NO ONE DESERVES TO DIE BY OVERDOSE

The rapper Eminem recently released a new album in which he discusses
the overdose that nearly killed him. At last month's Cannes Film
Festival, Heath Ledger's last film was shown, reminding viewers and
critics of the talent we lost when he died.

We are used to hearing about drug overdoses in the context of
fast-lane inhabiting film and music stars. But in fact, deaths from
drug overdoses have been rising and have reached crisis levels in our
country. A newly-released report by the Drug Policy Alliance documents
the extent of the problem: drug overdose is now the second-leading
cause of accidental death in America, surpassing firearms-related
deaths. And it's not just young people who are dying of overdoses:
overdose is the number-one injury-related killer among adults aged
35-54.

This crisis isn't only about people who take illegal drugs: while
heroin overdose has leveled off in many places as a result of harm
reduction efforts, the greatest number of people dying from accidental
overdose are those, like Heath Ledger, who used legal, prescription
drugs. These drugs are typically painkillers called opioids, which can
include both opium-derived drugs like morphine and codeine, and
synthetics like Percodan, Percoset, Oxycontin and Vicodin. Some of the
drugs involved in overdoses have been diverted to the black market and
sold illegally, while others are obtained through legal prescriptions.
Pain patients can misunderstand their doctors' instructions and
accidentally exceed their prescribed doses of painkillers.

Many of those affected are young people. Among teenagers there has
been a steep rise in misuse of prescription drugs. A December 2008
survey of high school seniors reported that more than 15 percent of
high school seniors reported using prescription drugs for non-medical
reasons.

There are a number of practical, low-cost interventions that could
help to deal with this crisis. In 2007, New Mexico became the first
state to pass a "Good Samaritan/911" law, which provides immunity from
arrest and prosecution for drug use or possession to anyone who calls
911 to report an overdose. Many lives could be saved if friends of
overdose victims weren't afraid of being prosecuted if the police are
called to the scene. Similar legislation is now pending in several
states.

Additionally, there is a drug, naloxone (also known as Narcan), which
if administered following an opioid overdose can reverse the effects
and restore normal breathing in two to three minutes. Naloxone has
been used effectively in emergency rooms and by EMTs to reverse
overdoses for over 30 years. Tens of thousands of lives could be saved
if naloxone were more widely available and more people (including
doctors, pharmacists and other health care professionals, as well as
law enforcement professionals, many of whom are currently unfamiliar
with naloxone), were trained in its use. Providing take-home naloxone
to opioid users, along with instructions in its use, could
significantly reduce the number of accidental overdose deaths.
Naloxone itself has no abuse potential, making it a good candidate for
over-the-counter availability.

Cities with programs that increase the availability of naloxone, among
them Chicago, Baltimore and San Francisco, have seen their overdose
rates decline dramatically. New Mexico, which for years had a high
number of deaths from drug overdoses, saw a 20 percent decline in such
deaths after the state's Department of Health began a naloxone
distribution program in 2001.

These are common-sense solutions that would save many thousands of
lives every year. But efforts to implement these solutions are
hamstrung by a drug-war mentality in which there are "good" drugs and
"bad" drugs and, by extension, good drug users and bad drug users, the
latter seen as somehow deserving of death when they overdose. No one
deserves to die by overdose. Everyone deserves a second chance at
life, and to be treated compassionately by a health care system that
values everyone's life.

We need to accept the reality that people will always use drugs,
whether legal or illegal, prescribed or sold on the street, mood or
performance enhancers, pain killers or stress reducers or
sleep-enablers. We are a nation of drug users. We must learn how to
reduce the harms associated with our drug use, including reducing the
unconscionable and unnecessary number of deaths from overdose.