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Heroin Holding More and More People Under Its Spell

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"It's the variability, it's increased number of people using, and, unfortunately, in the drug war environment, in which all of our emphasis has been on law enforcement, people don't feel free to call 911 if they witness a fatal overdose," Backes tells WebMD.

So what can be done to turn the tide? Oxman says they have an active outreach program in Portland with needle exchange, and general education for active users stressing an overdose reduction message, such as "don't shoot alone; if somebody 'crashes,' call 911; use a tester dose; try to get drugs from a consistent dealer," he says.

And there are efforts to increase drug treatment slots, something both Oxman and Backes claim is a good start. Seattle alone, for instance, recently has increased its licensed treatment slots from 2,100 to about 3,150.

In Salt Lake City, Backes says the community has worked with law enforcement to lower drug users' fear over calling 911. And a more controversial plan is to make available and train drug users in the use of naloxone, a drug that can counteract an overdose. Available over the counter in parts of Europe, the drug is prescription here, and no communities have touched that political hot potato yet.

But whatever happens, Backes tells WebMD, the solution will be community-based. "Treatment, primary prevention, and law enforcement is part of the picture, but in an era when we spent more resources on law enforcement than any other, we've seen an increase in heroin use, and so we also have to have interventions which work with heroin-using communities to reduce the rate of fatalities."

 

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