In her mind, Gail Box visualizes prescription drugs as a hand, reaching out and getting a hold of her son.
“That hand reached out, and it comforted him, it made him feel better, it made his pain go away — and then that hand would not let go of him,” she said. “I know he did not set out to die of an overdose, but he couldn't shake that hand off.”
Austin Box died in May 2011 of a drug overdose. He recently had finished his degree and would have been the University of Oklahoma's starting middle linebacker that year. He was 22.
To this day, Gail Box wishes she would have said something to her son. Call it a mother's intuition. She knew something was wrong.
She hopes that a law that went into effect Nov. 1 will help parents aid their children before they have their own tragedy.
House Bill 1782 allows a medical provider to prescribe an opiate antagonist to family members of someone who has a chance of overdosing.
One of the more common types of an opiate antagonist, which counteracts the effects of narcotics, is naloxone.
A naloxone injection works by blocking the central nervous system effects of several types of opiate medications such as morphine, oxycodone, methadone or illegal substances such as heroin, according to the National Institutes of Health.
It's used to prevent or reverse the effects of narcotic overdose, including difficulty breathing, sleepiness, low blood pressure and death, according to the National Institutes of Health.
Gail Box said she knows it can be difficult for parents to have conversations with their children about drug use.
But parents should consider talking to their children and also carrying naloxone if they think it could help save their children's lives, she said.
“I wish, if I could go back, I would try to act on those feelings that I had at that time,” she said. “You can tell me anything you want, but I will always shoulder a great deal of guilt as a result of what happened to my son because as a parent, as a mother, it's my job to protect him, and I didn't.”
House Bill 1782 also allows first responders — law enforcement, EMTs and firefighters — to administer naloxone without a prescription to people who are showing signs of an opiate overdose. Before the law passed, first responders were required to have a prescription from a doctor to carry the drug.
State officials still are working out the details of how first responders will be trained to use naloxone.
Targeting more than chronic abusers
Terri White, the commissioner of the Oklahoma Department of Mental Health and Substance Abuse Services, said although the law is targeted at people who are struggling with prescription drug addiction, not everyone who overdoses is a chronic abuser.
“There are people who have complete unintentional overdose who think they're taking the right amount of pain medication, or they legitimately have a prescription but it's not working so they take a little bit more,” White said. “This can also be critical in saving lives of people who are trying to use their pain medication appropriately.”
The law comes at a time when Oklahoma continues to see high rates of prescription drug abuse and overdose deaths.
Oklahoma ranks among the top five states with the highest rate of prescription overdose deaths. And prescription drug abuse is one of the fastest growing types of drug abuse in the state.
Prescription drug overdoses kill more people in Oklahoma than car accidents.
Oklahoma leaders plan to release the state's strategy for combating prescription drugs in the next few months.
“It's really good that we're addressing this now as opposed to 10 years from now,” White said.
Before House Bill 1782 passed, naloxone was carried on many, if not all, paramedic ambulances and fire engines across Oklahoma, said Dr. Jeffrey Goodloe, the medical director for the emergency medical services system for Oklahoma City and Tulsa metros.
However, the law expands who can administer the drug. That's where Goodloe's concern comes in. Goodloe said he's concerned about whether people who aren't trained in medicine, such as law enforcement officers, will be able to deliver the drug appropriately.
“The first tenet of medicine ... is do no harm, so in the process of helping people, we take an oath not to purposely harm them, and my concern with this bill is that, while its intent is nothing but admirable, the end result is I truly believe we will harm some people in fully executing its authority in the commission of trying to help people,” Goodloe said.
Goodloe said when people are given naloxone, they can wake up into a life-threatening withdrawal situation, suffering from horrific vomiting, extreme sweating and dangerously high heart rate and blood pressure.
Not every person given naloxone will go into this type of withdrawal, he said. However, it does occur.
“The takeaway point on this bill is, that it's the right drug, but it has to be given to the right person at the right time in the right amount by someone with the right training,” Goodloe said. “Naloxone is not a (harmless) drug. That is a gross misunderstanding of this drug.”