‘Addiction deserves all the same life-saving measures any other disease demands’

Last modified: 11/23/2015 6:03:05 PM
Maia Szalavitz, a proponent of the use of Naloxone, the medication used to reverse drug overdose, recently wrote that opioid overdoses kill around 17,000 Americans each year, and stressed the need to have Naloxone available over the counter for lay people. More recently, hopefully to clarify a mass audience misunderstanding of the drug, Natasha Lennard wrote, “To support Narcan is not to support heroin addiction. To oppose it, however, is to de facto support the unnecessary death of drug users. It amounts to saying hard drug use should be punishable by death.”

However, Naloxone is viewed by many people — including parents, business owners, school officials, law enforcement, and fire and rescue personnel — as a drug that enables addicts to continue using. I have been part of conversations where people said that heroin users are now going to have heroin parties with everyone shooting up, not caring if they overdose because they have Narcan in the house.

Others ask, what if someone gets “Narcanned” by someone untrained, and they overdose and die on Narcan? You cannot overdose or die from too much Naloxone.

Trainings in the administration of Naloxone can be found at the N.H. Department of Transportation Fire Safety Academy, and the U.S. Department of Veterans Affairs has produced a 6-minute video on nasal administration of Naloxone. After completing the 90-minute DOT-FSA Naloxone Training of Trainers, a registered nurse at Phoenix House in Keene and I will soon be offering trainings locally.

I attended a training session with a police officer speaker, who refuses to carry Narcan, saying it is “not my job to save lives — that is the job of the hospitals — my job is highway safety.” He also said, “Giving someone Narcan was like giving an alcoholic who drinks Budweiser, a Bud Lite instead — they’re still alcoholic. So if an addict knows they’re an addict, and keeps taking drugs, knowing it can possibly kill them, then that’s on them.”

Does this mean he wouldn’t give insulin to a diabetic in diabetic shock, because she knew she shouldn’t have eaten the whole bag of cookies but she did anyway, and now should suffer the consequences? Maybe he just doesn’t know yet that addiction is a real disease too.

Addiction is a treatable disease defined by the National Institute on Drug Abuse as “a chronic, relapsing brain disease characterized by compulsive drug seeking and use, despite harmful consequences. Considered a brain disease because drugs change the brain, its structure, and how it works, the changes can be long lasting and lead to self-destructive behaviors.”

Once the drug has manifested itself physiologically — abuse is now dependence or addiction — the element of choice is removed, and not using is no longer an option for the user without treatment.

The fact is that no one plans to overdose. Having Narcan in the house doesn’t encourage or condone addiction. In fact, it’s an addict’s worst enemy; they don’t want anything to do with it because it eliminates their high. I’m quite sure an addict’s mindset is not, “Let’s party because we have Narcan,” or “Let’s overdose because we have Narcan.” I don’t know anyone addicted to heroin who gets excited to know Narcan is available to them.

People across the state and country are at an incredible loss as to how to address this international epidemic. One popular model used in Canada and in the U.S. is a harm-reduction model, known as medically assisted treatment, or MAT, which is a way of treating opioid addiction with medications, such as suboxone or methadone.

A popular opinion is that this only enables people with addiction by replacing one drug with another, as both of these medications can be abused if not taken as directed. However, I believe MAT is the more rational choice when taking into account the social and economic impacts of untreated addiction.

A 2014 report by New Futures titled “The Corrosive Effects of Alcohol & Drug Misuse on New Hampshire’s Workforce and Economy” states, “Alcohol and drug misuse cost New Hampshire more than $1.84 billion annually in lost productivity and earnings, increased expenditures for health care and public safety costs.” The report outlines the societal and economic costs of drug and alcohol misuse. Considering that New Hampshire is second to last in the country for providing addiction treatment — only Texas is lower — and only 6 percent of people needing treatment in New Hampshire get it, anything providing a reduction in harm is welcomed.

Naloxone doesn’t fix addiction. When a person is revived he or she is still addicted and will need treatment to stay clean. Naloxone is just one tool to combat this country’s problem with abuse of prescription drugs, heroin and now fentanyl — the new drug that has surpassed heroin as the number one cause of drug overdose according to the N.H. Medical Examiner’s Office.

In New Hampshire, there were 326 fatal drug overdoses in 2014. But keep in mind, emergency responders also in 2014 administered Naloxone 3,275 times. If the medication had not been available, we would possibly have another 3,000 dead people — someone’s daughter or son, wife, brother, sister, teacher or boyfriend.

Perspectives and judgements need to change because addiction can happen to anyone at anytime — we’re seeing it every day. People with the disease of addiction deserve all the same life-saving measures any other disease demands.

Mary Drew, MS, MEd, CPS, is director of the Monadnock Alcohol and Drug Abuse Coalition.

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