Narcan (naloxone) nasal spray, used for the complete or partial reversal of an opioid overdose
These days, the odds are that you will have a family member, friend, or co-worker who will suffer the loss of a loved one who died of a drug overdose. You may also be someone who lives in fear of that occurring. The harsh reality we face in the United States is that the majority of those overdoses are a result of the abuse of prescription medications, though the
use of heroin as a cheaper substitute for addiction to prescription drugs is also on the rise, with related deaths.
Overdose death rates are tracked and monitored by government agencies, and the Centers for Disease Control (CDC) report that, "Every day, 44 people in the U.S. die from overdose of prescription painkillers, and many more become addicted." They also report that "between 2002 and 2013, the rate of heroin-related overdose deaths nearly quadrupled, and more than 8,200 people died in 2013."
Adding up all the mortality data has resulted in the figure quoted in this Washington Post article: "100 Americans die of drug overdoses each day. How do we stop that?"
Keep reading below for a discussion of the problem, its history, and some solutions you can get involved in supporting
Last year, VICE News posted this mini-documentary on the problem which examined not only the crisis but a potential partial solution.
Abuse of prescription painkillers, heroin, and other opioids has spiked over the past decade in the United States. According to the Centers for Disease Control, more than 100 Americans die every day from drug overdoses. Overdoses now kill more people in the US each year than gunshot wounds or car accidents. The stigma that surrounds drug users has made finding a solution difficult.
New England has been hit especially hard by fatal overdoses. In Massachusetts, deaths caused by heroin and other opioids have increased by more than 90 per cent since 2002. In response, the state started a pilot program in 2007 aimed at decreasing the number of fatal overdoses. The centerpiece of the program is a drug called Naloxone, known by its brand name Narcan. It's a nasal spray that can instantly stop an opioid overdose.
VICE News went to Massachusetts to see how effective Narcan has been in stopping fatal overdoses, and uncovered the reasons why other states may have been slow to adopt similar life-saving programs
This nasal spray video illustrates how Narcan can easily be used by lay people.
Sarah Mackin, Program Manager at the Boston Public Health Commission explain the signs of someone who has taken an overdose and how to administer the Narcan nasal spray to hopefully save a life. - Boston Herald staff video by Matt Stone
Watching these videos made me think back to my teenage and young adult years, when the heroin scourge had hit inner-city neighborhoods I hung out in and lived in like an ill wind of death. I lost a lot of people I knew to heroin. Those who didn't die wound up in jails and hospitals. I remember the first time I found my boyfriend on the floor, eyes rolled back in his head, a belt still tied on his arm, and a "bobo" (eye-dropper syringe) on the floor beside him. I panicked, trying to remember all the things I had picked up from overhearing
tecato (addict) conversations. "Administer a salt shot" (I had no clue how to do that), "walk him" (I was too small to lift him), "throw them in the shower" (couldn't do that either), "put ice on his balls" ... that i could do, and I ran in a panic to the kitchen, got a full tray of ice cubes, ran back, unzipped his pants and dumped in the whole batch. He came to. I was angry and happy and relieved, all at the same time. His journey out of the woods of heroin addiction and mine beside him is a story for another time. But during those years I watched a lot of neighborhood guys (and a few women) die, and the familiar sight of two guys walking a third guy, half-dragging him up and down the sidewalks of
El Barrio, is one I've never forgotten. Years later on the Lower East Side of New York City, I would live close to a "shooting gallery." All too frequently I'd leave my building only to discover a dead body dumped in the vacant lot next door. Death by OD.
When I became engaged in the radical politics of the Young Lords Party and the Black Panther Party, one of the pamphlets we studied in our political education classes was written by a New York Panther member, my close friend Michael Cetewayo Tabor. It was titled "Capitalism Plus Dope Equals Genocide." We learned to look at the dope epidemic in our community as part of a larger problem, involving the police and the government. Here's Cetewayo's introduction:
Recently in the Black colony of Harlem a 12 year old Black boy was murdered by an overdose of heroin. Less than two weeks later a 15 year old Black girl met the same tragic fate. During the year 1969 in New York City alone there were over 900 deaths resulting from drug addiction. Of these 210 were youths ranging in age from 12 to 19. Of the over 900 dead, the overwhelming majority were Black and Puerto Rican. It is estimated that there are at least 25,000 youths addicted to narcotics in New York City - and that is a conservative estimate.
Drug addiction in the colonized ghettos of America has constituted a major problem for over 15 years. Its use is so widespread that it can - without fear of exaggeration - be termed a "plague". It has reached epidemic proportions, and it is still growing. But it has only been within the last few years that the racist US government has considered drug addiction "a matter of grave concern". It is interesting to note that this growing concern on the part of the government is proportionate to the spread of the plague into the inner sanctums of the White middle and upper-class communities. As long as the plague was confined to the ghetto, the government did not see fit to deem it a problem. But as soon as college professors, demagogic politicians, money-crazed finance capitalists and industrialists discovered that their own sons and daughters had fallen victim to the plague, a virtual "state of national emergency" was declared. This is significant, for it provides us with a clue to the understanding of the plague as it relates to Black people.
Re-reading it all these years later has made me think about not only the so-called "War on Drugs," but the current attention and outcry about both black tar heroin and prescription opiates. This current "plague" is taking the lives of white people, especially those who are middle class. A Salon review of a recent book by Sam Quinones titled
Dreamland: The True Tale of America’s New Opiate Epidemic points in the same direction. The review's title: "
Heroin is a white-people problem: Bad medicine, economic rot and the enterprising Mexican town that turned the Heartland on to black tar."
The current upsurge in heroin addiction attracted little attention at first because its roots lie in what Quinones describes as “voiceless parts of the country — in Appalachia and rural America.” In the unconscious moral mythology of America, small town and rural life is associated with hard work, safety and wholesome virtues, while heroin is an affliction of big cities, with their vice, crime and scary dark-skinned residents. To admit that poverty and despair, irrespective of race, fosters heroin abuse is to undermine entrenched, unspoken prejudices that equate this particular addiction with the moral and cultural weakness of “other people.”
Nevertheless, the meth plague, which flourished in many of the same communities, drew plenty of notice. America’s smack crisis snuck up on us by beginning as a legal, and then a quasi-legal phenomenon. What’s most shocking about Quinones’s history of the rise of addictive pain-killers like OxyContin is that the apotheosis of these drugs was based on completely unfounded scientific claims.
The publishers provide
this synopsis:
In fascinating detail, Sam Quinones chronicles how, over the past 15 years, enterprising sugar cane farmers in a small county on the west coast of Mexico created a unique distribution system that brought black tar heroin--the cheapest, most addictive form of the opiate, 2 to 3 times purer than its white powder cousin--to the veins of people across the United States. Communities where heroin had never been seen before--from Charlotte, NC and Huntington, WVA, to Salt Lake City and Portland, OR--were overrun with it. Local police and residents were stunned. How could heroin, long considered a drug found only in the dense, urban environments along the East Coast, and trafficked into the United States by enormous Colombian drug cartels, be so incredibly ubiquitous in the American heartland? Who was bringing it here, and perhaps more importantly, why were so many townspeople suddenly eager for the comparatively cheap high it offered?
With the same dramatic drive of El Narco and Methland, Sam Quinones weaves together two classic tales of American capitalism: The stories of young men in Mexico, independent of the drug cartels, in search of their own American Dream via the fast and enormous profits of trafficking cheap black-tar heroin to America's rural and suburban addicts; and that of Purdue Pharma in Stamford, Connecticut, determined to corner the market on pain with its new and expensive miracle drug, Oxycontin; extremely addictive in its own right. Quinones illuminates just how these two stories fit together as cause and effect: hooked on costly Oxycontin, American addicts were lured to much cheaper black tar heroin and its powerful and dangerous long-lasting high. Embroiled alongside the suppliers and buyers are DEA agents, local, small-town sheriffs, and the US attorney from eastern Virginia whose case against Purdue Pharma and Oxycontin made him an enemy of the Bush-era Justice Department, ultimately stalling and destroying his career in public service.
Dreamland is a scathing and incendiary account of drug culture and addiction spreading to every part of the American landscape.
I haven't read this book yet, but plan to.
More background on the BigPharma connection can be explored in "How the American opiate epidemic was started by one pharmaceutical company."
The state of Kentucky may finally get its deliverance. After more than seven years of battling the evasive legal tactics of Purdue Pharma, 2015 may be the year that Kentucky and its attorney general, Jack Conway, are able to move forward with a civil lawsuit alleging that the drugmaker misled doctors and patients about their blockbuster pain pill OxyContin, leading to a vicious addiction epidemic across large swaths of the state. A pernicious distinction of the first decade of the 21st century was the rise in painkiller abuse, which ultimately led to a catastrophic increase in addicts, fatal overdoses, and blighted communities. But the story of the painkiller epidemic can really be reduced to the story of one powerful, highly addictive drug and its small but ruthlessly enterprising manufacturer.
On December 12, 1995, the Food and Drug Administration approved the opioid analgesic OxyContin. It hit the market in 1996. In its first year, OxyContin accounted for $45 million in sales for its manufacturer, Stamford, Connecticut-based pharmaceutical company Purdue Pharma. By 2000 that number would balloon to $1.1 billion, an increase of well over 2,000 percent in a span of just four years. Ten years later, the profits would inflate still further, to $3.1 billion. By then the potent opioid accounted for about 30 percent of the painkiller market. What's more, Purdue Pharma's patent for the original OxyContin formula didn't expire until 2013. This meant that a single private, family-owned pharmaceutical company with non-descript headquarters in the Northeast controlled nearly a third of the entire United States market for pain pills.
The problem is clear. The solutions involve local efforts and a multi-pronged approach.
As individuals, you can start in your own home. September 26 was National Prescription Drug Take-Back Day, which has passed but you can use the locator tool to find out where you can safely dispose of them near you.
Why is this important? Family members and visitors to your home use your bathroom, which is where most people keep pills.
A friend visited my home and brought a companion who spent too long in my bathroom and later was acting very strangely. This person later od'ed in my friend's home (but did not die). I found out this person had stolen and presumably ingested all my cat and dog medication. I had a cat who was prescribed tranquilizers and a dog who was on pain meds after suffering a broken leg. It never occurred to me someone would rifle through the medicine cabinet.
You can also find out what the laws are in your state about Narcan, and the availability of Narcan programs.
Take a look at the Naloxone Overdose Prevention Laws Map, and see where your state is either helping or failing to be a part of the solution. This article covers some of the compiled data: America’s drug overdose problem—and what states can do to help fight it—in 4 charts and maps
In order to help those who are overdosing, the report’s authors argue that states should pass more laws easing access to rescue drugs like nalaxone — which counters the effects of prescription painkillers, heroin and other opioids — and pass Good Samaritan laws protecting bystanders who call for medical assistance.
Access to nalaxone has been facilitated — in some form — in 34 states and D.C., while 26 states and D.C. have passed Good Samaritan laws.
The establishment of safe injection spaces is another related approach. It has been vociferously resisted in the past but is gaining traction, pushed by both the harm reduction community and public health workers alike.
Everywhere But Safe is a documentary film that examines public injection drug use in New York and charts a path toward healthier and safer communities.
Two articles cover this movement:
Could safe injection sites for IV drug users be in the works for NYC?
New York City -- Homelessness and public drug use are on the rise in New York, and accidental drug overdoses now kill more people than car accidents in the U.S. But effective public health solutions are available and being used in cities throughout Europe, Canada, and Australia. At a time when the Mayor and Police Commissioner Bratton struggle with homeless encampments and open air drug use in New York City, the Open Society Foundation is hosting a town hall on Wednesday, September 30th featuring international experts to talk about innovative solutions to public drug use and overdose, such as supervised injection facilities.
Supervised injection facilities (SIFs) – which are sometimes called safer injecting sites or drug consumption rooms – were first adopted as a strategy in Switzerland in the 1980s, and quickly spread to other parts of Europe, Canada, and Australia. SIFs provide people a safe place to use drugs, while linking them to services and support. Today, nearly 100 SIFs exist around the world. Rigorous scientific evaluation has shown them to reduce overdose deaths and infectious disease transmission, improve access to drug treatment and other health care for people who inject drugs, and reduce public disorder, including improperly discarded drug paraphernalia.
“This forum comes at a critical time for New York,” said Julie Netherland, PhD, deputy state director at the Drug Policy Alliance. “Homelessness is at all time high and the media is filled with reports of concern about public drug use. Fortunately, there are evidence-based solutions – like supervised injection facilities -- to reduce public drug consumption, while saving lives and linking people to services. It’s time for New York to take a page from the international drug policy playbook.”
I've written about some of these issues here before, specifically in "
Sin, stigma and syringes: The struggle for harm reduction."
This society punishes and stigmatizes addiction. For a long time, when drug addicts were portrayed as "other" (read black, Latino, and Asian) or as peripheral whites who hang out with "others" (like white jazz musicians), mainstream America could look away and lock 'em up, or let them die. No loss.
Now that the epidemic is suburban and not just urban and inner-city, which is code for people of color, we may actually see some progress. Attempts are made to blame the sellers. For example, if we'd just build a wall high enough, no non-prescribed drugs will be available. But that is pure b.s. What would tank the entire market would be legalization and access to safe spaces and treatment, instead of punitive imprisonment for those who are at the low end of the class scale. This is clearly wishful thinking, and I hope that President Obama's move to release federal drug offenders will lead to more. In the meantime, there are political steps that you can take.
Support legislation that can save lives. OD's are real. Once someone dies we can't bring them back, but we can significantly reduce the death totals.
In June 2015, two Democrats issued this press release.
Federal Lawmakers Introducing Overdose Prevention Bill to Combat Heroin and Opioid Overdose Crisis
Washington, D.C. – Today, U.S. Senator Jack Reed (D-RI) and U.S. Representative Donna F. Edwards (D-MD) are introducing identical legislation to support the expansion of overdose prevention services. Both bills support community-based efforts to prevent fatal drug overdoses from heroin, opioid pain medications and other drugs. Both bills would expand community-based overdose prevention programs that provide resources to those likely to witness an overdose and be in a position to help, such as first responders and family members. Resources include trainings on how to recognize the signs of an overdose, seek emergency medical help, and administer naloxone and other first aid. Both bills would provide federal funding for the purchase and distribution of naloxone by community and public health stakeholders to people at risk of experiencing or witnessing an overdose. A new Centers for Disease Control and Prevention (CDC) report released last week credits overdose prevention programs with training more than 150,000 potential bystanders who successfully reversed more than 26,000 overdoses using naloxone and other rescue techniques.
“Since I first introduced this bill in 2009, nearly 140,000 Americans have died from opioid related deaths, including more than 4,000 from my home state of Maryland,” said Congresswoman Donna F. Edwards (D-MD). “While I remain encouraged by the Obama Administration’s priority in expanding naloxone access across our nation, it is Congress’s role to appropriate funding. I thank Sen. Reed for leading this effort on the Senate side, showing lawmakers that we have a responsibility to fund programs that make a real difference in treating and preventing overdose, and ultimately saving lives. And while I understand that there is much work to be done in order to address substance abuse before it gets to the point of overdose, each year hundreds of Maryland families and tens of thousands of American families need immediate assistance.”
“We can’t let more young people fall victim to heroin and opioid abuse. This is a serious public health and safety problem in Rhode Island and every type of community across the country. Opioid dependence and overdose is a growing problem that cuts across social and economic boundaries and we need to take action or it will continue to get worse,” warned Senator Jack Reed (D-RI). “The Overdose Prevention Act will establish a comprehensive national response to this epidemic. It emphasizes collaboration between state and federal officials and employs best practices from the medical community. And it invests in community programs and treatments that have proven effective in combating this startling national trend. This is an emergency and it requires a coordinated and comprehensive national response. The Overdose Prevention Act brings together federal authorities, first responders, medical personnel, addiction treatment specialists, social service providers, and families to help save lives and get at the root of this problem.”
Contact
Senator Jack Reed (D-RI), and
Rep. Donna F. Edwards to voice your support.
Call your senators and congress members to get them on board with the bill sponsored by Reed in the Senate, and with the Edwards bill in the House.
Check for legislation in the works in your state.
Your support can help save lives, and it may be the life of someone you know.