ANTIDOTE TO HEROIN

The rest of Maine should listen carefully to the results of a meeting scheduled July 17 in Portland over whether supplying heroin addicts with an antidote to overdosing would reduce the number of drug deaths in that city. Whatever is decided on this issue in Portland will influence what happens in the rest of the state.

After 200 overdoses and 18 deaths this year, some state and local officials are wondering whether the use of nalo-xone, sold under the trade name Narcan, should be distributed. Paramedics and, just recently, specially trained emergency medical technicians now administer Narcan, which has the ability to bring an overdose victim quickly out of a drug-induced coma by outcompeting the opiates for body receptors. The thought is that just as a person especially allergic to bee stings is shown how to use a syringe of adrenalin, a heroin addict would be told how to use Narcan so that if fellow users overdose, a remedy is near at hand.

That is the theory, anyway, but as Maine is repeatedly discovering with drug abuse, the reality is more complicated and more dangerous. And that helps explain why some law enforcement officers have supported the idea in states such as New Mexico, which has some communities with pronounced drug problems, and others strongly oppose it. On the question of personal responsibility, law enforcement splits in outlook, with some believing that when an addict seeks Narcan he is admitting he has a problem, the first step to recovery. The other side believes that an addict carrying Narcan will feel safe against the effects of overdosing and will engage in even more drug abuse.

A 1999 study from the National Drug and Alcohol Research Centre at the University of New South Wales, Australia, summarized its findings on the question this way: “Given the proven efficacy and safety of naloxone, the supply of this medication to heroin users should be considered, particularly to those heroin users at higher risk of overdose (e.g. following discharge from prison). The potential for abuse of naloxone is negligible, it has no reinforcing properties and is strongly antagonistic to opioids. It rapidly produces a markedly unpleasant withdrawal syndrome in heroin users and is therefore unlikely to be abused.”

No one in Maine knows what would happen if Narcan were distributed in Maine, just as no one is certain of how to beat a drug problem that is killing dozens of residents annually. And Narcan’s potential use raises questions about the skill required to administer it and monitor its effects, the obligation of addicts with the antidote to come to the aid of someone overdosing, whether the availability of Narcan would make drug users even less likely to call paramedics in the event of an overdose, etc. That’s why the Portland meeting is important. Heroin abuse is a statewide problem; Maine needs to consider every reasonable solution to solve it.