The man in front of me is almost dead. His lips are blue. He isn’t breathing. His eyes are half open and still. His arms fall limply off the stretcher, and he doesn’t flinch as needles are threaded into his veins and his clothes are stripped away. His wife is wailing in the doorway.
His pulse—a barely palpable flutter beneath my fingertips—is the only indication that something might be done. We have only a few seconds to act before the faint, fast rhythm slips away entirely and he is gone. Irreversibly. Irretrievably.
We secure a syringe to his IV, we push the plunger, and we wait.
He coughs, he flails, then screams and kicks. He rips his IV out and tumbles to the floor: wild, naked, and incoherent. He is in agony. But he is alive.
This is Narcan. This is the scene that plays out daily in my emergency department at a community hospital fighting for lives deep in the heart of opiate country. We have only a few tools to combat the overdoses that will take more lives this year than car accidents or guns, and Narcan—the opioid reversal medication also known as Naloxone—is the most effective. A spray up the nose, a shot in the thigh, or a push through an IV and within seconds: a miracle. The dead live. A sin is forgiven. The hopeless receive hope. For a Christian doctor, Narcan looks like grace in a syringe.
As our country slips deeper into an epidemic that President Donald Trump declared a national emergency on Thursday, the debate around Narcan for opioid overdoses has surfaced as a unique pro-life issue. While this medication has the power to prevent the majority of opioid deaths, its efficacy relies on it being administered quickly, within minutes, to an overdose victim. But getting it into the hands of those who are most at risk and the first responders that are often nearby has proven difficult, and though it has been proposed as one of the pillars of a national plan to combat the opioid epidemic, its adoption has been slowed by the ever-increasing price of the medication, accessibility to those who need it, and the stigma surrounding opioid use and addiction.
Communities overwhelmed by opioid abuse have proposed limiting the number of times this life-saving medication will be administered by emergency services, forcing the victims to pay for it themselves, or just refusing to carry it altogether. Others, including senators and lawmakers, have asked the question of whether or not saving “drug addicts” is worth the resources, especially as many require multiple resuscitations over the course of their struggle. Still others ask if the knowledge that a rescue medication is nearby increases the risk-taking behavior of opioid addicts, making them more likely to abuse the drugs and worsening the risks to the public. As the tragic ramifications of abuse—like intoxicated drivers, opioid-addicted newborns, and shattered families—incite outrage across the nation, the question has been asked: How many resources should we devote toward a disease that is, at least in part, self-inflicted?.
But as the controversy has increased, so has the response of the church. As we face yet another year of skyrocketing opioid deaths and ask ourselves why we are losing an entire generation when we have the antidote, many Christian organizations—desperate to heal the wounds of their communities—have begun to augment their recovery outreach and relational ministries with Narcan distribution and training. Narcan has become the new compassion ministry.
David Stoecker knows why. After 24 years of opioid abuse, countless stints in rehab, repeated efforts at 12-step programs and trying “just about everything else” to get clean, Stoecker found Jesus. “I had some people who loved on me,” he says. “I was a troubled kid, I had a lot of abuse when I was younger. My dad passed away from suicide, and with opioids I finally found something that I could use to escape. I was a really annoying atheist. I liked to belittle Christians. But after a couple times of them inviting me to church, I finally gave in because they offered me live music and BBQ after church. And I like to eat.” Stoecker says that he attended Sunday church services and Celebrate Recovery meetings for six months because of the relationships he was forming. “Then one night, I offered up a foxhole prayer and made a bunch of deals with God. That was eight and a half years ago, and I haven’t used since.”
Stoecker raised his education level from a GED he completed in prison to a master’s degree in social work. He has since started two nonprofit recovery organizations and become the state advocacy and education coordinator for the Missouri Recovery Network. He distributes Narcan to community organizations throughout the state and trains everyone from pastors and outreach workers to the family members of substance abusers how to recognize an overdose and save a life. “When a pastor or a Christian asks me, you know, ‘Why do I need this?’ I tell them, ‘Because dead people don’t get saved.’”
Narcan, he says, keeps people alive long enough to engage in the community of the church, to hear the gospel, and to obtain the resources needed to overcome their addiction. Though 47,000 people died as a result of opioid overdoses in 2015, another 26,000 lived because Narcan was administered in time. As of 2016, 33 states have passed Naloxone Access Laws which make it possible for third party organizations to distribute the medication without a prescription, and Christian organizations around the country have taken it upon themselves to put this lifeline into the hands of those who need it.
When Holy Family Catholic Church in Cincinnati, Ohio, was approached by the attorney general’s office about distributing Narcan in their neighborhood, operations director Jeremy Bauer jumped at the chance. “I hadn’t seen an overdose in three years,” he said, citing his previous career at a substance abuse rehabilitation facility as the last time he had witnessed that type of emergency. “Then suddenly, within a month I saw three: one while I was looking out the window of our pastor’s office, one while I was at a restaurant with my kids, and another while I was walking down my street. So when they called me a week later and offered 70 units of Narcan, I thought This is God.”
Bauer provided CPR and hailed emergency services for the overdoses that happened in front of him but decided to set-up a Narcan booth at their yearly church festival to aid in the overdoses that were happening behind closed doors. “There was no big sign. The booth was in a high-traffic area right by door to the church where meals were being served. We had trinkets for the kids and free water bottles.”
He says that out of concern that people would be afraid to be seen approaching a Narcan booth, they chose to keep it unmarked. “We would start conversations, ask people how their day was going, and then in the course of things ask if they had ever heard of Narcan, if they were interested in learning how to use it or taking some home.”
All 70 units went home with community members and he says that he believes the state chose them because they knew that the church was a staple in the community. “Everyone within our neighborhood is our concern, whether they are a member or not.”
For a church that feeds the hungry, houses the homeless, and clothes the needy, giving Narcan to the opioid addicted was a natural next step.
While Narcan is not a solution to the problem of opioid use, it can be a cherished source of security for those struggling with their addiction and the people who love them, and because prescription opioid abuse has become a gateway for people of all ages and strata of society to develop addictions, most churches in America will be caring for someone affected.
In a letter to President Donald Trump asking him to declare the opioid crisis a national emergency, the Commission on Combating Drug Addiction and the Opioid Crisis proposed multiple steps to decrease the flow of opioids onto the street as well as to improve access to care for those already suffering. In addition to rapidly increasing our capacity for addiction treatment, improving law enforcement’s ability to share information across state lines, and educating physicians on appropriate prescribing patterns and alternatives to opioids for pain control, the commission recommended increasing access to Narcan in all states and improving the Good Samaritan laws that allow bystanders to report an overdose without fear of being prosecuted for drug-related charges themselves.
We as a country are diving headfirst into recovery efforts, but with 2.5 million of our neighbors currently addicted to either prescription opioids or heroin, the likelihood that people in the pews and those drawn to recovery ministries are still actively using opioids is high.
While the goal for most users attending recovery programs is to get clean, the process is extremely difficult. Because opioid use permanently changes the structure and chemistry of the brain’s reward and pleasure systems and the body’s perception of pain, withdrawal is excruciating and the rate of relapse is exceptionally high: around 90 percent despite the most effective therapies. Overdoses happen most frequently when an addict relapses after a period of abstinence because their body’s tolerance to the drug drops substantially, and the same dose that may have only barely touched their pain previously is now lethally potent. The drug depresses the user’s respiratory and central nervous system so much that they stop breathing, and the resulting lack of oxygen quickly leads to brain and vital organ injury and minutes later to cardiac arrest. This means that one of the most lethal periods in an opioid addict’s struggle—the time they are most likely to overdose—is when they are trying to get clean.
Repeated studies have borne out that having Narcan available and nearby does not increase risk-taking behavior in opioid users and in many cases decreases it. “I tell people it’s like a fire extinguisher,” Stoecker says. “I don’t have a fire extinguisher in my house because I want it to burn down, but I do have it there just in case.”
Despite the challenges, recovery can happen, and the church is in a prime position to lead the charge. In a recent TED talk on the misconceptions surrounding addiction, British journalist Johann Hari postulated the evidence-based theory being adopted by many in the field of addiction medicine and psychology today: that “the opposite of addiction is not sobriety. It’s connection.”
If the Christian church has anything to offer those hurting from opioid addictions, it is connection: connection to a community, connection to resources, and most critically, connection to a God who saves. Through relational ministries like Celebrate Recovery and Narcotics Anonymous, users can find the social connections they need for support. Through practical ministries like prison outreaches, rehabilitation homes, and homeless missions, users can find the tools to reclaim their lives. And the fellowship of congregations that are willing to pursue and love upon those with a disease as complex and spiritually entangling as substance abuse, the millions beside us ensnared by opioids may find the God who loves them no matter what. America’s recovery can find roots in the church.
But an addict cannot recover if they die first. “Giving someone Narcan is meeting them where they are,” Stoecker says. “I’ve had Narcan used on me three times. It’s saved my life and now I have two amazing children, a beautiful wife, and a ministry.”
Christ, he says, is the reason for his recovery, and the grace of a church family was how he found Christ. But the grace he found in a syringe of Narcan was how he lived long enough to get there.
Lindsay Stokes is an emergency physician in Pittsfield, MA, which has the fifth highest rate of opioid prescription abuse in the nation according to Castlight Health.