Keeping addicts alive

April 05, 2005

AN UNHAPPY indicator of Baltimore's struggle to tame one of the most serious heroin addiction problems of any major city has been a staggering number of overdose deaths. From 2000 to 2003, the number of fatal drug overdoses ranged from 297 to 336, outpacing the number of homicides each year. But the city's Health Department announced last week that in 2004, the number of fatal overdoses was 261, less than the homicide total of 278, and a five-year low.

What happened? Among other reasons, Health Commissioner Peter L. Beilenson and other experts attribute the dramatic drop to increased availability of drug treatment and a year-old experimental program that trains addicts to recognize an overdose and intervene to stop it. The Staying Alive program, which is funded by a two-year grant from the Open Society Institute, has trained about 560 heroin addicts to use mouth-to-mouth resuscitation and to inject Narcan (known generically as naxolone) - an antidote that can revive someone who is near death from an overdose. Participants, many of whom learned about the program at needle-exchange sites, have reported 52 successful Narcan interventions to 911 operators or needle-exchange workers.

Make no mistake: Narcan should not be considered a miracle drug. It provides temporary relief in an acute emergency, but an addict still needs medical help after taking it. It's also not a cure for addiction. That is most likely to come through treatment. While the number of people undergoing treatment in a given year has gone up from 11,000 in 1998 to 25,000 last year, state funding for treatment has leveled off, leaving the city struggling to help an additional 15,000 addicts a year, which would, in effect, give treatment on demand.

The Narcan experiment has apparently kept some drug users alive so that they can then seek long-term help and recovery. If that success continues this year, the city should seek additional private funding to extend the program beyond the current two-year limit. Getting addicts to treatment, which is likely to result in decreased drug use and criminal activity, is a worthwhile investment. But they can't be helped unless they stay alive.

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