LOS ANGELES- Researchers, medical professionals, city officials, law enforcement, drug treatment staff, and community members gathered on March 15, 2006 at the Los Angeles Overdose Prevention Summit, a landmark event sponsored by the Drug Policy Alliance and Clean Needles Now. Dr. Jonathan Fielding, Director of Public Health for Los Angeles County, in his keynote address, announced that the county is considering various options for programs to reduce drug overdose, including the distribution of naloxone, a prescription drug that reverses the effects of opiate overdose which is used routinely in emergency rooms, to drug users. “It is safe, it is not a drug of abuse, it is inexpensive, and it is not addictive,” said Dr. Fielding.
Drug overdose has ranked among the top 10 causes of premature death in Los Angeles County since 1993. Drug overdose was the second leading cause of death in Los Angeles County in 2002 among individuals ages 25-44, exceeding motor vehicle accidents and HIV. “We have a profound public health crisis,” said Shoshanna Scholar, Director of Clean Needles Now. “Each overdose death is completely, 100% preventable.” Kris Elgin, a substance abuse counselor, shared the story of her close friend, a drug user who was struggling to become sober, whose body was dumped on Sunset Junction in Silverlake last year after he relapsed and overdosed in the presence of an individual who was afraid to call 911 for fear of arrest.
Dr. Josh Bamberger from San Francisco’s Department of Public Health which has been operating a naloxone distribution program since November 2003, noted that the program resulted in reduced costs to the county as the number of overdose deaths dropped, and that no adverse effects have been reported. Dr. Steve Jenison of New Mexico’s Department of Public Health explained that under New Mexico law, anyone who administers naloxone in good faith to someone who has overdosed will not be held criminally liable. An emergency room physician commented that “This is still being approached as a moral issue, not a scientific issue. Substance abuse is not a choice but a disease. Just as you would not withhold insulin from a diabetic, naloxone should not be denied to an addict who overdoses.” Eugene Carpenter of the L.A. County Coroner’s Office said that “in eighteen years, I have not seen a narcotics overdose from a physician or a nurse or a dentist or a pharmacist. There are no fatal overdoses in these populations that have access to naloxone.” He noted that in 2003, there were 200 deaths strictly from heroin only, and that these preventable deaths were primarily among young people with healthy physical bodies.
Dr. Ricky Bluthenthal, Director of the Urban Community Research Center at the California State University Dominguez Hills, presented the findings of a research study conducted at California syringe exchange programs. His data indicated that in Los Angeles, only 4% of drug users interviewed reported receiving overdose prevention education, indicating a strong need to institute such programs. Dr. Keith Heinzerling, a research physician at UCLA, noted that from 1990 to 2003, the number of AIDS deaths decreased from 5,057 to 1,368, while drug-induced deaths increased from 1,984 to 3,736. He said that the decrease in AIDS deaths was indicative of prevention efforts and improved treatment options, and that increasing overdose education and substance abuse treatment could help to reduce fatal overdoses.
Rachel McLean, M.P.H., founder of San Francisco’s Drug Overdose Prevention Education project, emphasized the need to collaborate with law enforcement and drug treatment officials in the overdose program planning process. She noted that drug users are at high risk for overdose after being released from jail and after leaving treatment programs, because their tolerance for drugs is reduced after a period of abstinence. Barry Zack, Associate Clinical Professor at the University of California, San Francisco, and the Executive Director of Centerforce, which works on prison release issues, said that 35% of all California parolees are released in L.A. County, and that 83% of people in jail reported a history of drug use. Steven Maulhardt, Executive Vice President of Aegis Medical Systems, Inc., California’s largest narcotic treatment provider, expressed the agency’s support for a naloxone distribution program.
According to Dr. Jonathan Fielding, public health must be concerned about every individual with a public health problem. Dr. Josh Bamberger added that “the role of public health is to care for people who need the government to assist them to have better health.” Kai, a drug user shown in L.A. filmmaker Gretchen Hildebran’s documentary “Worth Saving,” spoke of his personal overdose experience. “If you’re brought back [from overdose], it makes you think—I almost died, do I want to continue living this lifestyle?”
Event co-sponsors included the California Association of Alcohol and Drug Program Executives; California Department of Health Services, Office of AIDS; California State Dominguez Hills Urban Community Research Center; Centerforce; City of Los Angeles AIDS Coordinator's Office; CorrectHELP, Inc.; Cri-help, Inc.; Los Angeles Needle Exchange Coalition; RAND Drug Policy Research Center; Tarzana Treatment Centers; UCLA Integrated Substance Abuse Programs; Western Pacific Med/Corp.