October 27, 2015
Bastiaan Slabbers/For PhillyVoice
Mickie, a Gloucester County heroin addict in recovery, brought his friend Anthony back from near dead, thrusting a Narcan needle into his leg. Mickie asked that only his first name be used.
This is the first of a three-part series.
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Mickie already was high when he picked up his friend Anthony from a drug recovery house and headed out to find some heroin.
Soon enough, they began shooting up while parked outside a Dunkin Donuts in South Philadelphia. Mickie went first and quickly felt “really high.” The heroin was potent.
Then Anthony used and immediately overdosed, the signs evident: difficulty breathing, reduced heart rate, bluish tinge to the lips and tongue.
“I was just slapping him in the face,” said Mickie, a Gloucester County resident who asked that PhillyVoice only use his first name as he continues his own recovery. “His face started turning purple. I almost didn’t believe it was happening.”
Quickly reaching into the center console of his car, Mickie pulled out Narcan, an opiate antidote that reverses the effects of a heroin overdose and restores breathing within several minutes.
Mickie injected the Narcan twice into Anthony's leg, thrusting the needle through his blue jeans. He then pulled him from the car and administered CPR before a crowd of onlookers. By the time an ambulance arrived, Anthony was breathing again.
“I made sure I put that in my car, just in case,” said Mickie, a 21-year-old who had abused drugs for years. “Did I think I was going to have to use it? No, it wasn’t a plan. … You think you’re invincible, but thank God I did.”
Narcan, the brand name for the drug Naloxone, has been used by paramedics for decades to revive people overdosing on heroin, prescription painkillers and other opiates. But as heroin makes its own harrowing revival, many states, including New Jersey and Pennsylvania, have expanded Narcan access to nearly anyone willing to carry it.
Now, hundreds of addicts are being brought back from the brink of death by family, friends, first-responders and even fellow addicts who are carrying Narcan without prescription. These life-saving experiences give addicts another chance to get clean and leave rescuers with vivid memories.
“I can see his face; I’m scarred by it,” Mickie said. “It’s just such a powerful experience, seeing the life coming out of one of your best friends – seeing the life coming out of the face and their body.”
For Mickie, the experience helped scare him straight after repeated attempts to get clean. But for Anthony, like many heroin addicts, even a near-death experience initially was not enough.
“We went to the hospital,” Mickie said. “Once he was awake, he ran back out. He went and got high again.”
Heroin addiction is so gripping that such a story fails to stand as an anomaly.
The rate of heroin overdose deaths in the United States nearly tripled from 2010 to 2013, according to a study released earlier this year by the Centers for Disease Control and Prevention.
That news comes as no surprise to many in the Philadelphia region, where heroin addiction has ravaged hundreds of lives and families, ripping through both poor and affluent communities.
At least 800 people died of heroin overdoses in Pennsylvania last year, according to a state report, though some counties, including Montgomery, had not reported any data. Hundreds more died from overdosing on other opiates, including prescription painkillers like Oxycodone.
In New Jersey, at least 781 people died of heroin-related overdoses last year, the fourth straight year that total has risen.
To save lives, both Pennsylvania and New Jersey passed legislation permitting law enforcement officers to carry Narcan, available both as a nasal spray and an injectable. The laws also enabled "Good Samaritans" to obtain prescriptions to carry Narcan and established immunity for those reporting overdoses.
In an overdose, opioids like heroin kill by suppressing the respiratory system. In effect, the drug drowses the user, who forgets to breathe. Narcan works by essentially bouncing opioids out of the opioid receptors of the brain. Once administered – sometimes more than one dose is necessary – more regular breathing returns within five minutes and the drug user can be wakened. Time is of the essence, however, as brain damage can result in minutes from a lack of oxygen to the brain. Once the Narcan has been given, helpers are trained to call 9-1-1 and perform rescue breathing until EMTs arrive.
CVS Pharmacy pushed efforts a step further this fall by making Narcan available without prescription in Pennsylvania, New Jersey and 10 other permitting states. Now, nearly anyone can carry the antidote.
"That drug becomes your life. It becomes your monster, your demons. It becomes the love of your life. You get the best high from it. It's essential. It's a different kind of orgasm – without having sex." – Ashley Gibbons
“Even in the past nine months, it’s grown so much that people like me might be obsolete now unless [an emergency is] on your block,” said Chris O’Brien, an Audubon resident formally trained in administering Narcan. “Everybody has it.”
O’Brien, a 35-year-old carpenter who owns a catering company, never expected he would ever have to use Narcan. That changed when he received a 1 a.m. phone call on Jan. 14 from an unknown number.
O’Brien had taken a Narcan training class at the request of Patty DiRenzo, an addiction activist who lost her son, Sal, to an overdose in 2010. He began passing his number to strangers who might need help, many of whom he met while delivering leftover food to homeless shelters in Camden.
Now, a troubled waitress he had met needed his help. Her friend had overdosed in a West Collingswood Heights building that O’Brien described as “a place where you don’t want anybody to be.”
O’Brien instructed her to call 9-1-1, but being scared of prosecution, she refused. O’Brien hurried to the scene, dialing the three numbers on his way. He arrived to find a girl in overdose. Her breathing was shallow, her heartbeat sporadic.
Nervous that he wouldn’t remember how to administer Narcan, O’Brien said he planned to reread the instructions. But adrenaline took charge.
“I was so shaky and everything,” O’Brien said. “I just went off of memory and a little bit of power reasoning. I shot her in the arm. … As I was getting ready for the second one, she came [to].”
Paramedics arrived and gained control. O’Brien eventually returned to his car, where he broke down thinking about the lives of people who might have been saved if Narcan was more accessible years ago.
“I was crying when I got in my car,” O’Brien said. “I walked in like a tough guy. I walked out like the first time I saw the movie ‘Rudy.’ It was pretty intense.”
O’Brien received another phone call several days later. This time it was the victim’s parents, who informed him that the girl had detoxed and entered a rehab program. They agreed to meet once the girl got clean.
He hasn't heard anything since.
Narcan saves lives, at least momentarily, by reversing the effects of an overdose. But it does nothing to relieve the staggering hold that heroin has on addicts.
Many addicts, revived by the antidote, return to the drug, an anecdotal trend cited by several first-responders and recovering addicts interviewed by PhillyVoice.
Ashley Gibbons was no different. The 25-year-old Mays Landing resident relapsed several times after her mother, Alicia, used Narcan to save her in April 2014.
"That drug becomes your life," Ashley Gibbons said. "It becomes your monster, your demons. It becomes the love of your life. You get the best high from it. It's essential. It's a different kind of orgasm – without having sex."
“She was probably out eight to 10 minutes. Then we started to feel a pulse. Then she started convulsing on the floor. … I am very, very lucky to have had that – the Narcan.” – Alicia Gibbons, Ashley's mother
Despite the relapses, Gibbons said her near-death experience served as a wake-up call, pushing her to fight a drug she first tried at age 21.
Her battle has been difficult, but Gibbons has been clean for 60 days. She is working at a ShopRite, attending recovery meetings and establishing new friends. She slowly is becoming a mother again to her daughter.
“Finally, after all these years I can see a change in her,” Alicia Gibbons said. “She wants to be in recovery. She wants to go to school and have her life back.”
Her recovery has a long way to go, but Ashley remains grateful that Narcan awarded her another opportunity to continue that fight.
Ashley had been out of prison just a short time when her mother found her unresponsive in the bathtub at the family home, her submerged body a bluish-gray. Alicia’s boyfriend, Jose Vega, needed to kick down the locked door to reach her.
“At first, when I looked at her I thought it was too late,” Alicia Gibbons said. “She looked like she was gone. But I decided to do it anyway.”
The first needle Alicia inserted into Ashley's body snapped, but she persisted. Finally, after three shots, Ashley revived.
“She was probably out eight to 10 minutes,” Alicia said. “Then we started to feel a pulse. Then she started convulsing on the floor. … I am very, very lucky to have had that – the Narcan.”
Alicia struggles to talk about the incident, let alone return to the bathroom where it happened. Nevertheless, the family willingly has shared its story with several news outlets, including The Washington Post.
Ashley Gibbons said she wants others to see the horrors of addiction, urging them to avoid a drug she described as "literally the devil." She is not ashamed of her addiction, recognizing the experience introduced her to many people she otherwise would not know.
"As much as my life was ruined, I don't regret anything," Ashley said. "Things happen for a reason. Everything that happened brought me to where I'm at. I want everyone to see my story, to where it got me. I want people to see what I went through and what happened."
Mickie can relate to Ashley Gibbons’ struggle to stay sober. Two days after saving Anthony, Mickie went away to detox. It was far from his first attempt to get clean.
By his count, Mickie had been to 14 recovery houses, nine rehabs, three intensive outreach programs and two psychiatric wards on his road to recovery. But this time was different.
Mickie said he could no longer bear to see the disappointment in his family’s eyes. And nearly losing a friend to overdose sent an additional shock.
“It took all of that for me to realize that I really didn’t want to get high or drunk anymore,” Mickie said. “There’s life out there. I was alive – I wasn’t living. … Today, it’s just a totally different ballgame.”
Mickie has been sober for six months, the longest stretch since he first entered a rehab facility at age 18. He has a job at a retail distribution center, where he was recently honored as employee of the month.
Anthony, whom PhillyVoice unsuccessfully tried to reach, is now living in California, and has been clean for about five months, Mickie says. They talk about once a week.
“I’m just glad I was there,” Mickie said. “I’m glad I had it and I’m glad he made it."
