In Michigan heroin epidemic, deciding whose lives are worth saving

Sgt. Daryn Santini heard a medical call come over his patrol car radio in late May and recognized the address. He knew exactly who was dying and why.

The 24-year-old who lived at the Mt. Clemens apartment had recently told Santini he was trying to kick a heroin habit. But like a majority of addicts, he had relapsed. Santini, who works for Macomb County Sheriff’s Office, arrived to see fire department and ambulance workers pressing on the young man’s thin chest and breathing air into his dying lungs.

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Santini told the rescue workers about the man’s addiction, and more important, that his patrol equipment came with the drug naloxone hydrochloride, an antidote to heroin and other opioid overdoses. The man’s lips had begun to turn blue from lack of oxygen. So Santini sprayed the naloxone into the man’s nostrils.

And waited.

For years, the drug known as naloxone has been available by prescription to addicts or given under emergency medical care, usually in intravenous injection form. But in recent years it has been credited with saving thousands of lives when administered by everyday people. Advocates in Michigan are pushing to make it more broadly available in the state, even if it means in some cases decriminalizing petty drug possession at overdose scenes.

About seven years ago, Santini saw a paramedic use the drug to revive an addict and thought that it was a miracle tool. Until January, Michigan law didn’t allow police access to it. And there Santini was, just days after being trained to use the drug in nasal spray form, watching to see if the man would live or die.

Two minutes after the spray went into his heroin-poisoned bloodstream, the young man opened his sobering eyes and was able to respond to questions. He was the first of six overdose sufferers saved by police in Macomb since May when Santini’s department put 114 naloxone kits in patrol cars.

“It’s an amazing thing to help save a life,” Santini said.

In just over a decade, U.S. heroin deaths have nearly quadrupled, with the spike in Michigan even grimmer. Macomb county has led the state in rate of heroin overdose deaths per capita. Yet only recently has the state begun to provide broader access to the drug that can rescue overdose victims from death cheaply, quickly and effectively.

Advocates of naloxone are urging Michigan lawmakers to pass two laws that follow the lead of other states: one, to make naloxone broadly available without a prescription, and another to essentially decriminalize petty drug possession for anyone who reports an overdose. (Often, overdose victims are left for dead rather than taken to emergency rooms by fellow users who are afraid of being arrested themselves.) New legislation in the works, if passed, would expand access to naloxone to help more drug users who overdose, but not all.

An epidemic, and a lifesaver

One out of four drug overdoses were related to heroin in Michigan in 2013, according to the Michigan Department of Community Health. Prescription painkillers account for the most common overdose deaths. But in recent months, the nation has turned its attention to the stark increase in heroin deaths in part because research shows those who abuse legal prescription painkillers move on to the illegal street drug at startling rates. Heroin and prescription painkillers such as Vicodin and Oxycontin, are chemical cousins in a family of drugs called opioids.

From 2009 to 2012, 826 people died from heroin overdoses in Michigan and 930 from prescription pain medications. Naloxone, commonly known by its commercial name, Narcan, can nearly instantly reverse overdoses related to both opioids.

The alarming number of opiate deaths led Gov. Rick Snyder to sign a package of bills that requires emergency personnel to keep the drug on hand by 2016, and allow friends and relatives of addicts to get access to naloxone with a prescription.

That was just the beginning, said Rep. Anthony Forlini (R-Harrison Township), one of the sponsors of those bills. Forlini expects to introduce another bill this fall to try to help opioid addicts. “You’re going to see more of these bills,” he said.

In August, a bill was introduced to protect people from being prosecuted for possessing a “personal use” amount of prescription drugs while being treated for an overdose or seeking help for someone suspected of overdosing. That bill came after a high school football player died at what teens call a “skittles” party where pills that were legally prescribed are shared. The bill seeks to encourage drug users and those around them to get help for an overdose rather than do nothing because they fear arrest. The “Good Samaritan” bill does not apply to heroin, however, nor does it apply to people over 21.

Naloxone has saved lives, but the legalization process is tricky. It’s not that there is a groundswell of opposition to naloxone in Michigan, but such legislation can take years to pass because it calls for moral discussions that some legislators find politically dangerous, advocates said. In Maine, for instance, where heroin deaths quadrupled between 2011 and 2012, the state’s governor, Paul LePage, balked at expanding availability of naloxone on the theory that it offered a safety net to addicts that would encourage them to continue using. He subsequently agreed to support its limited availability to some family members, but only with a prescription.

Advocates say that argument creates a double standard that punishes addicts.

Judge Linda Davis, president of Families Against Narcotics, said there’s no downside to making the overdose antidote available over the counter. Judge Linda Davis, president of Families Against Narcotics, said there’s no downside to making the overdose antidote available over the counter.

 

 

“We would never treat someone with a serious disease the way we treat people in (drug) recovery,” said Linda Davis, a district court judge in Clinton Township in Macomb County, and president of Families Against Narcotics. She favors broad public access to the drug. “There is a mental block when it comes to drug addiction. People look at it as a choice. We really need to educate the community as to how serious (addiction) is as a disease.”

The trend that shows overdose deaths skyrocketing also indicates that more people will die and fewer will be saved if Michigan delays expanding naloxone-access laws.

“We have to educate (legislators),” said Forlini. “They have to feel like they’re not encouraging drug use.”

More sobering highs

In Michigan, total overdose deaths have quadrupled since 1999, mostly spurred by the increase in prescription pain medicine abuse, according to the state’s 2014 report, “A Profile of Drug Overdose Deaths Using the Michigan Automated Prescription System (MAPS).”

The increase in prescription painkiller abuse – namely opiates such as Oxycontin and Vicodin – accounts for the largest increase in drug use and deaths. In Michigan in 2012, 9.1 million prescriptions were written for pain killers, MAPS data show.

Often, when those drugs no longer provide the desired balm, users turn to the heroin.

Among Michigan’s 1,138 drug overdose deaths in 2012, 80 percent of those who died had at least one or more controlled substance prescriptions filled within the year prior to death – half of those prescriptions were for painkillers, state records show.

Once on heroin, an addict is six to 20 times more likely to die than someone in the general population, according to the National Institutes of Health.

The U.S. Centers for Disease Control suggests, among other solutions, that states widely expand access to naloxone to reduce overdose deaths. From 1996 through June 2014, community and health organizations nationwide that provided naloxone kits to the public received reports of 26,463 overdose reversals, according to the CDC.

Helping or enabling?

As heroin use has spread, white males between 18 and 44 have by far accounted for the largest demographic group of overdose deaths over the past 13 years, but there has also been explosive growth among women. Heroin users are dying everywhere from trap houses to trailer parks, from rural outposts to bucolic college campuses.

Over the past decade or so, Michigan has paid a good deal of attention to treating opioid addiction, most notably through a drug called buprenorphine. Consider: In 2003, 327 prescriptions were written in Michigan for buprenorphine. By 2012, that number had risen to 392,544 prescriptions, a staggering 1,200-fold increase, MAPS records show.

But, as health advocates note, in order to get treatment the addict must be alive, not dead of an overdose.

Across the nation, 40 states and the District of Columbia have naloxone access laws while 31 states and D.C have Good Samaritan laws, according to the Network for Public Health Law based in St. Paul, Minnesota.

A few months before Michigan passed a law last year to allow police, family and friends to get access to naloxone by prescription, Ohio passed a similar law. Ohio then took it a step further this July, making naloxone available without a prescription.

Typically, people get a naloxone prescription as a precautionary measure if they know someone who is in treatment or at risk of an overdose, said Judi Moseley, program consultant for Violence and Injury Prevention Programs in the Ohio Department of Health.

Ohio runs Project Deaths Avoided With Naloxone (DAWN) in 30 community-based programs such as local health departments and treatment centers. From 2012 to April 2015, Project DAWN distributed 3,439 naloxone kits and recorded 232 overdose reversals or lives saved, Moseley said.

Joan Papp, an advocate for the passage of the Ohio legalization, notes that the drug halts the effects of an opioid drug and sobers up a person who is overdosing, but it cannot be used to get high so it is essentially immune from abuse.

And it’s fairly cheap. A single dose costs about $33, said Papp, assistant professor of emergency medicine at MetroHealth Medical Center in Cleveland and medical director for Project DAWN of Cuyahoga County in Cleveland.

Ohio and Michigan are following the typical process towards naloxone legalization, Papp said. First advocates go for the family-and-friends laws that allow acquaintances to get a prescription to buy the drug, followed by a law to make it available without a prescription. Only then do they push for the big win – a Good Samaritan law to encourage friends to get treatment for overdose victims.

There is no guarantee that steps two and three will get widespread support in Michigan.

Andrea Bitely, spokeswoman for Michigan Attorney General Bill Schuette, who is on the governor’s taskforce on opioids, stopped short of saying Schuette supported further expanding access to naloxone or instituting a Good Samaritan law. "The AG and other members of the Opioid Taskforce are weighing many options for the treatment and reduction of opioid related deaths and illnesses," she said in an email.

Saving a friend

Myles Dawson, 27, knows what it’s like to dumped for dead by a fellow heroin addict. About five years ago, he was overdosing and a friend pushed him out of a moving car and onto the concrete in front of the hospital in Columbus, Ohio.

A nurse who was getting off work happened to find him, he said.

“If there was some type of (Good Samaritan) law in place, he probably would’ve stopped the car, ran in and got somebody and stayed with me,” said Dawson, who suffered road rash – a series of nasty scrapes that resulted from his limp body rolling on the concrete.

“There’s a good chance that if that lady wasn’t walking by I wouldn’t have made it.”

Not everyone is so lucky.

Rep. Al. Pscholka (R-Lincoln Township) sponsored the Good Samaritan bill this summer and Forlini signed on as a co-sponsor. Pscholka said he introduced the bill after 16-year-old Mason Mizwicki of Watervliet in southwestern Michigan died from an overdose of methadone. The football player’s body was discovered on New Year's Day. Other teens reportedly were with him, getting high on a rainbow of prescription drugs at the “skittles” party on the night Mizwicki overdosed. None of the teens called for help.

But Pscholka’s bill is limited to emergencies involving prescription drugs (not heroin) and would only protect youth under the age of 21.

"We really wanted to protect minors and young people more so than adults who should kind of know better," he said.

Pscholka said he expects some critics will say his bill is soft on drugs and encourages drug use, while others will want the bill to be expanded to include cocaine, heroin and methamphetamines.
"I see prescription drugs as a common sense first step,” he said. “We do need to have more conversations. We're having some now having to do with heroin because it is becoming extremely popular."

Health advocates are among those who say Pscholka’s bill is too limited.

Judge Davis, the president of Families Against Narcotics, said she wants naloxone available over the counter, and for the Good Samaritan law to extend to all ages as well as to heroin in addition to prescription narcotics.

“There are kinks to work out with police but most police I know are as tired of seeing young people die as we are,” Davis said.

Back from the dead

First, there’s the warm tingle of euphoria. The comforting feeling that everything is going to be all right. Sleep takes over. Within minutes breathing slows. To a near stop.

That’s what a heroin overdose feels like.

A naloxone dose is the hellish opposite.

Picture the scene in “Pulp Fiction” where John Travolta revives Uma Thurman from an overdose. Subtract Travolta dramatically plunging a needle into her chest and Thurman’s even more dramatic gasping.

Naloxone can be administered using a nasal spray, syringe or autoinjector. Its impact is almost instantaneous. The drug yanks the overdose victim from the sleepy path toward death into immediate wakefulness. But then a sort of withdrawal sickness starts. A fierce headache, vomiting and a racing mind compound it.

Naloxone wears off in about 30 minutes, and may require an additional dose, and another round of sickness.

It’s a life-saving, horrible experience, said Dawson, the recovering addict from Ohio. He was resurrected twice with naloxone. He testified to the Ohio Legislature that the availability of naloxone did not encourage his drug use; but it did save his life.

“I was never using with the intent to keep a naloxone shot around so I can get really,” high, Dawson said.

Today, Dawson said he has been clean five years and is on the golf team at Columbus State Community College where he’s studying business and hopes to take over and expand his father’s pizza restaurants one day.

Naloxone should be as easy to get as Advil, he said. It hurts no one and saves thousands at a time when more people are dying.

“How many addicts are waiting to be saved by a naloxone shot and go on to…use all that will power and brain power for something good?

“To me, it’s common sense.”

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Comments

Patrick Shannon
Tue, 09/01/2015 - 10:36am
Thank you for this long overdue article. Having worked in prosecution and as a judge for the past 37 years I am amazed by the easy access and increased abuse of these highly dangerous drugs. Heroin and prescription drugs affect every strata of society and community in this nation and state. This problem is no longer an urban, ethnic, or class issue. Heroin and opiate abuse can be found above and below the Mackinac Bridge. This stuff kills and decimates families and children. According to the Centers for Disease Control and Prevention, heroin overdose deaths in the US have quadrupled since 2000, with overdoses surpassing car accidents as the number one cause of injury-related deaths in the nation. Roads and legislative affairs are good headline grabbers but heroin and prescription drugs are killing the citizens.
Chris
Tue, 09/01/2015 - 10:58am
Allowing access to naloxone without a prescription is going to do for heroin addicts what abortion did for women. Women use abortion as a method of birth control many times. Heroin addicts can end up the same way. The thinking is OK, I've got naloxone, lets get high. I overdose and then use naloxone to bring myself back and then I can start all over. The circle continues until the inevitable happens...the naloxone no longer works and the addict dies. You still have a dead addict and the stats go up on heroin related overdoses that end in death.
C
Tue, 09/01/2015 - 11:05am
What is the cost to taxpayers for rehabilitation, drug treatment, and hospitalization costs for these drug users once we rescue them from their self appointed death? Where are the statistics of the folks that then once again overdose after being 'saved' the first time? What is the impact to our medical professionals to be pulled away from legitimate medical emergencies for fools that use drugs? Perhaps I am not the only one who feels that each person makes their own choices and I am tired seeing our hospital emergency rooms filled with drug emergencies. I live in a town with a heavy heroin problem. You can see people passed out on street corners, merchant parking lots, and public buildings due to drug misuse. Aren't' we just encouraging the problem with this so called 'get out of jail free' card? Perhaps teaching children before they reach this point on how to avoid drugs and the hazards they create; how to make smart decisions through education might be a wiser method than a simple nasal spray.
joyce
Tue, 09/01/2015 - 9:45pm
Some of these comments kind of strike me wrong. As a mother of an addict, I believe if there is anything that can help my child, I am all for it. Some say its a choice, and you are right, it was a bad choice to even try it, BUT, no person has ever said they wanted to become an addict ever! Its a very sad disease. My child had a very good upbringing, a good student, athlete, a person everyone liked. She made a bad choice and now can't get it back. Although she is in recovery at the moment, but she has relapsed, she's been incarcerated because of her choice. She works hard on her recovery every single day. She works hard and pays her bills. But she still has the urges and cravings even after 2yrs being clean. So if any of you want to judge, shame on you! I'm glad you have no one with an addiction problem, its sad, and scary. No matter what, I will stand behind her 100% and love her forever since she made her bad choice. People that have no idea on addiction should maybe do some research and learn about it. You would be surprised at what you learn...a proud mom of an addict
Sat, 03/26/2016 - 2:04am
Hi Joyce, I am the program director of a women's recovery home and an addictions counselor. These are the comments of ignorant people who do not understand addiction. Addiction is a disease that encompasses all of society and those who don't think they are affected by it are and just don't know it. Addiction, in some cases is a choice the first time or two but not after that. In other cases it is not a choice as in the woman who was born addicted to heroin and was being shot up by her mom at the age of 14. Addicts are, above all human beings that are extremely hurting and need help. The fallacious and ignorant argument that if naloxone is made available to the public, or the addicts it can be compared to abortion is ignorant at best. How on earth would you pick and choose whose lives are worthy of preserving? Isn't that what Hitler did? The treatment program that I work at is 8000 dollars per year, it costs better than 30,000 per year to house one inmate and so far we have a better than 80% success rate with the people who have come through our program not relapsing after 3 years. Of those who have relapsed 100% are now clean and living a sober life. That is over a 3 year period. Hang in there and I pray that your daughter will continue to choose life and sobriety.
Liz
Wed, 09/02/2015 - 2:54pm
What's the cost? What's the cost of a human life? I'll tell you what the cost is for treatment, a hell of a lot less then to put them in the revolving door of jail, street, jail, street. Drug addiction is a HEALTH ISSUE not a moral issue. Do you think addicts CHOOSE to live like that? They don't. Your comment is the perfect example of why we need to change the public's perception around this deadly health issue before we can change public policy. We lost the war on drugs long ago, yet we still criminalize a health issue. It's time to try something different. Naloxone is a start.
Lisa
Fri, 09/04/2015 - 9:05am
C- please see the comment below from Lisa in response to your post.
Martha Russell
Tue, 09/01/2015 - 11:09am
I totally agree with this that Dawson said in the article above: "Naloxone should be as easy to get as Advil. It hurts no one and saves thousands at a time when more people are dying." I believe that you shouldn't need a prescription, it should be readily available everywhere, just in case it's needed. If it was your son, daughter, or friend, wouldn't you want them to be saved? Anyone opposed to easy access to Naloxone is contributing to the deaths.
Gloria Woods
Tue, 09/01/2015 - 12:20pm
Naloxone should be available over-the-counter and the legislature should pass legislation protecting good samaritans from prosecution for low level drug offenses if they use it to save someone's life after a drug overdose. I am appalled by some of the other comments to this article for their lack of empathy. No human is a throwaway. Addiction is not a choice.
John S.
Tue, 09/01/2015 - 12:34pm
Looking at the report where one figure (a map) shows pain medication prescriptions/100,000 residents by Michigan county, pain and the need for pain medications must be far more serious problems in some counties than in others. Of course, such a conclusion is nonsense. There's a MAPS system in place. Is there a legal responsibility for physicians to access the system and check for doctor shopping before writing a prescription for scheduled pain medications? Does the Michigan State Medical Society call the shots in this area? Self-regulation by professionals (e.g., codes of ethics) doesn't always work that well. Does any evidence support the moral hazard argument (people make bad choices in life and only if they pay the price for those choices, such as risking death from an overdose, will they change their ways)? It's an appealing narrative to some, but EMS and police are around to help save lives and in my view they should have access to naloxone. So should others who live with opioid addicts.
chuck md
Tue, 09/01/2015 - 8:55pm
First and very importantly addiction must be addressed and discussed as a medical problem and not a moral or choice problem. It is as much a chronic medical illness as diabetes. So any discussion regrading the emergency availability of Naloxone must include what is done after the reversal of the overdose. Using Naloxone to reverse an overdose and then discharging the patient from the emergency room or maybe not even going to the emergency room is irresponsible. This is like defibrillating someone and then discharging them from the emergency room without an evaluation and appropriate treatment for their heart disease. Reimbursement for addiction treatment is abysmal. Effective treatment for opioid/opiate addiction (and other addictions) is available but difficult to access because of inadequate insurance coverage. People may initially chose to drink or use a drug but very rarely does anyone choses to be or remain an addict - it is not a disease of choice.
Sat, 03/26/2016 - 2:18am
chuck md, all I can say is AMEN! Very well said. As the program director of a women's recovery home, it is refreshing to read your comment as I'm assuming that your are a physician. Addiction is very misunderstood not only by the public in general but also by many medical professionals. We as an organization are very proactive in educating the public about addiction and it amazes me when people meet the women in our program and hear their stories, how it completely changes their outlook on the problem of addiction. Thank you for your comment.
Pamela
Wed, 09/02/2015 - 1:18am
My son was a union roofer. He earned a good living. He owned a home, work truck, car and 2 sea doos, took two vacations a year. He was 38 yrs old when he fell off a roof. He broke his back 3 places, his pelvic bone in two places, broke his left arm and the 4th digit of his left foot and pulverized a bone in his right arm. He was on very strong opiates, but they didn't manage his pain. He started using Heroin to help relieve the pain. He was 39 yrs old when died of an accidental overdose. If he was your son wouldn't you do anything, wouldn't want something to save his life? Shame on you people above who made those heartless comments, you know who you are. If your pro-life, you are pro- everyone's life! Naloxone is a start in the right direction. There is a growing epidemic in this country. We must get our heads out of the sand!
Rick
Wed, 09/02/2015 - 10:59am
Another fairly simple, straight forward solution to a huge issue (think our broken roads...). But will our incredibly stupid legislature do anything? Unlikely. Just watch the circus over these two issues where many Repubs will see this as a 'moral' issue, not a practical one, and will vote against it (if it even gets to a vote).
Harv
Wed, 09/02/2015 - 2:57pm
This is an exceptional article. Most unfortunately, this is not new news. Heroin deaths have soared since 2000. Countless new reports, many in our nations' leading newspapers, have chronicled this soaring increase. In 2011, the Centers for Disease Control and Prevention and the Substance Abuse and Mental Health Services Administration reported that 20 percent of heroin deaths occurring between 2000 and 2010 were among 15 to 24 year-old men and women. To more fully understand the characteristics of those dying of a heroin overdose over this ten-year period, these federal Offices reported that nearly 90 percent of these deaths were among while men and women. (A recent report on NPR on heroin usage and the resulting deaths of many as well as incarceration of others gave the impression that this was largely a Black problem. It surely is not.) I must add that from what I have read and studied, Washtenaw County has lead Monroe County in some recent years in terms of heroin deaths per capita. The point here is that Washtenaw and Monroe Counties are the leading centers for heroin deaths. This is heavily influenced the geography of the region of SE Michigan--near or on the supply line. Sadly, ordering a delivery of heroin is as simple as order delivery of a pizza in some communities. Lastly, the only thing dark about addiction is our knowledge of it. Whether it be booze or heroin, intervention and treatment is the answer. It is not incarceration. We live in a nation which currently makes up 5 percent of the worlds population while incarcerating 25 percent of the world's incarcerated population. This continues to alarm me and others. On all of these fronts, I see the problem of drug-related deaths as getting worse rather than better. Answers don't come easy. It takes resolve and commitment by the policy makers to make much needed changes. And the sooner the better. Examples of what works are available. There are a surprising number of success stories in dealing with heroin use and related deaths. But emulating someone else's answer doesn't always sit will with our leaders. Yet that day will come when we'll realize that the heroin epidemic is our problem, not somebody else's. I'm confident that that day will come. When? You tell me.
Lisa
Fri, 09/04/2015 - 9:01am
For those of you who believe that addicts will use naloxone as a get out of jail free card, please consider the following: * Naloxone rips the opiates off of the opiate receptors in the body, causing immediate & severe withdrawal - no addict wants to experience withdrawal, that's why they'll do just about anything to stay high * Once naloxone is administered, opiates will not bind to the receptors until the naloxone has dissipated. This means no relief from withdrawal * Addicts don't spend money on much of anything other than opiates. Not food, medical care... Nothing but drugs. $33 for naloxone? Highly unlikely * Addicts spend time with other addicts. If everybody is high, who will administer the naloxone? * If you're an addict shooting heroin with other addicts that know you have a dose of naloxone, as soon as you nod off, they will steal your naloxone to sell it for more heroin Naloxone will be sought out by parents, siblings, employers, teachers, law enforcement and all of those people who don't want to see people around them die. Not by addicts looking to keep getting high. Don't make the availability of this life saving drug about the indictment of addicts. Withholding its availability is exactly the same as standing by and watching someone you know nothing about die while doing nothing to save them.
Connie
Tue, 10/04/2016 - 6:12pm
100% I want it to save the girl I remember back when. To save a couple of great parents from mourning over the loss of my friend who didnt want to be saved yet. I would want to save a life.. an addict brings all involved into their hell. Jen if you are reading this . We love you and still pray we will get you back to the before herion Jen.
Jams
Sat, 09/05/2015 - 12:48pm
Correct, no one sets out to be an addict, but the DO make a CHOICE to start. That said... not every story is the same and I'm sure there are some instances where that choice was made for them but those instances are the exception. The addictive nature of heroin is well known and even the most poorly educated person knows that even getting high once with heroin will likely result in you becoming dependent. It's not a moral or even a medical issue, at least not at the start. It's a psychological issue... You have to be mentally deficient to use a drug like heroin and until people realize this and receive treatment for the REASONS they choose to use drugs like heroin knowing the outcome we'll forever be addressing how to handle the repercussions. Virtually all addictions, from drugs to food to hoarding to extreme body modifications all stem from some mental defect that causes people to use something to fill a void, take them to some place better, make them forget... Until psychological issues are considered to be a priority the cycle of dependency will continue.
Harv
Sun, 09/06/2015 - 7:29pm
I very much appreciated Lisa and Jams responses to the article. Their comments are accurate and well stated. For the Governor of Vermont to focus his entire 2014 State of the State Address to his State's Legislature on the heroin crisis in their state is the kind of attention needed to built a broad coalition to respond to this national crisis. While facing a heroin epidemic, our nation faces a far greater drug-related problem: The annual death count of 135,000 men and women do to drug use and abuse. This upward-spiraling death count is chronicled in David Sheff's 2013 expose (CLEAN) which describes our failed system of controlling drug use...and abuse.
Thu, 09/10/2015 - 10:22pm
Life or death? Forget the legality or morality of the choice for legalizing this drug. Who among us has the right to choose whether someone lives or dies? Erring on the side of angels is always the right choice and always defensible.
Jacob Clark
Mon, 05/18/2020 - 6:49am

Great Article! Thanks for sharing this information. It is helpful information for everyone. I think that we should save to everyone from this Michigan heroin epidemic.