August 31 is International Overdose Awareness Day. It is always a difficult day for many people, for a variety of reasons. It's difficult to remember the people we loved whose lives were cut needlessly short. It's difficult to rouse a community out of apathy around this issue. And it's difficult to admit that our best efforts to keep all people drug-free all of the time will fail.
But we have to admit it.
We have to acknowledge that a certain percentage of the population will never be entirely drug-free, and we have to figure out what to do about that. It's costly and regressive to continually respond with arrests, drug courts and incarceration.
The Obama administration has appropriated the rhetoric of public health workers who have worked diligently for years to reduce the number of overdose deaths nationwide. The administration talks about a "public health approach," and not being able to "arrest our way out of the drug problem." The need to understand chronic drug misuse as an illness is best left to physicians, they proclaim. They talk about the need to prevent drug abuse in the first place by increasing education for young people, and they talk about expanding access to treatment and promoting recovery.
But they never talk about what to do with all of the people who currently, and perhaps will always, use drugs.
This is a fundamental problem with how our government approaches the incredibly long, unfailing reality of drug use in our country. We have always used drugs. We just have a hard time admitting it and figuring out how to manage it.
We know that many people who experience an overdose are simply people who use drugs casually and infrequently, or people with pain who accidentally take too much medicine. These are not people who are breaking into homes to steal television sets to feed habits, but people with jobs, people pursuing an education, just regular people who enjoy the occasional Xanax and cocktails. Some of them may even use prescription painkillers to get a buzz.
Some may disagree with their impulse to become intoxicated, or chastise them for not taking their medicine as prescribed. But that's an occasional reality for thousands of people across the country. They may not need drug treatment, and they certainly don't need to be incarcerated. But they do need access to the information that can save their lives, or the life of someone with whom they may occasionally use drugs. And many of them need naloxone. And that's a problem.
Naloxone is unquestionably the most effective tool we have to reverse an opioid overdose. But the medicine is scarce and it's becoming increasingly expensive. While still a comparative bargain for an incredibly safe drug with a very low side effect profile, save for causing withdrawal among opiate-dependent people, it's being priced out of reach for many of the programs that would like to make it more available.
A small grassroots effort has sprung up to bring attention to the problem and help raise urgently needed funds. I'm proud to be a part of it. But there's something just a bit depressing about a small handful of activists trying valiantly to raise more awareness about this lifesaving drug, let alone help raise funds for overdose prevention programs.
In a recent op-ed on The Huffington Post, drug czar R. Gil Kerlikowske from the Office of National Drug Control Policy (ONDCP) said, "The Administration supports the use of naloxone by public health and law enforcement professionals because we have seen how effective the drug can be." It was an intelligent response to the overdose crisis based on science and research about what works. It's the first non-punitive step on a long road toward addressing this multifaceted problem that affects an enormous range of people from many walks of life.
I hope this sensible approach doesn't stop here for ONDCP. I hope they continue to talk about solutions like the "Good Samaritan 911" laws being passed all over the country, to encourage people to quickly report a suspected overdose.
I hope they begin urging all drug treatment facilities to make naloxone available to their patients upon discharge. I hope they encourage colleges and universities to make naloxone available in their health centers.
But most of all, I hope they continue to reach out to everyone who cares so deeply about this issue, including people who use drugs, those who care for them, and those of us who work so hard to help them stay healthy and alive.
I hope fewer people have a difficult day this time next year.
Meghan Ralston is the Harm Reduction Manager for the Drug Policy Alliance
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