TREATMENT CENTRES, NOT NARCAN

This week's harm reduction cry comes
from MLA Jenny Kwan, who proposes that the heroin overdose remedy
Narcan be administered by the addicts themselves.

Problem one is this: In the time it would take to read today's Out of
the Blue, an injection of Narcan would have worn off. A mere twenty
minutes later, a ride to the hospital would be critical.

You'd be feeling perky enough, at first, as the drug scavenged the
deadly narcotic from your brain's opiate receptors. Heroin suppresses
respiration, in degrees related to dose -- meaning that death by
overdose almost results from respiratory shutdown.

Your heart keeps beating for a bit, circulating oxygen-starved blood,
but eventually it runs out of fuel and the show is over.

Of course, you would have avoided that. Your heart would still have
been functioning, the paramedics would have been breathing for you
with bags and masks, and right about now you'd be pushing their hands
away.

Any joy you might feel over cheating death would be brief: Narcan
reverses the effects of heroin so effectively, so suddenly that you'd
be plunged straight into drug-craving withdrawal.

Whatever made you want to get high in the first place would be back,
so forcefully you'd be up and walking away -- ignoring the paramedic's
"twenty minutes to live" warning to hunt down another fix.

I've never seen a junkie who didn't have to be persuaded to go to
hospital after Narcan resurrection. Given the chance, most would
inject more dope, making fatal overdose a near certainty.

Enabling and encouragement aside, spending money on street-Narcan is
difficult to justify, faced with the current lack of recovery centres.
Any recovering addict will tell you that getting clean is the only
issue of importance, the only meaningful thing anyone can offer.

Insisting we must acknowledge that most users aren't "at that stage in
their lives" is a sign of distance from the street. Almost every drug
addict in the skids is at that stage, right now; it's just that
interest in quitting comes to them for an hour or two at a time.

Currently, there are three-week waiting lists for beds in recovery
centres -- rendering hour-long windows of interest meaningless. Which
is more than sad, because these windows are useful.

I've met users in their hour of sanity, and worked with friends in the
recovery community to hunt down a bed, with resulting success -- it's
just shameful that I should have to call in favours to achieve such a
thing.

Governmental catering to addictive urges has already hurt people on
Vancouver streets. The last round of unthinking compassion in skid row
involved needle distribution, which I initially supported. The formula
seemed simple: The more clean needles out there, the less often
needles would be shared, the less often my friends and I would be
poked by infected syringes.

The reality left me feeling naive. Sharing of needles continued, and
syringes, once scarce and held dear, began to litter alleyways. The
spread of HIV and hepatitis marched on, and as the last few became
sick, proponents pointed to a decline in infection rates -- as though
there had been some sort of triumph.

I won't downplay the basic miracle of Narcan -- it makes my hair stand
on end every time I see someone start breathing again, but how much
more creativity can be expected of us?

Drive-by "Narcannings?" Where police spot someone on the nod and dart
them as they cruise past? Perhaps court-ordered Narcan implants --
where a device buried in the gluteus maximus releases Narcan whenever
it senses heroin in the bloodstream.

I'm still wondering why, if Narcan blocks heroin receptor sites so
well for 20 minutes, a drug couldn't be designed to block them
permanently. That would more or less end the problem, don't you think?

Opinions on addiction abound, as though plucked from trees -- with
anyone eager to exhibit social conscience parading some new plum,
insisting: "Here, here -- I have it!" But, there is no magic fruit, no
single tactic to solve this.

Paramedics conduct Narcan resurrections in dozens, every week in
Vancouver, and their response times are remarkable. We're definitely
fulfilling our end of the social bargain with overdoses -- it's time
we showed some real respect for users, by honouring their decisions to
quit, no matter how fleeting.

Show me a giant recovery centre in the downtown east side, with no
"safe shooting sites" or needle exchanges, or any of that nonsense --
just a door open 24/7, with people inside ready to help you get clean.