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The U.S. drug crisis does not appear to be letting up. The nation experienced a shattering 47,000 opioid-related overdose deaths in 2017.
Driving the surge are potent, cheap synthetics like fentanyl that have spread into the illicit drug supply. In...

The U.S. drug crisis does not appear to be letting up. The nation experienced a shattering 47,000 opioid-related overdose deaths in 2017.

Driving the surge are potent, cheap synthetics like fentanyl that have spread into the illicit drug supply. In response, communities have been trying a range of interventions, from increasing the availability of the antidote naloxone to upping treatment resources.

But an analysis released Thursday by the Rand Corporation, a policy think tank, concludes it’s time to pilot an approach from outside the U.S.: offering pharmaceutical-grade heroin — yes, heroin — as a form of treatment for longtime heroin users who haven’t had success with other treatments. It’s already happening in several European countries and Canada. But prescribing heroin would challenge culture, laws and practice in the U.S.

Here’s how programs that offer prescription heroin, or heroin-assisted treatment, work:

 Patients typically get a regular, measured dose of pharmaceutical-grade heroin — also known as diacetylmorphine or diamorphine — and inject it under close medical supervision inside a designated clinic. 

The idea is if people have a legal source of heroin, they’ll be less likely to overdose on tainted street drugs, spend less time and energy trying to get their next fix, and instead be able to focus on the underlying drivers of their addiction.

Is America Ready For Prescription Heroin?

Image: picture alliance/picture alliance via Getty Image

(Source: NPR)

In the lush green mountain town of Lares, Puerto Rico, even the dead and buried were scarred by Hurricane Maria.

The September 2017 storm dumped so much rain onto the town’s only cemetery that it triggered a landslide. The flow of mud and water was so powerful that it damaged nearly 1,800 tombs — expelling caskets from their graves and sending some of them tumbling down a hillside.

The damage was so extensive — and so horrifying — that health officials locked the cemetery gates. They haven’t been reopened in the 14 months since. And so, for the families and friends of those buried in the Lares Municipal Cemetery, every day has only brought more heartache.

“My father is in there. My grandmother is in there,” said Giovanni Ramirez Santiago. “The town can’t take this anymore.”

Now, the town’s residents are furious that officials have yet to make any repairs. And the longer they’ve been kept out, the more desperate they’ve grown to get in. They want to see the damage to their family members’ tombs but are also fearful of what they’ll find.

“We want to fix them up, take them flowers,” said José Luis Rivera López, whose parents and sister are buried there. “But we can’t. If we cross the fence, they’ll arrest us.”

Across Puerto Rico, people are trying to leave the traumas of Hurricane Maria behind. But doing so has been impossible because the pace of the island’s reconstruction has been so slow. In Lares, the unrepaired destruction in the town’s cemetery has been an especially brutal reminder of everything the storm took.

The yearning for closure — for peace of mind — has led many residents to take drastic measures. Since the start of the year, more than 50 people have gotten permits to exhume the cadavers of their loved ones and take them away, according to figures provided by Puerto Rico’s health department.

‘My Father Is In There’: Anguish Builds In Puerto Rico Mountains Over Decimated Tombs

Photos: Erika P. Rodriguez for NPR

(Source: NPR)