about preserving life.”
Blount, Weber and Botsch are among hundreds of law enforcement officers in Stanislaus County who, since March, have been trained by Aegis Treatment Centers staff to administer Nasal Narcan and now carry it in their patrol car.
The active ingredient in Narcan Nasal Spray, Naloxone, works by blocking opioids from the part of the brain that regulates breathing, according to a website for the drug.
More than 500 Narcan doses have been issued to Stanislaus County law enforcement by Aegis, the recipient of six of 19 California Department of Healthcare Services grants. Every law enforcement agency in the county is stocked with Narcan, although a small percentage of officers still need training.
Irean Castillo, a heroin user, has watched friends and family members die of overdoses. She has also witnessed the life-saving results of Narcan.
“It brings them right out of it; it makes them gasp and they will start coughing and then they will get up and feel woozy,” the Modesto woman said. “It takes everything out of them, all the drug that has been in them ... it takes you back to Square 1 where you feel like you’re sick, like when you wake up in the morning and you don’t have your heroin.”
She said overdoses are “very common, especially now ... they have what they call fentanyl in the (heroin) ... it is killing them, man. Them two drugs shouldn’t be together at all.”
Fentanyl is a synthetic prescription opioid similar to heroin but 50 to 100 times more potent than morphine, according to the U.S. Drug Enforcement Administration. Fentanyl has a legitimate use for pain management, but criminal organizations are increasingly mixing it with heroin and other controlled substances.
There was a 57 percent increase in fentynal deaths in California from 2016 to 2017, according to the California Department of Public Health.
Because the drug can be ingested, inhaled or absorbed through the skin or eyes, anyone who comes in contact with the highly potent drug is at risk of overdose, particularly first responders and law enforcement.
Most reports of law enforcement overdosing on the drug from accidental exposures have come from the Midwest and East Coast. However, last month an Alameda County Sheriff’s detective and sergeant assigned to the Narcotics Task Force were exposed to the drug during a drug investigation at a motel room.
The detective was exposed as he walked into the room to an “invisible or microscopic dust cloud of suspected fentanyl residue” and immediately became ill, falling unconscious and suffering respiratory distress, according to the Alameda County Sheriff’s Office.
After receiving two doses of Narcan administered by the sergeant, the detective awoke and started breathing normally.
The sergeant also was exposed to the drug, likely while saving his partner’s life. He was treated with Narcan a short time later by paramedics.
There have been several instances of Stanislaus County law enforcement encountering fentanyl, but no reported exposures.
Weber said the suspect to whom he administered the Narcan told him he used heroin mixed with methamphetamine and fentanyl. The suspect had used all the drugs prior to Weber’s arrival.
Stanislaus County Sheriff’s Deputy Marshall Denton, like Blount, is a former paramedic.
He said, “I feel a lot better knowing that if I come into contact with fentanyl, one of my partners can save my life. The training is very simple and as long as people know the signs of opioid overdose, they can save a life.”
Narcan also can be used on police dogs who can suffer the same symptoms of overdose and humans.
Denton and Blount both have seen Narcan work on patients who were blue in the face and breathing only a few times per minute.
Both have years of medic experience but, they like other law enforcement, will call for medics even if they administering the Narcan.
The patient will be encouraged to get further treatment at a hospital where they ideally will be referred to services for rehabilitation, said Aegis grant manager Sarah Khawaja.
“We are hoping that after the life of the (two-year) grant more funding can be secured,” she said. “We know that data drives change and are leaning on that data from California that shows that more patients are entering treatment.”
She said the goal also is to use the grant funds to train and certify physicians and mid-level providers to prescribe Suboxone to treat opioid addiction and to get Narcan, not just to law enforcement, but to family members and caregivers of opioid users.
A 2013 change in state law allowed anyone in a position to assist a person at risk of an opioid-related overdose — like police or family members — to administer the drug without facing civil or criminal liability.
Castillo, the Modesto woman, said equipping law enforcement with Narcan is a great idea because they often are first on scene but she thinks it should be given to anyone who might need it.
Last year the treatment center Genesis, managed by county Behavioral Health, began issuing emergency prescriptions for Narcan but the county recently received a separate grant that will make it possible to distribute the drug for free and without a prescription.
The $44, 205 grant will pay for 1,116 packs — there are two doses in each pack — of Narcan that will be given to family members of users.
“Our plan is to distribute the medication through a variety of partners, including treatment centers, Behavioral Health Services, Homeless shelters, and our own HSA clinics,” said Stanislaus County spokeswoman Amy Vickery.