Pubdate: Thu, 10 Aug 2006
Source: Boston Globe (MA)
Copyright: 2006 Globe Newspaper Company
Contact:  http://www.boston.com/globe/
Details: http://www.mapinc.org/media/52
Bookmark: http://www.mapinc.org/decrim.htm (Decrim/Legalization)
Bookmark: http://www.mapinc.org/hr.htm (Harm Reduction)
Bookmark: http://www.mapinc.org/find?137 (Needle Exchange)

SECOND CHANCE FOR ADDICTS

WITH A SMALL bag of heroin selling for less than a six-pack of beer, 
it is no surprise that heroin overdoses have become a major public 
health problem in Boston and elsewhere. Between 1999 and 2003, the 
latest year for which figures are available, drug-related deaths in 
Boston rose 50 percent. Heroin was involved in many of the 144 drug 
deaths in 2003. The Boston Public Health Commission is acting 
responsibly in trying to reduce this toll by making a key medication 
available to addicts for use in emergencies. Mayor Thomas M. Menino 
deserves credit for giving the pilot program his support.

The drug is called naloxone, marketed as Narcan. Hospital emergency 
rooms and city paramedics administer it, but now Boston is following 
New York, Baltimore, and Chicago in distributing it to addicts 
themselves. Under the plan, which is expected to get the approval of 
the commission's board next week, addicts participating in the city's 
needle-exchange program would be invited to enroll in the Narcan 
program as well. It would include training in treating overdoses and 
a consultation with a physician.

An overdose antidote that can revive patients near death, Narcan is 
available both as an injection and as an inhalant. According to John 
Auerbach, executive director of the city health commission, Boston 
will use the inhalant method. He said addicts will be taught to 
insert the pre-packaged dose into the nose of the overdose victim and 
squeeze a small ball to spray the medication, which will be absorbed 
by nasal membranes even if the victim is not inhaling voluntarily.

Needle exchanges protect addicts against blood-borne diseases such as 
HIV-AIDS and hepatitis C by providing them with uncontaminated 
syringes. Boston, Cambridge, Provincetown, and Northampton have such programs.

This year, the Legislature legalized over-the-counter sales of 
hypodermic needles, overriding Governor Romney's veto.

The public health term for distributing clean needles or Narcan is 
harm reduction.

The best choice in dealing with drug abuse is persuading individuals 
not to start taking them in the first place. The next best course is 
to get addicts into treatment. Needle exchanges and Narcan programs 
are third-tier methods: Simply keeping the drug abusers alive for the 
day when they can embrace treatment.

Baltimore's "Staying Alive" program of training and equipping addicts 
with Narcan is credited, along with an expansion in drug treatment, 
with reducing fatal drug overdoses in 2004 to the lowest level in five years.

Auerbach said there is a short window after addicts survive an 
overdose when they want to "turn their lives around." But many will 
no longer have a life at all unless Narcan is more readily available.
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MAP posted-by: Beth Wehrman