By the time I was first dosed with naloxone—the drug that can reverse an opioid overdose—I had been using heroin daily for a year and a half. Not only was I psychologically addicted, I was also physically dependent. Being dependant on an opioid meant that when the naloxone hit, I wasn’t just able to breathe again; I had also been jolted into withdrawal.
It began as a wave of anxiety, so heavy and intense it crashed over my body like a physical force. I had also taken Xanax, a benzodiazepine that enhances the depressant effects of opioids and can inhibit the production of memories, and I don’t remember too much. I do remember shaking violently. It was the shaking of someone who had relinquished control of her body, and was succumbing to the force of precipitated withdrawal.
“Narcan parties” hit the news cycle in 2017 when media outlets like the Atlanta Journal-Constitution began reporting them as the newest scourge on their communities (the news story it cites appears to have been removed). The idea is that opioid users gather together, stocked up on Narcan (the main brand name of naloxone) and take turns intentionally overdosing and reviving one another. Believers of this myth theorize that people at these parties can “use the opioids to whatever degree [they] want,” attaining an optimal high with the safety net of being revived.
In these poorly reported stories, the parties tend to be corroborated by law enforcement personnel or emergency responders. There are seldom any direct sources—such as actual party-attendees who can confirm having been at one of these events. The accounts often lack direct comment from physicians or other addiction treatment providers, who could easily dispute the notion that, for example, naloxone will “give the drug users a rush,” as reported by WFXT Boston.
Yet the rumors have persisted. Narcan parties even made it into a controversial paper, published earlier this year, in which a pair of economists argue that from a quantitative perspective, “while naloxone has great potential as a harm-reduction strategy...it encourages riskier behaviors with respect to opioid abuse.” Like other recent reports of these parties, the paper acknowledges the lack of evidence supporting this rumor, but continues to argue that these parties represent a dangerous trend in which naloxone promotes criminal behavior and reckless drug use.
To people who favor this kind of thinking, reviving this particular population—drug users—means promoting continued criminality, since people who are addicted to illegal opioids are likely to keep using illegal opioids. Furthermore, the argument goes, naloxone makes the use of opioids more appealing because it decreases the likelihood of fatal overdose. Overall, there’s an underlying implication that the lives of drug users are not worth saving.
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The authors of the paper claim that some of the areas that distribute naloxone at higher rates are actually seeing an uptick in overdose deaths, a figure they argue is not mere correlation but actual causation. These conclusions indicate that users feel safer using drugs more recklessly, and doing things like throwing Narcan parties—“though it is unclear if or how often such parties actually occur” because of the increased availability of naloxone. From their report, it could be gathered that naloxone is linked to crime and death (the authors of the paper declined to provide comments for this story).
Some doctors who directly treat the populations that require naloxone, however, share a very different perspective. “From a medical and physiological perspective, [Narcan parties] don’t make any sense at all. The concept is really absurd,” says Ryan Marino, an emergency medicine physician and toxicologist with the University of Pittsburgh School of Medicine. “Getting narcan-d is very uncomfortable for people who use opioids regularly.”
“The [narcan party] story seems completely ridiculous and like another example of fake news and hysteria around people who use drugs,” agrees Sarah Wakeman, medical director of the Substance Use Disorders Initiative at Massachusetts General Hospital and an assistant professor of medicine at Harvard University. “First of all, someone who is actively using opioids on a regular basis would want generally to avoid the experience of being immediately thrown into acute withdrawal, which is what naloxone does...then people want to be comfortable again, which costs money and requires more opioids.” She feels that the idea that someone would intentionally want to be administered naloxone is “ridiculous.”
Precipitated withdrawal is a state of sudden, acute withdrawal that occurs when someone who is opioid dependent has their opioid receptors emptied. Daniel Oldham, a 39 year-old-interior house painter in Alabama, has been revived with naloxone three times. As he recalled of two of those times, he began to shiver. An uncanny cold flooded his body, seeming to rise from his own marrow. Sweat spiked from his temples, then his chest, then his limbs, until his whole body was damp and freezing. “The first thing that runs through my head is, ‘am I going to the hospital, going to jail, or can I see my dope man?’ It just nearly killed you, but you want more—you’re that sick,” Oldham tells me.
I can still remember speed-walking through the damp streets of Seattle after an overdose and naloxone revival, hyperventilating as I tried to get to my dealer’s chic downtown hotel as fast as possible. Naloxone only lasts about thirty minutes, but it hadn’t yet worn off, so I could still feel the chills of withdrawal sweeping across my skin, and a craving for heroin so intense I could taste it, sickly, raw, and empty. I didn’t want to die, and I certainly didn’t want to be revived with naloxone again—that was not my hope, nor even a reassuring thought, even once during my nine overdoses. I just wanted relief. If I had ever been invited to a Narcan party during my active addiction, I would have vehemently declined.
What then of the idea that distributing naloxone creates more crime by allowing people who engage in criminal behavior to live longer? Certainly both Oldham’s account and my own support that theory—after all, didn’t we just go and score more dope the first chance we got?
“Society fundamentally doesn’t value the lives of people who use drugs,” Wakeman explains. “The idea that we would try to save the life and keep someone safe without the explicit goal of stopping them from using drugs is hard for some people to wrap their heads around.”
Addiction is a complex medical condition determined by a person’s unique genetic and environmental factors. It is defined as “compulsive drug use despite negative consequences.” One of those negative consequences includes the threat of death. This means that, while some people do become so frightened by an overdose they are able to immediately stop, most people can’t. Research has shown that, when it comes to opioids specifically, addiction therapy drugs such as methadone and buprenorphine are the tools that have the highest success rate.
Without prompt access to these medications, overdose survivors are likely to continue using, even if they don’t want to. It might be true that naloxone technically leads to further criminal behavior by allowing people to survive and continue taking illegal drugs, but that truth bears only a sociopathic relevance—and works to reinforce a lack of empathy for people who use drugs that our nation has chosen to criminalize.
If these drugs were decriminalized, or if people who survived overdoses had better access to low-barrier addiction treatment, naloxone would no longer be seen as “promoting criminal activity.” It would simply be seen as promoting life.
And promoting life is exactly what Lisa Smith, a North Carolina machine operator, wants to do—she attends actual narcan parties, which are community organized events to promote harm reduction. “[It’s] like a tupperware party but with Narcan,” Smith explains, a chuckle in her voice. “They set up tables and we work together making naloxone kits that will go to the harm reduction coalition.”
Nobody is using drugs; in fact, Smith doesn’t know much about drugs at all. She became involved with harm reduction because she wanted to help spare other families the ineffable pain she has lived with since December 2016, when her son died of an opioid overdose.
“I never thought he would do heroin. He was a smart kid, he went to college. He was trying to find a job,” Smith says. Now, Smith tries to get as much naloxone into the world as possible. “My goal is to end the stigma,” she says, adding, “shame on me for thinking it’s something that’s just done in a dirty alleyway. It’s not. I’ve met so many wonderful people with open arms.”
“I just can’t stress the importance of naloxone,” Marino says. “At the end of the day it boils down to the fact that some people are okay with some people dying. If that’s someone’s position, there’s not much you’re going to be able to say to those people.”
Of course, “Narcan parties” aren’t the first example of myths spreading around a stigmatized population. More recently, several law enforcement officials have claimed that they were contaminated by touching powdered fentanyl, despite that being next to impossible.
It’s become part of the conservative media narrative to dehumanize people who use drugs by spreading rumors about distinctly aberrant behaviors—cannibalizing people while high on bath salts or lacing marijuana with fentanyl in an attempt to kill teens, for example. Until very recently, it was normal to hear politicians label people with substance use disorders as immoral fiends deserving of punishment, and although that narrative is slowly changing in favor of a medical approach, the old drug war rhetoric still poisons how the general public feel about drug users.
Perhaps someone heard about a party similar to the kind Smith attends, and drew their own conclusions from the name. Or maybe a parent caught their teen using drugs in their room with Narcan sitting out on the bed. Whatever the origin, it’s clear this myth is based less on reality, and more on fear about drug users; leaving this community even more vulnerable until this narrative is addressed.