It’s a Friday night in Española. A small town in northern New Mexico often pegged as the heroin capital of the state.
“We get a lot of Percocet, Vicodin, Oxycodone, there’s so many out there, I can’t name them all, but they do it,” said Española Police Officer Dustin Chavez. “They crush it up and they snort it and then when they run out, they lead to other things.”
Chavez says in his experience with addicts, prescription drugs and heroin are usually interchangeable to users. And when the town is awash in either, he says it always manifests itself.
“I’m not sure if the shipment comes in or if they’re low on the shipment, then you can tell there’s more pills,” said Chavez. “If there’s a bad shipment you see more ODs. It depends what comes in.”
For almost two decades, New Mexico has led the nation in drug overdose deaths. In 2012, nearly 500 New Mexicans died from drug overdoses. For many, opioids — like prescription painkillers and heroin — are the drugs of choice, and they’re easy to find and often cheap.
Since 2007, prescription drug overdoses in New Mexico have surpassed illicit drug deaths, said epidemiologist Michael Landen of the New Mexico Department of Health.
“The good news is we’ve had a 7 percent decrease from 2011- 2012 in number of drug overdose deaths, and seven percent decrease in the volume of prescription opioids sold in the state,” said Landen. “It’s probably not a coincidence that those trends are basically related.”
Besides tightening up on prescriptions, another way the state has dealt with its overdoses has been through its harm reduction program.
“Over a long period of time we’ve worked using Naloxone primarily for the injection drug-using population,” said Landen. “Now we’re starting to see how we can best use Naloxone for this new population at risk for overdose, those using high risk prescriptions of opioids.”
Naloxone, also known as Narcan, is a drug that reverses overdoses by covering receptors in the brain that accept opioids.
In 2010 and 2011, the Department of Health says there were nearly 300 people whose overdoses were reversed in just three counties thanks to Naloxone.
“That’s why we’re trying to get Naloxone stocked in every single commercial pharmacy in the state,” said Landen. “We want to be able to basically have people get prescriptions for it.”
Or even get it over the counter. But the next step is something a little more radical.
"Supervised injection sites for example, we’ve seen strong evidence out of Canada that they really work,” said Olivia Sloan of the New Mexico Drug Policy Alliance. “The idea is that, you have a facility or location, and it actually has little areas where a drug user can come. There would be medical staff there — nursing staff in a lot of the places we’ve heard of in Canada — people will bring their own drugs, they’re not provided, but there’s access to clean needles, other sort of paraphernalia that drug users use. So clean water, clean cotton balls, all of that’s there, and then the medical staff can also make recommendations on their veins.”
In 2012 the state legislature passed a memoriam to study the prospect, and a feasibility study is likely to begin soon.
“A lot of injection drug users are stigmatized, sort of disenfranchised parts of the population, and that’s not the way to treat them by alienating them,” said Sloan. “If you can actually open the conversation, you have a way to talk about health, and their health, and their well-being and quality of life.”
Yet despite increased restrictions on prescription drugs, Naloxone’s growing availability in New Mexico, and serious consideration of ideas like supervised injection sites, something isn’t working. Which is what Española Officer Dustin Chavez continues to see in his nightly work.
“You would think the state of New Mexico would say, ‘okay, this is the heart of the problem, why don’t we just pound this town full of money to get these programs started,’ yet they’re ignoring the fact that we are number one in the country for injectable drug use, why aren’t they doing anything about it?”
Chavez says more money, more rehab, and more cops are a good start. Until then, his department is armed with Naloxone to deal with overdoses when they find them.