As Naloxone Spreads, Gaps In Addiction Treatment Remain

May 10, 2017

A drug that can reverse a heroin overdose is set to become more widely available in New Mexico. It’s the latest attempt to fight the opioid epidemic here—but even as naloxone becomes more available, other addiction and treatment services are struggling.

Today Abe Gordon is an addiction counselor in Española. But not long ago, he was struggling with heroin addiction.  One day he was using with some friends, and passed out after taking a large dose.

“I took too much obviously, but somebody happened to have Narcan and used it on me,” Gordon said, referring to the brand name for naloxone—a nasal spray that can stop an opioid overdose in its tracks. “And I woke up violently I’ll. It was a horrible situation. But at the same time it saved my life. Now, I wish I had said OK I’m not going to do that again.”

But not long after, Gordon overdosed again. And again, he was saved by naloxone. But when he came to his addiction was still there in full force.

“And then what happens is my sister came to pick me up with a loaded syringe, and I was off and going again. That’s just how it works around here,” he said.

Naloxone has garnered a lot of support from the medical community. Dr. Joanne Katzman, who directs the University of New Mexico’s Pain Center, is a vocal proponent of naloxone, and has advised lawmakers on legislation to increase access to the drug.

“Naloxone is the most powerful harm reduction tool we have in terms of the opioid epidemic,” Katzman said. “New Mexico has really led the country in naloxone distribution. Since 2001 we were the first state to really be distributing naloxone among communities, and it started with northern New Mexico, primarily Española.”

Naloxone has been so effective here that it’s become the focus of the state’s efforts to fight the opioid epidemic. Last year the legislature passed a bill to make naloxone available to whoever needs it, without a prescription. Federal money has helped underwrite naloxone campaigns here. And this year, the governor signed yet another bill pushing naloxone, this time providing the drug to law enforcement, jails and treatment centers.

Advocates say that bill will undoubtedly help people who overdose. But this year the governor vetoed bills that would have expanded protections for people calling 911 to report an overdose, and that would have made home visiting and early childhood programs more accessible. Those kinds of programs have been shown to get at the root causes of addiction, and to help break the cycle before an overdose happens.

And even as money has increased for naloxone, the state has stopped funding many detox programs.

Abe Gordon, the addiction counselor in Espanola, says the uneven focus on naloxone means people are overdosing again and again, without getting help with their addiction.

“That’s where they’re putting all their money,” Gordon said. “They’re not putting it into detox, and building rehabilitation centers, or even putting money into the ones that we even have.”

Kathy Armijo Etre, who oversees community health at Christus St. Vincent in Santa Fe, says there are big gaps in treatment for opioid addiction—gaps that show up every day in hospitals.

“Naloxone is awesome. But it is not treatment,” Etre said. “We’ve got a minimum of 30 people a day in the hospital that have an underlying behavioral health issue.”

That problem shows up in the emergency room too. Etre says every day between 10 and 16 ER visits at Christus are for drug or psychiatric emergencies.

“You know, it’s pretty extreme,” she said.

It’s something you hear a lot from doctors and emergency room directors in New Mexico: a big chunk of the people they see have untreated addictions and serious drug-related health problems—problems naloxone does not address.

New Mexico is getting some substantial money from the federal government as part of a health bill passed during the Obama administration—$10 million over two years, which advocates say could give a boost to the state’s struggling detox, treatment and prevention programs. The New Mexico Human Services Department says some of that money will go to pay for programs other than naloxone.