ELIMINATING DEATH PENALTIES FOR DRUG USE

CHICAGO - Heroin addiction is a regrettable condition, and there are lots
of theories about how to help people overcome it. But it is a truism, not a
theory, that you can't help addicts once they are dead. Step 1 in assisting
or even forcing heroin users into more socially productive behavior is
keeping them alive.

This elementary insight is one resisted by many supporters of the drug war.
They fear that if we reduce the risk of gruesome death from injecting
heroin or other drugs, everyone this side of Hilary Duff will soon be lying
in a gutter with a needle in her arm.

They don't want drug users to practice their habit in a less dangerous way;
they want them to give it up, period. Any assistance that doesn't tell
addicts they must stop using drugs, immediately and forever, is seen as
actively promoting irresponsible conduct.

That's why uncompromising prohibitionists, many of whom are in positions of
power, have long opposed one simple step to prevent the transmission of the
AIDS virus by drug users: giving them access to sterile hypodermic needles.
It's also why they are not lining up to support an innovation that would
save addicts when they overdose on heroin.

At least 28 percent of new AIDS cases in 2000 stemmed from injection drug
use. Some hard-liners think it's rough justice for those who insist on
using illegal drugs to get AIDS and die. Unfortunately, it's hard to detect
any sort of justice when the wives, husbands, lovers or children of these
people get AIDS and die through no fault of their own. Nor is it fair for
law-abiding taxpayers to pay the medical bills of those infected with HIV.

You could build a skyscraper out of all the studies documenting the public
health value of clean needles. Let drug users have uncontaminated equipment
and, it turns out, they will forgo the chance to inject themselves with HIV
microbes. After Connecticut scrapped its prescription requirement for
buying syringes, needle sharing fell by 40 percent.

Not only that, but people who don't use heroin, upon learning they could
get clean utensils, generally don't decide they want to be slaves to opium.
In fact, needle-exchange programs often serve as a gateway to get existing
addicts into treatment.

Armed with all that knowledge, Illinois Gov. Rod R. Blagojevich last week
signed a bill legalizing the over-the-counter sale of up to 20 syringes.
Only five states still require a prescription for hypodermic needles.

The general change of heart offers hope about another method for keeping
drug users out of the graveyard. The federal government reports that
emergency room admissions of people using heroin rose by nearly 50 percent
between 1994 and 2001. Thousands of people die each year from heroin
overdoses. Fortunately - well, some people think it's fortunate - there is
a simple, well-established remedy for this malady.

A drug called naloxone, administered by syringe, safely and immediately
reverses the respiratory failure that leads to death. There is no doubt
about its efficacy. Dan Bigg of the Chicago Recovery Alliance, which has
trained people in using the medication, says the effort has produced 165
"reversals" - lives saved - in the Chicago area.

Mr. Bigg wants Illinois to follow up the new syringe law with a measure to
exempt physicians from liability if they give naloxone to patients for
heroin overdoses. Just as people with severe allergies or diabetes carry
drugs that can prevent sudden death, he thinks heroin users and their
family members and friends should keep naloxone at hand to avert
drug-induced suffocation. New Mexico recently eliminated criminal and civil
liability for anyone administering it.

Another option is to allow the sale of naloxone, now a prescription
medicine, over the counter, making it far easier to get. Since the medicine
has no enjoyable properties, there's no chance it would be abused. And
there isn't much risk that more people would use heroin if they had a
lifesaving antidote, since receiving the antidote is not a pleasant experience.

This remedy will doubtless evoke opposition from anti-drug zealots, who are
suspicious of anything that diminishes the danger of drug use. They're
right that it would be nice if every heroin user would simply swear off the
stuff, or at least seek treatment to conquer their addiction. Given time,
some will. There's no rehab in the morgue.

Steve Chapman is a columnist for the Chicago Tribune, a Tribune Publishing
newspaper. His column appears Tuesdays and Fridays in The Sun.