Amarah's Corner: Prevention of disease and overdose in opiate addiction


Harm reduction is often perceived as helping addicts transcend their habits and being “cured.” To expect an addict to give up his/her drug is like asking the average person to imagine living without Facebook, Twitter, their social skills, support networks, emotional stability, or a sense of physical and psychological comfort. These qualities are what drugs, in their illusory and evanescent way, give the addict.

Harm reduction approach accepts that some people - many people - are too deeply enmeshed in substance dependence for the realistic “cure” under present circumstances. A harm-reduction model is essential to treatment. We cannot force another to give up addiction, but we can provide an island of relief where contemplation and self-respect can take root. For those who choose abstinence, every possible support should be given (more than we currently provide). For those who do not choose this path, we can provide other harm reduction supports. We can provide treatments with methadone, buprenorphine, naltrexone and harm-reduction programs such as, needle exchange programs and Naloxone for opiate overdose.

Methadone is a synthetic that occupies opiate receptors on brain cells, blocking the access of heroin molecules to the same binding site. When ingested orally, it does not cause a high in chronic narcotic users, but for many addicts it prevents heroin craving and withdrawal symptoms such as nervousness, pain, diarrhea and nausea. It is long-acting, so a once-daily dose will see most people through twenty-four hours. Crossroads in Alamosa has a Methadone clinic. You can call and get advice about receiving treatment.

Buprenorphine is a partial agonist at the mu receptor, meaning that it only partially activates opiate receptors. It is also a weak kappa receptor antagonist and delta receptor agonist. It is a potent analgesic that acts on the central nervous system. It helps to prevent craving and withdrawal symptoms as well. This is a medication that is given in an oral form as a tablet or a strip. It is dosed by individual needs. You can look at www.samhsa.gov to find a list of providers in the San Luis Valley who can prescribe this medication.

Opiate antagonist. Naltrexone competes for opiate receptors and displaces opioid drugs from these receptors, thus reversing their effects. It can antagonize all opiate receptors. Its action is like naloxone except that it is longer acting and administered orally.

All these medications for Medication Assisted Treatment (MAT) will enable addicts to stabilize. They can hold a job, take care of themselves, and their families, and be an asset to the community. When they are in treatment, they also attend counseling to help them improve brain function, attitude, and behavior.

Needle exchange is another harm-reduction tactic; users bring in dirty syringes and needles and are given new ones.  The spread of HIV and Hepatitis C from one person to another occurs by way of body fluids, specifically blood or sexual secretions. Clean, unshared needles limit disease transmission, as do condoms, during intercourse. Clean needles also help prevent skin infections, abscesses, and the spread of bacteria via the bloodstream.

Antidote for Opiate Overdose: Naloxone hydrochloride is an opioid antagonist which antagonizes opioid effects by competing for the same receptor sites. Naloxone is believed to act as a competitive antagonist at mc, κ, and σ opiate receptors in the CNS, with the highest affinity for the µ receptor. This is a medication that can be given nasally or by injection. It can save a life that has overdosed on an opiate, such as heroin or Percocet. Ask your provider for a prescription. Carry this life-saving drug with you and have it handy to save a life.

HARRP (SLV Health Access Risk Reduction Project) is a collaboration between the SLV Area Health Center, Alamosa Department of Health, the Alamosa Board of Health, SLV Behavioral Health and Valley-Wide Health Systems.

The program offers services free of charge for those who use injection drugs. Services include HIV and Hepatitis C testing and linkage to care, Naloxone (overdose reversal drug), sterile needles and syringes, safe needle disposal, evaluation for medical insurance eligibility and referral for mental health and substance use treatment, including medication assisted treatment. Ask your health care provider to test for Hepatitis A and Hepatitis B and ask about vaccines for prevention of disease. For more information call Charlotte Ledonne at (719) 589-4977.

There are ways to improve the health of the opiate addict. According to Dr. Bruce Perry, “We need to be very loving, very accepting and very patient with people who have these problems. If we are, they will have a much higher probability of getting better.” Harm reduction is as much an attitude and way of being, as it is a set of policies and methods.~Dr. Barbara Troy, chair/president, Hope for Kids Like Me.

Thank You, Dr. Troy!

Remember, Jesus Loves You, and JESUS IS LORD!

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