This post was originally published on December 22, 2014.
If there were ever a more deserving person to earn the label of “Unsung Hero” in 20th century medicine, you’d be pretty hard-pressed to find a more worthy candidate than Jack Fishman—at least for those of us in the addiction recovery community.
Dr. Fishman helped develop naloxone (commonly known as Narcan), the drug that blocks the effects of opioids and reverses an overdose, while working at the private pharmaceutical lab in the 60s run by Dr. Mozes J. Lewenstein. The drug is credited with saving literally thousands upon thousands of lives since its FDA approval in 1971, and has recently been made available to a wider range of non-medical personnel as America’s heroin problem escalates. December 7th marked the one-year anniversary of Fishman’s death, before which most people were not even aware of Fishman’s connection to the near-magical antidote.
But many in the addiction and recovery circles are certainly familiar with what the drug has meant in the prevention of overdose deaths from opiates. From 1996 to 2010, the Center for Disease Control credited naloxone with reversing over 10,000 overdoses between 2006 and 2010, a number which is probably grossly understated given the increased availability of the drug since that time. If you go to enough AA or NA meetings, you’re bound to hear a heroin addict tell the story of an overdose where he or she was brought back when the paramedics “hit me with the Narcan.”
Called a “miracle drug” by many, naloxone is an opioid antagonist that goes to the same place in the brain as the opiates hit and puts up a shield, which prevents the opiates from shutting down the vital respiratory and nervous system functions. The World Health Organization recently issued a release calling for countries to make the drug easier to obtain.
Long a staple of emergency room treatment for heroin overdoses, naloxone is now becoming increasingly available to first responders as well as ordinary folks like you and me. But unfortunately for Fishman and his business partner, this life-saving invention did not benefit them financially, as they were unable to acquire a second patent after the original one expired because of the expense. The pharmaceutical companies were then able to obtain the rights to manufacture and distribute the now-profitable miracle drug. Not surprisingly, as more and more police departments, state health departments and local community groups are stocking up on the naloxone kits to combat the rise in heroin overdoses, the pharmaceutical companies are jacking up the prices for the drug, which has spiked in cost by 50 percent in some markets in recent months.
Like many groundbreaking medical discoveries such as penicillin, anesthesia and yes, Viagra, Fishman’s creation came about largely by accident, while he was seeking a way to treat constipation caused by chronic opioid use. It still blows my mind that such a drug even exists, because it reminds me more of an antidote to a poison or spell that you might find in a Harry Potter or spy movie than a medical reality. But it’s real, and it works—really fucking well.
The police department of Quincy, Mass., which was the first in the nation to require every officer on patrol to carry Narcan reported, a 95% success rate with the treatment, according to the July 2013 newspaper account. From 2010 until the report came out, Quincy police had used Narcan 179 times, and reversed overdoses 170 times. In the cases where it didn’t work, five of the victims were already dead and four had other substances in their system, which the Narcan does not reverse, which means that it worked every time it was supposed to. Narcan is like magic, but it can’t bring people back from the dead. Since Massachusetts instituted a program in 2007 to train nearly 23,000 people how to administer Narcan, there have been more than 2,500 reported overdose reversals. So while it may not bring people back from death, it certainly prevents them from going there in the first place.
Despite his well-deserved hero status, and accounts that describe him as “humble and brilliant,” Fishman’s life was not without adversity. When he was only eight, his family fled the Nazi occupation of Krakow, Poland to Shanghai, China in 1930, before coming to the US when young Fishman was 18. And in a horrifying twist of fate, Fishman’s own stepson, Jonathan Stampler, died of a heroin overdose in Florida in 2004. According to a report, Jonathan had been clean for five years before he relapsed and suffered the fatal overdose. His girlfriend also overdosed on opioids a year later.
Still, Fishman’s legacy will continue to live on and grow as naloxone is more widely distributed to more and more community health agencies and increasingly made available to the general public. If you’d like more information on how to obtain your own kit for home or auto (where I keep mine), go to the StopOverdose site.
Photo courtesy of Intropin (Own work) [CC BY 3.0 (https://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons (resized and cropped)
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