“…hey sawbones, I’m just carryin’ on an old family tradition”

In his classic song the great philosopher and student of addictive disorders, Hank Williams, Jr., blames a traditional source for increasing the probability of developing substance abuse:

….Hank why do you drink?
(Hank) why do you roll smoke?
Why must you live out the songs you wrote?
Stop and think it over
Try and put yourself in my unique position
If I get stoned and sing all night long
It’s a family tradition!

A piece in the New York Times covers a county in New Mexico which experiences some of the highest drug-overdose rates in the nation

recorded deaths have been steady, around 20 a year in a county of 41,000. Meanwhile, the health department trades about 12,000 clean syringes for used ones in the county each week.

The article attributes much of the blame to a familiar “Grim Tradition”.

Money quotes from the NYT article:

Heroin use … zoomed in popularity in the 1980s and ’90s, abetted, surprisingly, by the tradition of close-knit extended families. “We start our addiction getting high with our uncles, then we turn on our own nephews,” said Manuel Anaya, who was an addict for 26 years and now runs a drug counseling program
–snip–

Her face tightened as she admitted to giving money for heroin to her addicted son, slouched nearby, who is in his 20s. “I’d rather give him money than see him panhandle or steal,” said the woman, …. “A lot of mothers here are in the same situation.”

–snip–

“Addiction can become a source of bonding between parents and their children,” said Angela Garcia, an anthropologist who was born in Rio Arriba County and studied drug use here.

–snip–
The man, who would not allow his surname to be used, is disappointed that his two sons, in their 20s, use heroin, too. “I had them deliver to me in jail,” he said. “Maybe that had something to do with it.”

Heroin ODs, heroin ODs….hmmm, where have we heard about that recently. Oh yeah. Bloggers, including [Ed: I originally forgot my coblogger’s contribution! my bad], YHN, Reporters, Abel, Ampersand, Tara, PZ and MikeTheMadBiologist had some pointed thoughts on the NPR coverage of the ONDCP position on the Narcan spray. As a reminder, Narcan is naloxone which is a high affinity competitive antagonist for μ-opiate receptor with lesser affinity for the other major opiate receptors (δ, κ). In short, a broad spectrum blocker of the effects of opiate-class drugs of abuse such as heroin, morphine and OxyContin. And it can save lives by ameliorating the acute respiratory suppression that can lead to death in cases of opiate overdose.
How are they doing in New Mexico with respect to saving lives? Are they following the ONDCP line? Or have they decided to save people first and ask questions about reducing the incidence of drug abuse later?

Proximo Martinez, 35, of Chimayo, counts 38 drug-related deaths in his extended family, including his brother and sister… he recently collected syringes from the van — sterile needles to protect his brother-in-law and other relatives — as well as kits with a new form of Narcan that is sprayed in the nose rather than injected.
Mr. Martinez said he had administered Narcan about 20 times. “But some can’t be revived,” he said. “People have died in my house.”
–snip–
Eric Lucero of Española, N.M., says he has used Narcan, an anti-overdose drug, to revive companions seven times.
–snip–
He survived five overdoses, he said, turning apologetically to his mother. “She would find me in the yard with a needle in my arm, all purple, or lying on the floor in the kitchen.”
He has been more careful, or luckier, in the last several years. But just in case, his mother took a quick lesson in Narcan administration the other day. She and her son watch over each other, she said. Every night, before going to bed, she checks to make sure he is breathing.

Saving lives, check. GoodThing.
…and how about the issue of dependence? Do they have their head’s screwed on straighter than in San Diego?

The most successful treatment, used on 75 patients at the community health clinic, is the opiate replacement bupenorphrine, which can be dispensed at doctors’ offices and is rapidly catching on around the country

Agonist therapy. Not perfect, sure. But proven effective at reducing harm from opiate dependence. Nice.
So apparently they are doing a good job in New Mexico by using scientifically justified interventions to keep people from dying and to assist with discontinuation. A positive note to a very sad story.
I’ll leave you with this. Turn. It. Up.