NARCAN: The danger of a "Three Strikes" policy

While speaking with a relative last week, the topic moved to the opiate crisis and the use of Naloxone (NARCAN) to reverse the effects of opiate overdoses.  He said something that I have heard all too often: "I think that once they've been Narcanned three times, we should just let them die."  It's a common sentiment, and one that quite a few people share.

I understand where they are coming from.  Opioid abuse and the fallout thereof are a great burden on the EMS system.  Most people who are "brought back" by NARCAN refuse to be transported for further evaluation at the hospital, meaning that the ambulance service generally bears the cost of the medication, equipment, and manpower required to save them.

But I hope that those reading will consider something else: rarely ever has anyone woken up and said, "I think I'm going to get addicted to Meth today."  A shocking number of people who abuse drugs of any kind got into it through fairly vanilla channels: the factory worker who hurt his back doing overtime to support his family, whose prescription ran out long before the pain did.  The mother of three who was told ibuprofen should be more than enough after her delivery, and in a moment of weakness tried something a bit harder.  In fact, one may be surprised how many Alzheimer patients have to be given Naloxone after they woke up, took their medications, then completely forgot they did so and took them again.

There is no "typical" overdose.  Those who abuse opiates (or have accidental overdoses of their prescriptions) have legitimate, real world problems that they are trying to overcome as well.  And the relapse rate for those in recovery is high: one study stated that it takes an average of 13 attempts for someone to finally be completely free of drug use.

Thirteen times.  That's a lot more than the "three strikes, you're out" many people are in favor of.  

There is a social stigma that is attached to those who have become addicted, and this stigma often hinders the ability of society to accept some of its most vulnerable citizens.  It shouldn't be "drug users, and everyone else."  Those who suffer from substance use disorder should be seen as what they are: humans struggling with real problems and who are often legitimately trying to overcome them.