Sunday, March 4, 2012

on opiate risk reduction

a couple of days ago, i posted on a message board, following the loss of a member of the detroit dance community to a seemingly out-of-the-blue OD (then again, doesn't it always seem out of the blue....).  in any event, someone suggested i re-post it here, and i thought, why not!  so, voilĂ .  maybe it'll help me kick-start this thing back up like i've been meaning to for the past, oh, 2 years....... click below for the post.

  • 2c on harm reduction, and hopefully the beginning of a productive discussion.

    By Doris  in PKU · Edit Doc · Delete
    so... i realize that to many, what happened last week was a tremendous tragedy, and ppl are more than justified in taking their time to look back, honour a life, and mourn its loss. but, for those who are ready, i think it's also important to look forward, and try to make sure nothing like this happens again in the community. so here's a couple of things that have been floating around my head. (quick disclaimer: i only know what little i've been told about last week's circumstances; i'm sure many things i was told are not true, and many things that are true, i wasn't told, so this may or may not be relevant to the particular situation -- but it's nonetheless true looking forward.)

    1. EDUCATION. none of us have the power to make decisions for someone else, but we CAN prevent harm that stems from ignorance (and a LOT of destructive decisions get made b/c ppl don't know better). i say we step up education efforts, and make a certain level of knowledge a PRIORITY if we (or anyone we can touch) are going to make certain decisions. for example, know the mechanistics of drug tolerance, and that a seasoned-person dose is nowhere NEAR appropriate for a rookie - and that even among seasoned people, setting can completely re-set tolerance levels and knock you back to rookie status. know the differences in effects between different routes of administration, and why it matters. know what effects/OD *are* in terms of physical response (not just brain, also rest of body), and how to minimize OD likelihood (like, opiate OD = breathing/heart rate suppressed to lethal levels, and mixing with other things with similar effects, like alcohol, potentiates that).
    my recommendation: identify and reach out to relevant organizations, or experienced/knowledgeable individuals, like addictions treatment specialists, harm reduction outreach workers (needle exchange etc.), clinicians working in methadone maintenance programs, etc., and have them do an educational workshop, or send over their educational materials, or at least make themselves available for questions (shit, *i'll* even put on a workshop if someone buys a train ticket and takes me to mudgie's :p). then spread the word. there is SO much knowledge out there that would be of SO much benefit if the communication lines were open, but my sense is they are not.
    good info for starters:

    2. GOOD SAMARITAN LAWS. in the drug abuse world, this refers to the idea that people who call 911 to report an OD, regardless of whether they were part of the situation, are protected from prosecution for possession. it's meant to prevent people from panicking and bailing, or dropping people off *near* hospitals instead of taking them in, b/c immediate medical attention can DRAMATICALLY increase the chances of surviving an OD. and a surprising number of ppl don't know about these laws. does MI have them? if yes, spread the word! if no, push for policy change! get your representatives behind them! no one should ever ever ever ever feel discouraged from getting somene the medical attention they need b/c they think they need to cover their own ass.

    3. OD PREVENTION KITS/NALOXONE. i am so proud of toronto, who just a couple of months ago started making OD prevention kits available to opiate users ( - whoo!!). naloxone LITERALLY saves lives by knocking opiate molecules off the receptors, immediately stopping their breath-/heartrate-slowing effects (back to education...). does MI have such a program? if yes, spread the word! if no, push for policy change! get kits made available! politicians don't like to support this kind of thing b/c they think it condones and encourages irresponsible drug use and makes them look weak on crime. but teaching people a lesson about "getting out of jail free" or whatever by letting them unnecessarily OD is not in ANYONE'S interest, so push back by supporting and raising awareness about these efforts. resources:

    i don't live in detroit anymore and don't know the state of things there, so a lot of these are handwavy notions pulled from other cities; someone in MI will have to take the initiative to find local solutions. but i'm happy to pull together more resources (i have many, both in neurobio and policy realms), and if there's anything else i can do from afar(ish), just say the word.

    i don't know how useful these are, but some potential places to start:

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