On Wednesday afternoon, Governor Tom Wolf announced that Pennsylvania is making naloxone, the drug that can reverse a heroin overdose, available to everyone in the state.
"We're here because we realize Pennsylvania has a problem, we have an epidemic here the likes of which we have not seen before," Wolf said before Physician General Dr. Rachel Levine signed a standing order, essentially a state-wide prescription. "Your next-door neighbors, people you know, members of your family, of all of our families—[overdoses] effect a lot of Pennsylvanians."
The move is interesting not only for its sweeping nature, but because the harm-reduction measure did not immediately trigger a deafening chorus of rage about coddling drug addicts. (In contrast, the needle exchange programs of the 1990s were roundly denounced by law-and-order types for allegedly fostering drug addiction.) That lack of opposition may indicate that heroin and other opiates are no longer seen as the purview of marginalized people of color in segregated neighborhoods.
The number of prescriptions to opioid painkillers began to spike in the late 1990s, and as of 2010, Americans consumed 99 percent of the hydrocodone on the planet. There was a quadrupling of overdose deaths from prescription painkillers between 1999 and 2013, and heroin overdose deaths in particular also nearly quadrupled between 2002 and 2013.
In other words, officials seem to be responding in part to the fact that too many white kids in suburbia are falling prey to these drugs.
"Just as there are no atheists in foxholes, there are no drug warriors at a kid's funeral," says Keith Humphreys, section director for Mental Health Policy at Stanford University. "States that have been getting hit really hard are [making naloxone more accessible]. And everyone is getting hit really hard. All legislators are hearing about it from families, whether Democrats or Republicans. Nobody wants to hear, 'We're not going to make it easier to save your kid because we need to send a tough message.'"
Watch the VICE News documentary on naloxone:
This standing order isn't the first action Pennsylvania has taken on naloxone, which is also known by its brand name Narcan. The previous governor, Republican Tom Corbett, signed a piece of legislation known as David's Law equipping first responders with the drug and granting immunity to prosecution to those who call in overdoses. The legislation was named after the deceased nephew of longtime Republican activist Lynne Massi. The ease with which she won attention and action to her cause speaks directly to the changing demographics of opioid use: Massi lives in wealthy Chester County, her husband is a police captain, and she had worked on the campaigns of State Senate Majority Leader Dominic Pileggi.
Many of the state's top law enforcement officials have embraced the drug, in stark contrast to the hard line that their counterparts took in previous decades to most harm-reduction policies.
"I grew up in the 1970s, when it was a whole different type of image associated with heroin users," says Jack Whelan, the hard-charging Republican district attorney of Delaware County and a leading proponent of Narcan in the state. "A lot of good kids with strong family background and values are getting severely addicted and dying all of a sudden. Children of attorneys and doctors and senators—these are not the kids you see in the inner city. Now it's getting a lot of attention that it never did before."
Whelan and his predecessors have wholeheartedly embraced zero-tolerance drug war tactics like mandatory minimums and are known for a much tougher attitude towards plea-bargaining than their urban counterparts. But the prosecutor has taken full advantage of David's Law, and Delaware County has provided 42 of its police departments with the drug.
That's not to say there isn't still some lingering opposition to this new approach to heroin use. Whelan admits that it wasn't always easy to get his colleagues in law enforcement to embrace naloxone. "Some of the skepticism is, 'Well, they are addicts who have done this to themselves and some of them are criminals,'" he tells VICE. "When has that ever been a bar for us in law enforcement to try and save somebody?"
In Pennsylvania, Upper Darby Police Superintendent Michael Chitwood reports hearing similar attitudes from colleagues in the interior of the state. A former Philadelphia police officer, Chitwood is not necessarily the guy you would expect to be a big supporter of Narcan. (His biography, Tough Cop: Mike Chitwood Versus the 'ScumBags', sports an image of him holding an AK-47.) But he champions the drug and talks up its virtues to skeptical colleagues.
"To be quite frank, the officers think they are drug addicts and so what if they get sick or get hospitalized," Chitwood recalls a district attorney from a rural county telling him. "That's a 60s or 70s mentality. But suppose it's their child or their brother's child? It's a different world of addict today."
And prosecutors around America are charging heroin dealers with murder when their clients overdose, suggesting the war on drugs is not exactly in the rearview.
During Wednesday's press conference, the Wolf administration expressed hope that law enforcement officials and officers across the state were coming around. That may be, but the numbers aren't showing it yet. According to the governor's office, 322 lives have been saved with naoxone in Pennsylvania so far, but 135 of them have been under Whelan's zealous watch in Delaware County, which is home to only 5 percent of the state's population. Over a fourth of those (38) were performed by Chitwood's Upper Darby police force. An August survey of police departments by the Center for Rural Pennsylvania found that 82 percent of respondents had not yet decided to equip their officers with the drug. They cited costs and the idea that police aren't meant to provide emergency medical treatment—even though they are first on the scene 70 percent of the time for overdoses.
Now residents across the state should now be able to get it on their own. And in a state with 2,400 drug overdose deaths in 2013, more law enforcement agencies are likely to come around soon.
"Some people argued needle exchanges facilitated the use of opioids," James B. Martin, Republican district attorney for Lehigh County, says of the 1990s. "We've had an epidemic of overdose deaths attributed to opioids and I think that's probably accounted for why there is the buy-in to naloxone.
"Perhaps you wouldn't have expected that 20 years ago," the prosecutor said. "Now we are in the process of providing it to all the police departments in the county."
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