Heroin Antidote Is a Lifesaver but Doesn’t Beat Addiction

Anthony Perez survived being left in the parking lot of a convenience store to fend for himself during a heroin overdose, but the next time, he wasn’t so lucky. His mom, Stacy Emminger, tells WITF of Pennsylvania about her son’s death and says she misses him every day.

“Of course if I had had it on me, I would’ve used it even though he was already cold,” she said , “but in some ways it’s prolonging the inevitable.” She’s talking about the antidote to heroin overdose, a drug called Narcan (a brand name for naloxone) that is now carried by Pennsylvania police officers to reverse opiate ODs, and her conflicting comments hint at the debate about the use of Narcan. Should we support its use as a lifesaving tool or decry it for failing to address the root cause of the issue?

What Is Naloxone (Narcan)?

Naloxone is an opioid antagonist, which blocks the effects of opioid drugs (like heroin, oxycodone and other narcotic painkillers) by taking the drug’s place at the relevant receptor in the brain. In other words, it jostles the opioid for position in the brain, and when it has taken the spot, the effects of the opioid are stopped, including when an overdose is in progress. Although it’s commonly found in injection form, the Narcan brand of naloxone can be used by simply spraying the drug up into the individual’s nose.

The Good Samaritan Bill 

The Pennsylvania bill that allowed police to carry Narcan was set in motion by Republican Rep. Joe Hackett, who previously served as a police officer in Delaware County. He talks about his experience trying to save overdosing drug users: “I’ve been there administering CPR for drug overdoses on more [occasions than] I want to remember, and it’s a shame.” When he heard about the new drug after becoming a state representative, he personally put the bill together to help police officers get access to it. The law was signed into effect in September and allows police officers, firefighters and families and friends of users access to Narcan. However, there is no funding, so those who need it must pay for it. Additionally, the bill allows users to call 911 without fear of prosecution if they’re with somebody who’s overdosing.

According to Hackett, it “still took too long in my opinion. We had people dying and we couldn’t move fast enough.”

Narcan Doesn’t Treat Addiction 

The problems with the approach are fairly simple to understand, though. As Emminger commented regarding her son’s death, the drug can seem like it’s merely “prolonging the inevitable.” When someone takes Narcan, he goes almost immediately into withdrawal, which includes incredibly unpleasant symptoms like nausea, vomiting, shivering, muscle aches, agitation and much more. If you’re addicted to opioids, you know that the quickest way to relieve these symptoms is with another dose of your drug of choice, and since Narcan does nothing to address the underlying emotional and psychological reasons for taking opioids in the first place, how can you really resist?

Of course, overdosing—for some users—can be a valuable “wake-up call,” and these individuals may decide to head straight to a detoxification and rehab center to get sober. However, this isn’t going to be the case for everybody, and without information on the risks of continuing heroin abuse and encouragement to attend treatment, some users will undoubtedly dive right back into their addiction. In these cases, it seems more like a “get out of overdose free” card that will be relied upon instead of addressing the deep-seated issues that drive them to use the drug in the first place. Drug prevention specialist Amy Sechrist sums the issue up succinctly: “Narcan is used for a moment. And addiction is a chronic disease; it’s a progressive fatal disease.”

However, as she also adds, there are huge benefits to its use. It would be foolish to treat Narcan as a cure for addiction, but it would also be heartless and bordering on sociopathic to oppose its use as a lifesaving tool—to do that, you’d be implicitly suggesting that opioid addicts deserve to die. With heroin overdoses in 2014 poised to double the number in 2013—fueled by the U.S.’s continuing prescription drug abuse problem—we need lifesaving tools like Narcan more than ever.

Narcan Is Controversial but Necessary

Ultimately, the controversy surrounding Narcan is resolved with a simple fact: to stop providing it would not lead to all heroin abusers magically deciding to attend treatment and successfully kicking their addictions. People are overdosing around the country, and we can’t make it stop by sheer force of will; police officers, paramedics, firefighters and loved ones of addicts need access to this medicine to reduce the death and suffering caused by addiction. Our only real challenge is to make sure that when people are ready to make a lasting change, they get the support they need. Providing support for those who can’t afford to attend treatment and taking steps to improve the amount of support available in order to reduce waiting lists is essential, and these steps will help people with any addiction, not just opioid users. Narcan might not solve a complex psychological, emotional and social problem, but it buys us time to make some real progress before too many more people die.

Posted on March 8th, 2015

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