Heroin Overdose Antidote Kit Available in Massachusetts

From the Boston Globe:

State health authorities will start supplying addicts next month with a kit containing two doses of a medication that can reverse a potentially lethal overdose within minutes, hoping to reverse a tide of heroin deaths sweeping Massachusetts.

The initiative by the Department of Public Health mirrors a similar project in Boston, where at least 66 overdoses have been reversed since the program began a year ago.

. . .

"We are aware sadly that despite our efforts, there are people who will not be ready for treatment, and we want to prevent them from dying from a fatal overdose before we have an opportunity to convince them to get into treatment," said Auerbach, stressing that treatment remains the state's priority.

But some substance abuse specialists criticize the distribution of Narcan to addicts, arguing that the practice encourages continued use and delays entry into treatment. Some also question whether it is wise medically to have one addict squirting Narcan up the nose of another user who is overdosing.

. . .

Narcan has been administered for decades in hospital emergency rooms and by paramedics, but time is crucial: Heroin races to regions of the brain that control breathing. Too much heroin dangerously slows breathing, starving the heart of oxygen and causing it to stop beating. The whole process can take just three to four minutes, making it essential to have the antidote readily available.

Heroin attaches itself to receptors in the brain, like a key sliding into a lock. But Narcan wrenches heroin out of brain receptors, taking the place of the opiate and reversing the devastating reduction in breathing.

Narcan, known generically as naloxone, was developed as an antidote for overdoses. It is not habit-forming and causes no long-term side effects, although the sudden reversal of a heroin high can induce vomiting, specialists said. A single dose costs about $20.

"It's a remarkably safe drug," said Dr. Peter Moyer, medical director for Boston's fire, police, and emergency medical services. "I've used gallons of it in my life to treat patients."

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Heroin is usually sold as a white or brownish powder or as the black sticky substance known as "black tar heroin." Purer heroin is becoming more commonly available, however most heroin available on the street is mixed or diluted with sugar, starch, powdered milk, or quinine. Street heroin can be mixed with strychnine or other poisons. Heroin addicts do not know the strength of the drug they are buying, or its true contents, so the risk of overdose or poisoning is high. Heroin can be injected, sniffed, or smoked, although injection is the most common method of use by heroin addicts. A heroin addict may inject up to four times a day, either intravenously or intramuscularly.