This post is part of a collaborative narrative series composed of my writing and Chris Arnade's photos exploring issues of addiction, poverty, prostitution and urban anthropology in Hunts Point, Bronx. For more on the series, look here.
Drug overdose death rates have increased steadily in the United States since 1979. In 2008, a total of 36,450 drug overdose deaths (i.e., unintentional, intentional [suicide or homicide], or undetermined intent) were reported, with prescription opioid analgesics (e.g., oxycodone, hydrocodone, and methadone), cocaine, and heroin the drugs most commonly involved (1). Since the mid-1990s, community-based programs have offered opioid overdose prevention services to persons who use drugs, their families and friends, and service providers. Since 1996, an increasing number of these programs have provided the opioid antagonist naloxone hydrochloride, the treatment of choice to reverse the potentially fatal respiratory depression caused by overdose of heroin and other opioids (2). Naloxone has no effect on non-opioid overdoses (e.g., cocaine, benzodiazepines, or alcohol) (3). In October 2010, the Harm Reduction Coalition, a national advocacy and capacity-building organization, surveyed 50 programs known to distribute naloxone in the United States, to collect data on local program locations, naloxone distribution, and overdose reversals. This report summarizes the findings for the 48 programs that completed the survey and the 188 local programs represented by the responses. Since the first opioid overdose prevention program began distributing naloxone in 1996, the respondent programs reported training and distributing naloxone to 53,032 persons and receiving reports of 10,171 overdose reversals. Providing opioid overdose education and naloxone to persons who use drugs and to persons who might be present at an opioid overdose can help reduce opioid overdose mortality, a rapidly growing public health concern.
Shelly: Hunts Point, Bronx. Courtesy of Chris Arnade.
Shelly's overdosed five times, once in a Starbucks bathroom, once in a McDonalds. She was found both times against a toilet in a locked stall by EMS workers and panicked employees.
Pepsi: Hunts Point, Bronx. Courtesy of Chris Arnade.
Pepsi's overdosed twice. Never in front of her kids, thank God. Sign of the cross, kiss to the sky.
Sonya: Hunts Point, Bronx. Courtesy of Chris Arnade.
Sonya overdosed after leaving jail in New Orleans. She needed to feel everything, so she bought everything. First, she scrawled her father's phone number in Sharpie across her stomach so that someone could call, so that she wouldn't get sent to potter's field upon death. Lucky or unlucky, the drugs were crap.
Eric: Hunts Point, Bronx. Courtesy of Chris Arnade.
Eric's first girlfriend died of overdose. He's married to Sonya now and is in Rikers Island jail awaiting sentence for direct heroin sale to a cop. He left a mandated inpatient rehab program because, he said, his roommate was smoking crack.
Neecy: Hunts Point, Bronx. Courtesy of Chris Arnade.
Neecy ODed under the bridge, naked, unable to sit up. It was after a months-long stint of being clean when she just couldn't take the pressure -- the living of life -- anymore. She left her family in New Jersey and hid in Hunts Point, a place beyond reach, ashamed.
Roland's mom overdosed and died when he was a baby, so he was raised largely in a group home. Now at 21, he's in Rikers Island jail for drug possession for the second time, re-arrested for heroin the day of his last release.