Monday, June 01, 2015

Make Naloxone a Bridge to Treatment

Last year, with New Jersey in the midst of a worsening heroin and prescription drug problem that daily left overdose deaths in its wake, policy-makers reacted with a harm reduction effort that has since kept many from perishing. The response provides police and first-responders with the drug naloxone, which reverses the effects of an opiate overdose. Yet this measure stops just at the point when it could set many on a path away from the drug use that nearly killed them.

The National Council on Alcoholism and Drug Dependence-NJ (NCADD-NJ) is pressing law-makers to take the next, vital step, namely to refer to treatment anyone who been resuscitated with naloxone, and do so as soon as possible following the overdose. Failing to make such a treatment referral only returns the person to the stranglehold of addiction. The possibility of another overdose is not small, and the next time EMTs may not arrive in time to revive the individual.

Local officials close to the opiate problem have been struck by the shortsightedness of squandering the chance to use naloxone cases as a springboard to treatment. One of these, Howell Mayor William Gotto (R), whose town and county (Monmouth) have suffered a great many opiate overdoses, said the current system amounts to a “revolving door” in emergency rooms.

A new study from Yale University offers insight into a treatment model that can put an end to having people with an addiction cycle through the ER and back into opiate use. Outcomes from the study indicate that of three options, the best course is a treatment regimen including buprenorphine, a medication that eases cravings for heroin and helps prevent relapse. Because buprenorphine quiets the withdrawal pangs an opiate-addicted person experiences after receiving naloxone, it is particularly well- suited to such patients.

New Jersey has a precedent in translating a harm reduction outreach into an opportunity of guiding people into treatment. The state introduced a syringe access initiative, now known as the Medication Assisted Treatment Initiative (MATI), which operates in five cities, offers a template for making treatment through a program whose first aim is keeping participants safe in the near-term.

The MATI arose from the goal of providing opiate-addicted individuals with clean syringes to prevent the spread of HIV. Supporters of this measure recognized early on that it presented an ideal opportunity to introduce treatment to many of those who came to one of the program’s mobile units for a clean syringe. When a participant approaches one of the program’s mobile units for a syringe, MATI staff provide them with treatment information and, if they agree, referrals to treatment.

As the MATI demonstrates, many addicted to opiates will consider treatment if it is presented under the right set of circumstances. The worst-case scenario in the MATI saw one in two embracing the chance for treatment; the best, nine in ten. One would expect people revived from an overdose with naloxone to respond at least as well. As a result, people referred to treatment will enter recovery and in time build families and careers. In itself, Naloxone fends off death; as a conduit to addiction treatment, however, its potential is to allow many to begin lives in which they will fulfill theirs.

Dan Meara
Public Information Manager

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