"Health & Medical News"

More communities in the U.S. are distributing the opiate overdose antidote naloxone directly to addicts for emergency use, but the Bush administration continues to oppose such policies, the New York Times reported Dec. 11.

Naloxone works by blocking the opiate receptors in the brain; it has been used by emergency medical personnel since 1971 to prevent overdoses. In recent years, a number of communities have distributed the antidote directly to addicts and their friends and family members — a policy credited with reversing at least 1,000 overdoses.

“From a public health perspective, it’s a no-brainer,” said Dan O’Connell, director of the HIV prevention division in the New York State Health Department. “For someone who is experiencing an overdose, naloxone can be the difference between life and death.”

However, Bertha Madras, deputy director for demand reduction at the White House’s Office of National Drug Control Policy, contended that such naloxone distribution projects are “not based on good scientific data,” citing a survey of San Francisco addicts concluding that some might feel more comfortable using heroin and less likely to call 911 in an emergency if they had naloxone on hand.

“It’s based on what some people would consider the right thing to do,” said Madras of naloxone-distribution schemes. “But the studies supporting it are so sparse it’s painful … I’m taking the stand that in the absence of scientific evidence we don’t engage in policies that would bring more harm than benefit.”

H. Westley Clark, director of the Center for Substance Abuse Treatment, echoed Madras’ stance, saying, “Our position is that naloxone should be administered by licensed health care professionals.”

But officials in cities and states that have distributed naloxone, including Chicago, Baltimore, New York, San Francisco, Boston, Philadelphia, Connecticut, Minnesota, New Mexico, Rhode Island and Wisconsin, dismiss such concerns. “The program here has been extremely successful,” said Richard W. Matens, assistant commissioner of health for chronic disease prevention in Baltimore, where the overdose death rate fell after the naloxone program began.

“Research has shown none of the concerns about naloxone distribution to be true,” said Dr. Sandro Galea, an addiction researcher at the University of Michigan. “It probably is one of the few interventions that truly can reduce the deaths from opioids overdoses.”

“In terms of lives saved, it’s probably the kind of intervention where there’s a likelihood of more good than harm,” added Herbert Kleber, a former antidrug official in the administration of former President George H.W. Bush who is now at Columbia University.

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