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Opiate effect on brainRichard Knox, NPR “All Things Considered” 02 January 08:

Every year, overdoses of heroin and opiates, such as Oxycontin, kill more drug users than AIDS, hepatitis or homicide.

And the number of overdoses has gone up dramatically over the past decade.

But now, 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.

One of the new rescue operations is located off a side street behind St. Peter’s Episcopal Church in Cambridge, Mass. Clients enter through an innocuous-looking door and climb a flight of wooden stairs to the Cambridge Cares About AIDS program for harm reduction.

The group says its mission is to provide prevention, education, advocacy and support services to the economically and socially disadvantaged.

At CCAA, drug users can obtain condoms, sterile needles, syringes and other resources to reduce their vulnerability to disease and death. Health educators also cajole their clients to undergo HIV and hepatitis testing, urge them not to share needles, and find them slots in detoxification programs and methadone treatment.

Drug Used as a Nasal Spray

On one recent wintry morning, health educator Eliza Wheeler teaches a 34-year-old client named Elissa how to rescue her friends from a fatal overdose.

“All right, Elissa,” Wheeler says in a getting-down-to-business manner. “The first thing I’m going to do is ask a series of questions about your current drug use. So, we’re going to talk about just the last 30 days.”

Elissa has been on methadone for six years, but she confesses that she used heroin a couple of days in the previous month because she was under a lot of stress.

Like most long-term heroin users, Elissa has had scary experiences with overdoses – her own and others’. Once, her partner became unresponsive after taking a mixture of heroin, benzodiazepine pills and alcohol, she says.

“He was not breathing, which is why I called the ambulance,” she says. “But I managed to wake him up before they came, and they didn’t take him away. He went out and convinced them he was OK.”

Many times, drug users and their friends don’t call 911, which is why overdoses are so often fatal. They’re afraid the police might come, and they could get arrested — or lose their housing or custody of their children.

Signs of Overdose

Wheeler runs through the signs of heroin overdose for Elissa.

“There are some clear signs, like people turning blue,” Wheeler says. “Sometimes, there’s like a gurgling sound and nonresponsiveness, of course. And there are some less clear signs, like people being in kind of a heavy nod — kind of being really sedated — not breathing very often. We usually say 12 breaths a minute is key. So, if people are breathing less than that, it’s time to really be concerned.”

Wheeler says stimulation — rubbing hard on the breastbone or the upper lip — can sometimes bring an overdose victim back to consciousness. If that doesn’t work, call 911 and start blowing air into the person’s lungs, a modified form of CPR called “rescue breathing.”

That’s when it’s time to open up the overdose rescue kit, Wheeler says, ripping open a plastic bag and taking out a small box containing a vial of medicine.

“This is what the box looks like,” she says. “Attached to the box is a little apparatus that makes it into a spray. It’s just a nasal spray. There’s no injection.”

“That’s so wonderful!” Elissa says, looking visibly relieved. “I had thought it was a shot.”

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.

The Cambridge program began putting Narcan kits into drug users’ hands in August. Since then, the kits have been used to reverse seven overdoses.

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.

Kral estimates that is at least 75 percent of all the reversals that have occurred so far among several dozen U.S. programs, many of which are new.

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?”

Program Has Critics

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.

Study Confirms Benefits

There is not much research on the effect of Narcan kits on drug abusers’ behavior, but one small study suggests that overdose-rescue programs reduce heroin use and get some people into treatment.

Karen Seal, an author of the study, says the study showed rescue programs have a tremendous impact.

“It was one of those great studies where we just all walked away and said, ‘Whoa! This is terrific!’” says Seal, of the University of California, San Francisco. “I mean, by our sheer interaction with these folks around these life-saving behaviors, we’re actually creating some real positive change here.”

And health educator Wheeler says putting overdose-rescue kits in the hands of drug users sends them a positive message.

“There is a real potential culture change among drug users because of Narcan,” she says. “Because, from my experience, I feel like drug users internalize a lot of stigma that’s out in the world about them. They come to believe that dying is just part of this life that they’ve chosen.”

Wheeler says it doesn’t have to be that way.

Despite the rescue program’s critics, it has not generated the kind of controversy that surrounded needle-exchange programs. Those programs seek to prevent drug users from getting HIV or hepatitis by sharing dirty needles and syringes.

So far, Narcan rescue programs have sprung up in big cities and rural areas around the country with little or no opposition.

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Maria LauterbachI have been watching the news reports about the young, extremely pregnant female Marine, Lance Cpl. Maria Lauterbach, who disappeared almost a month ago.

What has been most prominent in this case is the systematic marginalization of a young woman who dared to accuse a man, a superior officer, of sexual assault. I expected that out of the Marine Corps. I did not expect that from her family and civilian authorities.When she disappeared in December, the military did not report her missing, although certainly they were aware of it. Her stepmother was the person who filed the missing persons report. It now seems that her stepmother had advised her in a telephone conversation, shortly before her disappearance, to put her baby up for adoption because she couldn’t care for it. However, I’ve yet to see a Marine who can’t handle diaper duty. I suspect her stepmother really suggested adoption because of the identity of the father.

Apparently she had filed a rape charge against a superior officer, and a hearing was upcoming. The minute she filed a rape charge against a fellow Marine, she placed herself in danger, and the Marine Corps wasn’t about to do a thing to protect her.

As every female in the military is well aware (I used to be in the Air Force, many years ago) “don’t ask, don’t tell” applies to far more than sexual orientation. It also applies to females speaking out against the good ol’ boy system which is our military. They don’t want women there, and they especially don’t want mothers there. The latter is understandable to an extent, for many reasons; the former is not.

If a female is sexually assaulted by a fellow solder, and she reports that assault, she is assumed to be lying. Most females in the military will not report a crime committed by a male counterpart, and especially a superior officer, because they know how it will be viewed. The female, by filing such a charge, has bought their ticket out of the military, and with that goes all the benefits of being in the military, as well as the income. They will be forced out as a disgraced soldier.

Sure enough, it has been announced that she was facing involuntary discharge.

It has been said that she is suicidal and a chronic liar by her own family, by military authorities, and by the Onslow County Sheriff’s Department. Just yesterday, the Onslow County Sheriff made a plea for the missing woman to come back and face her problems.

Today, the Onslow County Sheriff announced that she is dead. Not only is she dead, she’s buried. It’s kind of hard to bury yourself when you’re dead. Obviously, she did not commit suicide. She was murdered. Obviously, the number one suspect is the superior officer.

Yet the Sheriff just said he is not terming this murder, because there are “a lot of twists and turns”. However, when you’re dealing with the military and they are covering something up, there are always going to be twists and turns. Sheriff Brown needs to get smart, and realize that he was being sent in other directions intentionally, to divert attention away from the Marine Corps.

Now, authorities are saying that the superior officer she accused is also missing. Apparently he’s been missing for a week, and was supposed to appear for duty at Fort Carson, Nevada.

Given the rape allegation, one would think he would have been noticed missing long before now. Undoubtedly the Marine Corps was aware that he had disappeared, and one would think they’d have made that information available. Had they done that, it would have been clear very early in the investigation that she had most likely been a victim of foul play, and the case would have been investigated as a possible murder rather than as a missing person. There is a huge difference between those two types of investigation, after all, since every adult has the right to disappear if they so desire.

But no. All this time, everyone – the Marine Corps, the Onslow County Sheriff’s Department, and even her own family – have worked on the assumption that she was lying about being raped by a superior officer. All this time, they have been protecting a murderer, a man who killed not only a fellow soldier, but an expectant mother and, quite obviously, her unborn child which could have survived outside the womb since she was eight months pregnant when she disappeared. As far as I’m concerned, that’s murder number two.

Today officials are saying that she was murdered because her unborn child would have been proof of her accusation of rape, which is undoubtedly a very big motive for murder on the part of the superior officer. So why wasn’t the Marine Corps ensuring this young woman’s safety from her attacker? Why didn’t they share that information with civilian authorities who were investigating her disappearance?

There are a lot of questions in this case which will probably never be answered. After all, the military is a law unto itself, and they don’t have to cooperate with local authorities.

However, this wouldn’t be the first time a Marine committed cold-blooded murder. The most famous case is undoubtedly that of Captain Jeffrey McDonald, who in the 70s murdered his pregnant wife and his two very young daughters, then tried to claim that drug-crazed hippies had committed the crime. It took decades to convict him of that heinous crime, due to the incompetence of the Marine Corps.

It looks like the Marines haven’t learn a thing since then. It’s all about protecting the reputation of the Corps. Semper Fi and all that, you know.

Originally posted by ElfNinosMom on Adventures in Frickintardistan

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