Tuesday, November 6, 2007

Overdose Kits for Heroin Addicts


Massachusetts to offer Narcan nasal spray

Noting that heroin overdoses kill more people in Massachusetts each year than firearms, Dr. Peter Moyer, medical director of Boston’s fire, police and emergency services, applauded the state’s decision to offer addicts an overdose reversal kit. The package contains two nasal doses of naloxone, known as Narcan, a drug that reverses heroin overdose and saves uncounted lives (many victims of heroin overdose never see a hospital) when administered quickly enough. “It’s a remarkably safe drug,” said Dr. Moyer. “I’ve used gallons of it in my life to treat patients.”

Predictably, other health authorities aren’t so sure. “You give them the Narcan, where is their motivation to change?” said Michael Gimbel, director of substance abuse for Baltimore County, Maryland. “Giving Narcan might give them that false sense that ‘I can live forever,’ which is not what we want,” he told the Associated Press. Although similar programs have met with success in Chicago and New York City, the Massachusetts program is not supported by the Office of National Drug Control Policy in the White House. Drug Policy officials do not like the idea of addicts medically treating other addicts. Other officials argue against distribution of the kits, as they have frequently argued against needle distribution programs—in the belief that distributing the Narcan antidote will encourage heroin use and delay treatment for addicts.

Almost no one disputes the fact that heroin is currently popular throughout New England due to low prices and a surge in demand. “It’s the perfect storm in all the wrong directions. We talk about availability, price and potency,” said Kevin Norton of CAB Health & Recovery Services, one of the state-designated Narcan overdose kit providers.

The state-sponsored overdose kits were first tried in a pilot program in Boston, where Public Health Commissioner John Auerbach decided to go statewide after the kits were used to save 66 overdoses in the Boston area. “Narcan’s been around for a long time,” according to Cindy Champagne, director of nurses at the Greater New Bedford Community Health Center. Nonetheless, Champagne expressed some reservations about the drug “being out there for addicts to use,” noting its powerful effects and the rapid reversal of overdose, which leaves some addicts “combative.”

But Joanne Newton of the Seven Hills Behavioral Health Center of New Beford, another of the administrators of the program chosen by the Massachusetts Department of Public Health (DPH) cautioned that the program is carefully regulated, and will not increase the likelihood of addict overdoses. “There will be protocols and policies,” she said. “We’ll have to see what DPH’s plan is.”

12 comments:

Mighty Morgan said...

I don't know if addicts would have a dose of the nasal spray, since most of us never think that we would overdose.....honestly most addicts would probably stick with the revive method that is known on the streets (Salt/water mixed)rather then expose themselves to the hospitals or potential life saving methods.

Education is the key

Dirk Hanson said...

I think you're right, addicts would generally steer clear of the medical system. But if they could get a kit from a regular G.P., or even a med tech, without going to a hospital for it, then maybe....

Dirk

jp said...

If these kits were available through a place such as a needle exchange then I think addicts would be way more likely to use them. I agree with Mighty Morgan that a lot of addicts have the mentality that we'll never be the one to fall, but there are also those who are as careful as one can be while strung out. I do disagree with Michael Gimbel, who states in the article that Narcan might decrease the motivation for change. In fact, I find it ironic because an addict that finds a way to use Narcan is actually in the process of changing. I've found the greatest deterrent of change for heroin, or other opiate addicts, to be the incredible fear of withdrawal. This is of course not taking into account the pure lack of resources and availability of and access to treatment.

Dirk Hanson said...

"I've found the greatest deterrent of change for heroin, or other opiate addicts, to be the incredible fear of withdrawal."
----------
Certainly true with opiates, generally true of any addiction. I am in favor of attacking craving with targeted medications, and attacking the fear of withdrawal with knowledge--forewarned is forearmed.

In addition, I think there is a fear of failure--the nagging worry that you aren't up to the rigors of detox--that you will relapse. And you will. Almost everybody does, at least once--relapse is a biological imperative and practically a defining feature of addictive disease.

Clio said...

It's a common fallacy: "Lets not make something safer, it will only encourage them."
But to only offer a life-saver to those who'll do as you want them to do, ie start a detox or maintenance programm seems ethically questionable.

Anonymous said...

Gee, I sure wish my friend who died off heroin would have had a kit like this.

Anonymous said...

I think its cold blooded to not give people narcan you might as well be a murderer not to atleast give it to a family member who can administer it it could save alot of lives gone astray they need help not to be outcasted

Anonymous said...

I think its cold blooded to not give people narcan you might as well be a murderer not to atleast give it to a family member who can administer it it could save alot of lives gone astray they need help not to be outcasted

Anonymous said...

its made of the same ingredient that is in suboxone... Naloxone and buphonephrine is just another addiction in itself. Trust me I know. You go to a suboxone clinic to get off opiates, and end up being addicted to suboxone, and paying 300 to 400 dollars for the office visit, and then another 500 to 700 dollars just for the prescription. Of course if you dont see a doctor, you can buy them on the street for 20 bucks a piece. Its sad that doctors have taken addiction and roused a get rich quick scheme.

phillyDOC said...

this is a great idea it will save so many lives...and making it safer wouldnt make people do drugs more no one thinks a overdose would happen to them and addicts hate Narcan it makes u go into withdraw right away...and Narcan isnt a addiction in it self like that guy said all it does is block the drugs from working so u dont die and the Narcan in suboxone isnt powerful and wouldnt stop a death...suboxone is addictive but the Narcan isnt...

Anonymous said...

the Narcan in suboxone is not addictive like that guy said the buphonephrine is addictive..but the narcan in suboxone is not that strong and will not stop a overdose...but this is a great idea and it will not make people get high because its safer most people think they would not over dose ever and narcan make u go into withdraw right away and no one would want that
this will save lives but most will not take it unless a loved one makes them

Anonymous said...

thats not true I have witnessed the Narcan in Suboxone bring someone back from an overdose...

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