An Ohio city councilman concerned about the price of emergency services for opioid overdose victims wants to cut costs by denying some people access to life-saving treatment.
Last week, Middletown council member Dan Picard asked the city to explore the legality of a proposal to refuse city-dispatched medical services to any overdose victim who has sought an intervention twice before. Some local media outlets have branded the proposal as a “three strikes” policy.
“I want to send a message to the world that you don’t want to come to Middletown to overdose because someone might not come with Narcan and save your life,” Picard told Ohio’s Journal-News. “We need to put a fear about overdosing in Middletown.”
Narcan is the brandname of naloxone, a drug that reverses the effects of an opioid overdose by essentially blocking the opioid receptors that heroin, fentanyl and other narcotic painkillers target.
Middletown’s law department hasn’t come to a determination on the legality of Picard’s idea, and city officials have largely held off on commenting until it does.
Picard did not respond to HuffPost’s request for comment.
Middletown Fire Chief Paul Lolli told the Journal-News that he understands the “frustration” people like Picard are feeling, but clarified that his department will continue responding to service calls and administering Narcan until it’s told to do otherwise.
“You would never say there’s a limit on the number of times your grandmother can fall ill and be taken to the doctor.”
- Jerónimo Saldaña, Drug Policy Alliance
Narcan, which is often administered as a nasal spray, has become a standard part of first responders’ toolkits to fight a surge in opioid-related deaths around the country. Naloxone doesn’t produce a high, but typically sends the recipient into an immediate withdrawal, which can leave some individuals seeking the very same drugs that nearly killed them.
Supporters of harm reduction have pushed for broader access to naloxone, noting that the alternative in many of these cases is death.
But Picard seems to believe that EMS crews are working a bit too hard to stem the tide of overdoses, and is upset that taxpayers are footing the bill to revive people, many of whom are transients and not residents of Middletown, he says.
Picard also proposed that instead of immediately arresting or jailing overdose victims, they should receive a court summons and be required to work off the cost of treatment by completing community service. But there’s a catch.
“If the dispatcher determines that the person who’s overdosed is someone who’s been part of the program for two previous overdoses and has not completed the community service and has not cooperated in the program, then we wouldn’t dispatch,” said Picard.
Although Middletown budgeted $10,000 for Narcan this year, overdoses across Ohio have skyrocketed in the first six months of 2017 as increasingly potent opioids flood the black market. The city is currently on pace to spend 10 times the amount it had allocated.
Middletown has suffered 577 overdoses so far this year, already eclipsing the 532 overdoses that occurred in 2016, according to local NBC affiliate WLWT5. With 51 fatal overdoses in 2017, the annual death toll appears likely to dwarf last year’s 74 fatalities.
Proposals like Picard’s are evidence of a phenomenon known as “compassion fatigue,” reports the Columbus Dispatch.
With 4,100 overdose deaths across Ohio last year, Martins Ferry Police Chief John McFarland said some people have begun taking these casualties as a foregone conclusion.
“You hear from the public, ‘Why don’t you let them die?’” McFarland told the Dispatch. “We’re not God; we don’t decide who lives or dies. … We have the ability to save them, so we do.”
Other policymakers have used arguments like Picard’s to justify controversial approaches to the opioid epidemic. Last year, Maine Gov. Paul LePage (R) vetoed a bill to expand access to naloxone, claiming that the drug “does not truly save lives; it merely extends them until the next overdose.” State lawmakers later overrode LePage’s veto.
Comments like Picard’s or LePage’s are a reminder that a “cold-hearted” ideology drives one side of the debate on drugs and addiction, said Jerónimo Saldaña, organizing and policy manager at the Drug Policy Alliance, a nonprofit that advocates for the progressive reform of drug laws.
“You would never say there’s a limit on the number of times your grandmother can fall ill and be taken to the doctor,” said Saldaña. “Just because it’s a different type of illness, a different type of problem doesn’t mean you can allow yourself to quantify the number of times someone can reach out for assistance.”
Rather than worry so much about how much it costs to save the life of someone suffering from addiction, Saldana says policymakers should invest more in treatment and recovery programs so those individuals can get the help they need when they’re ready to get it.
“People are forgetting the humanity of these folks,” said Saldaña. “People are forgetting that we can’t throw away lives, and we have to ensure that all lives are taken into account and receive the medical care they need.”