Linda Fletcher lives in fear of reliving a nightmare: a son dying from a heroin overdose.
Her son Kris Klipner succumbed to the drug in 2007. He was 28.
Klipner's half-brother battles the same kind of depression as Kris. He suffers the same heroin addiction Kris did.
Kirk Fletcher, 29, is in a methadone program to help him avoid the drug. He says he has his addiction under control. But he understands his mother's fear that it will return — just as his brother's did.
Linda Fletcher is hopeful that some relief is on the way.
New legislation, pushed by Fletcher and other parents, backed by the state health department and passed unanimously this year by both chambers of the Maryland General Assembly, creates a statewide program allowing family members of addicts to be prescribed and trained in administering Naloxone. Emergency responders already give the drug to overdosing patients.
The drug helps patients by restarting their breathing. Advocates say putting it in the hands of people such as Fletcher, who lives with her son, could save lives in the critical minutes before professional help arrives.
Relatives of drug addicts and of overdose victims, who lobbied heavily for the legislation, say it will give families some measure of comfort against the agonizing, day-to-day fear that they will watch helplessly as a loved one dies.
"I may not be here, and I pray to God it will never happen," said Linda Fletcher, of Perry Hall. "But if I am here and I see that he is overdosing, it would absolutely be peace of mind, and I could maybe save his life.
"I don't want to lose a second son."
The drug can be injected or administered nasally. Health officials say it is not addictive or considered dangerous to non-drug users. Prescriptions have been available in Baltimore for years as part of the city's Staying Alive Drug Overdose Prevention and Response Program.
Other states already allow personal prescriptions of Naloxone. Dr. Joshua Sharfstein, the Maryland secretary of health and mental hygiene, said officials in Maryland will be able to look at those programs and the one in Baltimore when crafting the new statewide program.
"There are more overdoses than homicides in Maryland every year," he said. "It's a very serious problem. …
"We will certainly look at the experience of localities across the country with Naloxone in figuring out the best approach."
In setting up the new Overdose Response Program, the state will partner with local jurisdictions to train family members in identifying an overdose and administering Naloxone.
The state health department will certify health providers, substance abuse treatment programs and other groups or institutions to conduct the training.
The program is expected to cost $50,000 next fiscal year and increase over time. Sharfstein said the costs would not be a "major burden" — especially for a program that could help put a dent in one of the state's most pressing health problems.
Naloxone works to revive overdosing patients, Sharfstein said, because it "knocks the opiate off the receptor" in the brain and takes its place.
He offered an image: imagine the receptor as a baseball mitt, which accepts the opioid like a baseball. When the ball fits into the glove, changes occur in the cell and the drug's effects take hold.
Naloxone knocks the opioid out and fits into the receptor itself, blocking the drug from being accepted by the body. It is not an opioid itself.
Critics of Naloxone programs say the drug could encourage more drug use by erasing the fear of overdosing. But health officials dismiss that idea. Family members of addicts said it isn't fear of overdosing that prevents drug use.
"That couldn't be further from the truth," said Toni Torsch.
The Perry Hall woman found her son Dan overdosing on heroin in his bedroom in 2010.
"It's such a demon, heroin, and the prescription pain killers. The physical addiction is just overwhelming," Torsch said. "They're going to continue to use until they get treatment, not because they have an antidote sitting in the drawer."
By the time paramedics arrived at her home, Dan was already gone.
To help deal with her loss, Torsch started a local chapter of the Grief Recovery After Substance Passing support group for family members of addicts.
Then, in the summer of 2011, Torsch and her husband, Carl, came upon a television documentary that showed parents of addicts being supplied a drug called Naloxone, which they could give to their overdosing teens or adult children to yank them back from the edge of death.
"I started questioning, 'Why isn't that here?'" Torsch said. She soon began to push for greater access to the drug.
Bette Ann Tassone of Bel Air, whose daughter Jessica died of a heroin overdose last year, said every parent in the GRASP group with a living child who is an addict wants a Naloxone prescription. She wishes she'd had one, too.
"It would just give them such peace of mind to have this in their possession," she said.
After hearing Torsch advocate for Naloxone prescriptions, Tassone took the message to her friend, Sen. Katherine Klausmeier.
Klausmeier introduced the bill in the Senate. Del. Eric Bromwell filed the House version.
"It's rare to have sort of a new idea come to Annapolis that gains momentum as fast as it did," Bromwell said.
Klausmeier had known Tassone's daughter. She met Torsch last year and went to a GRASP meeting, where the stories she heard brought her to tears.
Klausmeier praised the parents for pushing her and for talking to other legislators and gaining their support.
Kirk Fletcher says he is not using any illegal substances, has no desire to go back to "running the streets, looking to get high," and doesn't believe he is in "any kind of jeopardy of" overdosing.
Still, his depression persists, and he supports his mother in her desire to have Naloxone on hand — just in case.
"I believe that it would give her a peace of mind," he said. "That's fine with me."
Sharfstein said his department is looking at Naloxone prescriptions as just one tool in a much broader approach — including the identification of overprescriptions of painkillers — to address a major health problem in Maryland.
Overdoses in the state spiked in the first half of 2012, the most recent period for which numbers were available.
Torsch called the new legislation "a bittersweet victory."
"You can't help as a parent who's lost a child but to think, 'If only...'" she said. "I guess I shouldn't let my mind go there, because it puts me in a dark place. But I know this will save lives."