Pubdate: Sun, 16 Jan 2000
Source: New York Times (NY)
Copyright:  The New York Times Company
Contact:  http://www.nytimes.com/
Forum: http://www10.nytimes.com/comment/
Author: Sam Howe Verhovek
Cited: Lindesmith Center: http://www.lindesmith.org/
Bookmark: MAP's shortcut to heroin items:
http://www.mapinc.org/heroin.htm

CONFERENCE SEEKS WAYS TO REDUCE HEROIN DEATHS

SEATTLE, Jan. 15 -- Larry W. Campbell, chief coroner of British Columbia, 
where deaths from drug overdoses have risen tenfold in the last decade, to 
407 last year, said he came to Seattle this week for one reason.

"There are ways to prevent these people from dying," Dr. Campbell said, 
"and I'd like to learn more about them."

Dr. Campbell was attending an unusual conference here, "Preventing Heroin 
Overdose: Pragmatic Approaches," which was billed by its sponsors as the 
first international gathering of experts to center on the question of how 
deaths among heroin users can be stopped.

The 400 people who attended gathered in a city that has a heroin problem of 
its own: Seattle recorded a record number of heroin-related deaths, 144, in 
1998 and has one of the highest per-capita rates of such deaths in the 
United States.

The conference included scholars, researchers, doctors and other health 
care providers, drug-treatment providers and a handful of police officials 
who discussed strategies for dealing with heroin use.

Some strategies, including needle-exchange programs and informal pledges by 
the authorities not to prosecute drug users who call 911 or who are taken 
to emergency rooms by friends after an overdose, are already being employed 
in some American cities. Other approaches are being gingerly experimented 
with, including distribution to addicts of naloxone, a prescription drug 
that can counteract the effects of an overdose.

But other strategies that health experts came from Europe to discuss seem 
politically unimaginable here, including so-called "safe injection rooms." 
In such places, drug users are allowed to shoot heroin under the 
supervision of a trained staff, which can ensure that needles are sterile 
or arrange for immediate medical treatment in the event of an overdose.

The conference here was co-sponsored by the University of Washington's 
Alcohol and Drug Abuse Institute and by the Lindesmith Center, a New York 
drug policy center that is financed by the billionaire George Soros and 
advocates alternatives that are more liberal than the nation's drug policy. 
The Seattle police and health departments were also listed as co-sponsors.

The meeting had extensive, and at times impassioned presentations that 
generally favored an approach to drug abuse known in treatment circles as 
"harm reduction." That approach is less focused on telling drug abusers 
about the dangers of drugs than on getting them to use drugs more safely.

Advocates of the approach say that many drug abusers have heard the "just 
say no" message countless times -- "They hear it every day of their lives," 
said Heather Meschery, director of a needle-exchange program in Santa Cruz, 
Calif. -- but are determined to use drugs anyway. The effort, these 
advocates say, should be on minimizing the harm they can do to themselves.

Urban Weber, director of an agency that runs two of the four safe-injection 
rooms in Frankfurt, said that the approach had helped reduce overdose 
deaths there from 147 in 1992, shortly before the injection program began, 
to 26 in 1999.

"This is simply about keeping people alive," Dr. Weber said. "We say it's 
safer to do it here than on the streets." And, like many of the advocates 
here, he rejected the notion that such places encourage drug use, 
especially among the uninitiated.

"It is by no means an attractive place to see," Dr. Weber said. "It is not 
like going to a cafe and having a beer."

Several officials from American cities at the conference said the point was 
not to adopt all such approaches now in use around the world, but to get 
experts together to hear what was being tried.

"There is no one size fits all model to this problem," said Alonzo Plough, 
the director of public health for Seattle and surrounding King County, 
which operates one of the first and largest needle-exchange programs for 
drug users, and is formulating plans for a broader initiative to combat 
heroin-related deaths and H.I.V.

"It's very good to see the range of things that have worked in other 
places," Dr. Plough said. "It's clear that not all those approaches will 
work in any one place."

Ethan A. Nadelmann, director of the Lindesmith Center, whose critics say it 
undermines drug control efforts, was less restrained in endorsing the ideas 
presented here.

"We could cut heroin overdoses in half if the information from this 
conference was widely disseminated," Mr. Nadelmann 
said.
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MAP posted-by: Richard Lake