Pubdate: Fri, 18 Mar 2005 Source: North Shore Sunday (Beverly, MA) Copyright: 2005 Community Newspapers Inc. Contact: http://www.northshoresunday.com Details: http://www.mapinc.org/media/3465 Author: Gary Langis Bookmark: http://www.mapinc.org/hr.htm (Harm Reduction) Bookmark: http://www.mapinc.org/heroin.htm (Heroin) Bookmark: http://www.mapinc.org/find?199 (Mandatory Minimum Sentencing) Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone) Note: Mr. Langis is the board president of the New England Prevention Alliance. DRUGS CAN'T BE LEGISLATED AWAY I hope thatNorth ShoreSunday's recent article on naloxone ("I want a new drug," March 5) will help bring about a healthy debate on the most humane way to engage and deal with persons who are using opiates. I have been working in the prevention field for more than 15 years and have seen my share of people die needlessly as the commonwealth deals with health issues through law enforcement and legislative procedures. During the past 10 years, I along with others in the harm-reduction field have been providing training to people who inject heroin on what an overdose is, how it is caused, how to recognize an OD and how to respond to it. We also cover a wide range of health issues that affect members of the drug-using community; this training focuses on building skills to help individuals be proactive in self-care. The training sessions are aimed at educating people who use opiates, and like most prevention projects, it focuses on changing the social norms of a particular target population. Opponents may say that heroin addicts don't care or are not capable of changing their behaviors, but I would disagree. I have worked closely and observed the population and know for a fact that they not only care for themselves, they care for other people they use with. This may not be in the same realm as some of us see as self-care, but in the reality of a drug user's life it is caring and is often the first step to other, healthier choices. They are the first responders to an OD and, if trained in the proper manner, they are able of responding in a responsible way. No one is saying "just distribute Narcan," but that seems what people in law enforcement would want you to believe: that it would be passed out on street corners. One thing we encourage our participants to do when one of their using mates ODs is to call 911, but when many of them do this, they are faced with arrest, as a medical emergency often turns into a crime scene. We also provide training on rescue breathing and other techniques of keeping someone alive before administering Narcan. Over the years of engaging this population in this manner I have seen many participants become more and more concerned about their health and welfare - - sometimes to the point where they finally reach out for treatment. This is in no way saying that Narcan is the only way to deal with such a complex problem; it's just another tool in a war to keep people who are using drugs alive - a dead drug addict does not recover. The population of drug users is one of the most marginalized groups in our society today, and one of the largest contributors of our justice system. As long as we continue to treat nonviolent drug users as criminals and not treat them for their drug use, we will continue to put them into a system that only hardens them. Many of these new drug users who will be entering the prison system will be the new generation of OxyContin users who are the sons and daughters of more affluent families. Maybe then we will start to look at different approaches in dealing with mandatory sentencing and cuts in drug treatment programs that have been happening for years. If we could only look in retrospect at the last 40 years of drug use, you would see what a failure it is treating drug users in this way. We are paying now for the approach that started a long time ago. Look at the changing demographics of drug users - they're getting younger. If one of your children was overdosing on the bathroom floor with only seconds to live, would you be willing to inject them with Narcan? I know I would at least want the opportunity to keep my child alive and remain hopeful that someday he would recover from his drug use. For those of us who are in the trenches working to provide other options, we know drug abuse can't be legislated or arrested away. We can debate about this as we have done with syringe access for the past 15 years, thus allowing AIDS to get ingrained into a wider range of our society, even though studies have shown that syringe access would have slowed the spread of AIDS while not increasing crime or drug use. Maybe it's time that we implement evidence-based and scientifically proven methods and programs that will be effective in dealing with drug overdoses. - --- MAP posted-by: Terry Liittschwager