Pubdate: Fri,  1 Aug 2003
Source: Baltimore Sun (MD)
Copyright: 2003 The Baltimore Sun, a Times Mirror Newspaper.
Contact:  http://www.sunspot.net/
Details: http://www.mapinc.org/media/37
Author: Steve Chapman

ELIMINATING DEATH PENALTIES FOR DRUG USE

CHICAGO - Heroin addiction is a regrettable condition, and there are lots 
of theories about how to help people overcome it. But it is a truism, not a 
theory, that you can't help addicts once they are dead. Step 1 in assisting 
or even forcing heroin users into more socially productive behavior is 
keeping them alive.

This elementary insight is one resisted by many supporters of the drug war. 
They fear that if we reduce the risk of gruesome death from injecting 
heroin or other drugs, everyone this side of Hilary Duff will soon be lying 
in a gutter with a needle in her arm.

They don't want drug users to practice their habit in a less dangerous way; 
they want them to give it up, period. Any assistance that doesn't tell 
addicts they must stop using drugs, immediately and forever, is seen as 
actively promoting irresponsible conduct.

That's why uncompromising prohibitionists, many of whom are in positions of 
power, have long opposed one simple step to prevent the transmission of the 
AIDS virus by drug users: giving them access to sterile hypodermic needles. 
It's also why they are not lining up to support an innovation that would 
save addicts when they overdose on heroin.

At least 28 percent of new AIDS cases in 2000 stemmed from injection drug 
use. Some hard-liners think it's rough justice for those who insist on 
using illegal drugs to get AIDS and die. Unfortunately, it's hard to detect 
any sort of justice when the wives, husbands, lovers or children of these 
people get AIDS and die through no fault of their own. Nor is it fair for 
law-abiding taxpayers to pay the medical bills of those infected with HIV.

You could build a skyscraper out of all the studies documenting the public 
health value of clean needles. Let drug users have uncontaminated equipment 
and, it turns out, they will forgo the chance to inject themselves with HIV 
microbes. After Connecticut scrapped its prescription requirement for 
buying syringes, needle sharing fell by 40 percent.

Not only that, but people who don't use heroin, upon learning they could 
get clean utensils, generally don't decide they want to be slaves to opium. 
In fact, needle-exchange programs often serve as a gateway to get existing 
addicts into treatment.

Armed with all that knowledge, Illinois Gov. Rod R. Blagojevich last week 
signed a bill legalizing the over-the-counter sale of up to 20 syringes. 
Only five states still require a prescription for hypodermic needles.

The general change of heart offers hope about another method for keeping 
drug users out of the graveyard. The federal government reports that 
emergency room admissions of people using heroin rose by nearly 50 percent 
between 1994 and 2001. Thousands of people die each year from heroin 
overdoses. Fortunately - well, some people think it's fortunate - there is 
a simple, well-established remedy for this malady.

A drug called naloxone, administered by syringe, safely and immediately 
reverses the respiratory failure that leads to death. There is no doubt 
about its efficacy. Dan Bigg of the Chicago Recovery Alliance, which has 
trained people in using the medication, says the effort has produced 165 
"reversals" - lives saved - in the Chicago area.

Mr. Bigg wants Illinois to follow up the new syringe law with a measure to 
exempt physicians from liability if they give naloxone to patients for 
heroin overdoses. Just as people with severe allergies or diabetes carry 
drugs that can prevent sudden death, he thinks heroin users and their 
family members and friends should keep naloxone at hand to avert 
drug-induced suffocation. New Mexico recently eliminated criminal and civil 
liability for anyone administering it.

Another option is to allow the sale of naloxone, now a prescription 
medicine, over the counter, making it far easier to get. Since the medicine 
has no enjoyable properties, there's no chance it would be abused. And 
there isn't much risk that more people would use heroin if they had a 
lifesaving antidote, since receiving the antidote is not a pleasant experience.

This remedy will doubtless evoke opposition from anti-drug zealots, who are 
suspicious of anything that diminishes the danger of drug use. They're 
right that it would be nice if every heroin user would simply swear off the 
stuff, or at least seek treatment to conquer their addiction. Given time, 
some will. There's no rehab in the morgue.

Steve Chapman is a columnist for the Chicago Tribune, a Tribune Publishing 
newspaper. His column appears Tuesdays and Fridays in The Sun.
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