Interview With Amanda Cowan, Director of Outreach

What is Narcan?

Narcan the branded nasal spray containing Naloxone. Naloxone is an opioid antagonist meaning it displaces opioids that are sitting on the receptor site thereby reversing depression of the central nervous system

How has Narcan impacted the ongoing opioid epidemic?

As Narcan is a nasal spray I believe more “lay people” are less intimidated in its application and thereby willing to be trained and carry it on them. As more and more non opioid substances are contaminated with opioids (such as fentanyl), people have been carrying Narcan that previously may have not felt a need to be trained/carry.

What are some common misconceptions about Narcan?

That it is the same category as MAT, that it is self-administered, that it can be “abused”. Narcan is schedule 0 (no “abuse” potential, it will not do anything if someone does not have opioids in their system), folks overdosing slip into unconsciousness and cannot self administer Narcan and lastly, it is not a medication for opioid use disorder.

Over the past 3 years at CLARE | MATRIX, approximately how many people and/or agencies have you trained to administer Narcan?

I am unsure of the count, but somewhere north of 4000 or 5000 people.

What have been some of your biggest challenges related to your outreach and overdose prevention efforts?

Challenges have come from many arenas- areas that do not see their work as intersecting with substance use, providers who have been unwilling to embrace harm reduction, stigma which then hampers educational opportunities.

What would you consider your biggest successes related to your outreach and overdose prevention efforts?

Lives saved.  Getting a text/call/email that someone used the Narcan to save someone’s life.  Additionally, having an opportunity to discuss substance use to varying groups/audiences and engage in a dialogue.

What other agencies do you partner with and for what purpose?

A long list! Anything that intersects with people who use drugs so that means every and any agency that provides any services to anyone. So, this includes medical, housing, social services, education, food, libraries, etc.

Are you involved with any local government agencies? If so, tell us about it.

I have the honor of representing Supervisor Sheila Kuehl as a commissioner for the 3rd district on the commission for Alcohol & other drugs.

Why are community-based approaches important in the substance use and behavioral health treatment field?

By and large, community organizations know their participants and understand the needs of the population.  Substance use is not homogenous and looks different in each community- and the modalities we use need to be individualized and catered to those we are working alongside.

How have your Narcan trainings developed and/or strengthened community partnerships?

Narcan trainings have provided the space to change the narrative around substance use, to allow for people to ask questions and engage in intentional dialogue.  When people have Narcan or completed a training it provides the opportunity to be actively engaged in community care, not just a passerby.  You now have a tool to take care of another person.  For many, this is a deeply humanizing experience. So with that, we naturally strengthen community partnerships; people are curious, want to engage and ensure we are all utilizing our shared resources as best we can

What would you consider some of the areas with the most potential for growth and progress in the field? For example: Harm reduction.

I am excited to begin seeing change- it is slow and incremental but still worthy of acknowledgement and celebration.  Expansion of harm reduction services, including funding streams, development of technology to detect overdose, systems changing.

How should Narcan be distributed or made available to the public different than it is now?

If it was up to me, Narcan would be in every building, the Rx would be removed and the bulk of it would be in the hands of those who use drugs/are most likely to witness an overdose.

There are still common misconceptions or aversions to certain harm reduction and overdose prevention efforts – Do you see these tensions easing in the future?

I certainly hope so.  Everyone should be treated with dignity and respect; irrespective of if that person engages with substances.  Harm reduction is standing with that person and saying “you matter”