State Attorney General
Eric Schneiderman declared that his office would provide the funding of
more than $1.1 million to equip and train the NYPD officers as part of
the Community Overdose Prevention Program.
"By providing NYPD police
officers with naloxone, we are making this stunningly effective
overdose antidote available in every corner of the five boroughs. This
program will literally save lives," Schneiderman said at a press
conference.
Each naloxone kit
consists of a zip bag or pouch containing two pre-filled syringes of
naloxone, two atomizers for nasal administration, sterile gloves and a
booklet on the use of the drug, according to a statement from
Schneiderman's office.
The emergency treatment
works like the well-known EpiPen -- an epinephrine auto-injector for
serious allergic reactions -- as it is injected into the muscle and does
not require training, making it more user-friendly. Once injected, the
naloxone stops heroin and other opioids from slowing a person's
breathing down to the point that it stops.
The FDA approved the prescription treatment after just 15 weeks under priority status.
Currently, most law
enforcement agencies are using the nasal spray version of the antidote,
which is slightly different than the auto-injector.
"A recent pilot project
in Staten Island has already proven effective with several overdose
victims," said NYPD Commissioner William Bratton, who did not have an
exact time frame of when the officers would officially be equipped.
The training for each officer takes roughly 45 minutes, Bratton said.
Joining Schneiderman and Bratton at the announcement was Carol Christiansen, co-founder of Drug Crisis in Our Backyard.
Christiansen's son, a
former NYPD detective, died of a heroin overdose in 2012. Erik, 28,
injured his back at the gym and became addicted to oxycodone for the
pain, which led to an eventual addiction to heroin.
"It's an epidemic I
think everybody should be aware of," Christiansen said, who believes the
real problem is the poor monitoring of prescription medication.
"A recent pilot project
in Staten Island has already proven effective with several overdose
victims," said NYPD Commissioner William Bratton, who did not have an
exact time frame of when the officers would officially be equipped.
The training for each officer takes roughly 45 minutes, Bratton said.
Joining Schneiderman and Bratton at the announcement was Carol Christiansen, co-founder of Drug Crisis in Our Backyard.
Christiansen's son, a
former NYPD detective, died of a heroin overdose in 2012. Erik, 28,
injured his back at the gym and became addicted to oxycodone for the
pain, which led to an eventual addiction to heroin.
"It's an epidemic I
think everybody should be aware of," Christiansen said, who believes the
real problem is the poor monitoring of prescription medication.
Schneiderman also led
the effort to pass legislation to create I-STOP, a monitoring program
that prevents individuals from going from doctor to doctor to accumulate
multiple prescriptions.
"If the I-STOP law was in effect over two years ago possibly my son, Erik, would be alive today," Christiansen said.
The police department of
Quincy, Massachusetts, was the first in the nation to require its
officers to carry naloxone and has successfully reversed 211 overdoses
with a success rate of over 95%. In New York's Suffolk County, 563 lives
were saved last year alone, the statement said.
"Equipping the NYPD with
naloxone is a tremendously important step in the fight against New
York's growing opioid addiction epidemic," said Dr. Andrew Kolodny,
chief medical officer of Phoenix House in Manhattan.
How heroin works
Heroin is most often
mixed with water and injected. Injecting it minimizes the lag time
between when the drug is taken and effects are felt -- with injection,
the effects are almost immediate.
It can also be smoked, snorted or eaten, but smoking or eating destroys some of the drug and mutes its effects.
When someone takes
heroin there is an immediate rush. Then the body feels an extreme form
of relaxation and a decreased sense of pain.
What's happening inside the body is the heroin is turning into morphine. Morphine has a chemical structure similar to endorphins
-- the chemicals your brain makes when you feel stressed out or are in
pain. Endorphins inhibit your neurons from firing, so they halt pain and
create a good feeling.
Morphine, acting like
your endorphins, binds to molecules in your brain called opioid
receptors. When those receptors are blocked, that creates a high.
Why you die
Most people die from heroin overdoses when their bodies forget to breathe.
"Heroin makes someone
calm and a little bit sleepy, but if you take too much then you can fall
asleep, and when you are asleep your respiratory drive shuts down,"
said Dr. Karen Drexler,
director of the addiction psychiatry residency training program and an
associate professor in Emory University's psychiatry and behavioral
sciences department.
"Usually when you are
sleeping, your body naturally remembers to breathe. In the case of a
heroin overdose, you fall asleep and essentially your body forgets."
A heroin overdose can also cause your blood pressure to dip significantly and cause your heart to fail.
Studies show intravenous heroin users are 300 times more likely to die from infectious endocarditis, an infection of the surface of the heart.
Heroin use can also cause an arrhythmia -- a problem with the rate or rhythm of the heartbeat. During an arrhythmia, the heart may not be able to pump enough blood to the body, and lack of blood flow affects your brain, heart and other organs.
Heroin use can also cause pulmonary edema.
That's when the heart can't pump blood to the body well. The blood can
back up into your veins, taking that blood through your lungs and to the
left side of the heart.
As pressure in the blood
vessels increases and fluid goes into the alveoli, the air spaces in
the lungs, this reduces the normal flow of oxygen through your lungs,
making it hard to breathe. This too can give you a heart attack or lead
to kidney failure.
Heroin can also come with other toxic contaminants that can harm a user -- although deaths from such instances, while not unheard of, are thought to be rare.
Studies suggest
instantaneous death -- like what may have happened in Hoffman's case --
is unusual. The actor was found dead on his bathroom floor with a needle
sticking out of his left arm, authorities have said.
Such deaths, where a needle and syringe are still in place, would be considered instant by scientists. One study showed this accounts for only 14% of heroin-related deaths.
Heroin deaths increase when...
There are some common social characteristics in heroin deaths that would make Hoffman more of a typical case. Most fatalities involve men,
particularly those who have struggled with other drugs or alcohol (he
admitted to this in the past) and other drugs or alcohol are often present.
While many are single (Hoffman had a partner), most users die in their homes and/or in the company of another person.
An addict does have a much higher chance
of dying if he or she leaves treatment. The risk of death is higher for
newly clean heroin addicts. A number of fatalities appear to happen
after periods of reduced use, one 2000 study showed.
In fact, long-term users who die from overdoses are likely to have heroin levels no higher than those who survive.
That may be in part
because those who are newly clean don't know how much of the drug to
give themselves any more, Drexler said. They won't need the same amount
to get high as when they were using more regularly.
There are also some
studies that show tolerance to the respiratory depressive effects of
opiates increases at a slower rate than tolerance to the euphoric and
analgesic effects. As your tolerance
to the drug develops, you typically need more of it to produce the high
you are used to getting. This may be why long-term users are
potentially at greater risk of overdose than novices.
Statistics suggest that newer heroin users aren't the ones most likely to die. One study showed only 17% of the deaths studied were in new heroin users.
However, Drexler said
newer users can overdose because they don't know how much drug to take,
compared to experienced users. "I think it is misleading to say you
would not die if you only use it once or twice," she said.
A person's chances of dying from heroin use increase dramatically after 20 years of use. Studies show that after 30 years of use, 16% of heroin users have died, compared with 6.5% of cocaine users and 1.5% of meth users.
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