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US urges doctors to write more Rx for overdose antidote

FILE - In this Tuesday, July 3, 2018 file photo, a Narcan nasal device which delivers naloxone lies on a counter as a health educator gives instructions on how to administer it in the Brooklyn borough of New York. On Wednesday, Dec. 19, 2018, the U.S. government told doctors to consider prescribing the overdose antidote naloxone to many more patients who take opioid painkillers. (AP Photo/Mary Altaffer)

When injured, a person can bleed to death in as little as five minutes. Bleeding control is often the difference between survival and death.

In 2015, in response to the horrific Sandy Hook school shooting, a Connecticut trauma surgeon created Stop the Bleed, a program to teach bleeding control techniques to laypeople and provide them wound packing kits and tourniquets. Stop the Bleed promoted the message and made real the promise that anyone can save a life.

As mass shootings raged throughout the country, the program spread. In Pittsburgh, for example, it was delivered to law enforcement officers and in public schools. Concerned about rising anti-Semitism, Stop the Bleed training was requested for members of the Jewish community, and they purchased bleeding control kits for synagogues around the country.

Including one called The Tree of Life.

On Oct. 27, Robert D. Bowers charged into the Tree of Life synagogue armed with a semiautomatic assault rifle and three handguns. Shouting, epithets like “Death to all the Jews,” he slaughtered 11 innocent people.

A day later, trauma surgeons in Pittsburgh estimated that, thanks to the Stop the Bleed training, tourniquets applied by police officers and members of the congregation saved at least three shooting victims. The program did what it was designed to do.

Programs like Stop the Bleed are essential in these times. But they do nothing to stop the number of mass shootings in this country, which is considered by many to be a public health emergency.

And that’s important to remember when we consider our national and regional approach to another public health emergency: the opioid epidemic.

A great deal of time and money is directed to naloxone (Narcan), the emergency overdose reversal drug, while considerably less money is spent on preventing addiction from taking root in the first place.

Solutions to complex problems are never simple. Ending mass shootings and gun violence will require seemingly impossible elements: massive political will, the expenditure of vast sums of money, the weakening of the National Rifle Association, and changes to our relationships with firearms — and each other.

Ending the opioid epidemic will also require massive political will and tens of billions of dollars a year. And while that sounds like a lot, we currently spend $24 billion a year on HIV/AIDS and a great deal more on cancer, diabetes and a host of other conditions that, while deserving of the support they receive, cost society considerably less than does addiction.

For a problem like opioids or other drugs, it is inarguable that the most cost-effective investment would be for early and universal interventions. Curricula delivered in schools — in all schools, in all grades, for all kids — that provide evidence-based or evidence-informed programming could, in the coming years, put an end to this epidemic and prevent the next one from arising. Programming like this does more than stop the bleeding. It helps mitigate the deleterious effects of root causes, like early trauma or attachment issues.

There are more than three decades’ worth of social science literature telling us how to inoculate kids with the known protective factors to help insulate them from risks they may face later in life. Giving kids these life skills — these resiliency skills — makes it more likely that they’ll weather life’s inevitable hard times and forgo or delay the initiation of drug use. The longer they wait, the less likely it is they will ever develop a problem, let alone die from an accidental overdose.

Current strategies like increasing the availability of naloxone are indeed helping to “stop the bleeding.” They absolutely save lives and they need to continue.

But if we want to really attack this problem, consider this: When we wanted to live without fear of contracting polio in this country, we vaccinated all children. Once the Salk vaccine was deemed safe and effective, we didn’t wait until the disease had altered our children’s lives before we intervened.

Through a broad, sustained commitment to real prevention, we can reduce the incidence and prevalence of a deadly disease.

Or we can do our best to just stop the bleeding.

Howard Weissman is the recently retired executive director of the National Council on Alcoholism and Drug Abuse in St. Louis. His views are entirely his own and not necessarily those of NCADA.