Establishing residence in hell

English: Naloxone HCl preparation, pre-filled ...

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Saving lives is good an important, but something about this feels like building an addition on a house in hell.

Naloxone is a medication administered usually by injection which rapidly reverses the effects of opiate-type drugs such as heroin, including the respiratory depression which can cause what are normally referred to as ‘overdose’ deaths. … The 16 pilot projects trained 495 carers (family members, partners and other carers) to respond to an overdose using basic life support techniques, and all but one also trained them to administer naloxone.

Saving lives is a good thing, but what else might be done to prevent overdoses? Why this?

Yesterday’s post asked, “at what cost?” What are the costs of this to the family members?

8 Comments

Filed under Harm Reduction, Policy, Research

8 responses to “Establishing residence in hell

  1. Tom

    What about this makes you feel uncomfortable (residence in hell?)?

    Paramedics show up with CPR training and Naloxone, why not begin care while waiting for them to arrive?

    What else do you think could have been done instead (and as effectively) to save the 18 people who were saved in the study (not 18 other people but those 18 people)?

    Why not this?

    What costs to the family are you talking about? And how do those costs compare to being present when someone you care about dies of an overdose in front of you?

    I’m not trying to be dense. You asked some questions in your post and I really tried to guess your answers but I really don’t know!

    I’m actually thinking of starting a similar program to this where I work. I know similar programs exist in the state of New York (supported by the state health department), in Chicago and in New Mexico. It seems like a good idea to me, but I’m open to hearing another perspective.

  2. Thanks for asking. My problem with it is from a bigger system perspective.

    What are all of our options for responding to the problem? Do nothing, give naloxone to the family, give the addict an apartment, heroin maintenance, give the addict a place to inject, opioid maintenance, incarcerate the addict, institutionalization, provide cheap and crappy treatment, provide expensive treatment in disconnected serial episode whenever they crash and burn . . . or provide a treatment model that we know works–long term treatment that emphasizes recovery maintenance in something like a mutual aid group followed by long term (5 years) recovery monitoring and support.

    People say it’s too expensive, but my agency could do it for around $27,000.

    My problem is that we don’t provide meaningful treatment for the illness that is killing them and their families suffer as much or more than the addict.

    This feels a little like denying effective care to people who are debilitated and at risk of death from cardiac disease but giving their families defibrillators for their next heart attack.

    It’s the context that matters. If they are getting good care, the defibrillator may provide some reassurance. If they are being denied good care, it is a symbol of abandonment. Can you imagine that no one is offering real help and you’re stuck just waiting for the next heart attack? Sounds like hell to me.

    So . . . I have no objection in the context of a system that is offering meaningful treatment for the illness that is killing them, but, for most people, that’s not available.

    Thanks again for the question.

  3. Tom

    An excellent and enlightening explanation –I’m so glad I asked! This is why I like to read you so much. You are smart, informed and articulate (and think differently enough from me to be challenging and thought provoking). Thanks!

  4. michellemartin

    where do I purchase and how do I purchase? Cost is not a problem.
    I am in no way rich but, can not see my daughter overdose again.
    I want this and need to know how to get it. A rx must be given right? Why does this have to be such a problem. Her drug additon is killing me. I see her drouning in the water and everyyone would understand jumping in to help her. I am throwing her a life ring and she will not grab the ring. I throw , and throw and now I am panicing, My daughter hates me and I am the only one who is there for her. Why<????

  5. I think having access to this medicine is a great thing. That’s undeniable. Naloxone saves lives. It has saved my life more than once. Early last year I watched it save the life of a mutual friend of ours. Of course me knowing what to say to the EMT’s & 911 operator helped also. Essentially I called 911 & said there was a friend dying from a heroin o.d. & she needed Naloxone immediately. The EMT’s arrived in four minutes, immediately gave her the injection & she woke up. She began breathing on her own & the blue in her face turned to pink in a matter of seconds. Thank God!
    Using less heroin, in the initial injection might also prevent overdose.
    Not buying the heroin & prepping it for injection might have prevented the overdose, or at minimum delayed it.
    Let’s be frank, the Narcotics Anonymous bus could’ve pulled up to her apartment with 40 grateful recovering addicts on board & that wasn’t going to stop her from using heroin. It may have interrupted it temporarily but she was “on a mission.”
    Simultaneously heartbreaking & par for the course.
    -Ernie

    • We’re never going to be able to save everyone, and we’ll always need access to emergency care. We also need meaningful care after the emergency.

      While we may never be able to save everyone, I’m convinced that, if we had a system built around the beliefs that this is a treatable illness and recovery is possible, may of these people who “aren’t ready” would become ready.

  6. Sebastian H

    If they really want off heroin we could treat them with ibogane, but oh no, it is also a psychedlic so we can’t do that.