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Opposing the Overdose Antidote Narcan Means Approving of Death Sentences for Heroin Users

Those who argue against the expanded use of Narcan to save the lives of heroin users fail to understand the grip of heroin addiction.
Photo by Nilo Tabrizy/VICE News

Watch the VICE News documentary about Narcan, 'Back From the Brink: Heroin's Antidote.'

The search for an elixir of life, capable of reviving the dead, has persisted since the early mumblings of recorded history and ancient mythology. During one of China's earliest imperial dynasties, emperor Qin Shi Hang (260 - 210 BC) was fabled to have sent thousands of young people to the eastern seas to recover the elixir of life. Two expeditions never returned.

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In 18th century France, the courtier and philosopher Comte de Saint Germain claimed to be 500 years old, possessing the elixir of life, to deflect questions about his obscure origins. Given the ancient pursuit of a medicine to revive the dead, it is remarkable that a very real elixir of life was developed in the 1950s, but that it has only recently become a major topic of public discussion.

This magic drug, however, was not developed to preserve the lives of emperors and courtiers. Naloxone (brand name Narcan) is a life-giving medicine first invented in a small laboratory under elevated subway tracks on Jamaica Avenue in Queens, NY — and it brings heroin and other opioid users back from the brink of overdose-induced death. For a drug designed with the sole purpose of dragging otherwise mortally doomed individuals back to the world of the living, it has garnered disturbingly little support.

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Of course, Narcan does not reanimate corpses, but it does revive an individual who has stopped breathing after suffering an opioid overdose, enabling her to start breathing again. Loss of oxygen to the brain is how overdoses become fatal, so in countering this, Narcan is nothing less than an elixir of life. In the paired-down parlance of drug treatment, however, Narcan is designated as a "harm reduction" procedure, much like needle exchange programs.

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As a new documentary by VICE News shows, more and more states are embracing the proliferation of Narcan, and passing complementary legislation, known as Good Samaritan laws, to create immunities or other legal protections for people who call for help in the event of an overdose. In most states, however, only law enforcement officers and first responders are allowed to administer the drug (which comes in the form of a nose spray) without a physician present. Most states do not allow civilians — either those close to heroin users, or users themselves — to access take-home Narcan kits.

As Narcan use consultant Gary Langis said, one thing is certain — a dead person cannot choose to get clean.

A pilot Narcan training program in Massachusetts, covered in VICE News' documentary, unequivocally illustrates the value of empowering members of the public to access and administer the antidote. According to figures from the Massachusetts Department of Public Health, more than 27,000 people have been enrolled in the program in that state. As of July, bystanders in the state had overseen 3,131 overdose rescues with Narcan — about six times more overdose reversals than the number reported by first responders.

Of course, any statistic on overdoses is skewed, since many go unreported, driven by persisting fears in the drug-using community of law enforcement harassment and arrest.

Equipping cops and EMTs with Narcan doses and training is crucial, but providing ordinary people with the tools to reverse overdoses is even more necessary. Asking communities of drug users scarred by police harassment to trust the uniform now is too tall of an order.

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Arguments against making Narcan widely accessible range from the moralizing to the misinformed. As with opposition to harm reduction programs like needle exchanges, critics of Narcan say the medicine enables addicts to continue using. The riposte is simple: Narcan allows users to stay alive. As Narcan use consultant and harm reduction advocate Gary Langis told VICE News, one thing is certain: a dead person cannot choose to get clean.

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Those arguing against Narcan as a harm-reduction tool would claim that drug users are aware of the risks, including the possibility of death or disease, which still doesn't compel them to quit. This line of thought is situated in a profound misunderstanding of the phenomenology of addiction. The current epidemic of heroin use in the US makes it all too clear that fear of death or illness does not loosen the grip of an addiction.

To know addiction is to know that it has a logic all its own, which often stands at odds with rational decision making and a desire for self preservation. Harm reduction strategies understand this, while abstinence enforcement tries to moralize away this all-too material fact of addiction. 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.

Follow Natasha Lennard on Twitter: @natashalennard

Watch the VICE News documentary about Narcan, 'Back From the Brink: Heroin's Antidote.'