Junkies on the frontline

Some good news for drug injectors in the US: a nasal spray that costs less than US$ 10 can reverse the effect of an opiate overdose . Some even better news: programmes giving out these sprays have sprung up across the country. A programme on National Public Radio reports that these kits, which put drug users themselves at the front line of overdose rescue, have saved over 2,600 lives in recent months.

The not-so-good (but oh-so-predictable) news: the Bush administration thinks these programmes are a bad idea. According to deputy-drug czar Bertha Madras, knowing someone might save your life if you overdose encourages people to shoot up drugs. On top of that, Madras suggests it’s a bad idea to let junkies, rather than doctors, take care of overdose victims, because “drug users aren’t likely to be competent to deal with an overdose emergency”.

When I moved back to Jakarta in 2001, I lived on a needle park (so did the current vice president of Indonesia, while the governor of Jakarta and the US ambassador were just a block away). One night I was nearly knocked down by a gaggle of kids who were running away from something — a cop, I guessed. But no, they were running away from one of their friends, who was busy over-dosing on the pavement outside my house. So yes, they were “not competent” to deal with the overdose. But had they had an easy-to-use nasal spray handy, and ten minutes of training in what to do, they might not have panicked, and might not have left their mate to his fate. The fact is, other drug users ARE the frontline forces when other users OD; if we equipped them properly, they’d become competent.

I got that kid to hospital, but he was lucky. Over eight in 10 injectors in Indonesia say that one of their immediate injecting circle has died of an overdose. Madras thinks this isn’t enough, apparently. In comments that have sparked outrage across the blogosphere (see for example here (beautifully illutrated) and here and here), she also suggested that overdosing provides users with a reality check that will encourage them to give up drugs. I’m just waiting for a public health official to argue against seat-belts, because going through the windscreen can provide a reality check that will encourage people to give up driving fast.

This post was published on 28/01/08 in Ideology and HIV, Pisani's picks, War on drugs.

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  1. Comment by lovable liberal, 28/01/08, 05:18:

    I came to offer the seatbelt analogy, but I see you beat me to it. I do recall an English program(me) on risk in driving. One of the interviewees noted facetiously how safely people would drive if there were a spike on their steering wheel. All the progress we’ve made in making the domestic world safer is lost on the Bushists. I guess they’d prefer social darwinism, the only kind they believe in.

  2. Comment by Tom Levenson, 28/01/08, 05:39:

    Thanks for this post; I don’t know what it will take to get the outrage level high enough to make real change. I’m not prepared to wait until ’09 and hope that the new boss doesn’t trade reality based approaches to public health for some other political goodie.

  3. Comment by Tom Levenson, 28/01/08, 05:40:

    Sorry — pressed submit too fast…I meant to finish by saying that this kind of report on the real consequences of the political gaming of science going on in Washington is essential if we are too push back.

  4. Pingback by Bad Science Kills People: Bush administration/heroin edition. « The Inverse Square Blog, 28/01/08, 05:48:

    […] 4:  Click on this link to commenter Elizabeth Pisani’s blog for an amplification of her remarks below.  She’s […]

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