Pubdate: Thu, 18 Jul 2002
Source: Portland Press Herald (ME)
Copyright: 2002 Blethen Maine Newspapers Inc.
Contact:  http://pressherald.mainetoday.com/
Details: http://www.mapinc.org/media/744
Author: Kelley Bouchard
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)
Bookmark: http://www.mapinc.org/find?136 (Methadone)
Bookmark: http://www.mapinc.org/find?137 (Needle Exchange)

ADDICTS CLOSER TO GETTING DRUG TO STOP OVERDOSES

Portland officials are moving forward with a program to provide the 
anti-overdose drug naloxone to heroin addicts in an effort to reduce the 
number of drug-related deaths.

They also plan to begin stocking the drug on Portland firetrucks as well as 
ambulances, and to train intermediate emergency medical technicians to 
administer the drug along with paramedics.

Portland police, fire and public health officials met Wednesday to begin 
developing a strategy to deal with the growing number of overdose deaths. 
Portland has tallied more than 200 overdoses and 20 overdose deaths since 
January, up from 16 overdose deaths in all of 2001.

The program is being modeled after efforts in Chicago, San Francisco, 
Providence, R.I., New Mexico, Germany and Australia, where the use of 
naloxone has been credited with saving lives. Portland officials expect to 
have a plan in place by September.

"We're focusing on the problem as a public health issue rather than a 
criminal issue," said Gerald Cayer, Portland's director of health and human 
services. "Our short-term goal is to reduce mortality. Our long-term goal 
is to reduce opiate use."

Despite potential controversy over the naloxone program, Cayer said he 
expects it to be implemented without formal City Council review. 
Wednesday's meeting included Mayor Karen Geraghty and Councilor Peter 
O'Donnell, chairman of the council's health and human services committee.

"Clearly the state and Portland are experiencing a huge surge in the use of 
opiates," Geraghty said. "We have the added problem that a large number of 
people have ended up dead. In some of these cases, it's possible that 
naloxone could have saved a life."

The Portland program would provide addicts with a kit that includes a dose 
of naloxone, commonly known by the brand name Narcan, latex gloves and 
alcohol wipes. The kits would be distributed by prescription through the 
India Street Clinic, which is where the city operates a needle-exchange 
program started in 1999. The cost of the program has not been calculated.

Addicts would be required to go through a training program to learn when 
and how to administer naloxone. They also would be encouraged to call 911 
as soon as they suspect someone has overdosed.

During an overdose, a drug user stops breathing and loses consciousness. If 
naloxone is injected in time, the heroin, methadone or other opiate will 
stop working in the body for 45 to 90 minutes, allowing breathing to resume.

In many cases, it may be just enough time for paramedics to arrive and get 
the overdose victim to the hospital for further treatment. "We want people 
to stay alive long enough for EMS to get there," Cayer said.

Cayer said that naloxone is not addictive and that federal officials may 
make it an over-the-counter drug. Still, some people question whether 
naloxone will promote drug use. Others wonder whether it's a good idea to 
entrust addicts with medical care in the event of an overdose.

One of those people is Deputy Fire Chief Terence Walsh, who oversees the 
city's paramedics and emergency medical technicians. But Walsh isn't 
jumping to conclusions.

"We're taking a real hard look at the whole issue," he said. "We're not 
dismissing it. I'm keeping an open mind."

Until now, naloxone has been kept on Portland ambulances in locked boxes 
only accessible to 30 of the city's 52 paramedics. By Friday, Walsh hopes 
to get state permission to stock the drug on firetrucks, too, making it 
accessible to another 22 paramedics.

Walsh also hopes to get state approval to begin training Portland's 16 
intermediate EMTs to administer the drug. So when the city's ambulances are 
busy, emergency medical personnel on firetrucks won't have to wait to 
provide naloxone. "So far, it hasn't been a problem," he said. "It just 
hasn't been thought of."

Naloxone alone won't save a life, which is why Portland officials also plan 
to encourage addicts to call 911 as the first step in dealing with an 
overdose. Often addicts are reluctant to call because the emergency medical 
services' response typically includes police, and they fear being arrested 
for drug-related crimes.

Police Chief Michael Chitwood said he would never subvert a criminal 
investigation, but he believes the primary concern at the scene of an 
overdose should be saving a life.

"If somebody calls to save somebody's life, we'd have to take that into 
consideration," Chitwood said. "I support this program, just as I supported 
the needle exchange. The goal is to save lives."