Source: Vancouver Province (Canada) Contact: http://www.vancouverprovince.com/ Pubdate: Wed, 18 Mar 1998 Author: Mark Tonner - Out of the Blue -- (Const. Mark Tonner is a Vancouver police officer. The opinions and statements contained in this columns are those of the writer, not necessarily those of the Vancouver police department or the police board. Tonner may be contacted at The Province, or by e-mail at NARCAN THE PANACEA ONLY TO HEROIN JUNKIES Narcan is part of the larger marvel that our medical community refuses to give up on addicts. It's hard to know what to say to someone freshly back from the dead. Welcome to heaven? To purgatory? "Welcome back to the hell you've made of your life" may be more fitting for heroin addicts rescued by the lifesaving drug Narcan. Ask anyone working the downtown eastside - resurrected addicts are rarely thankful. Heroin highs are so intensely satisfying that interrupting one, even a lethal overdose, tends to earn curses. Naloxone hydrochloride, or Narcan, attacks the narcotic, scavenging heroin from brain receptors in the brain so quickly that recipients progress in seconds from not breathing to uttering profanity. The transition is so sudden that paramedics recently had to change procedure. Subcutaneous, under-the-skin injections now bring subjects up more gradually (three to four minutes) than when Narcan was given intravenously. Less time is wasted searching for unravaged veins, less blood (possible bearing contagion) is spilled, subjects are less likely to lash out. Typically they're eager to depart in search of new lows, which is problematic: Narcan works for about 20 minutes, while heroin lingers for hours. For a while, the user will be so clear-headed that withdrawal symptoms may be felt, but the heroin won't be gone, and respiratory collapse often returns once the Narcan wears off. What to do when an addict refuses to believe this? Police are allowed to take charge of those mentally ill enough to cause themselves harm, but calling addictive urges a form of insanity is risky in skid-row environments. Addicts and their advocates have enough time on their hands for handbill campaigns as well as placard-waving protests and they're not shy about attacking others. Heroin has become so cheap it's increasingly substituted for cocaine, which can be fatal to addicts with no heroin tolerance. That affordability makes a dose of Narcan (about $28) worth three times the price of the drug it counteracts. St. Paul's hospital administered Narcan over 450 times last year alone, bringing the total to more than $13,000 for one facility. Addicts arrive in need of Narcan continually; many have been fished out of next life 30 times and more than one paramedic recalls beginning a recent evening shift saving a life with the drug, then closing the shift by saving the same life again. Local prostitutes have been innovative, injecting their clients with heroin overdoses, robbing them, then dialing 911 to bring on the Narcan. Johns, anticipating cocaine-heightened sexual extremes, are instead receiving heroin and glimpses into eternity. Though the drug is essentially harmless, only doctors and paramedics are qualified to inject it. Distinguishing heroin overdose from other ills in an area where unconsciousness can mean anything requires more than simple willingness to push a plunger. It has been said that Narcan generates crime, by ending highs and leaving users with fresh cravings. In truth,, Narcan is a marvel, and part a larger marvel - the fact that our medical community refuses to give up on addicts. It's time the rest of society fought for these people to help them become drug-free, rather than patting them on the head and crying out for legalizing narcotics.