Reviving addicts doesn’t cure them, sheriffs say

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By JACK NISSEN
Capital News Service
LANSING — Drugs save the lives of some of Michigan’s opioid addicts, but they can’t solve the epidemic sweeping the state and nation.
Most Michigan police are equipped to revive people from an opioid overdose with the drug Narcan. But experts say it hasn’t done anything to help curb the addiction crisis. In fact, it may even falsely reassure addicts that they can continue their risky behavior.
“The dispensing of Narcan has nothing to do with getting anybody better,” said Ingham County Sheriff Scott Wriggelsworth. “It just saves their life. And we’ve had multiple instances where three or four hours later, we’re going back on the same person and administering Narcan again.”
Narcan, a nasal spray that restores breathing to patients overdosed on opioids or heroin, has been key to saving lives. For instance, the Washtenaw County Sheriff’s Office says it has saved  more than 100 people  this year. Ingham County sheriff officials say they’ve administered it more than 150 times this year.
Statewide figures show the number of deaths due to opioid and heroin has risen, from 99 in 1999 to 1,689 deaths in 2016.
Coupled with the increase in deaths is an increase in use and in questions about a limit on how many times Narcan should be used. Middletown, Ohio, spent $2 million responding to overdoses, prompting a member of its city council to propose a cap on how often someone can be given Narcan.
It’s not a popular solution in Michigan.
“We don’t get to say no, never mind, you’ve had 10 or eight chances and are capped for the night and we’re not coming,” Wriggelsworth said.
Some heroin and opioid addicts carry around their own Narcan in case they overdose by accident—or on purpose.
“They’re called Lazarus parties,” Wriggelsworth said, “where they take heroin to the tune of almost dying and then they have Narcan there to bring their buddies back.”
Narcan may save lives, but it’s not a solution to addiction, said Chad Brummett, director of Clinical Research with the Department of Anesthesiology at the University of Michigan.
Some experts disagree that proposed legislation that would limit how often someone can be revived with Narcan is the best solution.
“I frankly don’t understand the rationale behind this,” Brummett said. “I think the people proposing that legislation would be better off to focus on things like increasing access to care, addiction treatment, because this is a disease, it’s not a choice.”
Narcan is donated to law enforcement by community health agencies. A kit with two nasal spray units, a face shield used when giving cardiopulmonary respiration, gloves and information on addiction treatment costs $75. The kits are paid for with funds to the agencies provided by block grants from the federal government to the state Department of Health and Human Services.
Another drug also used to combat addiction is Vivitrol.
The  Department of Corrections recently began using it to block the desire to take opiates, while giving users little feel of euphoria if they relapse.
“We don’t have extensive knowledge of Vivitrol and its impact on prisons because it’s so new,” Anita Lloyd, the agency’s communications director, wrote in an email. “But if this medication can be used to treat addiction, and can be successfully managed as part of a larger treatment program—without a safety risk to staff or inmates—that’s a good thing.”
An injection of Vivitrol costs $1,000, requires 14 days of being clean ahead of time and is taken once a month.
Meanwhile, experts are predicting a long road ahead before the opiate crisis gets better.
“While prescribing of opioids has started to decrease, our prescribing still so far outpaces what is reasonable,” Brummett said. “Some are predicting it’ll get worse until 2020 or 2021.”
And it’s no longer just prescribed painkillers, he said. Heroin use has risen, while use of newer synthetic drugs like fentanyl and carfentanil, which are said to be 10,000 times stronger than morphine, have also increased.
Moves by some of the 10 regional health networks that assist law enforcement by donating Narcan are beginning to think of how further to assist addicts.
“We understood from the very beginning, as part of the training we provide, that officers not only use the medicine to revive, but provide information as well,” said Achilles Malta,a  substance abuse expert with the Southwest Michigan Behavioral Health, “either to family members of the individual or the individual themselves.”
Beyond making education more available, Malta wants overdosed patients to have someone there to help them as soon as they are revived, while also letting family know about other resources in the community.

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