CREDIT: Evan Agostini/Invision/AP
Philip Seymour Hoffman was found dead on his bathroom floor Sunday night, with two bags of what is believed to be heroin beside him. If Hoffman did, as suspected, die of a drug overdose, he is one of an estimated 105 people who die every day from that cause. In 29 states, drug overdoses now kill more people than auto accidents. And use of heroin has more than doubled, over the past decade, while overdoses of legal opiates — painkillers — have skyrocketed.
As public discussion over the failed War on Drugs has escalated and politicians mull marijuana and sentencing reforms, one part of the vision is to redirect enforcement resources toward education, treatment, and other health-oriented programs that help those struggling with addiction. But for those entrenched in addiction, there are low-hanging fruit solutions passed into law in a minority of states that directly tackle the problem of stopping preventable overdose deaths.
Shielding ‘Good Samaritans’ From Prosecution
The movie “Traffic” was one of several media depictions of a particularly tragic overdose scenario. Drug use frequently occurs in the company of others, who witness the overdose and are either too afraid to do anything at all, or, as in the 2000 film, drop the body anonymously outside of a hospital without reporting the problem, and get arrested anyway. In fact, studies have found that fear of prosecution is the single most common reason for not calling the police for emergency medical help. Last year, Vermont became at least the 13th state in addition to the District of Columbia to pass a law incentivizing witnesses to call 911, by explicitly providing legal protection to those witnesses who call the police for help. While Vermont’s “Good Samaritan” law is among the broadest — providing legal protection from prosecution for all charges and even from civil forfeiture of a person’s assets — other states such as New Jersey passed compromise measures to make exceptions for those who violate restraining orders and does not provide immunity from the seizure of assets.
Even when 911 is called, a second legal obstacle often prevents those who report to the scene from administering a drug that is known to reverse opiate overdoses. In many states, pharmacists and other health care professionals face criminal and civil liability for distributing naloxone to third parties — even police officers — who can administer it in an emergency situation. The drug has been described as a “miracle drug,” because it knocks opiates off receptors that make a user stop breathing, without any other known side effects. “Unless you have drugs in your body, opiates in your body, it won’t do anything to you,” said Allan Clear, executive director of Harm Reduction Coalition. “So you can’t get high.” In fact, the drug, which can be administered either as an injection or a nasal spray, also stops the user’s high while reviving their breathing.
But both medical professionals’ fear of liability and lack of disseminated naloxone kits prevent availability of the drug for friends, family members, community treatment programs, and police who may be called to a scene rather than paramedics. Laws are now emerging in some states to provide immunity to those professionals and laypeople, while other programs are equipping police officers with both training and kits to administer when they report to the scene. In 2012, then-White House Drug Czar Gil Kerlikowske for the first time endorsed broader distribution of naloxone. And after the city of Quincy, Mass. equipped every police officer with a naloxone kit, they reversed overdoses 179 times in three years.
Treating The Addiction
Hoffman’s state of New York happens to be one that already has a Good Samaritan law, and just last week state lawmakers introduced another measure to expand the availability of naloxone. But neither of these solutions work for those like Hoffman who may have overdosed alone, since individuals in the midst of an overdose can’t self-administer or call 911. For that population, Clear believes the greatest tool is increased prescription of addiction treatment drugs like buprenorphine that mimic some qualities of opioids with more limited harms. Some approved U.S. doctors are permitted to prescribe these drugs to treat opioid addiction (users can take them for a less harmful high), but Clear told ThinkProgress even those who have been through treatment should be prescribed the drug more often, recognizing the prevalence of relapse. In France, where all doctors have since 1995 been authorized to prescribe the addiction treatment, opiate overdose deaths decreased 79 percent between 1995 and 2004, according to one study.
“If you look at this as a spectrum, using Philip Seymour Hoffman as an example, … apparently he was in rehab,” Clear said. “He talked about his pill problem and then his heroin use. Well you have hundreds of thousands of people in that situation … the chances are that they may well relapse at some point after that.” The drug abuse community oftentimes approaches treatment from the viewpoint of mitigating the person’s relapse but with highly addictive drugs like opioids, “the treatment system really needs to embrace the notion that [this may happen],” Clear said. “It doesn’t hurt and it can save your life.”