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Globe Editorial

Lifeline for addicts

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November 19, 2007

IN 2005, 544 people in Massachusetts died as a result of overdoses of heroin and other opium-based drugs, more than twice the number killed by guns. An antidote called Narcan can keep the drug from stopping the user's breathing, but it has to be administered within minutes of an overdose. That is why the state Department of Public Health plans to distribute doses of Narcan to addicts and to train them in its use. The program has been in effect in Boston for more than a year, and should be expanded to four other regions of the state that DPH has identified.

Overdoses are an increasing problem in part because high-grade heroin has been available for about the price of a six-pack of beer. But while Narcan has been in use in hospital emergency rooms for years, it has not been made widely available directly to addicts. In Boston, addicts participating in the city's needle exchange program are trained to spray a prepackaged dose of Narcan, the brand name for naloxone, into the nose of the overdose victim. Nasal membranes absorb it even if the person has stopped breathing.

Narcan distribution has its critics. Many opponents worry that making heroin use less dangerous will simply keep addicts from seeking treatment. The White House Office of National Drug Control Policy opposes it on the grounds that an overdose is such a serious medical event it should be handled by medical professionals and not by an injector's friends.

Proponents, however, see it as a form of harm reduction - a way to keep drug users alive until they are ready to seek treatment. The success of Narcan distribution in saving lives trumps the critics' arguments.

Baltimore began distributing Narcan in 2004. By the end of 2005, participants in the program reported that they had successfully treated 194 overdoses. Heroin-related deaths in the city dropped to one-third below their 1999 peak. By last spring, Boston addicts had reported 60 reversals of overdoses through Narcan. Chicago and New York have also set up Narcan distribution programs.

Last year, despite the veto of then-Governor Romney, the state took an important step to protect the health of drug users by legalizing the sale of hypodermic needles without a doctor's prescription. With access to clean needles, addicts are much less likely to become infected with blood-borne diseases like HIV-AIDS and hepatitis C, or to transmit these diseases to their sex partners and other injection drug users.

Detox is still the preferred option for addicts, and both Narcan and clean needle programs always offer drug treatment first. Yet it is both humane and smart to show addicts how to stay alive until the day when they are ready to beat their addiction, not just evade its most deadly consequences.

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