March 9, 2017
ANOTHER VIEWPOINT CONTACT: Ron H. Graham, (440) 350-2543
March 2, 2017 LAKE COUNTY GENERAL HEALTH DISTRICT
FOCUS ON SOLUTIONS RATHER THAN PASSING JUDGEMENT
This is in response to Judge Diane V. Grendell’s Opinion article in the February 20, 2017 News-Herald. In her article, Judge Grendell argues that the opioid reversal drug naloxone, sold under the brand name Narcan, should not be used to save opioid drug users that have suffered an overdose because this action does not halt the flow of heroin into Ohio and enables those who abuse opioid drugs to continue their habit. In effect, she is stating that persons who use opioid drugs that have suffered an overdose should be left to die. There are several problems with this logic.
First, there is no scientific evidence that the use of naloxone enables people who misuse opioid drugs. In fact, published studies have documented that, “naloxone precipitates the same unpleasant symptoms that opioid-dependent people are trying to stave off with their opioid use in the first place, except that, with naloxone, the symptoms are more intense. People who use opioids and who have experienced the acute withdrawal effects that accompany naloxone consistently deny that they are more comfortable using heroin frequently or in higher doses because of naloxone availability (Kim D, Irwin KS, Khoshnood, K. 2009. Expanded Access to Naloxone: Options for Critical Response to the Epidemic of Opioid Overdose Mortality. Am J Public Health. 99(3): 402-407.).” An additional study has found that naloxone access “is associated with a 9 to 11 percent reduction in opioid-related deaths,” and that naloxone access does not, “increase the recreational use of prescription painkillers (Rees DI, Sabia JJ, Argys LM, Latshaw J, Dave D. 2017. With a Little Health from My Friends: The Effects of Naloxone Access and Good Samaritan Laws on Opioid-Related Deaths. National Bureau of Economic Research, NBER paper 23171).”
There is additional documented evidence that those who misuse opioid drugs who have such a near-death experience have a better chance of seeking and succeeding at treatment. Despite Judge Grendell’s statements, there is no evidence that, “giving naloxone to heroin addicts invites more and potentially more harmful heroin/fentanyl use.” Judge Grendell’s assertion that persons with a heroin addiction participate in “Lazarus parties” where they can be purposely revived is anecdotal at best.
Second, solving the heroin crisis requires a multi-faceted approach, including education (of our children, adults, persons who misuse opioids and the medical community), treatment, legal interdiction and overdose prevention. Most law enforcement officers agree that we cannot arrest our way out of this issue and that the best law enforcement in the world will not totally stop the flow of drugs into Ohio.
Finally, we cannot help persons who misuse drugs or get them into treatment if they are dead. If it were my friend, son, or daughter, I would certainly want them to be saved by a naloxone-equipped first responder, friend or relative. What would Judge Grendell say if it was her child? If a drunk driver is in a car accident, first responders and emergency room staff attend to their injuries and do not let them die in their car just because it is too expensive to care for them or because they were at fault. Naloxone is an antidote. We as a society do not withhold antidotes from those in need. The use of and easy access to naloxone is endorsed by the Federal (The White House, United States Centers for Disease Control and Prevention, and the Substance Abuse and Mental Health Services Administration) and State Governments (Ohio Department of Health, the Governor of Ohio, the Ohio Department of Alcohol and Drug Addiction Services), as well as by the American Medical Association and the American Society of Addiction Medicine.
Given the current opioid epidemic, we need to focus on solutions rather than pass judgement on those who are clearly suffering from the disease of addiction and condemn one of the tools we have to save a life. The true goal of a public health system is that of preventing disease and death by working collaboratively and utilizing the most current scientific evidence available.