I was talking to someone recently about the availability of Narcan where we live (a college town in southern Indiana, population 80,000). Narcan is a medication that blocks opiate receptors. When given to someone who recently overdosed on heroin, fentanyl, or painkillers, Narcan can save their life.
In the lobby of the county jail, there’s a vending machine that dispenses Narcan for free. It’s like those rest stop snack machines – type in a number for the item you want, then a corkscrew turns until that item falls into the slot for you. Every row has Narcan. Only Narcan. A sign on the front asks patrons to consider taking several doses.
I don’t know how many people actually used this vending machine – I always feel nervous about the surveillance state when I’m standing in the jail lobby, and I’m not even particularly likely to be incarcerated.
But I imagine that fewer people use the vending machine now. The jail lobby was open to the public, but now the outer door is locked and you have to be buzzed in. Press a button for the intercom, then a correctional officer’s voice crackles through to ask why you want to come inside.
The person I was talking to: she lost her partner to an overdose last autumn. She’s been distraught ever since, which led to a relapse (she has a child and had been clean since the beginning of her pregnancy), which led to jail.
“I actually hate that Narcan is everywhere. I don’t know if this is how it is, but it feels like the EMTs don’t try as hard. Like they’re thinking, if nobody cared enough to Narcan somebody back, then they aren’t going to do it either.”
“They’d brought him back before, a few years ago. But this time … I mean, maybe there was nothing they could have done. But I wish they’d tried. I wish there’d been a way for me to say goodbye.”
“And now, somehow, I have to tell our daughter. That her daddy’s never coming back. I mean, it happened months ago. Maybe she knows. She probably knows? But all she says is that her daddy’s in a box upstairs. Because that’s what I had told her.”
“And I wish my mom would stop talking bad about him. My daughter, she’s with my mother now. Thank god she’s with family. And, like, my mom, I get that she never liked him. He did some bad things. My baby shouldn’t have seen him throw me around.”
“I mean, he threw me, literally threw me out the front door one day. But, god, he’s dead, so can’t my mom just talk like my baby’s daddy wasn’t bad?”
There are facts that are true, and feelings that are true, and sometimes they tell us different things.
Narcan saves lives. Given at the right time, it can bring back a person’s breathing.
In that moment, Narcan helps.
But a dose of Narcan also apparently feels awful. A body was free from every ache and pain; suddenly, every harsh sensation returns. Many people, when revived, immediately use more of whatever drug had nearly killed them, hoping to take the edge off.
And, simply knowing that Narcan exists might make the world more dangerous. Perhaps the sense of security leads to riskier behavior? The same argument is made about padded football helmets – that thick helmets lead football players to block and collide in fundamentally unsafe ways. And in real estate: past insurance payouts have lead to the construction of extravagant homes in locations likely to be destroyed by future hurricanes.
When so many people have access to Narcan, then perhaps, if nobody revived a person, perhaps that person would seem to be less loved. Even if this wasn’t true. After all, there are all sorts of motivations that could prompt a person’s unsafe choices: they might’ve been using alone because they didn’t want the sight of drugs or needles to be triggering for a family member in recovery. They might’ve felt shame to be slipping back into old habits after months or years of doing better.
Because they’d tried to protect others, a person who overdosed might not be noticed until too late.
I always assumed that access to Narcan was helping. And, more: that access to Narcan felt like it was helping.
But perhaps not. After a loss, everything – including antidotes, and EMTs, and remembered stories – can cause pain.