At the Nov. 28 meeting of the Newton County Community Coalition, David Stoeker from the Missouri Recovery Network and the MO Hope Project presented an informational program about Narcan or naloxone and how it can save lives in the event of an opioid overdose.

At the Nov. 28 meeting of the Newton County Community Coalition, David Stoeker from the Missouri Recovery Network and the MO Hope Project presented an informational program about Narcan or naloxone and how it can save lives in the event of an opioid overdose.
Coalition member and local pharmacist Tim Mitchell introduced Stoeker, "He's a great guy doing a lot of good things all over the state of Missouri."
"Hi, my name is David and I am a person in long-term recovery," Stoeker told the large crowd who attended the lunch time meeting. "What that means for me is that I have not used drugs or alcohol since Jan. 31, 2009 and because of that, I have been able to accomplish things I never would have dreamed possible. I feel that I have the qualifications to speak to speak about Narcan because it was use to bring me back three times after I died."
Stoeker spent 7 and 1/2 years as a therapist, working with treatment. In January 2017, he was hired by the Missouri Recovery Network as an education and advocacy outreach coordinator.  He also works with the MO Hope Project.
The Missouri Recovery Network (MRN) was established in August of 1999. Their vision is to eliminate barriers to recovery for all those affected by substance abuse disorders and their mission is to promote awareness of substance abuse disorders and to strength recovery. Stoeker works tirelessly to do both.
Stoeker travels from one end of Missouri to another in his efforts to educate the public of the dangers of the ongoing opioid epidemic and to share information about Narcan to prevent overdose deaths.
He began his presentation with an overview of the opioid epidemic, which he states continues to grow and will in the future. Of the numerous individuals Stoeker has worked with, the death toll has also increased.
"I used to lose one per year," he said. "Now it seems like one a week."
In the past 2 1/2 years, Stoeker said he's lost 37 to overdose. Many had gone through a treatment program and died a short time after completing a program. According to Stoeker, it's more likely that someone who has a previous addiction problem will die from an overdose.
"We're here because we care and because we don't want people to die," he told those who gathered to hear his message.
Next, Stoeker explained what Narcan or naloxone is. Narcan is the brand name while naloxone is the generic version. It is a safe, effective medication that quickly reverses the effects of an opioid overdose, normally within two to five minutes. It can be administered in several forms including injection and nasal spray. Naloxone is a prescription medication and blocks the effects of opioids in the event of an overdose. Contrary to what many believe naloxone cannot get anyone high. If administered to an individual who has not taken opioids, it will have no effect.
On Aug. 28, 2017, a new law went into effect in Missouri that made Narcan available to anyone without a prescription through participating pharmacies. At one time, Narcan was available in hospital settings and emergency responders did not have access to the drug. Now, a statewide standing order issued by the Missouri Department of Health and Senior Services has authorized all Missouri pharmacies to dispense naloxone to anyone without a prescription.
Cost can be covered by some insurance plans and in some cases, the cost may be as low as a small copayment. Those without insurance coverage may also purchase naloxone from a pharmacy but the cost may be more. Different forms of the drug differ in cost.
According to Stoeker, many people should obtain Narcan to have on hand. The drug has a shelf life of 18-25 months but Stoeker says it remains viable longer.  Anyone who has prescription opioids in the home should consider having Narcan available.
"It's easy to forget you've taken a dose and take another," Stoeker stated.
He said it can save the lives of all ages, from grandparents to teens.
While Naloxone has no effect on an individual who has not overdosed on opioids, it does have major side effects when used to save a life because it causes immediate withdrawal.
"Imagine the worst flu you have ever had, the worst cramps you've ever had in your life and then be unable to hold anything down for two weeks and that's what withdrawal is like," Stoeker said.
While the first week of withdrawal is usually the most acute, the symptoms can linger for weeks.  This causes some overdose victims to react when they wake up in a hospital setting and they can become violent.
As the number of deaths from opioid overdose increase nationwide and here in Missouri, the fight for prevention continues.
"Overdose deaths are huge," Stoeker indicated.
Missouri remains the sole state without a comprehensive prescription drug monitoring plan (PDMP) in place. Although Governor Eric Greitens spearheaded a form of PDMP, many in the state feel it was not enough. Some Missouri counties have enacted their own PDMP plans but efforts to do so in Newton County ended when the Newton County Health Department encouraged the Newton County Commissioners to wait on any action.
According to Stoeker, PDMP plans will not solve the opioid crisis.
"PDMP works on the front end," he said. "But not so well on the back end. We have a prescription problem. We do need these medications for some things but it (they) have a high dependency level. Alternative pain treatment is one we really need to look at."
Some of the treatment options Stoeker advocates include expanded access to medication assisted treatment, harm reduction, syringe access, safe consumption sites and increased access to overdose education and Naloxone.
Now that Naloxone or Narcan is readily available, the other options need to be strengthened, according to Stoeker.
The Missouri 911 Good Samaritan Law (Senate Bill 501) that went into effect in August 2017 provides immunity to individuals who call 911 for a suspected overdose in the event the caller has also been using drugs or has drugs in their possession. Previously, many did not make the 911 call for fear of arrest or jail. There are a few stipulations - such as an individual with an outstanding warrant for arrest will still be taken into custody - but the law is designed to get help in time.  
Even when Narcan is administered, Stoeker says it's still vital to call 911. Although the drug can save a life, if additional emergency medical treatment isn't administered, the effects of Narcan do wear off and the individual could still die of overdose.
Stoeker, as previously stated, does recommend having Narcan on hand.
"Why keep it on hand?" he asked. "To be compassionate and caring and because you might save a life. If you overdose, people will save your life. If someone else overdoes, you can save their life. It's not dangerous and you can't get high on it. The only bad reaction - for someone with opioids in their system - is withdrawal."
"When I'm asked who should go to this training, I always say 'everyone,’" Stoeker stated.
Opioids are a class of narcotic medications used for pain relief. The term 'opioid' originated in the 1950's and combined 'opium' with 'oids' to create a new word to describe drugs derived from opium including morphine.
Some of the most commonly prescribed opioids include codeine, fentanyl, hydrocodone, methadone, morphine, and oxycontin. Opioids work by binding to receptors in the brain, spinal cord and other areas, reducing sending pain messages to the pain, thus relieving pain.
According to the Centers for Disease Control (CDC) the number of drug overdose deaths has never been higher and the majority of fatal overdoses involve opioids.
Stoeker agrees and maintains the trend will continue, which is why the availability of Narcan is significant to save lives.
Additional information about opioid addiction, abuse, overdose, and the use of Narcan can be found online. Missouri Recovery Network can be found at morecovery.org and the MO Hope Project at mohopeproject.org.
"Dead people don't find recovery," Stoeker stated, advocating the use of Narcan and the importance of reaching out to those dealing with addiction.
"When I was using, you couldn't have hated me more than I did myself," Stoeker said. "If  you looked down on me, you couldn't have looked down on me any more than I did myself."
His message is one of life, hope, and recovery.
The Newton County Community Coalition's mission is to strive to prevent drug and alcohol abuse and other risky behaviors among youth through collaboration, education, empowerment, early-intervention and community transformation efforts throughout Newton County.
The next meeting will be held from noon to 1 p.m. Dec. 19 at The Talking Foundation, 209 N. Valley, Neosho.