How Many Times Should We Save An Addict’s Life? As Many As We Can

By the time my father surfaced, he had been at the Worcester City Hotel, a seedy place known for fights, drug busts and prostitution, for at least a few days. While not his worst bender, it was certainly a notable one. When sunlight filled the room for the first time in days, it exposed a mass of dazed junkies, glass pipes and pills.

Though he claims to have only dabbled in opioids — crack being his drug of choice — the murkiness of this statement is obvious. (An addict who “dabbles” can in reality have a side habit chemically inconceivable to most people.) For the families of addicts, every story about the state's opioid crisis feels personal. Even if a different drug has been the culprit, accounts of families struggling with loved ones in the grip of substance abuse, wavering on the brink of death, feel chillingly familiar.

Opioids were on Governor Charlie Baker’s mind in June, when he was in Brockton to announce nearly $1 million in state grants to Massachusetts cities and towns to buy naloxone. This drug, commonly referred to by the brand name Narcan, is used to treat opioid overdoses. It is one of the few reliable tools that authorities and healthcare workers have in the state’s ongoing fight against opioids.

My father wasted chance after chance to overcome his addiction, and still received more. I’m thankful that he did.

For activists, this investment is welcome news, even though it’s little more than a Band-Aid on a gaping wound. Similar actions by the Baker administration in 2016 and 2017 have contributed to slowing the number of overdose deaths, even while emergency service calls for opioid-related issues have generally continued to rise. But for budget hawks and people who view addiction as a personal failure, $1 million more to subsidize naloxone is a waste of money and a dangerous precedent: A subsidization of personal failure.

For those of us who have been affected by addiction, the situation is less clear. It’s hard to find a person who doesn’t at least know somebody impacted by the crisis. My father was addicted to crack, but I — like many others across this state — also have close friends struggling with opioids. What obligation do we have to fix something that seems so out of control? As a society, it seems one thing we absolutely must do is act in a way that respects the humanity of the people affected. Most importantly, that means preserving life.

The ideas to combat the opioid epidemic cover a number of the multiple causes of the issue. Federal and state bills call for increased medical coverage, restrictions on opioid prescriptions, overhauling treatment and increasing educational resources. Authorities and researchers are  examining how effective our current rehab system is and calling for expanded access to addiction medications such as buprenorphine. There have also been serious questions raised about the responsibility that drugmakers and doctors bear in promoting prescription drugs that are widely considered to hook people on opioids before they move onto cheaper, and more dangerous, alternatives like heroin.

With all of these different approaches available, why focus on naloxone? Critics note that a number of the people treated with the drug will still die within a year, because the underlying problem isn’t addressed. This is true — but ignores the obvious fact that saving some is better than saving none.

Others maintain that money would be better spent on addressing and studying the root issues of the crisis. They insist that our focus should be on identifying and making available effective and ongoing follow-up treatments, education and resources within the communities hit hardest. These points are valid and deserve a continued and thoughtful conversation. It’s true, for example, that research into the best treatment options available for doctors, including mental health professionals, is important, necessary and often underfunded.

A number of the people treated with naloxone will still die within a year ... but this ignores the obvious fact that saving some is better than saving none.

But what can society do to combat this issue today as we grapple with those bigger questions that will take months, or years, to answer?

For now, the least we can do is make sure we save as many lives as possible. This may mean saving the same person’s life several times, funding treatment programs that have frustrating results and continuing to grant towns and cities money to purchase naloxone.

My father wasted chance after chance to overcome his addiction, and still received more. I’m thankful that he did. From what I’ve heard, his latest round of rehab seems to be sticking. That’s something — crack addicts with multiple heart attacks in their medical record don’t usually last long.

I haven’t spoken with him in close to three years. He’s seemed hell-bent on destroying himself for so long, but is also capable of being one of the most caring people I know. I don’t know what I owe my father. I don’t know how to solve all the problems between us. I do know that I’m glad he’s alive and maybe, because of that, someday we’ll have a chance to figure out how things went so wrong.