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As increasing numbers of individuals who have overdosed on heroin and other opiates and opioids have been saved in York, our office has heard from some in the community who are concerned that heroin and prescription drug addicts will use more often or in larger amounts because they and their families now have easier access to the antidote Naloxone (a.k.a. Narcan). Some addicts are using Naloxone as a sort of safety net — even stockpiling it in their homes.

First, we want to remind those of that persuasion that when the heroin/opiate/opioid addict uses, they are generally using to fight the excruciating flu-like symptoms of withdrawal. They are usually not thinking they are going to die from using heroin or other opiates/opioids. They actually feel as if they are going to die from withdrawal. They are usually not thinking about Naloxone being there to save them. They are thinking that heroin will solve their withdrawal symptoms. Because they hate withdrawal so much, most would not want to willingly use a drug – Naloxone – that puts them into an almost immediate state of such intense sickness.

Furthermore, they and their friends who are often using with them are not thinking as rational, sober individuals would think. That judgment and reasoning part of their brain has been altered by the chemistry of their drug addiction. They have a greater and faster dopamine release from the heroin or their opiate/opioid of choice than anything else can give them. Addiction specialists tell us that the drug addict's dopamine release (causing intense pleasure) is much stronger than any food, sex or relationships can give. And the addict craves the heroin/opiate/opioid at that time, and more than anything else.

Most heroin/opiate/opioid addicts are not stockpiling the antidote Naloxone. And if the addict is overdosing, someone else must administer the Naloxone anyway. The overdosing addict is usually in no state to self-administer Naloxone. However, their family members, and the addict him or herself should have the ability to have Naloxone available to use in case of an overdose. As we often ask, if you had a loved one who had a terrible disease and you had an antidote that could save them from sudden death from that disease, would you not want to try and save them? It is only when they are saved from an almost certain death, that we can sometimes talk about treatment and the help that is available.  And many times, because of the brain dysfunction of addiction, even that close call is not enough to convince them to get help.

We still hear the comments and receive the insensitive tweets stating, "Let them die. They don't care — why should we?" "Saving them is a waste of time and money." Sadly, we know there are some who feel that way. Again, we would remind them that this addiction is a disease and it often takes months and years to help someone get on the path to sobriety. We wouldn't think twice about offering life-saving, cholesterol-lowering medication to an adult who continues to make poor diet decisions (despite knowing better) or doesn't lose the recommended number of pounds. Yet some believe it is OK to let the drug addict die.

If our homicide rate drastically increased to 60 or 70 in a year, many would be clamoring for something to be done. In essence, we have a similar health crisis going on in York County — with the second year of 60 plus deaths (mostly all accidental) from heroin-related overdoses — a county-wide problem involving all economic classes. Our heroin-related deaths would have been more than double this year (over last year) were it not for York County law enforcement giving Naloxone and reporting 90 plus saves as of early December. Various police departments, the DA's office and the coroner's office would have been stretched beyond their capabilities were it not for Naloxone.

As we've said repeatedly in our 60 plus community and school presentations since June 2014, we realize Naloxone is not a cure, but it does save lives. Our office has been working with more than 120 families in the last two years who would have given anything to have had Naloxone with them when their loved one overdosed. Ask any of them. It is crucial that Naloxone continue to be available to the families and addicts as one of many tools in combating this epidemic.

To the skeptics who believe Naloxone will only perpetuate the heroin addiction, there is generally little to no evidence to support that theory. Naloxone itself is not addicting. And someday, it could be their friend or a family member who dies. Is that what it would take to change their mind? We would hope not. But sadly, it seems, that is sometimes what it takes.

We are grateful to law enforcement, EMS, the hospital emergency personnel, recovery house and rehab center staff, schools, responsible families and others who have armed themselves with this life-saving antidote, and we will continue to encourage others to do the same.

As law enforcement will tell you, most crime today is drug related because addicts often steal, or worse, to get drugs. From shoplifting to burglaries to homicides, this drug epidemic is a problem that affects us all — directly or indirectly. It is important that we continue to recognize and support the widespread use of Naloxone in our community as one of the many tools to help combat the heroin and opioid crisis that impacts us all.

Pam Gay has been a registered nurse for 34 years and coroner since January 2014. Claude Stabley has been a registered nurse for 21 years, and a deputy coroner for 18 years. Chief Deputy Stabley also served on the York City police force for 23 years.

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