At a recent training at the Ketchikan Public Library, community paramedic Ben Watson began by explaining the biology of an opioid overdose.
“Opiates and opioids, there’s both — one’s synthetic, one’s natural-producing,” Watson said. “They’ll bind to your receptors.”
They both can be deadly. Watson went on to say that opioids bind to the receptors in the brain responsible for maintaining the respiratory rate. They can slow it enough to stop a person’s breathing entirely.
“The danger with overdoses is it inhibits your respiratory drive,” Watson said. “You slowly start breathing more shallow and less often, and so over time, you’re slowly suffocating.”
Alaska saw a record number of opioid deaths in 2023, but nonfatal overdoses declined at the end of 2024. The exact reasons for that are unclear, but could be thanks to harm reduction efforts like Naloxone distribution and education. That’s something that the Ketchikan Wellness Coalition has been focused on this spring through free monthly trainings that are open to the public.
Naloxone is an overdose antidote commonly referred to by the popular brand name Narcan. The life-saving nasal spray works by bonding more strongly to the same brain receptors as opioids, replacing the opioid and reversing the effects of an overdose.
The synthetic drug fentanyl, which is far more potent than other opioids, is driving the current opioid epidemic. In Alaska, organizations like Project Hope have distributed thousands of overdose reversal kits throughout the state. Several organizations in Ketchikan give them out for free, in an attempt to equip as many people as possible in the fight against fentanyl. Tara Taro works with one of those organizations, the Ketchikan Wellness Coalition. At the March 27 training, Taro said Naloxone is easy to use; there are just a few things to keep in mind.
“First and foremost, always call 911,” Taro said, saying that should happen even before administering the Naloxone.
“The thing that we really want to emphasize is that Naloxone is not a cure-all for an overdose,” Taro said. “It temporarily stops an overdose. You can go back into overdose depending how much drugs you have in your system.”
Watson, who works for the city’s Mobile Integrated Healthcare program, said to next look for the telltale signs of an opioid overdose: tiny, pinpoint pupils and shallow breathing.
“[If] the person isn’t breathing and their pupils are small, I mean, it’s very unlikely it’s anything other than an overdose,” Watson said.
Even if you mistake the signs, Naloxone won’t cause any serious harm.
“The good thing about Narcan is there’s not a whole lot of risk to administering Narcan to a patient who isn’t overdosing,” Watson said.
In fact, Watson said, there are “Good Samaritan” laws that legally protect anyone who is reasonably trying to treat an overdose.
Administering the Naloxone is fairly simple; it works like a single-dose nasal spray. Watson brought a medical dummy, inviting the trainees to practice using expired Naloxone.
“Two fingers up top, your thumb down below,” Watson said, pointing to a diagram demonstrating how to hold the cartridge. “And you’re going to have your two fingers resting up against the nostril of the patient.”
Taro emphasized always prioritizing your own well-being. Only approach a patient if you feel safe, and as soon as you administer Naloxone, back up, because that patient may become agitated.
“It may feel like to you that you are ‘I’m saving this person’s life, look at me go!’” Taro said. “They might not feel that way coming out of it. So they might not be happy that you took that high away.”
If possible, maneuvering the person onto their side could help them avoid choking on potential vomit. Taro said if you’re able to communicate with the person once they come to, let them know what happened and that you have called emergency services. But there’s a good chance they turn down those services.
Taro said more often than not, people who survive an overdose are not ready to seek treatment. But the point is to meet people where they are and give them that opportunity.
“If we can keep people alive long enough, hopefully they will make a decision for a better path,” she said. “And the only way we can do that is by providing these kits to as many people as we can, and letting them know that we are here for them in any way that they need.”
Watson added that he had just helped a patient sign up for treatment. He had been giving them Narcan on a weekly basis.
“So it does work,” Watson said.
He’s been in the medical field since 2017, and has seen a recent increase in compassion and investment in addressing addiction.
“I think there’s a lot more hope than there used to be a few years ago,” Watson said. “I don’t want to say it seemed hopeless or anything like that, but it was definitely more stigmatized, and there were less people who were getting involved in these types of programs. So I would like to think that things are getting better.”
The Ketchikan Wellness Coalition has another Naloxone training scheduled for May 28 at the downtown fire station at 3 p.m. Free overdose kits can be picked up from several Project Hope partners in town, including the police and fire departments, the Ketchikan Indian Community, and the Wellness Coalition.
