“On that night, I was exhausted, so I started to see certain changes in my seizure disorder that wasn’t something that was of the norm,” he recalled. “I wasn’t aware of going into one because I normally have my seizures while I’m asleep. So I’m downstairs, and I’m helping out the family and I’m working with a blender to try and create a drink for my lady. And when I’m in the middle of trying to get it done, they said they heard a pattern that had changed—I was repeatedly pressing the blender.
“That’s not me, it’s not my normal routine. And I’m fading in and out. I remember her calling me, but I ended up dropping a blender on the floor and they hear glass shattering but they just think that’s a mild act.”
His family noticed it was the blender and sent Harrell upstairs for a break. Sitting down and falling asleep, he had a seizure—he doesn’t remember much else. EMS workers arrived on the scene. His partner, Toni Mitchell, said she explained the situation to them, mentioning that Harrell recently took medication to counteract his seizures. The responders told her they needed to flush any narcotics from his system. Mitchell, who worked as an ER medical assistant, told them he didn’t need naloxone, a medication used to stem opioid overdose, often sold under the brand name Narcan. The EMS workers applied it twice.
“Their whole interaction with me was a bit arrogant,” said Mitchell. “That’s why they weren’t really listening to me…it’s like they wanted to do what they wanted to do.”
They say the experience was frustrating, stigmatizing and traumatizing, especially for Harrell, a Black New Yorker boasting a straight-edge lifestyle due to an opioid-related family tragedy from his childhood. But medical professionals say the EMS workers’ administration of Narcan is routine, harmless and potentially life-saving—the medication is safe, even if opioids are not present according to the NYC Department of Mental Health and Hygiene. A leading substance use expert from Columbia University’s Mailman School of Health—who wished not to be named due to professional reasons—told the Amsterdam News that medical workers are trained to be safe rather than sorry when it comes to naloxone.
“It is embedded in the potential stigma and discrimination, so it’s a thorny situation, a complicated situation,” she said. “But if they administer Narcan, it wouldn’t cause harm, even if [the patient] didn’t have opioids in their system. It [could] save their life.”
She adds the due diligence is important in the event opioids are accidentally ingested or if medication or other narcotics are laced with them. Naloxone only works on opioids like heroin, fentanyl and prescription painkillers.
According to the NYC Department of Mental Health and Hygiene, some signs of opioid overdose include unresponsiveness, unconsciousness. and slow or stopped breathing. But these are also symptoms for other conditions, including Harrell’s seizures.
Dr. Edwin Chapman, a Howard University-educated physician and leading expert on the opioid epidemic, argues that a more conservative administration of naloxone for Black patients can cause even more harm.
“The timeframe is so short, EMS workers [have] to pretty much throw the kitchen sink at the patient so you don’t miss something inadvertently,” he said. “This whole circumstance could actually work counter to the African American culture if we are undiagnosed or under-suspected of overdosing [and] we’re not given Narcan when we could have.”
He’s seen the benefits of naloxone first-hand. According to the Washington Post, Chapman treated 275 opioid users a month in the majority Black neighborhood of Ward 6 in the D.C. area during the height of the pandemic. This year, he recalls reviving a trio of patients with Narcan.
“It was very difficult to resuscitate those patients, because all three of them had overdosed on fentanyl,” said Chapman. “It took six doses of Narcan to resuscitate those patients. And those patients looked like they were dead; we could virtually get no pulse. They stopped breathing. But because they were in the waiting room and we were able to get Narcan to them right away, it saved their lives. And they’re all alive today.”
Chapman later concluded, after consulting with multiple other experts—including a Howard University clinical pharmacist, an opioid treatment program medical director and an emergency room physician—that a unanimous, collective opinion is that “treatment with Narcan should never be withheld and is even appropriate when there is little or no corroborating history of opioid use.”
In 2015, the de Blasio administration made naloxone available at participating pharmacies without a prescription. Last year, the City Council passed legislation to provide Narcan supplies at nightlife establishments, as well as employee training for the medication.
For Harrrell, the frustration stems from the dismissiveness, especially given Mitchell’s long-time understanding of his seizures.
“You’re sending somebody who’s saying, ‘Well, it looks like he’s on some kind of narcotic, so we know how to handle this better than you,’” he said. “You have someone who’s clearly standing there telling you he doesn’t [use] and has never touched any kind of narcotic. So why would you say that he looks like [he did]? You’re basically putting him in a stereotype or in a category just because you feel this is the best location this person fits.”
Tandy Lau is a Report for America corps member and writes about public safety for the Amsterdam News. Your donation to match our RFA grant helps keep him writing stories like this one; please consider making a tax-deductible gift of any amount today by visiting https://bit.ly/amnews1.