"Tough On Crime" Approach To Drugs Can Mean Death For An Opioid User
André Picard, at The Globe And Mail, argues for the distribution of Naxolone, which reverses overdoses:
As R. Gil Kerlikowske, former head of the U.S. Office of National Drug Control Policy, has said: "We cannot arrest our way out of the drug problem." What is required is a series of measures, such as better education about the real benefits and risks of drugs like painkillers (for patients and medical practitioners alike), sounder prescribing practices, investment in non-pharmaceutical pain-control methods, better access to addiction treatment and harm-reduction measures.What is also needed are pragmatic approaches to dealing with one of the frightening symptoms of the public-health crisis that is opioid abuse: overdoses.
...Naloxone is a drug that has been used for decades in emergency rooms to reverse opioids overdoses. It blocks opiate receptors and essentially reverses the effects of drugs such as heroin. Paramedics carry naloxone (also known as Narcan) and so do firefighters and police in many cities. In fact, there are ongoing squabbles about who should be allowed to administer the drug.
When turf wars are set aside, the simple answer to that question is whoever arrives first. That's because, when stopping an overdose, a few minutes can mean the difference between life and death.
Administering naloxone is simple. It works much like an epinephrine auto-injector (best known by the brand name EpiPen). You have a vial loaded with the drug (or sometimes a syringe and liquid that need to be combined) and stick the needle into a muscle (thigh, shoulder or buttocks); if that doesn't work, you inject a second dose. When responding to an overdose you should also perform CPR and make sure the person gets to hospital, because the drug can trigger withdrawal. It should be noted, however, that the drug works only for opioid overdoses; it won't reverse an OD from cocaine or crack, drugs that bind to other receptors.
...Naloxone is so easy to use and effective that forward-thinking public-health officials have taken to handing out take-home naloxone kits to regular drug users, those who tend to use needle-exchange programs.
About 85 per cent of intravenous drug users who overdose do so in the presence of others, according to a study in the Annals of Internal Medicine. But, because their activities are often illegal, there is a reluctance to call 9-1-1 for help.
In New York City alone, more than 20,000 kits are distributed a year, and some 500 overdoses are reversed. (And that doesn't count all the other ODs reversed by paramedics and firefighters.) Toronto, Edmonton and Vancouver also have take-home naloxone kits, and others are considering them.
Just a little devil's advocate questioning here...
-Is it "worth it" to save people who habitually risk their lives in this way?
-Should the costs/benefits to society be considered, or is saving a life, ANY life, merit the cost of the kits?
-What happens if the kit is used when it's nearly too late? Can the people saved end up on permanent life support? If so, who pays?
-Supposing people who end up ODing on drugs have some underlying problem (say, chronic illness, depression, etc), does this harm our species at the gene pool level by keeping any underlying genes in the population?
-Is there any potential harmful use of the kit? Just as insulin injected into a non-diabetic can cause serious health consequences (hypoglycemia), is there any potential for misuse of these kits? If so, does that change the answer to the above questions?
Shannon M. Howell at April 5, 2014 7:44 AM
Amy Alkon
http://www.advicegoddess.com/archives/2014/04/05/tough_on_crime.html#comment-4458665">comment from Shannon M. HowellI'd guess it's cheaper, if you simply look at financial costs, than having EMS come out.
Amy Alkon at April 5, 2014 7:55 AM
There was a report today on our local news about heroin overdoses among released prisoners.
Basically there has been a spate of them happening where someone was picked up some theft or something similar that was not directly a drug charge. The sheriff was saying the average stay is 42 days. So then they essentially have have been detoxed but have no requirements for any other treatments. So they get out of prison and then go look up their dealer and get the same amount they were taking when they were arrested. But because of the detox period that is too much for them to handle. So they overdose.
But handing them a Naloxone kit on exiting the jail would be like condoning parole violations.
So there is no easy answer.
Jim P. at April 5, 2014 8:18 AM
There is research being done with a variant of naloxone that may, when taken at the same time as an opiate like heroin or morphine, be able to prevent addiction without blocking the pain-relieving effects.
Ken R at April 5, 2014 10:04 AM
What makes opiates so deadly is the fact they're illegal. If drugs were decriminalized, the death rate from overdose would decline. Of course, few realize or want to recognize that fact.
Janet C at April 5, 2014 10:35 AM
"-Is it "worth it" to save people who habitually risk their lives in this way?"
It's a good question.
I mean, just look at Aldous Huxley. Carl Sagan. Bill Gates. Steve Jobs. Francis Crick. Sigmund Freud.
Not one of them worth saving.
Gog_Magog_Carpet_Reclaimers at April 5, 2014 1:09 PM
> Sagan. Bill Gates. Steve
Whoa there, Pilgrim.
billg did opiates?
> Is it "worth it" to save people who...
Why is everyone so slutty with quotation marks on this blog?
Crid [CridComment at Gmail] at April 5, 2014 2:37 PM
Shannon Howell,
You question whether the life of a drug abuser is worth saving. Are you perfect? If so you have a right to ask that, I suspect however that you are as imperfect as the rest of us.
Nelson Struck at April 5, 2014 3:01 PM
Why is everyone so slutty with quotation marks on this blog?
Posted by: Crid [CridComment at Gmail] at April 5, 2014 2:37 PM
Possibly because I am too damn dumb or disinterested to figure out how to get an iPad to do bold, italics, or underline.
Isab at April 5, 2014 5:19 PM
Amy Alkon
http://www.advicegoddess.com/archives/2014/04/05/tough_on_crime.html#comment-4459569">comment from Isab"slutty with quotation marks..."
Love that.
Elmore Leonard would have liked you. It was a form of promiscuity he was not in favor of.
Amy Alkon at April 5, 2014 6:10 PM
Aldous Huxley. Carl Sagan. Bill Gates. Steve Jobs. Francis Crick. Sigmund Freud.
Didnt realize they were all addict ODing on a regular basis. What were their drugs of choice?
lujlp at April 6, 2014 1:48 AM
Shannon Howell,
You question whether the life of a drug abuser is worth saving. Are you perfect? If so you have a right to ask that, I suspect however that you are as imperfect as the rest of us.
Posted by: Nelson Struck at April 5, 2014 3:01 PM
I think a better question is, what would be the unintended consequences of handing out Naloxone to every junkie?
What kind of effect does it have when given to someone who has overdosed on a non opioid?
Would addicts play games with it? Like, how close to dead can I get before you bring me back?
Would they push the envelope with heroin and deliberately overdose for a higher high knowing that the Naloxone was at hand?
Isab at April 6, 2014 3:26 AM
http://en.wikipedia.org/wiki/Naloxone
According to wiki it is in short supply, and is quite expensive, begging the question, as to who is going to be paying to save all these people who OD.
The taxpayers? The giant magical Obama money tree? The pharma companies who manufacture it?
Sounds like the demand is exceeding the supply already.
Isab at April 6, 2014 3:36 AM
Naloxone kits cost $20-40. Naloxone has no effect on someone who has not taken opiates.
Ken R at April 6, 2014 5:14 AM
As for the question of my being perfect, of course I am not. Didn't we cover that with the comments about the quotes? More on the quotes in a minute.
There are two questions behind my worth question. One is the actual cost - long term and in dollars - of such a policy. If it took the entire GDP to do it, well, that means there are a lot of other things not being done with that money. So, one question is it worth whatever it costs, since that money cannot be used elsewhere (say, in cancer research). That is an economics/policy question.
The other question is more of a moralistic one. Does a life being squandered deserve to have that squandering supported and enabled, or should we let biology weed those genes out? If somebody decided to go be bitten by snakes for an adrenaline rush, would we subsidize their anti-venom treatment? Should taxpayers subsidize cancer treatment for chain smokers with lung cancer? Or, does this only encourage risky behavior for the next generation? What are the moral ramifications of such a position.
Regarding the quotes, true they weren't necessary. I was trying to indicate that I didn't necessarily mean to use worth as a pecuniary measure, but rather that it might be taken multiple ways.
Shannon M. Howell at April 7, 2014 9:37 AM
Leave a comment