POINTED QUESTION, CONTINUED FROM PG. 09
literally everyone coming in purchasing syringes, to offer them naloxone directly,” says Green. Pharmacists are particularly suited for increasing access to naloxone for several reasons. “They understand the pharmacology of what is happening in addiction,” Green says. And of the nearly 3,000 pharmacists she has trained in naloxone distribution, Green says, many “understand that this is no different from other chronic diseases in many respects.” And public-health advocates say an understanding of the effects opiods have on users is important for pharmacists and others who may be helping users transition out of rehabilitation or incarceration. “There is a lot of potential for death reduction by focusing on incarcerated populations, people leaving detox, and people who are transitioning from the emergency departments after having been medically treated for an overdose,” says Green. “Those instances and those transition points we know are very high-risk.” For example, periods without opioid use lower an individual’s tolerance. Thus, a typical amount used before a period of detox could be a fatal amount after.
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PITTSBURGH CITY PAPER 08.26/09.02.2015
This kind of knowledge can be life-saving for an opiod user coping with addiction. But it’s difficult for public-health advocates to stay on top of the epidemic when the opiod drugs on the street are in constant flux. “The challenges that we have now are not the challenges that we had yesterday,” says Green. “Five years ago, we were dealing with prescription opioids and a little bit of heroin, and now we are dealing with a lot of heroin and a little bit of prescription opioids.” For instance, batches of fentanyllaced heroin have entered the supply in Allegheny County, causing almost two dozen deaths in 2014. New developments like these leave the public-health community struggling to get ahead of this deadly issue. But part of that effort also involves changing perceptions about users. Advocates say this includes a commitment to recognizing the humanity in intravenous drug users, and treating them like any other patients with a disease. “You can live with addiction — in your past, your present and potentially, you never know, in your future,” says Green. “You can succeed, and you’re human.”