Harm Reduction: The Anti-Drug

"After all, there’s nothing like a little death to put a stop to bad behavior" — Bertha Madras, Deputy Director for Demand Reduction under President George W. Bush

A mother from suburban Hartford, Conn., had a life-saving drug on hand when she truly needed it. One evening last spring, she found her son, who had recently returned from an addiction treatment pro-gram, unconscious in his bedroom. He had relapsed and overdosed on heroin.

“He was not breathing, and he was gray,” says the woman, who requests anonymity to protect her son’s privacy. “That’s when I called 911 and went running around the house trying to find my Narcan. We gave him two injections to get him breathing again before the ambulance got to our house.”

Narcan is the trade name for naloxone, a drug that’s been used by emergency medical personnel for decades to reverse accidental drug overdoses from opioids, including heroin, methadone and prescription pain medications like oxycodones. This mother had received her supply through a Connecticut program that trains individuals to administer it in their home. A physician involved in the program says the drug is so safe that if it’s given to a person who’s not overdosing on an opioid, it will have no effect—so it has no street value.

In June, Rep. Donna F. Edwards (D-Md.) introduced the Drug Overdose Reduction Act in 2009. It would provide cities, states and community-based groups with $27 million in annual grants to prevent and reduce drug overdose deaths. The bill emphasizes naloxone distribution, and calls for tracking overdose deaths and developing a national strategy to address the problem.

“I introduced the [legislation] because overdose is the second leading cause of accidental death in the United States,” Edwards said in an e-mail, “and the number of overdose deaths continues to rise.” So far her bill has attracted nine co-sponsors.

Increasing the availability of naloxone is an example of what is known as “harm reduction,” a public health approach to social ills like substance abuse and sexually transmitted diseases. Harm reduction initiatives include having “designated drivers” for drinkers and needle exchanges for IV drug users.