Drug Harm Reduction Programs

[LucidResq]

Watching a documentary on heroin tonight... they are featuring a "Medic" (I'm assuming paramedic but they didn't specify) with the Chicago Recovery Alliance - a "Harm Reduction" non-profit.

His duties include mainly visiting crack houses/"shooting galleries" to pass out naloxone and educating users how to use it in an OD. He also occasionally comes upon acute ODs and administers it himself.

I watched him come upon a prostitute with a heroin OD in his visits, and it looked like he just very quickly assessed her, gave her two doses of narcan, watched her to make sure she came to, and that was that. No transport or anything.

The organization also offers a needle exchange, hep b vaccination, condoms, and other programs designed to reduce the risk of drug use.

What are your opinions on a program such as this?

 

[MrBrown]

Brown thinks its a good thing, but then again Brown's step dad takes 120-300mg of methadone daily and has done so for 20 years.

 

[JPINFV]

I think there's a very fine line between providing a bit of safety as well as public health concerns and enabling addicts. Of course that last part leads to a discussion on the proper role of government.

 

[LondonMedic]

In the UK, there's good evidence that they work to reduce the health burden, when you think of the cost of a single episode of Hep B, HIV or even a simple phlebitis I reckon they're good value for money.

People aren't going to stop injecting drugs just because they don't have access to clean works and drug counselling.

As for narcan, I dunno, especially when you remember it's duration of action.

 

[emtchick171]

All in all it seems like a wonderful program, but I also believe there is a fine line. If these addicts know that they have something to save their life in case they OD or that someone else will be there to save their life, they may just continue to use heroin more and more...

It is definitely a good program but I think it gets into the government being involved and I would have to see more specific information about it before I could make an actual decision on whether or not I would support it.

 

[LondonMedic]

If these addicts know that they have something to save their life in case they OD or that someone else will be there to save their life, they may just continue to use heroin more and more...

In my experience and opinion, very people are going to stop injecting heroin because they are worried about dying and those people are going to have a good chance of stopping anyway. Most of them don't particularly care - which is why they OD in the first place.

You could equally argue that people would carry on smoking, driving, getting pregnant and all the other risky behaviours if they know we'll try to save them.

 

[CAOX3]

Back in the day medics use d to strip overdoses so they couldn't refuse when they came to, nowadays they no the game, after they regain consciousness if they refuse transport there isn't much you can do but let them out, now we don't even intubate them, we bag until the narcan takes effect. I look to put them in the truck first their less likely to refuse if where on our way already. Kills two birds with one stone, the y get evaluated at the er and usually won't cop again that night.

We cut pockets too, so no one gets suck while packaging them unless of course the police are they're then they can search them but they will usually do the same to avoid any chance.

As far as handing out narcan and clean syringes it a defensive stance, some areas are so overwhelmed the the hospitals can't handle the numbers.

 

[jjesusfreak01]

Back in the day medics use d to strip overdoses so they couldn't refuse when they came to, nowadays they no the game, after they regain consciousness if they refuse transport there isn't much you can do but let them out, now we don't even intubate them, we bag until the narcan takes effect. I look to put them in the truck first their less likely to refuse if where on our way already. Kills two birds with one stone, the y get evaluated at the er and usually won't cop again that night.

We cut pockets too, so no one gets suck while packaging them unless of course the police are they're then they can search them but they will usually do the same to avoid any chance.

As far as handing out narcan and clean syringes it a defensive stance, some areas are so overwhelmed the the hospitals can't handle the numbers.

The medics I have talked to always give the narcan slowly in an OD. The patient doesn't need anymore than it takes to keep them breathing.

I don't think I would administer narcan in a drug house without planning to transport, because of the risk of the patient ODing worse after the narcan wears off (if they shoot up again after they wake up). I can definitely support leaving some on the premises in case someone ODs and stops breathing, since otherwise they're dead.

 

[emtchick171]

The medics I have talked to always give the narcan slowly in an OD. The patient doesn't need anymore than it takes to keep them breathing.

Yes pushing narcan slowly is VERY important, due to the fact that if you push narcan quickly...it can cause violent projectile vomiting! Also, the patient will get extremely restless and agitated and generally will become combative.

 

[CAOX3]

The medics I have talked to always give the narcan slowly in an OD. The patient doesn't need anymore than it takes o keep them breathing.

I don't think I would administer narcan in a drug house without planning to transport, because of the risk of the patient ODing worse after the narcan wears off (if they shoot up again after they wake up). I can definitely support leaving some on the premises in case someone ODs and stops breathing, since otherwise they're dead.

My point is to restore adequate respirations, medics here dont slam Narcan, well most of them anyway.