Missouri AFL-CIO’s John Gaal drew attention to a problem. Now Southwest Airlines is adding Narcan to its flight first-aid kits



SOUTHWEST AIRLINES has begun adding the overdose reversal drug Narcan to its flight first-aid kits. The Missouri AFL-CIO’s John Gaal and others lobbied for it after Gaal and his wife, Mary, saved a passenger suffering an overdose on a Southwest flight in October 2022. Southwest didn’t carry Narcan on the flight. Gaal had it in his pocket. – Southwest Airlines photo

Southwest Airlines is adding Narcan to flight first-aid kits in part due to the efforts of Dr. John Gaal, director of the Missouri AFL-CIO’s Missouri Works Initiative’s Worker Wellness Program.

Gaal and other advocates have been lobbying the airline to carry naloxone, which is also called Narcan, to protect passengers from opioid overdoses since Gaal witnessed an apparent overdose on a Southwest flight in October 2022.

Gaal and his wife, Mary, saved a passenger on the flight from an opioid overdose with the nasal spray version of Narcan. The airline did not have the medication available on the flight. Gaal and his wife carry it with them.

Southwest began stocking new medical kits across its fleet in December. It hopes to have all flights equipped by June. The kit includes naloxone sprays to treat opioid overdoses, as well as federally required epinephrine, nitroglycerine tablets and other drugs to handle allergic reactions, heart problems and other issues. Flights also are required to have automatic external defibrillators on board.

Of the major airlines, Southwest was the only one that didn’t have Narcan on flights. Delta, American and United already carry it on their flights, Gaal said.

“This is a huge leap because at least they’ve committed to carrying it on board,” Gaal said. “But what are they doing about training their cabin crews? That’s going to be the missing link to assume that every flight is going to have a doctor or nurse trained to administer Narcan or an EpiPen, that’s ridiculous. I can come over to your shop and in less than 30 minutes train your whole shop.”

Driven by the death of his son to suicide related to concussions, Gaal is on a mission to make Narcan, the opioid overdose reversal drug, also known as the “Lazarus drug” more available public places and on job sites.

Although the two may not seem related, the Center for Disease Control and Prevention (CDC) says the construction industry ranks No. 1 in opioid overdose deaths as compared to other occupations, and ranks second in deaths by suicide.

“That’s the only reason I was prepared to act that day,” Gaal said. “I do believe losing my son, seeing other people lose their family members whether it was to suicide or opioid misuse, I can tell you it gives you a different slant on life. You appreciate what you have and hope that others can gain from you.”

Construction workers are seven times more likely to die of opioid-related overdoses than the average worker.

The construction industry has one of the highest injury rates in the U.S. Opioids have commonly been prescribed to construction workers to treat the pain caused by occupational injuries. While opioids are effective for treating pain, their frequent and widespread use has led to increased dependence, addiction and unintended overdoses.

Men working in construction also have one of the highest suicide rates, according to the CDC: a reported 49.4 out of 100,000, or twice the total suicide rate for civilian working men.

Construction workers have nearly twice the rate of substance abuse as the national average, and the rate of suicide for men and women working in construction is about four times higher than that of the general population.

Narcan works by blocking the effects of opiates on the brain and restoring breathing and can be administered through an injection or nasal mist.

Last year, the Food and Drug Administration approved the sale of naloxone over the counter. But stigma remains around its use even though it is no different than carrying an EpiPen for someone with allergies, the CDC says.

Government officials in the St. Louis region have been placing Narcan in libraries, rec centers and other public spaces to make it as accessible as possible for people to use when they witness someone experiencing an overdose, St. Louis Public Radio (NPR) reports.

For information on administering Narcan, visit the CDC website at https://www.cdc.gov/stopoverdose/naloxone/index.html.


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