Tuesday, January 29, 2008

Narcan, or: Why You Deserve to OD and Die

Pharmacy colleague (and I hope he doesn't mind my calling him that) and fellow blogger Abel Pharmboy provides a most excellent summary of the current buzz in the blogosphere about statements made by Dr. Bertha Madras. Dr. Madras, in the event that you were unaware, is a head member of the White House Office on National Drug Control Policy. And Dr. Madras would rather see opioid abusers die than distribute rescue kits that "encourage" opioid use.

I'm sorry, I thought we lived in a country that gave a damn about whether or not its citizens lived or died. Apparently, moral paternalism trumps compassion, which should be no surprise considering the government's track record with the "war on drugs."

This provides me with a handy segue into a topic that bothers me immensely: Pharmacists who refuse to dispense needles and syringes without a prescription, even in states that have laws that protect them from liability. Dispensing syringes without a prescription is clearly legal in 26 states, and most states that permit dispensing without a prescription absolve pharmacists (and technicians) of all responsibility.

The risk of contracting AIDS, hepatitis, or other blood-borne illnesses is not an effective deterrent for IV drug-users. Thinking otherwise is just flat-out delusional. If you believe that denying clean needles to drug users is going to make the give up their habit, you are way off. Drug use, especially injectable drug abuse, is a risky behavior, and it is an all-consuming urge. The fear of withdrawal symptoms is often considerably more powerful than the fear of contracting an illness. Many AIDS or hepatitis patients have no symptoms; they don't even know they carry the disease. They can and will pass that disease to others. It isn't that they don't know that sharing needles is dangerous. Using heroin is dangerous, too. The issue is that the risk is acceptable, given the information that they have. And if you don't know you're a carrier for a disease, you don't have all the information, which means that you're going to incorrectly evaluate the odds.

What denying needles (and Narcan) to addicts does do is send a powerful message. It says "society doesn't care about you, and we're secretly hoping you die so that we don't have to deal with the problem anymore." These are the same people who think you deserve to be punished for unintentionally getting pregnant. They don't care about outcomes. They don't care any more about addicts than they care about single mothers. They can all die, and decrease the surplus population.

They just want you to shut up and pay your taxes.


Anonymous said...

As you are most likely aware Dr. Bertha Madras has NOT been trained as a health care provider. She is a bench scientist who has made the jump from research to directing policy for the government. She shows the same compassion that I am sure she showed her lab rats right before she guillotined their little squirmy heads off. Another fine example of a Bush appointment.

Abel Pharmboy said...

We are indeed colleagues! Thanks much for the link. Apologies for taking so long to read your post and get you on my blogroll.

Keep up the great work!