DOCTOR PUSHES FOR OVERDOSE ANTIDOTE
But some argue long-term treatment is more crucial
Physician Leana Wen has trained heroin addicts, first responders and drug court officials in how to administer the antidote for an opioid overdose. So why not a group of wealthy white women gathered at a stately clubhouse in Baltimore’s toniest neighborhood?
Wen is Baltimore City’s health commissioner, and she has emerged as one of the most aggressive and innovative public health officials in the nationwide fight against opioid addiction. Naloxone, a medication that reverses the effects of an opioid overdose, is a centerpiece of Wen’s crusade — something she says “should be part of everyone’s medicine cabinet.”
Her approach to the epidemic is not without controversy.
But controversy doesn’t seem to bother Wen, a petite Chinese immigrant who took the stage at the Woman’s Club of Roland Park last month after the ladies ran through announcements about their gardening club, bridge lessons and other business.
For the next 45 minutes, Wen, 33, held her audience transfixed with a mix of emotionally gripping tales from her days as an emergency room doctor, staggering statistics about everything from lead poisoning to infant mortality and inspirational accounts of how seemingly small health policy changes can transform lives.
As she pivoted to the health department’s approach to Baltimore’s addiction crisis, she made sure her audience understood this wasn’t about someone else’s problem.
“The fastest-growing demographic of people is not what you might imagine: It’s not the African-American youth in the inner city,” Wen said, as she called her assistant to the stage and readied a dose of Naloxone. “It’s actually white, middle-age, middle-class suburban women.”
Having just described many of the women in her audience, Wen proceeded with the demonstration, as her aide played near-dead and she showed how to spray the antidote into his nostrils.
“So,” she declared afterward, “you are all able to save a life now.” It was both empowering and unsettling, and that may have been Wen’s intention.
Last fall, Wen helped persuade Maryland legislators to give her blanket authority to prescribe naloxone to every one of Baltimore’s 620,000 residents, as long as they undergo a few minutes of training.
So far, she and her deputies have trained more than 8,000 people — on street corners and in needle-exchange vans, at pharmacies and in the city’s drug court. Within the first month, newly trained officers saved four people who had overdosed.
Some critics say Wen’s emphasis on naloxone is misguided, and they argue it could backfire by diminishing the fear among addicts that they risk dying of an overdose.
“What harm-reduction does is reinforces the addict’s behavior,” said Mike Gimbel, who served as the “drug czar” for Baltimore County for 23 years.
Even more worrisome, Gimbel said, is that making naloxone widely available could give policymakers a false sense they are addressing the opioid epidemic.
“Politicians want a quick, fast solution to a problem, and she gave it to them,” said Gimbel, a former heroin addict who now works as a substance abuse counselor. “The only thing that changes the behavior of an addict is long-term treatment.”
Long-term treatment is expensive and a more difficult sell politically, he said, but it’s desperately needed. Gimbel said he scrambles day-in, day-out to find treatment slots for his clients — something echoed by other substance abuse experts across the country.
Nationwide, more than 23 mil- lion Americans are addicted to alcohol and drugs, but only 11% are receiving treatment.
Wen knows that grim statistic as well as anyone. Her family left China when she was 8, seeking political asylum in the U.S., and they settled in a rough neighborhood outside Los Angeles. There, her parents worked a series of menial jobs — dishwasher, hotel maid, newspaper delivery man — to scrape together money for rent and other bills.
She saw her friends and neighbors cope with violence, and the physical and emotional trauma that went with it. And she watched as a close family member struggled with addiction.
“The issues of poverty … are very acute to me,” Wen said.
Wen has ready answers for the critics who question her push to make naloxone widely available.
For one thing, she says she’s pushing just as hard for treatment as she is for naloxone.
But naloxone has to come first — or at least hand-in-hand with a push for treatment, she says. “There’s not going to be any treatment if the person cannot survive today,” Wen says.
“The fastest-growing demographic is ... actually white, middle-age, middle-class suburban women.”
Leana Wen