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Providing naloxone to reduce drug-related deaths
Sarz Maxwell, Medical Director, Chicago Recovery Alliance, USA
Abstract
Heroin overdose death is increasingly recognized as a major international problem. Naloxone, an opioid antagonist with no abuse potential, has been used to reverse opiate overdose in emergency medical settings for decades. In Chicago, USA, we developed a program to educate opiate users in the prevention of opiate overdose and its reversal with intramuscular naloxone. Participant education and naloxone prescription are accomplished within a large comprehensive harm reduction program network. Since institution of the program in January 2001, more than 15,000 10ml (0.4mg/ml) vials of naloxone have been dispensed and 776 reports of peer reversals received. The Medical Examiner of Cook County reported a steady increase in heroin overdose deaths since 1991, with a four-fold increase between 1996 and 2000. This trend reversed in 2001, with a 34% decrease in opiate overdose deaths by 2003.
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Biography
Dr. Maxwell graduated from Loyola University Stritch School of Medicine in 1984, and completed her psychiatric residency training at Rush Presbyterian-St. Lukes Hospital between 1984 - 1988, during the early years of the AIDS epidemic.
She paid off her scholarship obligation to the National Health Corps by spending the next four years practicing in rural northwest Missouri. In 1992 she returned to Chicago and has since been developing her clinical and research interests in addictive disorders. She has always been drawn towards the patients whom no one else wants: multiple personalities, adults disordered by childhood trauma, mentally ill substance abusers, and heroin addicts.
Dr Maxwell is now Medical Director of Chicago Recovery Alliance, a large urban harm reduction program, and sees patients at CRA's street outreach sites. From 2005-2007 she directed MOST, a Mobile Opiate Substitution Treatment Program, where methadone treatment is integrated with psychiatric care, as well as with a full spectrum of harm reduction measures.
Dr. Maxwell lectures and writes extensively about clinical aspects of addiction and dual diagnosis.
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