Why increasing access to naloxone doesn't enable addicts
There is a simple solution to the opioid overdose crisis, but denying medical patients a lifesaving drug is not the answer
Addiction knows no boundaries. At any time, anyone given the right circumstances can develop an addiction. From having that first cigarette or cup of coffee in the morning, to spending every penny of one's savings on methamphetamine or alcohol, addiction is an illness that can be both physically and psychologically devastating.
Medical associations, such as the American Medical Association and the American Psychological Association, have framed addiction as a medical condition, requiring intensive medical and psychiatric treatment to drive it into remission. Recovering addicts will say that addiction is a lifelong affair, a daily battle to stay sober.
Addiction is so common it's almost a fashion statement. Think alcohol during prohibition; tobacco in the '50s; cocaine in the '70s and meth in the '90s.
Opioids, in the form of heroin, were chic in the 1980s among fashion models, musicians and entertainers. Heroin is back again, often mixed with other stronger narcotics like fentanyl that is causing soaring overdose death rates.
The rate of narcotic addiction has also risen with the increasing rate of prescriptions as medical providers try to relieve patients' pain. Opioid overdoses, in most states, are the leading cause of accidental death, even exceeding motor vehicle collision deaths.
Complex problem requiring a complex solution
Despite the complexity of the problem, legislators, regulators and the uninformed continue to look at addiction as a "choice," a "lifestyle," and apparently something very simple to stop. There is a growing backlash and opinion that by increasing access to naloxone that somehow the community is condoning narcotic addiction, that naloxone enables addicts to live their "chosen lifestyle."
EMS providers know all too well that nothing could be further from the truth. Most of us have seen the devastating effects of addiction. Consider the emphysema patient who continues to smoke or the patient in liver failure as a result of alcoholic cirrhosis who continues to drink alcohol. Neither of these patients chose to become addicted. And we spend billions of dollars annually treating these diseases of addiction. Is narcotic addiction that different from these diseases?
There is no evidence to support the enablement of addiction by increasing access to naloxone. Research points to the contrary. Rapid access to naloxone for overdosed patients has gained acceptance as a stop gap measure to help addicts into therapy. This can be ironically verified by the rapid onset of a major naloxone shortage in this country.
As for the frustrations cited in the article, let's look at them a little more closely. For example, for every image of an addict behaving badly, there are hundreds, probably thousands, more who are struggling to quit their addiction. Most states give drunk drivers a chance to enter therapy and sober up before sending them to prison. Most law enforcement agencies offer immunity for turning in firearms to protect their communities. But substitute heroin or prescription narcotics for any of these terms and somehow it's different.
Just to be clear, I offer no simple solution to the current crisis. It's too complex of a problem to offer a pithy response. Legalization is no panacea — tobacco and ethanol show the results of legalizing consumption. But denying medical patients access to a lifesaving drug is not the answer.