Pubdate: Mon, 18 May 2015
Source: Seattle Times (WA)
Copyright: 2015 The Seattle Times Company
Contact:  http://seattletimes.nwsource.com/
Details: http://www.mapinc.org/media/409
Authors: Molly Carney and K. Michelle Peavy
Note: Molly Carney is the executive director and K. Michelle Peavy is 
research and training manager of Evergreen Treatment Services.

LIFESAVING DRUG FOR OPIOID ADDICTS IS NOT EASY TO GET

MORE than 500 people die of opioid overdoses in Washington state each 
year. This death toll has skyrocketed over the past decade as opioid 
addiction rates have risen, fueled by expanded access to prescription 
opioids and more potent, inexpensive heroin.

Increasingly, public-health advocates and researchers have shone a 
light on an antidote to overdose death. Naloxone, also known by its 
brand name Narcan, can be injected or administered intranasally after 
someone has overdosed. Naloxone quickly binds to opioid receptors in 
the brain, reversing the overdose, and frequently forces the person 
into a speedy, but often painfully intense, withdrawal. For many 
people, naloxone means the difference between life or death.

But naloxone is not the silver bullet that will end our state's - or 
our nation's - opioid-use epidemic.

One limitation of naloxone is that not enough people can get it. 
Anyone who is at risk for having or witnessing a drug overdose can 
obtain naloxone, but it must be prescribed. Only about 30 locations 
in Washington - most of them pharmacies - currently provide it. Our 
organization, Evergreen Treatment Services, an outpatient opioid 
treatment program, is stuck in naloxone limbo. We dispense opioid 
medications like methadone but we cannot distribute naloxone from our 
premises without cumbersome regulatory and practical arrangements.

Police and other emergency first responders need more freedom to 
legally carry naloxone, as do organizations that are likely to 
interact with people who are overdosing. Many Evergreen Treatment 
patients, for example, are in the early phases of treatment, and 
therefore still at high risk of overdosing or witnessing an overdose 
of a friend or family member. If this were to happen at Evergreen 
Treatment, we would not have naloxone on hand to help save the person's life.

A bill that was passed by the Legislature and signed by Gov. Jay 
Inslee last week will improve this situation. ESHB 1671, which was 
introduced by a thoughtful group of state lawmakers led by state Rep. 
Brady Walkinshaw, D-Seattle, will loosen the restrictions on naloxA 
kit with naloxone. An opiate overdose essentially makes the body 
forget to breathe. Naloxone works by blocking the brain receptors 
that opiates latch onto, helping the body "remember" to take in air. 
one and make it easier for organizations like Evergreen Treatment to 
have the drug on hand in emergencies. We applaud this legislative effort.

But emergency interventions alone will not solve our state's 
opioid-use epidemic. We need an integrated approach, which includes 
expanded access to treatment, to drive down rates of overdose and 
address opioid addiction. Recently, the Alcohol and Drug Abuse 
Institute at the University of Washington and the U.S. Attorney's 
Office convened a group of law enforcement, treatment specialists, 
policymakers, public-health specialists and others in Eastern 
Washington to discuss what this approach could look like.

Opioid-use disorders are medical disorders that dramatically alter a 
person's brain chemistry and respond well to treatment. Recovery does 
happen, but it takes time - months, years or even a lifetime. The 
combination of medication-assisted treatment and behavioral 
interventions that help people learn how to live drug-free has been 
shown to be the best way for patients to recover and avoid relapse.

We also need to eliminate the stigma that allows opioid addiction to 
remain in the shadows and prevents people from seeking help. We hear 
the ugly opinions often: Addicts don't deserve treatment. What these 
critics do not see is the tremendous courage and persistence of 
patients we meet every day. In many cases, Evergreen Treatment 
patients have lost everything - families, jobs, homes - to addiction 
and they are painstakingly piecing their lives back together while 
pursuing an intense daily regimen of medications and visits with 
counselors and health-care providers. These patients deserve respect 
and support. Recovery does happen and treatment does work.

Bolstering treatment and combating stigma make our communities 
stronger and saves taxpayer dollars. According to the state 
Department of Social and Health Services, the risk of felony 
conviction is 83 percent lower for those in methadone treatment for 
more than one year, compared to opioid addicts who are untreated. 
DSHS also explains that treatment of opioid addiction saves 
Washington state taxpayers $765 per patient a month in Medicaid 
health-care costs, compared with not providing this treatment. It is 
cost effective, and it works.

It is important that Washingtonians support expanded access to 
naloxone and its lifesaving potential. But it is not a cure-all. When 
people are whiplashed back to life with naloxone, their journey may 
be just beginning. We need funding, infrastructure and supportive 
policies to keep them alive.
- ---
MAP posted-by: Jay Bergstrom