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Just the right dose

January 30, 2006

LOS ANGELES HAS THE CHANCE to save hundreds of lives this year for only a few dollars each. By simply distributing naloxone -- a safe and legal drug- overdose medication -- the city could drastically reduce the number of deaths due to overdose, which has become one of the state's most urgent public health crises.

In 2003, the latest year for which the state has figures, nearly 3,600 drug users died, up 73% since 1990. Los Angeles accounted for nearly a fourth of that total. That number surpasses deaths caused by firearms and AIDS, and it soon could overtake auto accidents as the state's leading cause of accidental death.

It's hard to say why so many drug users are dying, but the trend mirrors what's happening across the country. A number of cities, including New York and Chicago, have begun distributing syringes filled with naloxone, at a cost of about $3 each, to drug addicts. (The hope is that they will use them to save friends who have overdosed.) Once injected, the non-mood-altering medication works by reversing overdose symptoms such as respiratory distress, bringing victims back within minutes.

Since beginning its overdose prevention program three years ago, San Francisco, which has one of the highest rates of drug use in the state, has seen drug deaths fall to fewer than 100 last year -- their lowest level in a decade.

Thankfully, Los Angeles County's public health director, Dr. Jonathan Fielding, has taken a belated interest in the issue locally. Fielding recently asked the county's narcotics advisory board to study the topic, and he will probably ask the county Board of Supervisors to approve a naloxone program as early as next month. If the board approves the plan -- a big if, considering its lukewarm response to other programs aimed at reducing drug harm -- the earliest Fielding expects addicts could begin getting naloxone is later this year.

That is not soon enough. By then, too many more people will have died in Los Angeles. Yes, all the dead will be drug addicts. But their deaths are still needless. Ask yourself: If this were an antibiotic that was saving hundreds of lives across the country, would you tolerate such a casual delay?

On a single day late last month, three people overdosed on skid row, a tragedy that might not have happened if public health officials had moved more quickly. If cleaning up skid row is a priority for the city and county, then one of the best places to start is with a naloxone program in Los Angeles.

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