For the past eight years, the San Francisco Department of Public Health has been handing out the opioid antagonist naloxone (Narcan) in a bid to reduce heroin overdose deaths. This week, the city marked what it said was the 600^th life saved by using the overdose-reversal drug.

[image:1 align:left caption:true]The city distributes naloxone through needle-exchange sites, nonprofit organizations, and community organizations that deal with injection drug users. The department also prescribes the drug to people in residential hotels and the friends and families of heroin users, and conducts training sessions in the county jail.

Not only have hundreds of overdose deaths been averted, but the department also reported that heroin-related visits to the city's emergency rooms had declined by half between 2004 and 2009.

The lifesaving measure is funded by a department expenditure of $73,000 a year, which goes to the Oakland-based Drug Overdose and Prevention Education Project (DOPE Project). DOPE uses the money to buy and distribute the drug and train people on how to use it.

"San Francisco has always been a heroin town," Alice Gleghorn, DPH's head of Community Behavioral Health Services told the SF Weekly. "At one time, San Francisco had an overdose death every day, and that rate has really gone down. I hope our naloxone programs have contributed to that drop. But we don't have the money to do the research."

Eliza Wheeler, director of the DOPE Project, compared naloxone to insulin and said its use posed few problems for injection drug users. "The folks we see are pretty adept with administering drugs, so they'll be okay. People are very capable and willing to save their friends' lives... my experience is that people are really proud of themselves," Wheeler said.

Harm reduction is saving lives in San Francisco. Perhaps other cities and counties should take heed.