Heroin overdose was the number one cause of death for men aged 25 to 44 in Portland, Oregon last year, according to a report
published today by the Center for Disease Control. Official reports from Salt Lake City, Utah, Seattle, Washington, and parts of New Mexico indicate that overdoses rates have skyrocketed in the western United States in the last ten years. The CDC reports -- which focused on Portland and Seattle -- suggest that increased availability of heroin, wide variability in its potency, low prices, and a fear of police all contributed to the record number of deaths in the Northwest. Seattle Moves To Fight Addiction
In response to the rash of heroin overdose deaths, Seattle authorities expanded methadone treatment availability by fifty percent, offering it both through established clinics as well as hospitals and doctors' offices. The county even deployed a mobile home to deliver the medicine to addicts in areas far from the city's clinics. Evaluations of methadone maintenance over the last four decades has established it as the single best tool for reducing both illicit heroin use and associated death, disease, crime and suffering. There is good reason to believe that widened methadone availability, more drug-free residential treatment slots, and a more aggressive prevention campaign aimed at youth will reduce overdose deaths. This study showed a slight decline in deaths in 1998 compared to 1997, but it is too early to determine if these steps will be enough to the turn the tide. Portland From A Street Perspective
In addition to relying on death certificates and post-mortem reports, public health officials in Portland consulted another group of experts-current heroin users--to find out why so many people were dying and what might be done about it. Drug users who had survived previous overdoses reported that Mexican black tar heroin was plentiful and cheap in the Northwest, but its potency varied drastically. What was a safe shot one week could kill you the next.
Of those surveyed who had witnessed an overdose, most reported that they would hesitate before calling 911 because they feared arrest or shabby treatment by police and medical personnel. "This is consistent with findings in other cities," said Glenn Backes, a public health analyst at The Lindesmith Center, a national organization that is supporting research and interventions to combat heroin overdose. "An unintended consequence of the get-tough approach to drug use has been to scare drug users off, to make them afraid to call 911 even in a life-or-death crisis," said Mr. Backes. Portland is one of a few Western cities now reforming their police polices, teaching CPR to drug users, and encouraging drug users to call 911 without undue fear of arrest. Salt Lake City Considers A New Approach
In 1992, Utah suffered eighteen overdose deaths statewide. That number increased each year until 1998 when according to a published report from the Utah State Department of Health, 130 people died of a drug overdose, mostly killed by heroin used in combination with alcohol or other drugs. "In 1999, 146 deaths were attributed to accidental drug overdose in Utah, an eight-hundred percent jump from just seven years ago," reports Luciano Colonna, Director of the Utah Harm Reduction Coalition, "It's obvious that we have to pull together as a community if we are going to stop this."
Mr. Colonna coordinates an inter-agency task force whose aim is to reduce the rate of overdose deaths in Salt Lake City. The task force includes representatives of the city police department, city prosecutor's office, drug treatment specialists, state and county public health officials and the Harm Reduction Coalition. "What we are discussing is a state of emergency during which all city and county agencies share a common goal-saving lives. We are already teaching overdose recognition and CPR in the jails. The next crucial step is making it easier and safer for drug users to call 911."
"Police can play an important role in reducing heroin overdose deaths," said Ethan Nadelmann, Director of The Lindesmith Center, "They are often the first ones present at the scene of an overdose. If they know what to do, and if those present when an overdose occurs are not afraid to call police right away, hundreds of lives can be saved. Ultimately the obligation to save life must prevail over the mandate to arrest people for using drugs".