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Editorial: Don’t Just Rescue Opioid Addicts, Treat Them

Sunday, April 12, 2015
With New England in the grip of an opioid addiction crisis, much attention is being focused on naloxone, a relatively easy-to-administer drug that saves lives by reversing the deadly effects of breathing failure in people who have overdosed on heroin or prescription opioids. Remarkably, advocates say, all this is accomplished without producing major side effects other than withdrawal symptoms and without creating a high.

“It really is quite a miracle drug,” the coordinator of emergency medical services at Concord Hospital told the Concord Monitor last year.

Public safety officials in New Hampshire, where 311 people died from overdoses last year, recently announced that they would offer police officers a voluntary eight-hour course that would include first aid and CPR training as well as a naloxone-specific component instructing them in how to administer the drug and how to monitor the breathing and other reactions of overdose victims. Previously, only emergency medical technicians with 100 hours of training could administer naloxone in New Hampshire, so this is an important step forward in getting a life-saving tool out onto the streets.

Vermont has already gone several steps further. In 2013, it increased access to naloxone by making it available to addicts and their families as well as to first responders. Since then, nearly 1,900 naloxone kits have been distributed in the state, and they have been used about 190 times to reverse overdoses, The Associated Press reports. The state also has adopted a so-called Good Samaritan law, which grants immunity from prosecution to those who call an ambulance if someone has overdosed. The New Hampshire Legislature is considering similar legislation during the current session.

Encouraging as all this is, though, we urge policy makers to ask themselves this question: After naloxone, then what? Preventing an addict from dying by overdose is wonderful, but it is not exactly the same thing as saving — or more precisely — salvaging his or her life. There’s no wonder drug for doing that, unless it’s money — money that needs to be invested in the hard work of supplying high quality, affordable and easily accessible drug treatment options at the local level and encouraging addicts to take advantage of those services. Stepped-up efforts to divert drug users charged with minor crimes from the criminal justice system into treatment are also needed, as are initiatives aimed at curbing the diversion of prescription drugs to illegal use in the first place.

The Vermont experience is perhaps instructive. After Gov. Peter Shumlin declared the state to be in the throes of a “full-blown heroin crisis” in his 2014 State of the State address, the Legislature provided one-time financial grants to addiction treatment clinics as a way to cut down their long waiting lists. As The New York Times reported in February, all five clinics in the state were able to make significant inroads, but as soon as the money ran out, the waiting lists began to grow again. And Dr. Harry Chen, the state health commissioner, told the Times: “We’re just scratching the surface. Even if we almost double the number of people in treatment, for each person who seeks it, there are probably 10 others who need it.”

Given that the opioid crisis coincides with a budget crunch in both states, lawmakers will face some tough choices about how to provide adequate and sustainable funding for addiction treatment. Without that, though, naloxone is just a small Band-Aid being asked to staunch a hemorrhage.

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