Pubdate: Tue, 02 Oct 2001
Source: San Francisco Examiner (CA)
Copyright: 2001 San Francisco Examiner
Contact:  http://www.examiner.com/
Details: http://www.mapinc.org/media/389
Author: Tanya Pampalone
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)
Bookmark: http://www.mapinc.org/hr.htm (Harm Reduction)
Bookmark: http://www.mapinc.org/find?132 (Heroin Overdose)

CITY'S HEROIN USERS FIND NEW HOPE IN UCSF STUDY

Amelia is learning to be a careful junkie. In her bright, orderly studio in 
the heart of the Tenderloin, the 21-year-old has been shooting up three 
times a day for the past four months.

She uses her own syringe, her own spoon and she won't share her cotton or 
her fixing water. Next to her kitchen table she keeps a Department of 
Public Health overdose prevention pamphlet that she picked up at the needle 
exchange.

With one person dying every other day from a heroin overdose in San 
Francisco, Amelia has good reason to be concerned: the possibility of an 
overdose is what junkies face each time they fix.

The supply of black tar heroin has surged with demand and prices have 
dropped from $100 to $30 a gram over the past 10 years -- and with it the 
amount of deaths have doubled statewide to 1,400 a year, according to Glenn 
Backes, director of Health Policy for the Lindesmith Center-Drug Policy 
Foundation.

As heroin deaths increase across the state, so do prevention efforts.

The state Legislature passed a measure in mid-September that, if signed by 
Gov. Gray Davis, will create a statewide framework for overdose prevention 
programs. This summer, The City's health department promoted prevention 
awareness through a controversial "Fix with a friend" campaign that covered 
a Sixth Street billboard.

But a new University of California, San Francisco study, takes prevention 
efforts to a new level. Not only does the study educate addicts on overdose 
prevention, but it also advocates distributing naloxone -- an injectable 
drug that is normally used by doctors or paramedics to stop a person from 
overdosing. And since the study began seven weeks ago, five lives have been 
saved.

"There is a perception that if you use dope, you are going to die," Backes 
said. "But it doesn't have to be that way."

That is the message that Backes and other overdose prevention experts are 
trying to spread nation wide.

A large-scale study involving naloxone distribution in Chicago is showing 
positive results, while another was recently approved at the University of 
California, Davis. After overdose deaths reached 15 times the national 
average in a rural town in New Mexico, the state authorized prescribing 
naloxone to the addict's caregivers.

In the San Francisco study, 12 couples are participating for six months. 
They have been trained for eight hours on overdose prevention and have 
learned how to recognize a heroin overdose, how to perform CPR and how to 
administer naloxone.

They also learn how the drug works.

When naloxone is injected into an overdose victim, the drug goes to the 
same brain receptors that heroin does, binding and blocking the receptors. 
After that, the heroin isn't able to bond to the receptors and the user 
wakes up and can go into acute withdrawal, depending on the amount of the dose.

The participants also learn that naloxone will wear off quicker than 
heroin. So, even hours later, a person could overdose if they have 
excessive amounts of heroin in their body.

But according to Dr. Josh Bamberger, head of Housing and Urban Health in 
the Department of Public Health, naloxone is a completely safe drug that 
would not affect someone who has not taken opiates.

"It is completely benign," he said. "There is no rush, it is not mood 
elevating."

Some critics say that there is a danger that people could use the drug in 
excess, knowing that there is an easy revival method. Bamberger says no way.

"Heroin is precious (to addicts) and they don't have enough to waste it," 
he said.

Prevention experts agree that just as important as the naloxone, is 
teaching people CPR, encouraging them to discuss the overdose possibilities 
with an intimate -- and the need to dispel myths around reviving people.

"There are a lot of things that people try that waste time and increase the 
risk of death," Backes said. "Sticking people in the shower, packing them 
with ice, kicking them in the groin ... doesn't do anything to revive someone"

But another big reason that people die from overdose is because the people 
they are with are afraid to call 911, fearing arrest.

When one of Amelia's friends passed out after shooting up, her boyfriend 
performed CPR as Amelia cleaned up the drugs and held the phone tightly, in 
case they had to dial 911.

It was the seventh time that her boyfriend revived an overdose victim. If 
she had the naloxone, she said she would have used it.

"Absolutely," she said. "I would have it in my first aid kit."
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MAP posted-by: Beth