REALITY CHECK 03.21.16 9:01 PM ET
The media is hooked on stories of overdoses being magically reversed by wonder drug naloxone, but what follows is arrests, pain, and more addiction.
PHILADELPHIA — Michael Charles Meeney turned 26 in jail on March 2, a week after his arrest for misdemeanor heroin possession. But his entire life may as well boil down to an inglorious 30 seconds of tightly edited video, played on local news channels, that shows him nearly dying.
On Feb. 18 a closed-circuit surveillance camera captured him shooting heroin, then falling out of his seat on a crowded city bus in Philly suburb, Upper Darby. The video cuts to a police officer hovering over the unconscious man and applying a dose of the powerful overdose antidote naloxone.
Naloxone (sold under the brand name Narcan) has been the subject of increasing media attention since the Food and Drug Administration approved a nasal spray version of the drug in last November to reverse the effects of opioid overdose, namely severe respiratory depression that can be fatal if left untreated. Narcan works by reversing those symptoms. A number of police departments now outfit their officers with it, and changes to state laws have made the drug legal for sale over the counter in some pharmacies. In 2014, Pennsylvania passed a law that made naloxone available through a standing prescription to laypeople, including drug addicts themselves and their families.
The video footage of Meeney’s overdose concludes with him back on his feet and being escorted off the bus by police paramedics—a seemingly happy ending to a nearly fatal tragedy.
But Meeney’s story is anything but happy. And it’s far from over.
After saving his life, the police arrested him for the tiny amount of heroin (four baggies) they found on him. While Meeney suffered the first pangs of opioid withdrawal in a jail cell (imagine severe flu combined with anxiety and depression) the police humiliated him by tweeting a link to the video provided by the transit authority.
It went viral.
“VIDEO: Man shoots up, passes out on bus,” New Jersey television station WWOR reported.
“Guy Shoots Heroin On Bus, Keels Over (DISTURBING VIDEO),” shouted Huffington Post.
“He asked me how they could just use his video like that, without his permission, but since it happened in public they can do what they want with it,” said Bonner, who argued unsuccessfully at Meeney’s preliminary hearing that his client should be diverted into drug treatment instead of being locked up.
“They got him through [the overdose] and now they’re prosecuting him when what he really needs is help,” Bonner said.
Upper Darby Police Superintendent Michael J. Chitwood defended his decision to release the video.
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“There is a lot of value in seeing how people who are addicted will go to whatever ends to use drugs,” he explained to a reporter, vowing to continue his strict policy of arresting addicts police find in possession of any amount of drugs.
Yet it’s hard to see any value in such exposure for Meeney, who will forever be defined by one of the most shameful experiences of his life.
Meeney isn’t the only drug user to become the unwilling face of America’s festering opioid problem. As policymakers struggle to rein in the addiction crisis, promising stories about the lifesaving potential of naloxone have been sullied by a torrent of overdose porn depicting its use in the field.
Since January the press has reported on no fewer than four similar cases of overdose reversals caught on video. Some were shot by bystanders using a smartphone.
In early February, a 25-year-old New Jersey woman achieved Internet notoriety after falling out in a parking lot in Paulsboro, just across the Delaware River from Philadelphia. Her overdose was caught on video by a witness and posted the same day to YouTube.
Newspapers as far away as the United Kingdom picked up the story, publishing still shots of the victim—who has an 8-year-old daughter—lying prone on the asphalt, being tended to by rescue personnel with her naked torso in full view.
The video was shared more than 22,000 times on social media and sparked hundreds of comments, including several speculating what kind of diseases the girl might have and one calling her a “walking tombstone.”
The woman’s mother told The Daily Beast the past month has been an ordeal for the family, starting with being forced to see a loved one’s near-death experience replayed over and over.
“I didn’t know there was a video at first, I knew just she had overdosed,” said Kelly Hemphill. “The woman who shot it tracked me down and sent it to me. I didn’t watch it at first. When I finally did I was devastated.”
Kelly Hemphill said her daughter’s Facebook page was inundated with messages calling her a bad mother. Then the account was temporarily suspended after her daughter defended herself by going after her attackers. Hemphill told The Daily Beast she contacted a lawyer to determine what, if any, action she could take to get the video removed but was told it was legal under New Jersey’s wiretapping laws.
Hemphill—who is herself a recovering addict, and has been clean since 2008—said her daughter has been using heroin on and off for at least six years. She relapsed in 2014 after her father was killed in Staten Island by an off-duty police officer who was driving drunk and had been trying unsuccessfully to get help for her addiction prior to her overdose.
“For weeks we were trying to get her into treatment, but people don’t understand you can’t just walk up to rehab, knock on the door and they let you in,” said Hemphill. “All the rehabs we called in New Jersey, even after the overdose, they never even called her back.”
The video did finally open some doors. A nonprofit group in New Jersey helped arrange treatment for Hemphill’s daughter in Florida. She returns home this week. But she still faces scorn from people who don’t even know her. And evidence of her life as an addict will always be just a Google search away.
“I don’t see how we’ll ever be able to do anything about that,” Hemphill said. “I always wanted my daughter to be famous, but not like this. Why isn’t there something else that can make her memorable besides that video?”
Samantha Sitrin works for Prevention Point Philadelphia—a harm-reduction organization for drug users and sex workers that dispenses naloxone to individuals at high risk of overdose. She calls these videos “exploitative.”
“It’s not for the intention of getting them help or more resources for the future,” she said. “It’s an attention-grabbing way to get headlines without getting to the whole story.”
For many the “whole story” includes multiple encounters with the justice system that for decades has considered them “junkies,” who refuse to quit and are unworthy of compassion. They are in fact addicts who have cycled in and out of the criminal justice system for years thanks to long-standing drug policies that have viewed addiction as moral failure rather than a medical problem.
That’s Meeney’s story: more than a dozen cases on his rap sheet, mostly for drug possession and retail theft. Like many non-violent drug offenders, his periodic brushes with the law have been punctuated by stints in jail for not making court dates or for violating probation by getting rearrested.
A review of his docket sheet shows that at least four times since 2009 he has been ordered by a judge into drug treatment upon release from jail, only to be locked up again when he failed to complete the court-mandated program. As recently as last year the suburban Philadelphia county where he was adjudicated did not permit the use of maintenance drugs like methadone or Suboxone in their court-ordered treatment programs. Meeney is walking proof that many courts still only pay lip service to the idea of treating addiction like a medical issue.
Drug addicts can count on being treated like human beings at Prevention Point’s drop-in center, housed in the back of a church in a neighborhood known as the “Badlands” for its prevalence of crime, violence, and drugs. Just down the street is Huntingdon Station, where three weeks ago medics used Narcan to save a man who had overdosed on heroin on the train platform. That incident was also caught on video and was broadcast by local media, but police didn’t arrest the man or release his name.
On a recent afternoon drug addicts and prostitutes shared the sidewalk in front of the station with a pair of uniformed transit police who can do little more than monitor the flow of traffic in and out of the neighborhood. Many described struggling with addiction for years, and almost everyone who talked to The Daily Beast had overdosed at least once. Most said they had been brought back using Narcan.
Behind the heroic headlines about a miracle drug for addicts in distress is a complex reality that often reinforces stereotypes about opioid addiction when reported without proper context. For instance, to the uninformed, it is inconceivable that someone who nearly died from a drug would run out that very same day and buy more of it. Narcan works by binding to opioid receptors, blocking the effect of narcotics like heroin. In drug users with a physical dependency, it also has the effect of causing severe withdrawal symptoms. This all but guarantees that the first thing a user will think of after their overdose is reversed is getting another fix.
Carlos, a 52 year-old man with teardrop tattoos on his face, sells “works”—clean syringes—in front of Huntingdon Station. He said he has been using heroin for 20 years and has overdosed twice. One of those times he was revived with Narcan. He credits his mother for calling emergency personnel and saving his life, but cringed when he recalled the naloxone shot.
“It hurts, it hurts bad,” he said, making the gesture of stabbing a needle into his upper arm. “You wake right up, but you feel real bad. You sick now. Maybe the next day you can get better.”
Tammy, a tiny 19-year-old with fresh track marks on her arms, said she’d overdosed last year on the street just across from where we’re standing. Paramedics used Narcan to revive her. She described the experience as jarring.
“It’s snaps you right out, but now you’re sick,” she said. Tammy explained how EMTs took her to a nearby hospital for treatment, but her withdrawal symptoms were so bad she ran from the vehicle when it reached its destination. She says she tried shooting up to feel better but the naloxone in her system blocked the heroin.
“You could do 30 bags and you’re not going to feel nothing for hours,” she said.
That’s a potentially deadly hyperbole. According to documentation on the drug, naloxone actually has a half life of 60-90 minutes, so it wears off relatively quick. In fact some overdose victims run the risk of falling into distress again after a shot of Narcan as they attempt to counteract the effect of the drug and “get well” by using higher doses. However the initial impact can indeed be traumatic for heavy users. A video shot inside an emergency room in 2011 shows the extreme reaction that a dose of naloxone can provoke in a heavy opioid user.
Silvana Mazzella, program director at Prevention Point, says the group trains its participants to deliver Narcan in graduated doses designed to ease an overdose victim out of danger but stop short of precipitating full-blown withdrawal.
“What we try to do is look at the most creative way to get them stabilized and let them ride it out instead of putting them into the shock of withdrawal,” she said.
The group is budgeted to distribute 1,500 naloxone kits this year, she said, and its kits have been used to reverse more than 200 overdoses since the start of the year. According to Mazzella, one frequent visitor to the center has used its Narcan 70 times in 2016 alone to reverse overdoses.
Mazzella says Prevention Point has also been working with police to facilitate “warm hand-offs” between law enforcement and treatment professionals within a short period after an overdose is reversed. Philadelphia police—who began carrying naloxone kits last year—call emergency personnel to all overdose scenes, but the focus is typically on medical triage rather than addiction referral.
Meanwhile, several users told The Daily Beast that police officers sometimes use the drug irresponsibly to rouse addicts who are sleeping or nodding out in public. That claim is hard to independently verify, but Jeff Deeney, a treatment professional who works with drug-addicted populations in North Philadelphia, told The Daily Beast he has heard similar anecdotes from clients.
All these complexities get ignored when reporting on the dangers of heroin is presented in a narrow frame designed to elicit an emotional response.
Deeney, whose treatment facility dispenses the opioid replacement drug Suboxone, says the videos raise “serious ethical questions” about media coverage of the nation’s drug problem and reporting on criminal justice.
“When you see these viral OD videos you need to follow the story all the way to the end and find out what happened after the camera is turned off,” he said. “Did the police arrest the guy after reviving him? Did a parole or probation officer see the video and violate him back to prison? Was he subsequently victimized in jail? Did he ever get treatment? What if he didn’t want treatment and was forced to accept it as a result of the video?”
An overwhelming majority of Americans now believe drug addiction is a problem best left to doctors, not prosecutors. Whatever one thinks about the public benefit of broadcasting video without their consent of drug addicts overdosing, questions like these will surely become more important as the media takes a larger role in the national conversation on drug policy. If we’re serious about treating addiction like the medical issue it is, the attitude reflected by Upper Darby’s police superintendent won’t help.
At the press conference announcing Michael Meeney’s arrest, he asked rhetorically: “OK, we saved a life, for what? So that [he] can continue down a path of addiction?”
Drug users are human beings, many of whom have jobs and children and people in their lives who depend on them. There is far more to their lives than addiction—even when it’s caught on tape.
http://www.thedailybeast.com/articles/2016/03/22/life-is-hell-after-narcan-heroin-s-miracle-cure.html
