SALT LAKE CITY — Sam Plumb and his sister Jennifer Plumb usually meet beneath the plum tree.

They planted it in honor of their brother, Andrew. He died 19 years ago after heroin slowed his breath and stilled his heart, and his friends left him for dead in a basement, taking the drugs and the evidence with them.

At the time, Jennifer Plumb said, a paramedic looked at her and said, "Gosh, I wish he would have had naloxone."

"That got stuck in my head," Plumb said.

Back then, naloxone was a powerful overdose rescue drug that few people knew about besides EMTs and hospital workers.

But now an increasing number of doctors, pharmacists and recovery advocates are trying to get naloxone kits — and the power to reverse an overdose — into the hands of family, friends and even strangers.

Utah, which has the fifth-highest rate of drug overdose deaths in the country, joined the battle last year after lawmakers passed a bill that permits people to administer naloxone to someone they believe is overdosing.

Jennifer Plumb, now a pediatric emergency medicine doctor at Primary Children’s Hosptial, lost no time co-founding Utah Naloxone with her brother to start coordinating the purchase and handout of naloxone kits.

Since July, Jennifer and Sam Plumb have given out more than 800 kits, resulting in 11 confirmed overdose reversals.

In their eyes, that's 11 second chances.

"Nobody's going to recover from addiction if they're dead," Sam Plumb said. "Naloxone gives them that chance."

* * *

When Calvin Harrison woke up, he was bleeding and disoriented, his body wracked with sweat, his brain going a million miles an hour. Shaking from pain, Harrison blinked and looked up at the lights of the church bathroom where, moments before, he had injected heroin and cocaine into his ankle.

At 22 years old, Harrison was alive, but just barely.

Naloxone had brought him back.

Harrison, who grew up in a comfortable home with a loving mother, has struggled with addiction since he was 17. It started with Xanax for his sleep problems, then quickly progressed to OxyContin and heroin.

His mother, Rebekah Harrison, got a kit from Utah Naloxone and now keeps it above her refrigerator. The two small vials of clear liquid are a comfort.

Naloxone, often referred to by its brand name, Narcan, works by kicking the opiates out of the receptors in the brain. It's effective — the person who is overdosing starts breathing again, but he or she also starts feeling the pain of withdrawal almost immediately.

Now available in a nasal spray as well as in an injection format, naloxone is also notable for its safety. Even at 700 times the recommended dose, it produces no negative effects.

“Yes, I would use it. I have no doubt. I would use it on a stranger. I would step in because … I'm telling you, everyone has an addict in their family,” Rebekah Harrison said.

Last year, the bill to pass naloxone sailed through the Utah Legislature. The sponsor, Rep. Carol Spackman Moss, D-Salt Lake City, said she had several relatives who died after overdosing.

Utah joins a growing chorus of states that have changed their laws in recent years to expand access to naloxone. According to the Robert Wood Johnson Foundation, the number of states with naloxone laws doubled between 2013 and 2015. Some, such as California, have allowed pharmacies to dispense naloxone without prior approval from a physician.

But the program, which has been embraced by harm reduction advocates, has been challenged by others.

"I really don't think it's a good idea," said Jason Kern, an EMT with Gold Cross Ambulance. "That gives people license to take pretty large amounts of opiates because they believe their friends will save them."

Kern worries that people will treat owning a naloxone kit like having a designated driver at a party.

Already, he said, EMTs have seen people using naloxone instead of calling 911 because they “don't want police, they don't want EMTs, they don't want to be bothered because they fear being incarcerated or being in trouble. But you're talking six to eight minutes before they start getting brain cell damage."

The drug is extremely effective at pulling people back from the brink, Kern acknowledged. But it doesn't prevent people from returning to drugs again and again. The majority of people he's rescued with naloxone have been repeat users, some of them on their ninth or 10th overdose.

Calvin Harrison is one of those people. He's been brought back by naloxone seven times.

But, he said, anybody who thinks drug users will feel safer because they have naloxone doesn't understand the core of addiction.

Every time he prepared a hit, Calvin Harrison said, he knew he was probably going to die. Naloxone or not, he slammed the speedball into his veins anyway.

"When you're in your addiction, death does not matter," he said. "You look at the bright side of death — if I die, at least I don't have to deal with addiction."

Calvin Harrison said he believes every household should have a naloxone kit. For all the times he didn't think he was worthy of living, he was glad someone else did.

* * *

By early next year, people may also see naloxone kits being distributed at each of the University of Utah's 10 community clinics and Intermountain Healthcare's 25 community pharmacies.

The decision came after “a lot of discussion about the pros and cons,” according to Buck Stanford, Intermountain's community pharmacy operations director.

"Really, what it comes down to — what I would say personally — (is) what is a life worth?” he said.

Right now, patients need a prescription from a physician to obtain naloxone with Intermountain, but Stanford said they hope to relax those rules with something called a collaborative practice agreement. That will involve working through legal issues with the Utah State Board of Pharmacy and state medical boards, but what it means is that patients might one day be able to walk in and get a naloxone kit without a prescription in hand.

"What we learned is that when you need the kit, you need the kit," Stanford said.

Doctors at the University of Utah are considering a similar idea. Right now, David Anisman, a family physician who is one of the leaders of the project, is proposing that any patient who is prescribed painkillers of a certain strength should be educated about naloxone and offered the opportunity to get a kit.

“It just seemed logical to me to make this product available,” Anisman said. “Do we want to lower their risks or just tell them, ‘Hope you get to the ER in time?’”

Anisman is less certain about wider distribution of naloxone to the public, with an eye toward use on illegal drug users — what Sam and Jennifer Plumb are working on, essentially — but he said it was an “outstanding social discussion that needs to happen."

For Sam and Jennifer Plumb, the time is now.

Their Facebook page is full of moms and concerned friends asking where they can get the kits, whether they were available at CVS and when they will be restocked.

Through a Utah Commission on Criminal and Juvenile Justice grant, they are buying kits and distributing them through partners such as the Apothecary Shoppe in Salt Lake City and the Veterans Affairs Medical Center Pharmacy. Once or twice a week, they also go out into Major Street or Pioneer Park, strike up conversations with the homeless and tell them about naloxone.

At Pioneer Park on Monday, the Plumbs are handing out Subway sandwiches and naloxone kits, standing under the very tree that bears their brother’s name.

"Oh, so you muscle it?" said one man with a hoodie pulled over gray hair.

"Yup. It's like this, right?" Jennifer Plumb said, showing the man a picture on the kit. "That's the spot you're going to inject it. Arm, thigh, butt."

Once the naloxone bill was signed into law last year, it became legal for Jennifer Plumb and any physician with prescribing authority to prescribe and distribute naloxone kits to people.

The man spoke a little about his kids, a little about his addiction, and then asked about “the cops.”

Nodding, Sam Plumb explained that naloxone is legal for anyone — even strangers — to administer to someone they believe is overdosing. The law provides immunity for those who administer naloxone in good faith, he said.

"You can't get better if you're dead, right?" Sam Plumb said.

Out here, explained Katt Roberts, gripping four naloxone kits and a Subway sandwich that the Plumbs had given her, "We're the first responders."

The people who make Pioneer Park their home see someone overdose at least once a day, Roberts explained. But people don't know what to do besides "slap them really hard."

Roberts and the two women with her each grabbed several kits from the Plumbs, with plans to redistribute them to their friends. Roberts plans to call the Plumbs next week to ask for more.

"I'm gonna keep at least two of them, one for my son and one for my friends," Roberts said. "Some of these kids I look at are younger than my son."

* * *

Sam Plumb will admit naloxone is only part of a solution, if that. Naloxone doesn't cure people of their addiction, he acknowledges. What it does is give people another chance. And if needed, another, and another, and another.

Calvin Harrison knows that after nine overdoses, his karma is going to run out eventually. Even with naloxone as a safety net, he is walking along a razor-thin path.

On this day in September, Calvin Harrison is sitting in the apartment he shares with his mother. He's been up for two straight days because of anxiety. His therapist thinks he's been using, based on trace amounts of opiates in his urine, but Harrison keeps trying to tell her it's just his anti-diarrhea medication.

A little over a month ago, he overdosed again after he got out of jail.

“The addict mind is starting to play around. If I’m screwed already, why not use and actually get a benefit from it?” he said. “I’m trying to access the other part of my brain that says, ‘No, no, no.’”

But there was something different about the last overdose, he said.

His mom says the same thing.

Recently, her son has been talking about the future, Rebekah Harrison said.

"Before, when Calvin was first starting, he wanted to die," she said. "He wasn't happy. Drugs make it so you wish you were dead. But now, Calvin wants to live. He wants to go to school, he would love to be a teacher, he wants to find a girlfriend. He's happy."

But Rebekah Harrison knows all too well about the grip of addiction, about the way it changes your brain, about the pitfalls on the road to recovery.

So she keeps the kit handy.

"I can tell you, as a mom, having that in my home … there's comfort knowing that's on the top of my fridge," Rebekah Harrison said. "It would be so terrible to lose a life that wants to make a difference."

Email: dchen@deseretnews.com

Twitter: DaphneChen_