STAYING ALIVE

How to Survive the Heroin Epidemic

Stopping the spread of heroin use is possible, but it’s going to take big changes.

01.05.16 5:01 AM ET

The latest opiate-related mortality statistics, taken from 2014, are in and we’re seeing more of the same. The death toll rose 14 percent in the last year, making it apparent that, so far, attempts to stem the flow of death have not worked.

Kenneth Anderson, veteran of safe drug-using practices, recently wrote, “I would like to see The New York Times publish a front page story tomorrow titled ‘How Not to Die When Using Heroin,’” as opposed to dedicating yet another story to the dubious comparison between heroin overdose and traffic fatalities.

“We need methadone clinics for everyone paid for by the government,” Anderson told The Daily Beast, in reference to the Swiss Model, which has seen dramatic reductions in both mortality and infectious disease since doing exactly that.

Though the “heroin hysteria,” as Anderson called it, is indeed warranted—after all, we are seeing premature death en masse—so few are reporting studied, practical solutions that if taken into effect, would ameliorate the current situation.

***

The group responsible for driving heroin’s numbers way up happens to be 18- to 25-year-old, white millennials. In order to help this group one must get to know them, their habits, and their practices. I should know, after all this is my cohort and I was once a heroin user, barbarically tying off with my Keds shoelace while driving home from Chicago’s West Side. In more than one sense, I’m a good example of a bad example.

Perhaps the unusually high millennial death rate is an artifact of geography and class. We covertly shoot up at suburban locales: a Wendy’s parking lot, Starbucks bathrooms, our childhood bedrooms. In effect, we’re insulated from life-saving services provided by syringe exchange programs (SEPs) that are commonly found in big cities.

Aside from being issued clean needles and cookers, at a needle-exchange you are provided with safe practices, information, and tested for blood-borne disease. Most importantly, people who run SEPs care about you—the user—who is so often shoved to society’s fringe or cast out by their family in the name of “tough love.”

It appears we’re dying from missing, yet easily obtained, information; from stigma that forces us into secrecy; from the penal state that criminalized our habit and continues to incarcerate and arrest drug users; from the same government that remains unwilling to treat us humanely, under the umbrella of public health.

I am alive not because I’m smarter than the young person who died; I’m simply lucky. The world is absurd, and by that I mean it remains silent and still at any attempts to reason with it.

***

Sociology professor and harm-reduction researcher Greg Scott told The Daily Beast what he sees as critical to keeping other injection-drug users alive.

“Get your hands on lots of naloxone, the opiate overdose antidote,” he said. You can find a place that distributes it near you here. Once you’ve obtained naloxone, he continued, “Provide it to your friends, family, coworkers, and anyone else who might be around when you’re using.”

“Try to avoid using alone or in a place that’s not accessible to others who might be able to save your life in case of an OD.” Lastly, Scott stressed to “train everyone in your network on how to recognize an overdose and respond effectively with naloxone and rescue breathing.”

There is also some unlearning one must do. The ODs you’ve seen in movies are by and large bogus. Overdoses tend not to be instantaneous, à la Uma Thurman in Pulp Fiction. More often than not, an overdose has a gradual onset, as though the person is gently slipping off to sleep. All the signs and symptoms of overdose are available here.

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On top of carrying naloxone, sociologist Julie Netherland, who works for the Drug Policy Alliance in New York, stresses the potential dangers of mixing opioids with alcohol and other drugs such as benzodiazepines (e.g. Xanax). “Many of the overdoses we’re seeing are actually because people are using drugs in combination that are quite deadly,” she said.

“The good news about opioid overdoses is that many of them are preventable,” said Netherland, who understands the shadowy nature of injection drug use as a function of stigma. It can’t remain one’s shameful secret and people need naloxone, she emphasized.

“The fundamental problem” that Netherland thinks we’re facing “is the stigma surrounding drug use in general, and toward injection drug users in particular—that stigma is killing people.”

Heroin users are sons, daughters, mothers and fathers who deserve to be alive. Kim Brown is an affected parent. “My son died of an accidental heroin overdose in 2011,” she told The Daily Beast. “He used unsafe practices because he was pushed into the shadows.”

Brown, a registered nurse, is now president of Quad Cities Harm Reduction in her home state of Iowa. Firmly rooted in failed law enforcement practices, Iowa is particularly against passing public health legislation to combat the opiate problem.

“I was told by Iowa legislators that our 911 Good Samaritan bill was ‘soft on crime,’” she said. Thirty-two states in America have 911 Good Samaritan bills and Iowa is not one of them.

Such a bill would grant certain immunities (e.g. paraphernalia/possession charges) to people who phone in an overdose to emergency responders. Midwestern states like Iowa and Missouri that are without these life-saving laws are seeing the grotesque practice of “body dumping.” People ditch an overdosed body to save their own skin from drug charges, rather than calling 911 to revive the person in time with naloxone.

Iowa is also one of six states left in America that does not have a bill expanding access to naloxone. “We can’t even get a naloxone access bill here,” she said, sounding frustrated. “We should all have a naloxone kit in our pocket.”

Aside from SEPs and increased access to naloxone, there is data backing another effective, yet even more controversial public health measure. Shilo Murphy, a former heroin user turned advocate, is on a mission to get Safe Injection Facilities (SIFs) operating in his hometown of Seattle.

“SIFs are a place that tells someone they’re loved,” Murphy told The Daily Beast. “They give people a tomorrow.”

Since opening its doors in 2003, InSite, a SIF located in Vancouver, has not seen one single fatal overdose. Murphy, along with others at Vocal NY, are seizing on a growing need for these facilities in the United States. Other countries such as Switzerland and Denmark that operate SIFs see significant reductions in opiate-related mortality. Other positive health outcomes are seen through reductions of HIV and hepatitis C.

Denise Cullen is a licensed clinical social worker and co-founder of Broken No More, a grassroots organization helping families cope with addiction. She lost her son to an accidental overdose in 2008, and has created meaning out of her loss by becoming an ardent drug policy reformist.

“I fully, absolutely support Safe Injection Facilities,” she told The Daily Beast.

She wishes her son Jeffrey had access services like a needle exchange or SIF. “It is a sterile environment in which someone who is using drugs can do so safely, without risk of arrest or being hassled,” she said.

“The last thing drug users need is for their family to turn on them,” said Brown. “We are all they have, and in the darkest moments of their life, we’re their lifeline. If you whack that off, they are hopeless.”