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Gambling with lives

January 29, 2008

 EDIT: Added citations

 Every time that I think I couldn’t be more disgusted with this administration, some moron in office sinks to a new low.

This story via NPR starts off so well by bringing attention to a $9.50 kit that public health workers across the country are using to immediately reverse an overdose of heroin. The kit contains a vial of Narcan (naloxone) with a nasal spray attachment. Narcam is a drug that has been used for years in emergency rooms to reverse the effect of an opiate overdose, as it quickly blocks opiate receptors in the brain. An intravenous injection of .4 to 2mg of Narcan can completely reverse an overdose in 1-2 minutes [1]. Side effects of Narcan are very rare, but can include mild heart arrhythmia and the symptoms of acute opiate withdrawal[2], however you cannot OD on Narcan. The dosage of .4 to 2mg of Narcan is suggested, though additional doses are recommended until the patient shows the desired effect. “Failure to respond to a total dose of 10 mg usually indicates: a) that poisoning is not due to opiates; b) that poisoning is due to a partial agonist/antagonist; or c) that hypoxic brain damage has occurred.”[3].

Because of this inability to overdose Narcan and the delivery method is via nasal spray, public health officials have decided to offer these kits and usage training to drug users. The training includes questions about the trainee’s recent drug use, signs of an overdose, and how to administer the treatment. From the article:

New data compiled for NPR by researcher Alex Kral of the consulting firm RTI International show that more than 2,600 overdoses have been reversed in 16 programs operating across the nation.

Over 2600 lives saved at a calculated cost just shy of $25000. This doesn’t include the benefit of sending the message to drug users that the public does care for them and wants to give them every opportunity to change their ways. That’s a powerful message to send.

So, what else is there to say about this? Ah, yes. The Bush administration… Deputy director of the White House Office on National Drug Control Policy Dr. Bertha Madras, yet another ignorant monster on Team Dubya, opposes these life-saving programs. Why, you may ask? From the NPR article:

“First of all, I don’t agree with giving an opioid antidote to non-medical professionals. That’s No. 1,” she says. “I just don’t think that’s good public health policy.”

Madras says drug users aren’t likely to be competent to deal with an overdose emergency. More importantly, she says, Narcan kits may actually encourage drug abusers to keep using heroin because they know overdosing isn’t as likely.

Madras says the rescue programs might take away the drug user’s motivation to get into detoxification and drug treatment.

“Sometimes having an overdose, being in an emergency room, having that contact with a health care professional is enough to make a person snap into the reality of the situation and snap into having someone give them services,” Madras says.

Obviously, Dr. Acula has not researched either the antidote or the method of administration. I guess a procedure shown to save thousands of lives does not deserve that level of scrutiny. As to taking away a drug users motivation, any fool can see the value of extending the life of a user, as it gives them that much more time to try to turn it around. My gut feeling is that somewhere near to 0% of users who have died of an overdose were later able to kick the habit. I’m sure research would prove that feeling correct.

Speaking of gut feelings, where does Dr. Acula get her opinions? It turns out she gets them from Nowhere At All. She’s not quoting studies, or giving facts, she’s using limp terms like “aren’t likely to be competent” or “might take away”. One could argue that she has the credentials to make those statements, but I disagree based on the fact that she seems to exhibit no knowledge at all of the drug or its administration procedure.

In short, a procedure that has been documented and proven to save thousands of lives has no support from the White House Office on National Drug Control Policy, because it might sorta maybe make users that much less likely to seek help for their addiction. I can’t wait until this monstrous and idiotic administration is nothing more than a bad memory. Is it January 20, 2009 yet?

 Citations:

[1] IPCS/CEC Evaluation of Antidotes Series, International Programme on Chemical Safety, section 2.12.2 Advised routes and dose

[2] IPCS/CEC Evaluation of Antidotes Series, International Programme on Chemical Safety, section 2.13.3 Precautions/Contraindications

[3]IPCS/CEC Evaluation of Antidotes Series, International Programme on Chemical Safety, section 2.13.2 Dosage and route

(h/t to Pharyngula via Inverse Square via The Reality-Based Community, Compassionby Mark Kleiman)

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One Comment leave one →
  1. Steve permalink
    January 30, 2008 12:44 pm

    Hey Joe, great post. It’s really sad that we have people like this in office.

    “Sometimes having an overdose, being in an emergency room, having that contact with a health care professional is enough to make a person snap into the reality of the situation and snap into having someone give them services,” Madras says.

    Interesting… I have an idea that she’ll just love. Emergency services should stop sending ambulances to pick up overdose victims all together. Instead when they call 911 the operator should email them directions to the nearest hospital and tell them to walk.

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