Not all medical professionals are sure that providing pharmaceutical-grade heroin is the right approach. A local pediatrician who has treated children of parents with substance use disorders told the Daily Lobo that allowing people with opioid use disorder to get their “fix” in a clinical setting may not help move people toward recovery in the same way that the slower acting opioid replacement medication like buprenorphine or methadone do.
Kimberly Page, University of New Mexico professor of internal medicine and an expert witness who testified on the bill, asserted that recovery is actually not the goal for many people who have chronic opioid use disorder.
“The term ‘recover’ is used for some diseases but substance use dependence, in particular, opioid use dependence, is a chronic, relapsing disease,” Page said. “So, our goal is not to cure them, but to help them from relapsing and to help them to have a productive, non-chaotic, best-possible life.”
Kaltenbach also made the point that “there are many people where that treatment protocol just doesn’t work. Traditional treatment options don’t work and (people) continue to use. And, the problem is that they are using it in a chaotic way — in an unsafe environment — they are getting their drugs off the street,” said Kaltenbach in an interview with the Daily Lobo.
In the hearing, Rep. Miguel Garcia (D) asserted that the program would reduce the criminal activity of substance users.
“They break into our homes. They break into our cars. They steal our cars. They engage in that criminal activity to acquire our personal belongings to sell on the black market to get money to get a fix for that day… this program will eliminate that scenario,” Rep. Garcia said.
Rep. Greg Schmedes (R), who voted against the bill, said he didn’t think this program would have any greater impact on the crime rate than the existing methadone and buprenorphine treatments that are already available.
“I’ve seen long term evidence (about 12 months) show that traditional treatment versus hydromorphone or diacetylmorphine (has) an equivalent rate in the decrease in crime,” Schmedes said. “So you have patients that are on a traditional treatment and the patients that are on the injectable treatment, after 12 months, both groups have equally decreased crime use.”
Carolyn Carlson’s son died of an opioid overdose on October 31, 2019, and she is frustrated there weren’t better options for her son.
“I may be too raw after finding Ryan, who was on suboxone, dead in his sober living house. I got his cause of death and it was a heroin laced with fentanyl overdose,” Carlson said.
Despite her own loss, Carlson said she supports the vision behind HB 73 for the sake of those that don’t have the options her son had.
"If the (injectable heroin) works then it should be given to addicts in jail, prison, on the streets, etc in order to prevent the many deaths that are happening that go unreported,” Carlson said in an email with the Daily Lobo.
According to a 2019 New Mexico Department of Health in Drug Overdose infographic, “New Mexico’s drug overdose death rate in 2018 was about 23% higher than the US rate in 2017.”
HB 73 made it through its first committee on a 5-1 vote but has yet to be placed on the agenda of the House Appropriation and Finance Committee. If approved and included in the approved state budget, the HB 73 funding would be available for expenditure in fiscal years 2021 and 2022.
“We know in our state that a lot of treatment options have not worked for some communities, some people. This is just another tool in the toolbox, another treatment option for those select people where other treatments have not been successful,” said Kaltenbach.
Lissa Knudsen is a beat reporter for the Daily Lobo. She can be contacted at firstname.lastname@example.org or on Twitter @lissaknudsen.