The Office of National Drug Control Policy prefers dead heroin addicts to living heroin addicts. At least, it's hard to put any other interpretation on this story:
Public health workers from New York to Los Angeles, North Carolina to New Mexico, are preventing thousands of deaths by giving $9.50 rescue kits to drug users. The kits turn drug users into first responders by giving them the tools to save a life.
The nasal spray is a drug called naloxone, or Narcan. It blocks the brain receptors that heroin activates, instantly reversing an overdose.
Doctors and emergency medical technicians have used Narcan for years in hospitals and ambulances. But it doesn't require much training because it's impossible to overdose on Narcan.
New data compiled for NPR by researcher Alex Kral of the consulting firm RTI International show that more than 2,600 overdoses have been reversed in 16 programs operating across the nation.
John Gatto, executive director of the Cambridge program, says such dramatic results are unusual in the world of substance abuse treatment and prevention.
"In the work that we do, oftentimes the results are very intangible," Gatto says. "This is amazing to be involved in something that literally can save people's lives. Why wouldn't we do it?"
But Dr. Bertha Madras, deputy director of the White House Office on National Drug Control Policy, opposes the use of Narcan in overdose-rescue programs.
"First of all, I don't agree with giving an opioid antidote to non-medical professionals. That's No. 1," she says. "I just don't think that's good public health policy."
Madras says drug users aren't likely to be competent to deal with an overdose emergency. More importantly, she says, Narcan kits may actually encourage drug abusers to keep using heroin because they know overdosing isn't as likely.
Madras says the rescue programs might take away the drug user's motivation to get into detoxification and drug treatment.
"Sometimes having an overdose, being in an emergency room, having that contact with a health care professional is enough to make a person snap into the reality of the situation and snap into having someone give them services," Madras says.
Got that? Preventing thousands of deaths isn't "good public health policy" if it doesn't involve the appropriate laying-on-of-hands by the medical priesthood. Anyway, if heroin addicts aren't afraid of dying, they might keep using heroin.
Why not just go all the way and poison the heroin supply? If withholding Narcan in order to generate more overdoses in order to scare addicts into quitting were proposed as an experiment, it could never get past human-subjects review. But since it's a failure to act rather than an action, there's no rule to require that it be even vaguely rational.
I get angry at the people who call themselves the "drug policy reform movement" for their insistence that we could make more drugs legal without having more addiction. But unlike their counterparts in the equally reality-challenged but politically dominant "drug-free America" movement, the "drug policy reformers" lack the power to kill in the service of their dreams.