Pubdate: Mon, 14 Jun 2004
Source: New Mexican, The (Santa Fe, NM)
Copyright: 2004 The Santa Fe New Mexican
Contact: http://www.freenewmexican.com/emailforms/letters.php
Website: http://www.freenewmexican.com/
Details: http://www.mapinc.org/media/695
Bookmark: http://www.mapinc.org/coke.htm (Cocaine)
Bookmark: http://www.mapinc.org/decrim.htm (Decrim/Legalization)
Bookmark: http://www.mapinc.org/hr.htm (Harm Reduction)
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)
Bookmark: http://www.mapinc.org/find?136 (Methadone)

'MAKING A DENT' IN DEATH

On a typically busy Friday morning at Una Ala methadone clinic in 
Espanola, men and women pour into the tiny building and wait in line. 
Many clench money in their fists to pay for their daily dose of the 
synthetic opiate they drink as a substitute for the heroin they crave.

Jeanne Block, a nurse and health educator for the New Mexico Health 
Department, waits by the front door so people looking for free doses 
of Narcan can find her.

Narcan is a prescription drug that reverses the effect of heroin. 
Given to a person who has overdosed, the lifesaving drug "knocks the 
heroin off the brain receptors," Block says. It acts almost 
instantly, and those who've seen it take effect say it's like 
watching a dead person come back to life.

Paramedics have used Narcan on overdose victims for years. But many 
drug users are reluctant to call 911, fearing it will lead to their 
arrest. In Espanola, where police are often the first to answer a 911 
call, some people are more likely to leave an overdose victim at the 
hospital door. Or they'll try reviving the user with cold water or an 
injection of milk or salt water. Such folk remedies are ineffective 
and lengthen the time a victim's brain is starved for oxygen.

In 2001, New Mexico became the first state to legalize the 
distribution of Narcan to addicts and their relatives. The law was 
part of the Health Department's attempt to lower the state's 
fatal-overdose rate, which is the country's highest and six times 
higher than the national rate.

Block designed training materials to teach people how to help 
overdose victims, first by restoring breathing and, if that fails, by 
injecting Narcan.

Her approach is straightforward and realistic -- she knows that if 
friends or family call 911, they might leave the overdose scene 
before the ambulance comes. She tells people to leave overdose 
victims in an obvious spot so paramedics will find them quickly and 
to lay them on their sides, so they don't choke.

Narcan distribution, like the Health Department's needle-exchange 
program, was unpopular at first. After agreeing to carry Narcan and 
being trained in its use, Espanola police backed off, saying the use 
of syringes raised safety concerns. But Block says the New Mexico 
State Police have agreed to carry Narcan in a nasal-spray form.

In the past eight months, Block and her team have trained more than 
250 people -- addicts and their families -- in the Espanola area in 
harm-reduction techniques.

She goes where she's invited, including the Rock Christian Fellowship 
in Espanola, El Duende Bar in Hernandez and Ayudantes and Una Ala 
methadone clinics.

Her classroom at Una Ala is a narrow storage space piled high with 
boxes. Before a typical class, she arranges her pink CPR training 
dummies and waits near the clinic entrance.

All her students this day are return customers -- people who used 
their Narcan on someone who was suffering an overdose. One woman 
tells of coming upon a man lying in the street. "A girl nearby was 
screaming, 'He's overdosed, do something.' "

The woman had a dose of Narcan in her car, and she used it to revive 
the man. She used another dose on an addict friend, who "went in the 
bathroom and never came out."

"You did good. You saved two lives," Block says as she sends the 
woman off with a red-plastic container holding two more doses of 
Narcan, a breathing mask, rubber gloves and alcohol swabs.

The woman has an abscess scar on her arm. She used to shoot heroin, 
but she's not using now, she says. She seems proud of having saved two lives.

In the next two hours, Block learns of three more rescues by her 
trainees. She adds them to more than 60 cases documented by the 
Health Department.

A man tells of injecting Narcan into a woman who had "just come out 
of rehab and slammed a giant speedball" -- a mixture of heroin and 
cocaine. He recalls the time he stumbled across an unconscious man 
lying on the ground. "That guy was gone. He was blue, blue, blue," 
the man says. "Then, after I saved his life, he starts telling me off 
because he was feeling withdrawals."

Saving the lives of people who aren't grateful or are likely to 
overdose again can be thankless, but Block says it's "pretty 
thrilling" nevertheless.

"We have no way of knowing with certainty that these people would 
have died without Narcan, but it's likely," she says. "I have to 
believe we're making a dent."