NARCAN - The Great Debate
Proponents of Naloxone (Narcan), the medication used to reverse a drug overdose, site in 2017 opioid overdoses killed over 63,000 Americans, and stress the importance of having it available to laypeople and to professional personnel in schools and the workplace. Wrote former New York Times writer Natasha Lennard, “To support Narcan is not to support heroin addiction. To oppose it, however, is to de facto support the unnecessary death of drug users. It amounts to saying ‘hard drug use should be punishable by death.”
Opponents say Narcan “enables addicts” to continue using. I have heard the argument, “Heroin users are having parties… everyone shoots up, not caring if they overdose because they have Narcan in the house.” And, “What if someone “gets narcanned by someone untrained, and they overdose and die?” Lesson one - people cannot overdose or die from too much Naloxone.
What about the costs of our EMTs and firefighters having to go to the same residence multiple times for an overdose – how many times do we pay for that? Should we limit the amount of times we save a life? Should we stop giving insulin to a diabetic in shock because we already helped him and he knew not to eat more cookies? Lesson two - addiction is a real disease too.
Once the drug has manifested itself physiologically, meaning abuse is now dependence or addiction, the element of choice is removed, and not using is not an option without treatment. Lesson three – people struggling with addiction cannot “just put it down” without intervention and treatment if needed.
A popular but largely debated model used in Canada and in the USA is a harm-reduction model known as Medically Assisted Treatment. MAT is medication such as Suboxone or Methadone, provided to assist in the with-drawl from opioid dependence and not intended for long-term maintenance. I’ve heard, “Giving someone suboxone is like giving an alcoholic who drinks Budweiser, a Bud Lite. If an addict knows they’re an addict and keeps taking drugs knowing it can kill them, that’s on them.” And, “It only enables addicts by replacing one drug with another”. Lesson four – treating addiction is not an option – it is an ethical responsibility.
There are strong arguments for and against. When considering the economic and social costs and harm associated with untreated addiction – including foster-care placements, incarceration, child neglect and abuse, criminal activity, emergency room admits, babies being born addicted and their after-care, academic failure and drop-outs, lost workplace production, traffic fatalities, and premature deaths, to name a few – we believe using this harm reduction model in conjunction with counseling and a network of recovery supports, will help alleviate at least one aspect of this unprecedented and historical multi-systems failure.
What I know is this - people with the disease of addiction deserve all the same life-saving measures that any other disease demands. “