THE BURNED OVER DISTRICT

Junkies have never been known to be the most thoughtful or cautious people, but now with the advent of naloxone, trade name Narcan, they have no reason to avoid what they know will kill them.

Every day across the country, hundreds, if not thousands, of people who overdose on opioids are being brought back to life with naloxone. Hailed as a miracle drug by many, it carries no health risk; it cannot be abused and, if given mistakenly to someone who has not overdosed on opioids, does no harm. More likely, it saves a life.

As a virulent opioid epidemic continues to ravage the country, with 78 people in the United States dying of overdoses every day, naloxone’s use has increasingly moved out of medical settings, where it has been available since the 1970s, and into the homes and hands of the general public.

But naloxone, also known by the brand name Narcan, has also had unintended consequences. Critics say that it gives drug users a safety net, allowing them to take more risks as they seek higher highs. Indeed, many users overdose more than once, some multiple times, and each time, naloxone brings them back.

Advocates argue that the drug gives people a chance to get into treatment and turn their lives around. And, they say, few addicts knowingly risk needing to be revived, since naloxone ruins their high and can make them violently ill.

With drug overdoses now killing more people than car crashes in most states, lawmakers in all but three — Kansas, Montana and Wyoming — have passed laws making naloxone easier to obtain. Its near-universal availability reflects the relatively humane response to the opioid epidemic, which is based largely in the nation’s white, middle-class suburbs and rural areas — a markedly different response from that of previous, urban-based drug epidemics, which prompted a “war on drugs” that led to mass incarceration, particularly of blacks and Hispanics.

But even junkies don't like dancing with death, not the least because it has hash after effects.

Yet most users loathe naloxone’s effects. By blocking opiate receptors, it plunges them into withdrawal and makes them “dope sick,” craving more heroin or pills.

“I hate it,” said Melissa Tucci, 44, a heroin user here who has been revived seven times. “When I start withdrawing, I vomit, you get diarrhea, you sweat profusely, your nose will run, you sneeze and have runny eyes, and you ache so bad you can’t even walk.”

She said she has overdosed so often not because she relied on naloxone to save her, but rather because she underestimated how potent the heroin was. And she said she keeps using heroin to avoid the agony of withdrawal.

She hates the effect of naloxone but she keeps on shooting up to avoid the symptoms of withdrawal which puts her in a position sooner or later to get another load of naloxone which makes her feel so bad. No one ever accused junkies of being the sharpest knife in the drawer.