Wednesday, August 31, 2005

DIY Narcan

From the Chicago Tribune, emphasis added:

"Heroin addicts get overdose remedy
Training helps put treatment on streets"

Street lore holds that in case of a heroin overdose, the victim should be made to walk, placed in a cold shower or shot up with everything from salt water to milk.

But on Tuesday, a Chicago health organization tried to spread the word about the remedy that works best: a drug called naloxone.

It's a clear liquid that reverses the potentially fatal effects of opiate drugs. The Chicago Recovery Alliance, which has trained 5,000 people in how to use naloxone, says the instruction has saved at least 336 lives over the last four years.

"As a physician, this is some of the most rewarding work I've ever done," said Dr. Sarz Maxwell, the alliance's medical director.

She was leading a workshop for six outreach workers who, in turn, are supposed to pass their knowledge to heroin addicts. Once trained, drug users can get bottles of naloxone and syringes from Maxwell.
Heroin kills by depressing breathing. Naloxone reverses that effect, which for decades has made it the standard emergency room method of reviving overdose victims.

The alliance, formed in 1992, operates needle exchanges--providing sterile needles in exchange for used ones--around the city and suburbs. Alliance officials believe that heroin addicts can save fellow users with naloxone. Most won't call 911 if a friend gets in trouble for fear of the police, Maxwell said.

Naloxone "wakes people up enough that they can walk to the car and go to the hospital," she said. "That might be a better idea [to users] than inviting the cops up to your apartment where all your dope is laying out."

Dr. Richard Feldman, head of the emergency department at Advocate Illinois Masonic Medical Center in Lakeview, said he saw little downside to the training.

"It's an extremely rapid-acting, effective and safe drug," he said. "I would be very supportive of [the training program], because there are a lot of heroin addicts who die without ever getting to the hospital."


But in the view of Dr. Andrea Barthwell, a public health consultant and former official with the White House Office of National Drug Control Policy, distributing naloxone helps support drug habits and makes addicts harder to reach.

"If you engage in strategies that delay confrontation of the disease and application of curative strategies, you actually do more harm than good," she said.

But those who took the training said their main concern is to help in a moment of crisis. Ana Arias, an HIV case manager at Howard Brown Health Center in Lakeview, said that some of her clients use heroin, and that naloxone could keep them and their peers around until they're ready for help.

"If you know for sure this person isn't going to stop, you're not enabling them, you're helping to save their life," she said.

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