5 ways to help heroin addicts

With heroin deaths on the rise throughout the region, and police in the suburbs saying they are seeing the drug more and more, addicts and their families — along with health and law enforcement officials — are looking for help.

More arrests are not the only answer, said Jay Perry, a supervisory special agent with the Virginia State Police who leads a regional drug and gang task force. “If somebody is going to stick a needle in his arm, not knowing whether he’s going to live or die, I don’t know how much more we can penalize him by locking him up.”

So what can people do?

Here are five frequently suggested ideas:

1. Ensure that all first responders can carry naloxone — and consider allowing family and friends of addicts to have it too.

This prescription drug, also known as Narcan, can stop some opiate overdoses from becoming fatal, if administered in time. But some people worry that first responders and people with daily access to addicts would not be properly trained to administer it. They also caution that access to naloxone could give addicts a false sense of security that any overdose could be easily reversed.

Virginia is developing a pilot program to provide naloxone to family members of recovering addicts in a few hard-hit jurisdictions, said Mellie Randall, director of Substance Abuse Services at the Virginia Department of Behavioral Health and Developmental Services.

“Dad would go to the family doctor, and say, ‘I want a prescription for my son,’ ” Randall said. Once people get trained, “they’ll get a little kit, with a cartoon of steps to go through, atomizers, breathing mask, latex-free gloves.” If a trained naloxone dispenser saves someone and sends in a card to report the overdose, the state would send that person another free kit.

Maryland is launching programs in counties including Howard, Anne Arundel and Calvert to train friends and family of addicts to use naloxone.

In addition, the FDA recently approved a new device, Evzio, that would allow people to give naloxone through an automatic injector.

2. Make Suboxone (buprenorphine) and methadone more widely available.

Both drugs ease withdrawal symptoms and reduce cravings. But there are only four publicly funded methadone clinics in Virginia. And unless people have good insurance, Suboxone is expensive, especially over the long term. Families of addicts also said it is difficult to find a doctor to prescribe Suboxone — they must be specially licensed by the DEA.

Madison Walker was a beloved extrovert surrounded by friends, but in private he struggled with a heroin addiction. David Mundy, Walker's best friend, recounts Walker's story and the battle he eventually lost. (Gabe Silverman/The Washington Post)

Maryland has increased its treatment programs, said Joshua Sharfstein, secretary of health and mental hygiene, “but there are still parts of the state where there’s a stigma on methadone treatment.”

In Baltimore, where heroin has long been a problem, Sharfstein launched efforts starting about a decade ago to expand access to methadone. Fatal overdoses dropped dramatically.

“Treatment with buprenorphine is effective — but I see a lot of people who can’t get access to it,” said Darius Rastegar, who treats patients in the Chemical Dependence Unit at Johns Hopkins Bayview Medical Center. “That’s one of the most effective treatments. Unfortunately it’s not available to a lot of people.”

3. Create more, and more affordable, long-term treatment.

Heroin addiction is so strong that addicts need long-term treatment, ideally in a residential setting, several doctors said.“It’s not simply the medicine, but a package of services that need to be provided for most patients,” said Eric C. Strain, director of the Johns Hopkins Center for Substance Abuse Treatment and Research.

But not everyone can afford such programs, and waiting lists can create a delay at the crucial moment when an addict seeks help.

There’s very little residential capacity in Virginia, said Randall, of that state’s Department of Behavioral Health and Developmental Services. And there aren’t enough publicly funded detox centers to handle the acute needs of addicts trying to quit. Private options can be very expensive; one local center costs $1,500 a day.

4. Pass “Good Samaritan” laws.

Friends should be able to call for help if they see someone overdose, advocates say, without worrying about getting arrested for their own drug use.When a 16-year-old from McLean passed out last summer after injecting heroin, according to court papers, her friends were too scared to get help. Police found her dead two days later.

At least 14 states, and the District, now have a Good Samaritan law, with the majority enacted since 2012.

5. Encourage people to talk about addiction.

With so much stigma around drug use — especially heroin — many parents said they were unaware of signs that their child was addicted, reluctant to acknowledge a problem, or unsure of how to help.

In Maryland, Cyndy Glass organized an awareness and fundraising run, “Jeremy’s Run” after her son died.

In Virginia, after 21-year-old Christopher Atwood fatally overdosed last year, his parents began a foundation in his name (www.theCAF.org). They are working with recovery communities on college campuses in Virginia, hoping to catch addicts at the crucial moment when they decide to quit, and ensure that they have some support.

“It’s got to be society’s change,” said Perry, the Virginia state police supervisor. “Prevention, education, treatment and law enforcement. That’s the only way we’re going to be able to combat this, is to come together and hit it as hard as we can.”

Susan Svrluga is a Virginia rover for the Washington Post, covering anything and everything that’s happening in the Commonwealth.
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