Overdose Prevention

Washington State 911 Good Samaritan Law to Prevent ODs Now in Effect

A law that provides some legal immunity for people who report a drug overdose in Washington state is now in effect. That makes Washington the second state to enact a "911 Good Samaritan Law." New Mexico was the first in 2007. Under the measure, if someone overdoses and someone else seeks assistance, that person cannot be prosecuted for drug possession, nor can the person overdosing. Good Samaritans could, however, be charged with manufacturing or selling drugs. The measure is aimed at reducing drug overdoses by removing the fear of arrest as an impediment to seeking medical help. According to the state Department of Health, there were 820 fatal drug overdoses in the state in 2006, more than double the 403 in 1999. The bill also allows people to use the opioid agonist naloxone, which counteracts the effects of opiate overdoses, if it is used to help prevent an overdose. Washington is the first state this year to pass a 911 Good Samaritan bill, but it may not be the last. According to the National Conference of State Legislatures, Hawaii, Massachusetts, Minnesota, and Rhode Island are considering similar measures. Supporters of the new law held a press conference Monday to tout its benefits. âIn 2008, there were 794 drug overdose deaths in Washington state,â said Dr. Caleb Banta-Green, a drug overdose researcher from the University of Washington. âThese overdoses do not need to be fatal. Death often takes several hours to occur,â and people are often present. He said more information on the law is available at www.stopoverdose.org. âWeâre here today to encourage people who donât work in hospitals to help saves lives,â Attorney General Rob McKenna said. âMore people are dying now from prescription drug overdoses (than traffic accidents) and yet fewer people are aware of it,â McKenna said. He said drug overdoses are a hidden problem because they arenât as visible as, for example, traffic accidents.. Sen. Rosa Franklin, who worked to pass the bill, said she worked as a nurse before becoming a legislator and wanted to address a problem she saw and read about. She said this bill will save lives. âWe can no longer â¦ put our heads in the sand and say that drug overdose is not happening.â Alison Holcomb of the ACLU of Washington said drug overdoses wouldnât happen in an ideal world, and this law wouldnât be necessary. She said people do drugs to cope, find acceptance or escape. âWe can continue to condemn such people as morally deviant and treat them as criminals,â but, she said, that doesnât work. She said this law is an important step and a compromise agreement. âMy son, a bright, creative, compassionate and funny kid, began using prescription opiates â¦ during his senior year of high school,â John Gahagan said. Just weeks after graduation, his son died of a drug overdose. âThe 911 Good Samaritan Law will save lives,â he said, adding that his son was alone at the time of his overdose, but he knows parents of other teens who could have been saved. âThis law will only be effective if there is awareness of it â¦ Call 911 to save a life,â he said.

For the record: State Department Report, NYC ODs drop, Guatemalan Top Cop & Head Narc Busted, Salvia Banned in Wisconsin

Even though there was no Chronicle last week--due to your editor's death-battle with a vicious Mexican bug; I only returned to the land of the living on Friday--things continued to happen anyway. Here are a handful of items that would have been in the Chronicle had there been one last week: On Monday, the State Department released its annual state on the world on drugs report. The report, called the 2010 International Narcotics Control Strategy, was going to be the subject of a feature story last week before I got sick. I may still go with it this coming week. Also on Monday, the New York City Health Department reported overdose deaths fell in 2008 to the lowest level since 1999. OD fatalities fell from 874 in 2006 to 666 in 2008. Increased use of naloxane, an opioid agonist used to undo overdoses may get some of the credit. On Tuesday, Guatemala's national police chief and its head narc were arrested for links to drug traffickers and for the murders of five policemen. Police Chief Batlazar Gomez and anti-drug head Nelly Bonilla were arrested during an "investigation into a drug robbery (in April 2009) in Amatitlan, which those detained today are believed to have participated in", said Attorney General Amilcar Velasquez. Five police officers were killed during the robbery. The pair currently face charges of conspiracy, breaking and entering, abuse of power, making illegal arrests, drug trafficking, obstruction of justice, illegal possession of firearms and ammunition. On Thursday, Wisconsin Gov. Jim Doyle signed into law a bill banning salvia divinorum. That makes Wisconsin the 19th state to move against Sally D. A few states have limited its sale to adults, but most of those states have simply banned salvia. The Wisconsin bill, AB 186, bans the manufacture, distribution, or sales of salviaâalthough not its possessionâand backs it up with a $10,000 fine. I'm back at it now, and that means the Chronicle will be back on Friday. In the meantime, I'll most likely post a story or two in the blog just to see if you're paying attention.

Harm Reduction: Washington Senate Passes Good Samaritan Bill; Would Protect Against Prosecution in Overdose Cases

The Washington state Senate Friday passed SB 5516, the 911 Good Samaritan Act, on a vote of 47-1. One member was absent. The bill now goes to the House. The measure provides immunity from prosecution for drug possession offenses for overdose victims and people who seek medical assistance for overdose victims. It does not grant immunity from prosecution for drug distribution offenses. It also allows expanded access to naloxone, a powerful opiate antagonist that can bring people back from the brink of death from overdoses in a matter of moments. The bill comes as the number of drug overdose deaths in Washington state have increased from around 403 in 1999 to 707, or nearly two a day, in 2006. Drug overdose is now the second leading cause of accidental death in the state, second only to traffic accidents. The bill was opposed by the Washington Association of Prosecuting Attorneys, who argued that because there was no budget for publicizing the bill, it would not affect drug-taking behaviors, and thus would be no more than another complicating factor in drug prosecutions. Drug overdose fatalities now outrank traffic accidents as the leading cause of accidental deaths in more than a dozen states. But only one state, New Mexico, has approved a Good Samaritan law. Now, perhaps Washington will be next.

Nation's Mayors Take a Stand For Harm Reduction

The United States Conference of Mayors has put saving lives ahead of drug war politics and rejected the Drug Czar's dangerous public policy ideas. Via the Drug Policy Alliance:

The USCM last year declared the war on drugs a failure and called for a âNew Bottom Lineâ in U.S. drug policy, which should be measured by the number of lives saved rather than the number of people imprisoned. This yearâs resolution sets forth a comprehensive strategy for cities and states to reduce overdose morbidity and mortality by:

*Supporting local programs that distribute naloxone â an opiate antagonist medication effective in reversing the respiratory failure that typically causes death from opioid overdose â directly to drug users, their friends, families and communities;
*Urging state governments to adopt emergency âGood Samaritanâ immunity policies that shield from prosecution people who are experiencing or have witnessed an accidental or intentional drug overdose and who have contacted 911 to request emergency medical treatment for the victim of drug toxicity or overdose;
*Calling on the National Institute of Drug Abuse and the Centers for Disease Control and Prevention to urgently fund research to evaluate scientifically the effectiveness of overdose prevention interventions and develop model programs; and
*Calling on the Food and Drug Administration to take all necessary and reasonable steps to facilitate the testing and approval of nasal and/or over-the-counter formulations of naloxone and to consider recommending prescription naloxone concurrent with prescribing strong opioid analgesics

None of this should be even remotely controversial, and yet it is. Shockingly, the Drug Czar's office is actually opposed to distributing overdoses prevention kits based on the callous theory that bad outcomes will teach users to behave:

Madras says the rescue programs might take away the drug userâs motivation to get into detoxification and drug treatment.

"Sometimes having an overdose, being in an emergency room, having that contact with a health care professional is enough to make a person snap into the reality of the situation and snap into having someone give them services," Madras says. [NPR]

Thinking about this, I can't get over how sad and embarrassing it is that our mayors are forced to take a leadership role in developing sensible drug policies at the national level when we have a White House office that's supposed to be doing that. The public officials in Washington, D.C. who've been tasked with addressing the nation's drug problem have abdicated that role, arguing instead for malicious restrictions on proven life-saving interventions.

America's mayors deserve our gratitude for stepping forward and doing what they can to fill the gaping hole created by the Drug Czar's pitiful lack of leadership with regards to preventing overdose deaths.

Update: SSDP has a page where you can contact your state legislators about Good Samaritan policies. It only takes a second, do it.

Why Does the Drug Czar's Office Oppose Efforts to Prevent Drug Overdoses?

This has already been addressed at DrugWarRant and The Agitator, but I'd just like to echo the observation that Dr. Bertha Madras is a cruel witch whose idea of drug prevention is willfully letting drug addicts die before our eyes.

In her capacity as Deputy Director of Demand Reduction at the Drug Czar's office, Madras is speaking out against medicines that effectively treat drug overdoses. If that sounds crazy to you, well, what can I say? These people are deranged:

...Dr. Bertha Madras, deputy director of the White House Office on National Drug Control Policy, opposes the use of Narcan in overdose-rescue programs.

"First of all, I donât agree with giving an opioid antidote to non-medical professionals. Thatâs No. 1," she says. "I just donât think thatâs good public health policy."

Madras says drug users arenât likely to be competent to deal with an overdose emergency. More importantly, she says, Narcan kits may actually encourage drug abusers to keep using heroin because they know overdosing isnât as likely.

Madras says the rescue programs might take away the drug userâs motivation to get into detoxification and drug treatment.

"Sometimes having an overdose, being in an emergency room, having that contact with a health care professional is enough to make a person snap into the reality of the situation and snap into having someone give them services," Madras says. [NPR]

Um, maybeâ¦if you donât die. I seriously canât believe my eyes. This is just as cold as it gets, even by ONDCP standards. Does she know or care that lives will be lost if her vision of good public health policy prevails? How many people should we allow to die in order to spread the message that heroin is dangerous?

This is one of those moments that reveal in stark terms the complete logical bankruptcy of the drug warrior mindset. By rejecting any interest in saving lives, Madras leaves one wondering what the hell she even wants. Seriously, what are we paying these people to do if not save lives?

This is not some crackpot narc spouting off silly soundbites in a local paper. This is a spokeswoman for the White House Office of National Drug Control Policy. These people are supposedly the smartest, most competent drug experts, charged with drafting public health policies to protect us all, and their idea of the week is to cheer from the sidelines as people die from drugs so that the rest of us will learn to behave ourselves.

ONDCP's hateful, literally fatal contempt for the people they should be helping is just so creepy and awful that one struggles to understand the continued need to expose their behavior for what it is. Really, what could I say about this organization that is not made perfectly evident by the philosophy which its own spokespeople espouse openly in our newspapers?

If I didn't know better, I'd predict that ONDCP's open opposition to preventing drug overdoses would immediately cost them what remains of their shrinking legitimacy.

If You Oppose Harm Reduction, You Support AIDS and Death

The Drug Czar's blog has been very concerned about harm reduction lately. They've taken the counterintuitive position of opposing efforts to save the lives of drug users, which seems like a strange choice. Now I understand why: they think harm reduction is the opposite of what it actually is.

These so-called "harm reduction" strategies are poor public policy because their underlying philosophy involves giving up on those who can successfully recover from drug addiction. [PushingBack.com]

This is wrong for a very simple reason: you cannot recover from addiction if you're dead. Harm reduction programs are not an alternative to treatment, rather they go hand in hand. Harm reduction keeps people healthy and alive, thereby creating opportunities for them to subsequently recover from addiction.

We could do nothing. That would be "giving up." We could ask drug addicts to either quit or die. That would be "giving up." Instead, harm reduction activists have taken to the streets and attacked this problem directly. They've studied the leading causes of death among drug users and created programs to reduce those casualties. That's the opposite of giving up.

Just pretend for a moment that you're cruel and you want drug users to die in large numbers. How would you go about it? Well, you would begin by eliminating regulated distribution so that users are forced to obtain unsafe products from criminals on the street. You would reduce access to clean needles in order to spread AIDS. You would enforce criminal sanctions against users so that they're afraid to seek help. And you would lobby aggressively against anyone who's studied the problem and proposed programs to reduce AIDS and overdoses.

Now I'm not saying the Drug Czar wants to kill people. I'm just saying he presides over a policy that is perfectly tailored to achieve that outcome. And he dares to suggest that the people out there working with addicts and saving lives are the ones who've given up.

"We made brownies and I think we're dead."

TalkLeft drew attention this evening to a report in the Dearborn, Michigan, Mail & Guardian of a now-former police officer who confiscated a suspect's marijuana and wound up calling 9-1-1 over it. He and his wife baked some of it into brownies, and then (apparently) freaked out. Officer Edward Sanchez resigned, and the department decided not to press charges, which irritated city councillor Doug Thomas. TalkLeft's Jeralyn Merritt is glad he wasn't charged:

Yes, it's bad to take a suspect's pot. But I don't think it warrants criminal charges. Disciplinary charges, to be sure, but the cop resigned first. And, in the grand scheme of things, it's better that someone who overdoses on drugs like heroin not to be afraid to seek medical attention. Some things are better confined to the realm of the doctor-patient privilege.

I agree with the overdose prevention angle. In fact, we have a whole category devoted to that idea on this web site. But I'm not sure how I feel about just having disciplinary action in most cases. It's one thing to slip up, especially when it comes to an activity like drug use that shouldn't be a crime at all. It's another thing to arrest a person, take his drugs (his property), send him to jail for the drugs and then commit the same crime that you took the first guy to jail for. That makes me wonder about the officer's moral fiber (even though I don't call for sanctions of officers for mere drug use -- because I don't call for such sanctions for anyone). The Mail & Guardian article did not discuss the fate of the original possessor of the marijuana. I would like to know whether Sanchez arrested him or her, and if so what the outcome was. That said, losing his job is probably enough (even if by resignation), and as I said I agree that 9-1-1 calls over drug overdose scares should not lead to criminal prosecution, for reasons of public health policy. Update: Mark Hemingway commented on this story guest blogging for The Agitator too. In descending order of harshness toward the officer: Hemingway, me, Merritt. Another update: Orin Kerr of the Volokh Conspiracy found audio of the 9-1-1- call.