Pubdate: Sun, 17 Jun 2012
Source: Worcester Telegram & Gazette (MA)
Copyright: 2012 Worcester Telegram & Gazette
Contact:  http://www.telegram.com/
Details: http://www.mapinc.org/media/509
Note: Rarely prints LTEs from outside circulation area - requires 
'Letter to the Editor' in subject
Author: Bronislaus B. Kush
Bookmark: http://www.mapinc.org/find?132 (Heroin Overdose)

DRUG TO COMBAT OVERDOSE DEBATED

Narcan Weighed Against Treatment

A state program that provides to opiate addicts and their loved ones 
a drug that can miraculously counteract a potentially lethal overdose 
has been credited with saving at least 1,500 Bay State lives.

The five-year-old project, however, continues to draw fire from some 
who believe that the life-saving narcotic actually coddles drug 
abusers and makes them less likely to seek out more effective 
substance abuse treatment services.

Naloxone, commonly known as Narcan, its brand name, counteracts the 
effects of heroin, OxyContin, Percocet, Vicodin, codeine, morphine, 
and other powerful opiate painkillers. Specifically, it blocks the 
life-threatening opiates from depressing an individual's respiratory system.

"Opioid" overdose is one of the leading causes of death in 
Massachusetts. Its death rate, officials said, is higher than that of 
motor vehicle fatalities.

According to public health authorities, two people die of opiate 
overdoses in Massachusetts every day.

Narcan has been used in emergency rooms and by emergency first 
responders since the 1970s.

But many states, over the last few years, have been giving away the 
drug, at no charge, to addicts and their families and friends in an 
attempt to battle the alarming rise in opiate-related deaths across the nation.

Many officials blame the spike on the illegal use of OxyContin and 
other prescription drugs.

The federal Centers for Disease Control and Prevention reported that 
heroin deaths nearly doubled from 1,725 in 1999 to 3,278 in 2009. 
Over that same time period, deadly overdoses caused by all opiates 
nearly quadrupled from 4,030 to 15,597, the agency said.

The Harm Reduction Coalition, an advocacy group that lobbies on 
behalf of those impacted by drugs, believes that as many as 10,000 
lives nationally may have been saved since Narcan began to be 
distributed to non-emergency personnel in the mid-1990s.

In Worcester, officials said Narcan is used by emergency room 
personnel at the Memorial and University campuses of UMass Memorial 
Medical Center and by UMass Memorial ambulance and LifeFlight 
helicopter crews. Unlike in some other communities, it is not used by 
police or firefighters.

About a year ago, AIDS Project Worcester signed onto the state 
program and began giving away Narcan to opiate users and their loved 
ones, prompting concerns from some quarters including activists in 
Worcester's inner city neighborhoods.

"Narcan should be administered by medical professionals and it 
shouldn't just be given away to drug abusers and their friends," said 
William T. Breault, chairman of the Main South Alliance for Public 
Safety. "The money used to buy the drug should be used instead to 
provide treatment programs."

However, state and many municipal officials from across Massachusetts disagree.

"For a variety of reasons, these overdoses are a very serious problem 
in Massachusetts. The death rate here is among the highest in the 
country," said Hilary Jacobs, deputy director of the Bureau of 
Substance Abuse Services at the Massachusetts Department of Public 
Health. "Narcan gives an (overdosed) addict another day to live. It 
provides another opportunity for that individual to change some very 
bad life patterns."

State officials said the distributed Narcan is administered nasally 
by syringe and that each dose costs $16.

Opioids, which are usually referred to as opiates, are in a class of 
drugs that are derived directly from opium or are manufactured 
synthetically with a chemical structure similar to opium.

Dr. Marc C. Restuccia, the medical director of LifeFlight and 
emergency medical services at UMass Memorial Medical Center, 
explained that opiates deaden pain but they also depress the 
respiratory system of users.

He said that Narcan effectively blocks all the effects of the opiate 
and allows the body to breathe normally.

Dr. Restuccia said there are no side effects to Narcan, but once it 
is absorbed, the overdosed addict begins to feel withdrawal symptoms 
that can be severely painful.

Ms. Jacobs said that it's important that people who have been treated 
with Narcan still go to the hospital because the drug only works for 
about 45 minutes. Meanwhile, opiates can stay in an individual's 
system for up to two to three hours.

"Basically, Narcan knocks the opiate out of brain receptors," she 
explained. "When the Narcan wears off, there's a chance the opiates 
can migrate back to the receptors."

Officials said Narcan cannot treat overdoses caused by non-opiates 
and does not cause any adverse effects on its own.

"It's rather benign," Dr. Restuccia said.

He said that he didn't know how many times UMass Memorial personnel 
have dispensed Narcan but added it is at least once or twice a week.

"It's boom or bust," said Dr. Restuccia. "Overdoses tend to run in cycles."

The DPH now provides Narcan to social service agencies in 16 communities.

The distribution program is part of a two-pronged attempt by the 
state to cut down the number of opiate overdoses.

The second element of the state effort provides funding for 
municipalities interested in drawing up and implementing their own strategies.

For example, Worcester received a three year, $300,000 grant to 
provide educational and other services to opiate drug abusers.

The money designated for the second component was expected to end 
this fiscal year but state officials recently decided to continue 
funding for at least another year.

Derek S. Brindisi, Worcester's public health director, said the grant 
has been used for a variety of outreach programs.

For example, police have met with residents and neighborhood groups 
to allay concerns that people might not report an overdose out of 
fear of being held criminally responsible. Officials said many 
overdose deaths occur because the addicts sharing the drugs don't 
call for help and flee instead because they worry about being arrested.

The grant money has also been used to help inmates at the Worcester 
County Jail and House of Correction transition back into the community.

According to city officials, about 13 percent of inmates will 
overdose within 72 hours of their release. National statistics show 
that between 80 and 90 percent of those incarcerated have substance 
abuse problems.

"The money has helped us do a lot of good things," Mr. Brindisi said.

Officials at AIDS Project Worcester did not return telephone calls 
seeking comment.
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