Last year,
with New Jersey in the midst of a worsening heroin and prescription drug problem
that daily left overdose deaths in its wake, policy-makers reacted with a harm
reduction effort that has since kept many from perishing. The response provides
police and first-responders with the drug naloxone, which reverses the effects
of an opiate overdose. Yet this measure stops just at the point when it could
set many on a path away from the drug use that nearly killed them.
The National
Council on Alcoholism and Drug Dependence-NJ (NCADD-NJ) is pressing law-makers
to take the next, vital step, namely to refer to treatment anyone who been
resuscitated with naloxone, and do so as soon as possible following the
overdose. Failing to make such a treatment referral only returns the person to
the stranglehold of addiction. The possibility of another overdose is not
small, and the next time EMTs may not arrive in time to revive the individual.
Local
officials close to the opiate problem have been struck by the shortsightedness
of squandering the chance to use naloxone cases as a springboard to treatment. One
of these, Howell Mayor William Gotto (R), whose town and county (Monmouth) have
suffered a great many opiate overdoses, said the current system amounts to a
“revolving door” in emergency rooms.
A new study
from Yale University offers insight into a treatment model that can put an end
to having people with an addiction cycle through the ER and back into opiate
use. Outcomes from the study indicate that of three options, the best course is
a treatment regimen including buprenorphine, a medication that eases cravings
for heroin and helps prevent relapse. Because buprenorphine quiets the
withdrawal pangs an opiate-addicted person experiences after receiving naloxone,
it is particularly well- suited to such patients.
New Jersey
has a precedent in translating a harm reduction outreach into an opportunity of
guiding people into treatment. The state introduced a syringe access
initiative, now known as the Medication Assisted Treatment Initiative (MATI),
which operates in five cities, offers a template for making
treatment through a program whose first aim is keeping participants safe in the
near-term.
The MATI arose from the goal of providing opiate-addicted individuals with clean
syringes to prevent the spread of HIV. Supporters of this measure recognized early
on that it presented an ideal opportunity to introduce treatment to many of those
who came to one of the program’s mobile units for a clean syringe. When a
participant approaches one of the program’s mobile units for a syringe, MATI staff
provide them with treatment information and, if they agree, referrals to
treatment.
As the MATI
demonstrates, many addicted to opiates will consider treatment if it is presented
under the right set of circumstances. The worst-case scenario in the MATI saw one
in two embracing the chance for treatment; the best, nine in ten. One would
expect people revived from an overdose with naloxone to respond at least as
well. As a result, people referred
to treatment will enter recovery and in time build families and careers. In itself, Naloxone fends off death; as a conduit to addiction treatment,
however, its potential is to allow many to begin lives in which they will
fulfill theirs.
Dan Meara
Public Information Manager
NCADD-NJ
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