With spike in heroin use, San Francisco battles overdose deaths

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28-year-old Nicholas Clark is a self-described daily heroin user. Sitting on a sidewalk in San Francisco, he sticks a needle in his leg to shoot up. Clark says he tried to quit, but he can't, "It's like coffee for my soul."

Dr. Phillip Coffin, the Director of Substance Abuse Research for the San Francisco Department of Public Health, (SF DPH)says in the last five years, heroin use has spiked in neighborhoods all over the city.
"We've seen a transition as we've tried to clamp down on opioid prescribing, because we've prescribed so much, we've expanded the pool,” said Coffin.

The Centers for Disease Control and Prevention (CDC) says 47,055 people died of drug overdose in 2014, or the equivalent of about 125 Americans every day.

The use of Naloxone, or Narcan, is also on the rise. Health officials say in 2010 the overdose-reversal drug was used 62 times by a friend or family member of someone who overdosed. Last year, that number jumped to 599. In addition, the San Francisco Fire Department says it also uses Narcan on patients one to two times a day.

Eliza Wheeler, the manager of the DOPE Project (drug, overdose, prevention, and education) says since 2003 there's been more than 2,000 overdoses reversed in the city since 2003.

The non-profit, with the help of SF DPH, coordinates the distribution of Narcan in the city.

"Our model is like a vaccine model. So the idea is that you get as much naloxone into a community as possible and flood it in hopes that at any time an overdose is witnessed somebody there has naloxone. Think about vaccinating a community against death of an overdose."

The problem, wheeler says, is she's running out of the drug because the costs of the drug is rising and with the rising costs, she's struggling to meet the demand from groups and clinics that hand it out for free.

San Francisco has been fighting back against overdose deaths with a "harm reduction" approach. "When I go to national conferences people want to hear about what we are doing here," said Dr. Judith Martin, San Francisco Medical Director of Substance Abuse. "One goal is to offer medication treatment basically on demand, same day access that would save a lot of lives."

This year, the San Francisco Fire Department launched a new unit called EMS 6. It is comprised of one paramedic and one outreach worker who work together on the streets every day. The mission is to reach high-risk users in the 911 system and connect them with services.

"One of the biggest things I'll say is people want help," said Dr. Clement Yeh Medical Director of the San Francisco Fire Department. "We had 221 encounters in the 1st 30 days, and we find people who have an acute overdose are four to five times more likely to have another one that may be fatal."

Nicholas Clark said he's tried getting off the drug, describing the experience as throbbing pain, arthritis of the mind, body and soul. "The worst thing about heroin is it’s never enough. Black glutinous hole of dissatisfaction and in order to be in possession of that dissatisfaction, you have to give up anything and everything you care about, it’s a real rip off."

Dr. Yeh says EMS 6 will continue to work, continue to hold out a hand hoping that people in need of help grab hold, and never let go. "It's a lot harder to deal with the addiction than the overdose, but if people don't survive then that's the tragedy they never get a chance. And if not to at least help give people a chance, then I don’t know what we are doing."