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."