http://www.huffingtonpost.com/andrew-kolodny-md/naloxone-necessary-but-not-nearly-enough_b_5485291.html
Naloxone advocates have a secret mission. That is we are trying to increase the numbers of people using illicit opiates…..COME ON PEOPLE….We are not trying to normalize illicit drug use or send a message that opiate addiction is okay. What we are doing is trying to save lives! Drug Users lives matter.
I don’t know why it is that when we treat marginalized individuals with dignity and respect people become suspicious that some secret agenda is being covered up.
Naloxone Programs are already making a tremendous difference here in Greensboro, NC and surrounding cities. I just watched a news report about heroin overdoses here in Guilford county. “http://myfox8.com/2015/03/18/police-see-drop-in-heroin-deaths-overdoses/ Fox news reported that the number of deaths from overdose has been just about cut in half this year. They did not say one word about Naloxone instead they attributed the reduction in deaths to arrests, but I would argue that what is really happening is exactly what the research told us would happen….”
If you flood the community with Naloxone you will reduce overdose deaths by 49%!
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I have been working with drug users, methadone clinics, treatment centers, schools, recreation centers, mental health facilities, pain clinics, and homeless shelters distributing naloxone and teaching overdose prevention. We train around 12o people per month. Most of the people that my team and I are involved in training are active drug users. We are also working to connect with the family members and friends of people who use opiates. This is so important because drug users are sometimes found by family members unresponsive and in need of Naloxone. I think it is important that NO ONE FEELS AS IF THEY ARE POWERLESS. There are things we can do to improve our situations and actions we can take that move us toward positive change. Next time a substance abuse counselor or social worker is complaining that there is nothing else they can do for John X ….they have done everything they know to do and he still keeps on using…..Instead of complaining, blaming John X, and giving up on John X….REMEMBER that you can practice harm reduction and give JOHNX naloxone. Train him in overdose prevention. Doing this empowers John…makes him feel as if he is doing something positive. REMEMBER-ANY POSITIVE CHANGE!!!!
We are reaching out to anyone who has contact with people that use opiates. This includes people who sell heroin and/or pain pills. When we first approached the dealers most of them were not interested in helping us distribute Naloxone or any other supplies but we have discovered that working with them has enormous benefits. They have a vested interest in ensuring their customers safety.
Naloxone was just made legal for CBO’s to administer last legislative session and there are lots of people freaking out about it. It seems that anytime services are provided for people that actively use drugs or engage in behaviors that are stigmatized and moralized people freak out.
They seem to think that if you do anything to help someone who is actively using you are sending the message that you agree with their behavior. WE DO NOT CONDEMN OR CONDONE LEGAL OR ILLEGAL DRUG USE.
So, lets take a hard look at what people are saying:
1. Naloxone distribution is not enough it needs to be part of a comprehensive approach.
This is absolutely true. There is no doubt that there are many pieces to this puzzle and Naloxone is only one piece. Naloxone alone is not enough. Guilford counties response to opiate misuse is pretty fucking sorry as is North Carolina’s response to mental health/addiction.
HERE ARE SOME OF THE PROBLEMS WITH OUR RESPONSE TO OPIATES IN GSO-
There are NO methadone clinics in High point which is hard to believe given the size of the opiate problem in that city. Replacement therapy is expensive and many people do not seek out this kind of treatment because there is tremendous stigma attached to replacement therapy. Even though Methadone and Suboxone are the gold standard for opiate addiction treatment replacement therapy it is not respected in the recovery community. 12 step programs with their 5-10% success rates (and the 90% recidivism rates) make substitution therapy seem horrible. They further stigmatize those who are treated with methadone or suboxone. They teach people to think that those that use methadone and other substitution therapies are not serious about their recovery and they are just switching one addiction for another . They are told that they are not really well at all. They are not allowed to pick up clean time chips in meetings, or chair meetings. They are often told to just be quiet and listen because they have used that day and no one needs to hear from a using addict. 12 step groups are outright rude to people who admit to being on methadone. They are not considered “clean” They are second class citizens within the rooms.
THIS IS DEADLY BULLSHIT! People who desperately need help are not getting it because if they can’t be “totally clean” they won’t do it! We should be encouraging ANY POSITIVE CHANGE- NOT looking down on people for using evidence based scientifically sound interventions.
2.Treatment is inadequate and expensive
Methadone clinics cost on average 15 dollars per day and do not take insurance. That is pretty expensive for a program that treatment is expected to last at least 18 months. Suboxone treatment is equally expensive. Clients usually need around 400 dollars to even begin Suboxone treatment.
Methadone clinic costs per week : $ 450 per month
12 x 450= 5400 per year-
18 x 450= 8,100 18 months- standard treatment time
Suboxone: 30 days =$600 600x 18= 8400
The cost of replacement therapy is very high especially if a person is struggling with unemployment or having difficulty getting a job because of a nasty criminal record. Lots of times couples stop using drugs at the same time so a couple might be on methadone or suboxone making the cost double. Things can get pretty tough!450 per month for one person but $900 a month for 2 people.
We do not have adequate access for drug treatment and we only offer 12 step abstinence based treatment and recovery. These options leave many people to deal with their substance abuse issues on their own. It is important for people to understand that the 12 steps may very well provide people with a plan for living spiritually but it is not drug treatment.
Detox facilities and long-term treatments are full most of the time so treatment on demand is rarely an option.
So —-now lets address the biggie …. People are convinced that if you provide services for people that use drugs you are somehow sending the message that drug use is okay ! Harm Reduction is an essential public health approach that respects peoples dignity and autonomy. For drug users, harm reduction recognizes that many drug users are either unable or unwilling to stop, do not need treatment, or are not ready for treatment at a given time. Harm reduction programs focus on limiting the risks and harms associated with unsafe drug use, which is linked to serious adverse health consequences, including HIV transmission, viral hepatitis, and death from overdose.
Harm Reduction…Emphasizes tolerance, respect for the personal choices of others and respect for human rights. It favors evidence over anecdote, courage over cowardice and doing what is right even if it seems to send the “wrong message.”
It means doing what has to be done to protect the public health in the face of opposition from all quarters because it is the right thing to do.
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