The opioid overdose-reversal drug naloxone has enabled first responders to save lives, but while the drug provides a safety net, said AMED Executive Director Gary Watters, it doesn’t always work.

Naloxone doesn’t bring people back from death, Watters said.

“You need cardiac activity and blood circulation for it to be able to work,” he said.

Naloxone attaches to opioid receptors and reverses and blocks the effects of an overdose, according to a National Institute on Drug Abuse web page.

Naloxone prevents people who have overdosed from going into cardiac arrest, Watters said.

It’s a strong drug itself, with the dosage distributed to regular individuals much higher than the dosage administered by ambulance crews, he said.

Those who pick up naloxone to have on hand in case they or someone they know overdoses receive a prepackaged dose of 2 milligrams, Watters said.

Ambulance crews, on the other hand, give 0.5 milligrams because they can manage a patient’s airway.

“We breathe for them,” Watters said, through a bag valve mask.

The lower dose allows crews to mitigate the violence of withdrawal symptoms for patients, he said.

“It’s more placid our way,” Watters said, noting a person who has been saved by naloxone may experience agitation, fighting, vomiting and aspiration of vomit into the lungs.

“(Naloxone) itself is safe, but some of the things it’s reversing are not necessarily safe,” he said.

The violence occurs because people are hypoxic, or short of oxygen in their tissues, not lucid and they’re desperate for air, Watters said.

Sometimes, crew members arrive at scenes in which the participants have made special arrangements to avoid a crisis, Watters said.

In such cases, members of a group assign one of the group to refrain from using — and to be ready with naloxone to revive anyone who overdoses, he said.

But sometimes that member ends up using, too, he said.

“Now you have three unconscious patients,” he said.

The biggest recent concern has been the lacing of fentanyl into other drugs, Watters said.

Experienced drug users generally know what they can handle, but they can get into trouble when they get a packet that includes fentanyl, he said.

“Next thing you know, they’re unconscious,” he said, and it happens not only with users of heroin, but also meth.

Once a patient is stable, AMED crew members conduct screenings to see whether they use drugs or alcohol, and, when appropriate, refer them for treatment, Watters said.

To accept treatment, they need to be “at the mindset where they want to,” he said.

Responding to overdoses can be frustrating for ambulance crews, who often revive the same people several times in a month. There have been cases where the same person was revived more than once in the same week and even in the same day.

Still, “you need to realize that many people need that safety net, because (addiction) is a horrib(ly difficult) habit to break,” Watters said.