Wednesday, September 18, 2013

Fighting drugs with drugs

One of my big fears in writing about drug reform is that I'll be seen as the drug guy, at a certain point.  But I do believe that the reforms I have advocated for and will continue to advocate for are important measures and deserve to be discussed with a wider audience

Imagine that we had a way to prevent many of the deaths in the nation's leading cause for accidental deaths.  Should we try to do it?

According to the CDC, the leading cause of injury death in the United States is drug overdose.  Every day 105 people die as a result of drug overdose.  60% of of the drug overdoses are related to pharmaceuticals.  Of those related to pharmaceuticals, 75% of these deaths are caused by opioid analgesics, known as opioid pain relievers or prescription painkillers.

During these over 400,000 trips to the emergency room for opioid overdoses, doctors use a generic drug called naloxone.  Naloxone reverses an opioid overdose by restoring the overdoser's breathing and heart rate.  Naloxone only works if there is opioids in the system, without opioids the medication is useless.  While naloxone is typically given by emergency personnel, it can be given by laypeople with minimal training.

California's longest running naloxone prescription program in San Francisco has prescribed 3,600 naloxone prescriptions since 2003.  According to the San Francisco Department of Health, 916 lives have been saved by laypersons who have been trained to give naloxone during an overdose.  The San Francisco Medical Examiner reported that heroin-related overdose deaths declined from 120 per year in 2000 to under 10 per year under 2011.  The CDC reported that overdose prevention programs training laypersons to administer naloxone has trained over 50,000 laypersons resulting in over 10,000 overdose reversals.

Despite this, physicians are afraid to prescribe naloxone because of fear of civil and criminal liability.  There is a current bill that has passed California's legislature, AB 635, that tries to decrease the number of drug overdose deaths in California.  AB 635 protects doctors and other healthcare professionals who prescribe naloxone to those who need it, such as prescription drug users.  Naloxone would also be allowed to be distributed under doctor's standing orders.  The bill would also encourage physicians to prescribe naloxone alongside opioid medication to decrease the overdoses.

So, why aren't we trying to do more to stop drug overdoses?

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