An article in the Washington post (read it here: https://www.washingtonpost.com/news/wonk/wp/2016/12/08/heroin-deaths-surpass-gun-homicides-for-the-first-time-cdc-data-show/) from December 8, 2016, serves as a reminder of the growing human cost of the War on Drugs: In 2015, for the first time, heroin-related deaths outnumbered gun homicides. While this was, sadly, not entirely surprising (as I have blogged about previously, that heroin use would reach epidemic proportions was evident as early as 2008), heroin-related deaths are avoidable.
I do not advocate for drug use, period. I do, however, advocate for harm reduction practices and for drug law reform.
“Harm reduction” refers to policies, programs, and practices that aim primarily to reduce the adverse health, social, and economic costs of drug use. Harm reduction does not focus on reducing the use of drugs, but instead, focuses on reducing overdose deaths, and other social costs of drug use. It should go without saying that anyone with a substance abuse problem should seek substance abuse treatment. But, in the interest of keeping people alive so that they can seek substance abuse treatment, the following are some harm reduction practices.
Never use alone or without supervision. It is incredibly dangerous to use heroin, period. But using heroin alone is particularly dangerous. If a person is using alone and overdoses, there is no one there to call for help, or to administer life-saving opioid antagonist medications. Safe injection sites exist in some areas where drug users are monitored by medical professionals (safe injection sites exist currently in Vancouver; sites proposed in Seattle and Itchaca; Boston has a site where drug users can ride out their high after injecting offsite.) Obviously, if available in your area, a safe-injection site is the least dangerous place (but still dangerous) to use heroin.
Always have an opioid antagonist on hand. I have written previously about where you can find opioid antagonists (drugs that block the effects of opiates, and reverse the effects of opiates immediately, thereby preventing fatal overdose.) Narcan, Naloxone, and Evzio are all opioid antagonists that, in Texas, can be purchased over-the-counter at Walgreens and CVS pharmacies. You do not need a prescription to acquire or possess opioid antagonists. If you are in Denton and need Naloxone, please call my office. No questions asked.
Know what you are using. Heroin and fentanyl are not the same thing. Fentanyl is about 50x stronger than heroin. Some heroin appearing in the United States now has been mixed with fentanyl, which makes it incredibly dangerous.
Recognize an overdose and act quickly. If someone is overdosing, the person’s breathing will become labored or they will stop breathing altogether. The person’s lips and skin may begin to turn blueish. If someone is overdosing, you should immediately call for emergency help, and begin administering an opioid antagonist. The person should be placed on their side to prevent choking. You should continue to administer an opioid antagonist until the person regains consciousness.
To be clear, there is no such thing as “safe” heroin use. There are, however, things that can be done to prevent fatal overdose.