If we came up with a sure cure for lung cancer, we wouldn't withhold it because it might encourage people to smoke. But something about heroin addiction tends to cloud our thinking on public health policy. On this subject, though, Los Angeles has enjoyed a moment of sunny clarity.
The federal Centers for Disease Control reported in July 2006 that more than 16,000 people died in 2002 from drug overdoses. Philadelphia loses more lives to heroin than to homicide. Chicago witnessed nearly 200 deaths in 18 months from overdoses of fentanyl, an exceptionally powerful opiate that is often mixed with heroin.
One way to prevent people from overdosing is to stop them from using drugs. But as smokers have demonstrated, knowing you should quit and actually quitting are two different things. Despite all our law enforcement and education efforts, there are nearly 120,000 heroin users in the United States.
Abstinence is best, but when it's not universal, other remedies are needed. Luckily, one has emerged. Naloxone is a medicine with one conspicuous attribute: It can stop a heroin overdose in its tracks.
In 2006, the Los Angeles County Board of Supervisors voted to spend $100,000 to dispense naloxone to community organizations that offer treatment and other help to addicts. It's the latest government to acknowledge that the first step toward curing drug abuse is keeping the abuser alive.
The board has grounds to act. Fatal drug overdoses in Los Angeles have hit the highest level in a decade. Among whites between the ages of 25 and 44, they are the leading cause of death. In 2002 and 2003, there were more than 900 known deaths involving heroin, or more than one every day.
The fiercest critics of drug use may think overdoses are not such a bad thing, since they get rid of troublesome lowlifes. But even by that harsh logic, naloxone is worthwhile, if only because not all excessive ingestions are lethal. Hundreds of heroin users are admitted to Los Angeles County's public hospitals every year with nonfatal overdoses, at a typical cost of $16,000 apiece. Many others get emergency room care. All this means an overdose of tax burdens for local residents.
There is no question that naloxone (also known as Narcan) works. Emergency medical service providers in Los Angeles County already use it about 1,000 times a year.