Heroin Addicts Recieve Antidote

Thanks for pointing us to this eye-opening story Michael, (Corrections Sentencing)

Kit and training for heroin users

By Stephen Smith, Globe Staff | November 2, 2007

State health authorities will start supplying addicts next month with a kit containing two doses of a medication that can reverse a potentially lethal overdose within minutes, hoping to reverse a tide of heroin deaths sweeping Massachusetts.

The initiative by the Department of Public Health mirrors a similar project in Boston, where at least 66 overdoses have been reversed since the program began a year ago.

State Public Health Commissioner John Auerbach, who introduced the Narcan program while leading Boston's health agency, said the results are so impressive that he wants to expand it to four areas of the state grappling with heroin epidemics. That drug and other opiates killed 544 people in Massachusetts in 2005, more than double the number felled by firearms.

"We are aware sadly that despite our efforts, there are people who will not be ready for treatment, and we want to prevent them from dying from a fatal overdose before we have an opportunity to convince them to get into treatment," said Auerbach, stressing that treatment remains the state's priority.

But some substance abuse specialists criticize the distribution of Narcan to addicts, arguing that the practice encourages continued use and delays entry into treatment. Some also question whether it is wise medically to have one addict squirting Narcan up the nose of another user who is overdosing.

"You give them the Narcan, where is their motivation to change? The addict is going to say, 'I just overdosed and I got another lease on life - great,' " said Michael Gimbel, a recovering heroin addict who was director of substance abuse in Maryland's Baltimore County for 23 years. "Giving Narcan might give them that false sense that 'I can live forever,' which is not what we want."

Narcan has been administered for decades in hospital emergency rooms and by paramedics, but time is crucial: Heroin races to regions of the brain that control breathing. Too much heroin dangerously slows breathing, starving the heart of oxygen and causing it to stop beating. The whole process can take just three to four minutes, making it essential to have the antidote readily available.

Heroin attaches itself to receptors in the brain, like a key sliding into a lock. But Narcan wrenches heroin out of brain receptors, taking the place of the opiate and reversing the devastating reduction in breathing.

Narcan, known generically as naloxone, was developed as an antidote for overdoses. It is not habit-forming and causes no long-term side effects, although the sudden reversal of a heroin high can induce vomiting, specialists said. A single dose costs about $20.

"It's a remarkably safe drug," said Dr. Peter Moyer, medical director for Boston's fire, police, and emergency medical services. "I've used gallons of it in my life to treat patients."

State authorities said they believe that Massachusetts will be just the third state with a Narcan program. A number of cities including Chicago, New York, and Baltimore already provide the antidote to drug users.

In Baltimore, nearly 1,600 addicts were trained in using the medication from April 2004 through the end of 2005, and participants reported that 194 overdoses were reversed. At the same time, heroin-related deaths in the city reached their lowest point in six years, dropping one-third from the peak recorded in 1999.

Heroin has maintained a powerful hold on New England, fueled by high demand and low prices. At $5 or $6 for a small bag of the drug, it can be cheaper to get high on heroin than to buy a six-pack of beer.

Boston Review