Reducing OD Deaths by Peers
A new article describes for a small pilot cohort in SF a program to train heroin dependent individuals to administer CPR and provides them with pre-filled naloxone syringes and the education to use them. The article points out that naloxone is non-"abusable," and that among the lay community CPR training has been deemed reasonable (though largely ineffective because so few folks in the community at large witness cardiac arrests). OD events were self-reported "but were corroborated by one or more witnesses. . . " In a six-month period naloxone was used by the study-population in 15 of 20 cases of observed OD; no deaths were reported, and the subjects claimed to have lessened their own use of heroin. The limitations of the study are acknowledged - but one has to wonder: what could possibly argue AGAINST such training and distribution of naloxone? One plausible reason to hesitate (not discussed in this paper) might be fear of legal liability if individuals die and blame is attributed to the training and the trainers.
Surely there's some way to deal with that issue - if medical intervention in general were to be withheld from patients in need as long as the threat of liability existed, no one would get care for anything. Article appears in J of Urban Health (Bull. of NYAM), 2005, KH Seal et al.