In Michigan, naloxone has reversed over 6,600 overdoses since 2020

• Naloxone has reversed at least 6,600 overdoses in under 4 years through a Michigan program, state health expert says 
• The actual number of lives saved is unknown. Some people may overdose more than once; other reversals go unreported
• Naloxone and other supplies are among the largest expenses of Michigan’s share of an opioid settlement fund.

Chris Chapin had been on the new job less than two weeks. But the guy in the restroom on this winter morning at The Grand Rapids Red Project, a public health clinic, had been in there just too long.

Chapin knocked. No answer. With this being an office frequented by people battling drug addiction — he knew every second counted.

Chapin grabbed a packet of naloxone hydrochloride — Narcan — from his desk, raced into the bathroom, stretched over the man slumped on the floor, and jammed a nasal spray up the man’s nose.

Such scenes play out countless times each month throughout the nation, as parents, peers, police and emergency personnel reverse overdoses with the life-saving, opioid-reversing drug, naloxone. 

In Michigan, more than 6,600 overdoses have been reversed in the last 3 and a half years, according to Jared Welehodsky, senior analyst for the state health department. The devices have generally been paid for by federal grants from the Substance Abuse and Mental Health Services Administration, according to Chelsea Wuth, a state health department spokeswoman.

Related:

• Michigan unveils spending on $1.5B opioid settlement, amid secrecy fears
• Lifesaving Narcan for drug overdoses approved for over the counter sale
• Ingham County adds naloxone vending machine to combat opioid overdoses

Perhaps it’s no surprise, then, that the purchase of naloxone kits is a hefty expense in the state’s spending from its share of legal settlements against opioid manufacturers, distributors and pharmacies. Those payments, over 18 years, will total an estimated $1.5 billion to address the damage of the opioid epidemic.

As the first settlement payments begin to arrive, the state Department of Health and Human Services set aside $7 million for Emergent Devices, which sells Narcan, the brand name for the first naloxone formulation approved to reverse overdoses. (There are now multiple formulations and brands for naloxone.) 

While it may take decades, if ever, to kick opioid abuses, naloxone’s results are immediate. In just minutes, the drug blocks the effects of opiates on the brain and restores breathing, offering drug users on the brink of death a second chance instead.

As for the 6,600 overdose reversals, that’s likely an undercount, said Dr. Natasha Bagdasarian, Michigan’s chief medical executive. 

“Most overdose reversals happen at 2 in the morning, when no one is calling the police, and no one is calling for help,” agreed Andrew Coleman, a site supervisor at the Sterling Heights office of the Arab Community Center for Economic and Social Services, or ACCESS, which also distributes naloxone.

Regular drug users have learned to take care of each other in an overdose, he said.

“They see their friends falling out; they are turning blue, and they are Narcaning their friends,” he said. “But you’re not calling police if you’re with a group of people around who are involved with felony-level drug activity.” So those reversals never get recorded by the state. 

Also complicating counts is that some people may overdose more than once, said Coleman, so those 6,600 recorded reversals may involve fewer than 6,600 people. 

Still, the more steady, reliable funding stream from settlement dollars — as well as the imprecisely counted but real overdose reversals — cements naloxone’s role in the long-term effort.

Naloxone already had become more readily available this spring, after the U.S. Food and Drug Administration approved its use without a prescription, allowing its distribution in convenience stores and even vending machines like the one outside The Grand Rapids Red Project, where Chapin saved the client’s life.

Hundreds of Michigan pharmacies also now carry naloxone under a standing prescription order by Bagdasarian. (Michiganders can find participating pharmacies on this map here and the Red Project offers online training videos here.) 

The goal is to make naloxone nearly ubiquitous in a state that recorded 13,679 overdose deaths in five years through Dec. 2022. Bagdasarian, the medical executive, calls it a “fire extinguisher strategy.”

Those deaths reflect overdoses from a variety of drugs, but nearly 3 in 4 cases in 2021 involved synthetic opioids, according to state data.

“You don't know which household is going to experience fire, but you want to get fire extinguishers out in as many settings as possible so that they are there at the right place at the right time,” the state’s Bagdasarian said.