Naloxone is a drug that reverses opioid overdoses, bringing a heroin user back from the brink of death. Known by the brand names Narcan or Evzio, this meek little opiate antagonist resuscitated approximately 27,000 people in the United States between 1996 and 2014.
Naloxone earned FDA approval in the 1970s, but only now, with the rising tide of America’s opioid epidemic, has the drug become more widespread. Yet a stream of local and national news stories spanning the last two years warn of a “a deadly new twist to Heroin.” The stories spin up a dark side to naloxone’s life-saving benefit. In them, law enforcement officials say that increased access to naloxone is leading to riskier heroin use, including something called “Narcan parties.”
What’s a Narcan party? Depends who you ask. Craig Stedman, a district attorney in Pennsylvania, told a local news outlet that it’s when injection drug users will get together and combine their stashes. Sen. Lisa Boscola and Rep. Daniel McNeil from Pennsylvania insisted that “kids are having opioid parties with no fear of overdose.” An EMS chief and sheriffs from Ohio and Pennsylvania have made similar statements about this “disturbing trend.” Even an agent from Utah’s Drug Enforcement Administration said he’s heard of “narc-me” or “Lazarus parties.”
“You know, like raising someone from the dead,” Special Agent Brian Besser told KSL News, the implication being that drug users are overdosing on purpose.
The only problem with these media reports is the astounding lack of evidence. If these Narcan parties are occurring, where is the proof?
“I have been asking the same question for about a year now,” Bill Stauffer, Executive Director at Pennsylvania Recovery Organizations, said in an email. “I have not been able to verify a single case of this and I suspect it to be an urban legend.”
Three others I spoke with said something similar. Mark Kinzly has worked in overdose prevention for twenty years, founded the first needle exchange on the East Coast, and headed up HIV-related research at Yale University. He’s now on the Board of Directors for the National Harm Reduction Coalition and co-founded the Texas Overdose Naloxone Initiative.
“[Narcan parties are] such a ludicrous concept, because when you get reversed with naloxone from an overdose, it’s an incredibly unpleasant experience,” Kinzly said. “There’s no evidence, even by the police, that this stuff has ever occurred. They’ve never been able to bring one person forward to justify these claims.”
To find out where the idea of “narcan parties” came from, I reached out to multiple officials who warn about them in recent news reports. First, I contacted the Lancaster County District Attorney’s office, and was referred to Craig Stedman’s media specialist, Brett Hambright. He said the label “party” might not be the “best use of the term,” but added in an email, “It is not uncommon for multiple users to get together and combine what they have and consume. I think almost any addict or person in recovery will tell you that is common.”
“I think almost any addict or person in recovery will tell you that is common.”
Not according to the addiction specialists I spoke to — not one of them agreed that riskier drug use was linked to naloxone. Stedman’s office did not offer any solid evidence beyond a photo of a heroin bust including Suboxone.
I called Portage County Sheriff David Doak, who last month mentioned Narcan parties to the Record-Courier, to ask where he got his info. All he would say was from “informants,” but added, “We don’t have a way to confirm it.”
I emailed Lancaster County Chief Jack Soberick, in response to his comments in local news that people are “now taking advantage of Narcan” and “us[ing] the opioids to whatever degree [they] want.”
“I do not have firsthand knowledge or physical evidence of any Narcan party occurring in my borough,” he responded. “This is not to say that it does not happen, I just do not have that knowledge.”
Declining an interview, Rep. Daniel McNeil said he “could not recall” where he heard of Narcan parties, but his assistant referred me to the August 2, 2016 PA HOPE Caucus. “It might have been mentioned there,” I was told, but I watched all 2.5 hours of the video — the only Narcan party testimonies came from Rep. McNeil and Sen. Boscola.
Senator Boscola, Sheriff Richard Jones, and the DEA did not respond to numerous requests for comment.
On the other hand, a Station Commander for the Pennsylvania State Police, the Recording Secretary for the Fraternal Order of Police Pennsylvania Lodge, and April Hutcheson, the press secretary for Pennsylvania Department of Health, all said they had not seen any evidence of Narcan parties. “We don’t have anything, even anecdotally, about that,” Hutcheson said.
A 2016 study in Addiction concluded that “There is no empirical evidence to support the concern that THN [take-home naloxone] programmes might encourage heroin use.” Two studies of a combined 117 injection drug users trained with naloxone found a decrease in heroin use. In 2014, a much larger retrospective cohort study in BMC Public Health looked at nearly 5,000 Massachusetts opioid users given naloxone and found “no clear evidence of increased heroin use.”
But what if even one of these Narcan parties rumors was confirmed? What if there was at least one case where heroin users combined their stashes at a party, just to feel what it’s like to get so high they pass out and nearly die?
According to Gail Scott, manager of Philadelphia's Substance Use Disorders Institute at University of the Sciences, it comes down to what’s called “risk compensation,” a theory that if you reduce a risk, people will respond with more dangerous behavior. “Somebody might drive faster because they have a seatbelt on, [that] generally does not outweigh the health benefit of everyone having seatbelts,” Scott explained. “We think that’s true with Narcan.”
See here to learn more about how to recognize an overdose and how to administer naloxone.