No One Deserves to Die by Overdose
The rapper Eminem recently released a new album in which he discusses the overdose that nearly killed him. At last month's Cannes Film Festival, Heath Ledger's last film was shown, reminding viewers and critics of the talent we lost when he died.
We are used to hearing about drug overdoses in the context of fast-lane inhabiting film and music stars. But in fact, deaths from drug overdoses have been rising and have reached crisis levels in our country. A newly-released report by the Drug Policy Alliance documents the extent of the problem: drug overdose is now the second-leading cause of accidental death in America, surpassing firearms-related deaths. And it's not just young people who are dying of overdoses: overdose is the number-one injury-related killer among adults aged 35-54.
This crisis isn't only about people who take illegal drugs: while heroin overdose has leveled off in many places as a result of harm reduction efforts, the greatest number of people dying from accidental overdose are those, like Heath Ledger, who used legal, prescription drugs. These drugs are typically painkillers called opioids, which can include both opium-derived drugs like morphine and codeine, and synthetics like Percodan, Percoset, Oxycontin and Vicodin. Some of the drugs involved in overdoses have been diverted to the black market and sold illegally, while others are obtained through legal prescriptions. Pain patients can misunderstand their doctors' instructions and accidentally exceed their prescribed doses of painkillers.
Many of those affected are young people. Among teenagers there has been a steep rise in misuse of prescription drugs. A December 2008 survey of high school seniors reported that more than 15 percent of high school seniors reported using prescription drugs for non-medical reasons.
There are a number of practical, low-cost interventions that could help to deal with this crisis. In 2007, New Mexico became the first state to pass a "Good Samaritan/911" law, which provides immunity from arrest and prosecution for drug use or possession to anyone who calls 911 to report an overdose. Many lives could be saved if friends of overdose victims weren't afraid of being prosecuted if the police are called to the scene. Similar legislation is now pending in several states.
Additionally, there is a drug, naloxone (also known as Narcan), which if administered following an opioid overdose can reverse the effects and restore normal breathing in two to three minutes. Naloxone has been used effectively in emergency rooms and by EMTs to reverse overdoses for over 30 years. Tens of thousands of lives could be saved if naloxone were more widely available and more people (including doctors, pharmacists and other health care professionals, as well as law enforcement professionals, many of whom are currently unfamiliar with naloxone), were trained in its use. Providing take-home naloxone to opioid users, along with instructions in its use, could significantly reduce the number of accidental overdose deaths. Naloxone itself has no abuse potential, making it a good candidate for over-the-counter availability.
Cities with programs that increase the availability of naloxone, among them Chicago, Baltimore and San Francisco, have seen their overdose rates decline dramatically. New Mexico, which for years had a high number of deaths from drug overdoses, saw a 20 percent decline in such deaths after the state's Department of Health began a naloxone distribution program in 2001.
These are common-sense solutions that would save many thousands of lives every year. But efforts to implement these solutions are hamstrung by a drug-war mentality in which there are "good" drugs and "bad" drugs and, by extension, good drug users and bad drug users, the latter seen as somehow deserving of death when they overdose. No one deserves to die by overdose. Everyone deserves a second chance at life, and to be treated compassionately by a health care system that values everyone's life.
We need to accept the reality that people will always use drugs, whether legal or illegal, prescribed or sold on the street, mood or performance enhancers, pain killers or stress reducers or sleep-enablers. We are a nation of drug users. We must learn how to reduce the harms associated with our drug use, including reducing the unconscionable and unnecessary number of deaths from overdose.