“I can’t wake him up!” The mother says as we come into the bedroom. Her voice and hands are shaking. “He was fine when I went out for groceries. Now he won’t respond.” She is crying. “Honey! Honey!” she says.
Her son lies limply back on his bed, breathing only about four times a minute. He is wearing a New York Knicks jersey and has a few days growth of beard. There is a long scar on his shoulder. He looks to be about twenty years old. “What drugs does he use?” I ask as I check his pupils. They are pinpoint. “Pills? Heroin?”
“No,” she says. “He doesn’t use drugs. He just came home yesterday from college for the holiday. He doesn’t even drink anymore.”
My partner hands me the ambu-bag. I place the mask over his mouth, tilt his head back and squeeze the bag, sending oxygen into his lungs. When he doesn’t respond after a few breaths, I have my partner breath for him, while I put an IV in his arm. Our monitor shows his oxygen saturation is low and his carbon dioxide is dangerously high. I take the naloxone out of my med kit, draw up a small amount in a syringe and slowly push it through the IV. In a matter of moments, the boy’s respirations pick up, his carbon dioxide drops as his oxygen rises. I no longer have to breathe for him. Two minutes later his eyes open and he looks about with a start. “It’s okay,” I say. “Rest, you overdosed. We had to give you naloxone. You’re not in trouble.”
He swears and lays his head back down. “I just used half a bag,” he says. “I can’t believe this.”
“Rest,” I say. “It’s okay.”
He tells me the story. He just broke up with his girlfriend and when he met the guy who used to sell him drugs before he went to rehab after his junior year, he let his guard down.
While my partner helps him find his shoes, I go into the hallway where his mom is still with the police officer. “He’s fine,” I say. “He’s alert and breathing. We had to give him some narcan.”
“He overdosed?” She says. “That can’t be!”
“His pupils were pinpoint. He wasn’t breathing well. We gave him a little naloxone and he came around. He’s talking to us now. You should have naloxone in your house. Do you know where to get it?”
“But he doesn’t use anymore. He went to rehab. He’s been clean for almost two years. I was just talking to him. He’s been doing great.”
She isn’t the first mother who has been shocked to find her child has overdosed. I explain to her that she shouldn’t be upset with her son. Two years of not using is something to be proud of. Relapse is not unexpected. If he made it two years, he can do it again, and maybe even longer, but she needs to have naloxone in the house just in case. I tell her how to recognize an overdose and where to get naloxone and how to use it. Then I take her in to see her son. She sits beside him on the bed and hugs him.
“I’m sorry, mom,” he says.
“It’s okay,” she says, tearfully. “I’m not mad at you. You’ve been through alot. You mean everything to me.”
On the wall there is a picture of him in a wrestling singlet and a medal around his neck. His parents are standing proudly on either side of him.