ADDICTS TAUGHT TO SAVE LIVES WITH ANTI-OVERDOSE KITS

EDMONTON - James Gush knows the deal if a buddy overdoses on morphine
or heroin: Take out his vial of Naloxone, fill a clean syringe with
the anti-opiate, and jab his friend in the arm or leg.

Gush hasn't had to use his Naloxone kit, but he knows it and a
first-in-Canada training program for street people in Edmonton could
save the lives of drug users who overdose.

Gush, who quit morphine three years ago in exchange for methadone
treatment, is a regular at Streetworks, Edmonton's needle-exchange
office. Streetworks launched an overdose prevention program three years ago.

Back then, Gush was overdosing every week, sometimes every day,
passing out for 48 hours, only to wake up in hospital having his
stomach pumped.

"I was a pig and I ate as many (pills) as I could every day, and I
would be in the hospital every day," said Gush, 49.

"I used to live in the Remand (centre) in my drug days. And I used to
see quite a few doctors and I was tired of it, getting pumped out.
Geez, an awful feeling."

That changed in 2005, when he was trained by Streetworks staff on how
to inject himself and others with Naloxone, a drug that revives
people who have overdosed on Tylenol 3s, codeine, Demerol, morphine
or heroin by blocking opiates from binding to receptor sites.

Gush learned to give Naloxone to addicts when their mouths have
turned blue, eyes have rolled up and breathing has slowed or stopped,
causing unconsciousness. The treatment stops the drug high, revives
the person by restoring proper breathing and gives a 30-minute window
to seek medical help before the treatment wears off.

Learning those skills empowered Gush to quit his habit and live
healthier, said Andrea Allen, the overdose program's manager and
nurse educator.

Gush now has his own downtown apartment, was able to be by his
father's side when he died six weeks ago and has become closer to his
mother and six siblings.

"I'm cautious of the drugs I take," he said. He limits himself to
marijuana and only a few pills instead of handfuls.

"It saves lives," Allen said of the overdose prevention program.

"It empowers people who are trained by giving them a whole wealth of
knowledge they never thought they could have. People in this
community are often pushed down so low that they don't think they
deserve to know anything."

Edmonton's program, which mimics similar ones in such cities as San
Francisco, New York, Chicago, Baltimore and New Mexico, began as a
demonstration project with $150,600 in funding over three years from
the Canadian Drug Strategy. It was sparked by a one-week period in
which three street people overdosed and died in Edmonton.

In the program's first year, when 50 street people were trained
locally, 18 per cent of drug overdoses were reversed. That's a better
result than in U.S. cities, which see an average 10-per-cent reversal
rate in their first years.

"People had probably given up on (James) at one point," Allen said.
"Now, he felt acknowledged and part of something."

Opponents say Naloxone programs legitimize drug use and encourage
people to continue hard with their habit, since they have an escape
valve that will save their lives.

But Marliss Taylor, Streetworks' program manager, said studies have
found overdose prevention programs reduce drug use, since people take
on more responsibility to save themselves and their friends.

"They're more aware, they're more careful," Taylor said. "If someone
feels that they have to keep an eye on everybody, they're much
healthier in a whole lot of ways."

Drug overdoses kill approximately one person in Alberta each day,
Taylor said. Most are accidental, as frantic, high and careless
people sneak behind garbage cans and hurriedly shoot up for fear of
being seen or caught.

Friends or family who witness an overdose don't want to phone police
or paramedics for help. Allen said she trained one woman six months
ago who was shooting drugs with her partner when he overdosed.
Because the woman had misplaced her Naloxone kit, she called an
ambulance. When police showed up alongside the paramedics, officers
found drugs on the woman and charged her with attempted murder, even
though she hadn't injected her partner, Allen said.

Even so, Allen tells everyone they must call for help, even after
injecting Naloxone, because it only works for 30 minutes, whereas
methadone can stay in the bloodstream for 24 hours.

Allen knows one man who has used his Naloxone kit five times to save
five different people.

"These are valuable people, really neat people, people who contribute
to society one way or another," Taylor said.

She isn't currently looking for an agency to fund the program, even
though the original money has run out and Streetworks now spends
about $400 each year to purchase Naloxone through a partnership with Chicago.

Each vial contains 10 doses and costs $2.50 when purchased from the
United States. Those vials cost $79 if bought in Canada, Taylor said.

Instead, she wants to raise awareness of the human cost of overdoses.

"I don't know how to convey how tragic it is when this is so
preventable," she said.

"Right now, I'm concerned with the lack of concern of society with
overdose. I think that sometimes people think: 'Well, they've done it
to themselves. They're just a bunch of drug addicts anyway,' without
thinking that could be someone's niece or nephew."

OTHER CITIES

Toronto, Montreal and Windsor are all trying to set up overdose
prevention programs, says Marliss Taylor, program manager at
Edmonton's Streetworks. But because the programs will likely be
delivered by the health regions in those cities rather than by an
independent agency such as Streetworks, the wheels are turning
slowly, she said.

The health regions have to worry about possible liability and other
bureaucratic hiccups, even though Taylor said she has fielded no
negative feedback about her program.

People can't overdose on Naloxone, the generic form of the brand-name
drug, Narcan. If it's injected into someone who hasn't taken any
opiates, it runs through the body as harmlessly as saline solution.

Naloxone works to block the effects of morphine, codeine, heroin,
methadone, oxycontin, percocet, hydrocodone, fentanyl and hydromorphone.

Naloxone doesn't work for alcohol, benzodiazepines, tricyclics,
ketamine, cocaine, amphetamines, methamphetamine or ecstasy.

According to a study published in the Harm Reduction Journal in 2007,
an estimated 900 opiate users die from overdoses each year in New
York City. Since its overdose prevention program was set up in 2005,
1,485 people were trained and 104 had overdoses reversed.

The Chicago Recovery Alliance reported that 3,500 people were
equipped with Naloxone since 2001, resulting in 319 overdose reversals.