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lic health matter, and not necessarily as a legal and moral matter.” Dr. Tirado challenged the notion
that making naloxone readily avail- able to reverse overdoses enables addicts to continue giving in to their addictions. He says he’s sensitive to the emotional side of that concern but finds the logic behind it troubling. He says he has personally treated patients rescued from overdose who have be- come stable, productive citizens. “There isn’t a shred of rigorous evi-
dence that opioid addicts misuse nal- oxone as a ‘get-out-of-jail-free card’ to allow them to keep using heroin. There may be a few anecdotes here and there, but this is by no means a common practice.” Judgments about whether certain
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people are deserving of having their lives saved, Dr. Tirado says, “get us on shaky ethical and moral grounds. If we have a person who is diabetic and morbidly obese who falls over in the middle of a shopping mall with cardiac arrest, is someone going to deliberate whether or not that person has been observing their dietary and medication requirements and losing appropriate amounts of weight in or- der to deserve to be defibrillated?” he said. “I don’t think that we go through a similar mental exercise when we’re talking about resuscitating someone who’s gone into cardiac arrest.” Dr. Kowalchuk says the Walgreens
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standing order will be key not only in saving the lives of opioid users but also in giving their families a sense of empowerment. “If they have a loved one that
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54 TEXAS MEDICINE September 2016
they’re concerned about their opi- ate use [who’s] living with them, for example, previously they could’ve felt pretty helpless about that,” she said. “But this is at least enough to have something emergently on board, in their home, that they feel like they have a sense of control over that.” n
Joey Berlin is a reporter for Texas Medicine. You can reach him by phone at (800) 880-1300, ext. 1393, or (512) 370-1393; by fax at (512) 370-1629; or by email at
joey.berlin@
texmed.org.
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