Thursday, April 24, 2014
There’s a lot of noise surrounding the debate over naloxone, a drug that can reverse the effects of an opiate overdose if administered quickly.
The debate overlaps with discussions on Medicaid expansion, and coincides with Gov. Paul LePage’s push for more drug enforcement. It even shares elements with the recent arguments about welfare reform in Maine.
But the bottom line is that naloxone is a simple way to save the lives of dozens of Mainers each year, and it should be made available to the people most likely to reach an overdose victim in time.
Naloxone, also known by the brand name Narcan, works by binding to the opioid receptors in the brain, stopping the effects of opiates such as heroin and reversing deadly overdoses. It comes in a nasal spray, as easy to administer as a decongestant. And as safe, too — naloxone has no effect whatsoever on someone who is not suffering from an overdose.
In Maine, only licensed paramedics can administer naloxone. A bill now being considered in the Legislature would make the drug available to emergency medical technicians and family members or friends of those at risk of overdosing. Police officers and firefighters may be added to that list as well.FAILED ARGUMENTS
Last June, Gov. LePage vetoed a similar bill, citing the “false sense of security” nearby naloxone would give users, making it easier “to push themselves to the edge, and beyond.”
That same argument is being used this time around, along with claims that Medicaid reimbursement for naloxone would stress a system that already is struggling financially.
In addition, another administration official, speaking against the bill at a hearing last week, argued that naloxone can cause an overdose victim to become violent or ill.
There’s no evidence that the availability of naloxone increases the intensity of heroin abuse. In fact, some research suggests that active outreach as part of a distribution program can cut drug abuse, and push more people toward treatment.
Cost should hardly be a factor, either, as a dose of naloxone costs as little as $22, with only several dozen used each year, and only minimal training necessary.
It is true that people given naloxone can come out of an overdose agitated. But the point is, they come out of it. It makes no sense to dwell on a medication’s limited side effects when the alternative is death.SAVING LIVES
The truth is, naloxone has been effective wherever it has been used. In San Francisco, overdose deaths fell from a high of 155 in 1995 to 10 in 2010 after distribution began in the late 1990s. Police in Quincy, Mass., began carrying naloxone in October 2010 after the city experienced 47 overdose deaths in a span of 18 months. Since then, there have been 16 deaths. Naloxone has been administered more than 200 times by Quincy officers, with a success rate of more than 95 percent.
Similar results can be expected in Maine, which has one of the highest rates of prescription drug addiction among youths and young adults, as well as a growing heroin problem.
Every year, 160 or so Mainers die of a drug overdose. In both 2010 and 2011, seven of those were related to heroin.
With stronger and cheaper heroin flooding the market, however, that number jumped to 28 in 2012, and the surge has continued unabated since.
Mainers addicted to opiates need access to treatment methods that have been proven to work. Unfortunately, the overdose victims of the last few years will never get that chance.
Putting naloxone in the hands of the people most likely to be on the scene of an overdose will make sure that others do.