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Does Narcan increase Heroin use?

3/26/2016

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   In economics, moral hazard is the failure to take adequate precautions because of insurance.  This was a term that was bandied about relentlessly during the 2008 financial crisis, but in spite of that, not many people still realize its meaning or consequences; therefore an example.  Lo-Jack is a vehicle anti-theft device that works exceptionally well.  When your car is stolen and you report it to police, the Lo-Jack homing device is activated and the receiving unit in police cruisers, points to where it is and how far away it is.  It is exceptionally successful since the retrieval rate of Lo-Jack equipped vehicles is 95%.  Having been a police officer in excess of 35 years, I know 1st hand how successful this is, yet, I don’t have a Lo-Jack in my car.  Why? Simple, I have insurance and I’m not emotionally attached to my cars.  The cost of a Lo-Jack unit is about 900, and even tho I know how well it works, I’m only benefitting my insurance company ( I get a $50 break/year on insurance which translates to an 18 year breakeven).
  Now that you’re familiar with the concept of moral hazard, let’s look at it in terms of heroin use.  Within the past two years, we have seen a large increase in the number of heroin OD’s in the northeast.  The reason is that heroin is being laced with the cheaper and more potent drug fentanyl.  Most heroin addicts would like to quit, and the greater possibility of an OD death would normally be more incentive.  However, enter the drug naloxone, sold as Narcan.  Very simple, Narcan reverses the effect of the opiate and prevents death; sounds great, and by preventing a death it is.  However, Narcan now becomes a form of insurance.  According to WMUR/NH, drug dealers are giving away free Narcan (it’s sold over-the-counter) with every bag of heroin they sell, hence insurance and it takes away a motivation for kicking the habit.  To further emphasize the problem, I have spoken to paramedics from both Hampton and Salem, NH who have told me of multiple times they have used Narcan on the same individual.  While they keep statistics of OD’s they don’t have those numbers readily available for multiple OD’s of the same individual.  


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​   Is there an alternative?  An experiment was conducted in Frankfurt Germany in the 1990’s call café fix.  In this experiment, addicts were allowed to come in to this half way house and “shoot up”.  They were given free needles (which decreased cases of hep C) and counseling.  Over a 10 year period, they achieved the following results:  HIV declined by 40%, a decline in robberies of 20%, a decline in court drug cases by 60%, and drug addicts amongst drug users declined from 27% to 9%.  Would this be a good idea for the US?
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    John Tommasi is a retired Senior Lecturer of Economics & Finance from Bentley University and  the University of New Hampshire.

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