The pitch for my narrative, “8 minutes, 19 seconds: Inside one man’s dying body as Narcan molecules rush to reverse an overdose,” was simple. I’d write a millisecond-by-millisecond account of everything happening in the body on a molecular level when naloxone, the substance within a container of Narcan, effectively brings somebody back to life. The first expert I called quickly made me aware of how difficult this would actually be. When I asked how opioid molecules communicate with nerve cells, he found a gentle way to say, “I don’t know how to explain this in a way you’ll understand.” I got more people on the phone, and while trying to wrap my arms around phrases like “voltage-gated ion channels,” I also inquired about how fast naloxone travels when it’s sprayed into someone’s nose. No one knew off the top of their head. More coverage Everywhere they go, people ask for Narcan. But overdoses are increasingly hard to stop. Inside one man’s dying body as Narcan molecules rush to reverse an overdose Narcan’s maker, the Maryland-based company Emergent, probably had an answer. I called. I emailed. I emailed again. Nothing. I reached out to the U.S. Food and Drug Administration, which had approved the spray. A spokesperson said they had nothing to share. Nor did the fine print that comes with a box of Narcan. My narrative had the potential to reveal the inner workings of one of the most important substances on our streets and influence whether readers carried their own spray. I wasn’t about to write a sentence like, “That Narcan shot out real fast.” Furthermore, the story was inspired by two works of nonfiction and one novel: Luis Alberto Urrea’s “The Devil’s Highway,” Sebastian Junger’s “The Perfect Storm” and Tom Clancy’s “The Sum of All Fears.” Each work builds to a climactic scene where people’s lives are at risk, yet instead of rushing to show who, if anyone, survives, the authors slam on the brakes to detail how heat stroke destroys the body or what drowning feels like or the inner workings of an exploding bomb. San Diego State University was the last big school in the area where I hadn’t yet interviewed anyone. I reached out to their press office. Could anyone there at least tell me how to make my own speed test? A few emails later, a spokesperson sent directions to a lab. *** SDSU’s old engineering building sits atop a hill near College Avenue. In early November, I walked inside to meet Xiaofeng Liu, an associate professor of aerospace engineering, and two students in the same department, Evan Pruitt and Natalie Thiel. Inside the lab, sitting atop a tripod, was a camera. The machine was gray and boxy, like shoulder-mounted camcorders of old. But this was a Fastcam SA-Z, paid for by the U.S. Department of Defense, and it could shoot 2 million frames per second. To put that in perspective, iPhone video is generally 30 frames a second, meaning the footage is more or less made up of 30 still pictures. Slow-motion video comes from replaying high-rate footage back at “normal” speeds, like 30 frames. The more stills you have, the slower the slo-mo. Watching a single second of video shot at 2 million frames would take more than 18 hours. As a result, Fastcams can capture how individual droplets of liquid bounce off each other, intelligence that can help rockets burn fuel more efficiently. I was told the federal government considers that frame rate so sensitive that non-citizens are restricted from using it. (Photron, the company that makes the camera, primly notes on its website that “export restrictions may apply.”) We did not need speeds that high. Pruitt, a graduate student, started us at a mere 5,000 frames a second. The plan was to balance a container of Narcan on a metal frame, a few inches from the camera, so the spray passed the lens before landing in a tub. Somebody lifted a ruler to the nozzle. Knowing the distance molecules traveled would help calculate their velocity. Natalie Thiel, an SDSU undergraduate studying aerospace engineering, holds a ruler next to a container of Narcan in a campus lab on Nov. 1, 2023. (Blake Nelson / The San Diego Union-Tribune) The camera was connected to a computer. On a screen, the spray container’s rounded tip appeared as a black silhouette against a colorless background. Thiel, an undergraduate, stepped onto a ladder. Leaning over the tub, she gripped a Narcan container. Pruitt sat by the computer. They were ready. *** Around the same time, I was trying to witness a Narcan revival. I could have published just the science stuff and my story might have served as a helpful explainer. But I didn’t think readers would register the human toll at play until we showed a real person trying to save another. San Diego Union-Tribune photographer Ana Ramirez and I spent part of two days shadowing members of the Harm Reduction Coalition of San Diego as they carried Narcan into encampments. We followed a street health team from Father Joe’s Villages doing similar work downtown. There was a day with an ambulance crew in Santee and more than a week’s worth of ride-alongs in El Cajon with Heartland Fire and Rescue. Lots of people were helped. But no Narcan. Part of the issue may have been that naloxone has been so widely distributed that people don’t necessarily call 911 every time somebody stops breathing, although they should, because the spray wears off. I finally asked police departments if I could watch body camera footage of overdoses and interview the responding officers. La Mesa agreed. After reviewing several videos, I chose one incident in a suburban bedroom. While the homelessness beat pulled me into this topic, overdoses are obviously not restricted to encampments. *** In the lab, Thiel, the undergraduate, pushed in a long red cylinder on the spray container. Pfffffft. The naloxone bloomed into a cloud. Droplets flashed on the screen. Pruitt, the graduate student, replayed the footage. It was blurry. Plus, the nozzle wiggled. He went looking for a different lens. Others searched for ways to keep the container still. Somebody found a metal plate. Another grabbed a mottled vise. Zip ties appeared. A second container was tied to the plate that was gripped by the vise on top of the frame. Pffft. Pruitt watched the video and decided to up the frame rate to 20,000 per second. Natalie Thiel, an SDSU undergraduate studying aerospace engineering, prepares to spray Narcan in front of a high-speed camera in a campus lab on Nov. 1, 2023. (Blake Nelson / The San Diego Union-Tribune) A third container shot down. “This is better,” said Liu, the professor. The new image was clear enough to see naloxone forming waves in the air, the liquid rippling out from the nozzle and crashing in on itself. A fan inside the camera whirred as the group set up a fourth test. Pfft. “Wow,” Liu said. They were close. A fifth container was tied to the plate. “Ready,” Pruitt asked. Thiel hovered over the tub. “Set.” The fan whirred. “Press.” Pfffft. On screen, droplets appeared sharp and slow. We had it. https://wpdash.medianewsgroup.com/wp-content/uploads/2024/06/Narcan-Video-1.mp4