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Tag: opiates

The Frightening Opiate Tales From The Emergency Room

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By Ross Parker
ticklethewire.com

The mind numbing opiate epidemic is not news, but the number of overdose deaths keeps climbing, and DEA agents say that we are still on the uphill side of the worst drug crisis in U. S. history. Until the opiate epidemic invades you or your family or friends, it is easy to underestimate the intransigence of the scourge.

Emergency room physicians and nurses have to cope with the unending tide of hopeless and desperate patients who are wheeled into the ER every day.  These are stories from a typical urban hospital where all classes, ages and races end up unconscious on their front door step. The fact that the stories are so unexceptional illustrates the extent to which the drug has a death grip on the country.

One ER doc relates that at the beginning of his twelve-hour shift a young woman comes in close to death in an opiate overdose. The medical team uses their best efforts to revive her, and they are successful. The doctor and a nurse both advise her strongly that the next incident may not have a good outcome and that she needs to remain in the hospital for a full medical work-up by an internist as well as counseling and treatment. But she signs herself out of the hospital AMA (Against Medical Advice) before he or anyone else in the hospital can do anything to prevent her from leaving.

The ER doc’s shift proceeds with other patients. An hour before the shift ends, the same young woman is wheeled into the hospital with her second overdose. Again she is revived. Physicians are trained to make no moral judgments about their patients’ lifestyles, but frustration pervades the atmosphere of the facility. What’s the point?

At a different hospital an ER physician tells a story that is going around ERs about a practice of opiate addicts driving to the hospital parking lot, leaving the car in drive with their foot on the brake and taking their drug of choice. If they remain conscious during the “high,” they keep that foot on the brake until they can drive away to another destination. If they overdose and lapse into unconsciousness, their foot slips off the brake, and the car crashes into something stationary, another car, a wall or such. Hospital security then finds the overdosed driver and rushes him or her into the ER for emergency treatment.

How Much Is Too Much?

A third doctor relates a post-overdose conversation she had with a chronic user. The problem, the user explained, is that the most euphoric effect comes only when he is close to slipping into unconsciousness. So users, at least the ones who want to live, must gauge what amount will reach this point without unintentionally going too far. Could the doc give him a little advice on this problem?

Each drug, used legally or not, has a Therapeutic Toxic Ratio or Therapeutic Index, which is a comparison of the amount of drug that causes the effect sought to the amount that causes toxicity. There is a safety continuum between effectiveness and a lethal side effect. The user who was seeking advice was saying that the best high is one which occurs as close to the toxicity point as possible without going too close to a lethal overdose.

The problem with this over simplistic analysis is that there are so many factors and unknowns in the context of illegal drugs that predicting this point is impossible. Using recreational drugs doesn’t happen in the hospital laboratory. The unknown mixture of different drugs (e.g., heroin and fentanyl) prevents this assessment by a user. Also the strength and purity of the drug(s), user tolerance, and contaminants affect the reaction to the drug and change the safety continuum.

So, even if the doctor was inclined to have this discussion, it would have been impossible to do so.  Instead the answer was that any time the user took a drug he was spinning a deadly roulette wheel. The unknown factors were the ones which could kill him or her. Even the same dose of a single drug can be effective one time and kill the user another time. The practice is inherently and unpredictably dangerous.

These are stories of a public emergency sliding toward a cataclysm, one not being addressed by policymakers and politicians. Appreciating its grim tenacity is only the first step to finding an answer to the epidemic.

DEA: Police May Die from Handling Fentanyl Because It’s So Powerful

Fentanyl tablets

Fentanyl tablets

By Steve Neavling
ticklethewire.com

Fentanyl, the painkiller that killed Prince and is responsible for hundreds of over deaths in recent years, also poses a significant danger to law enforcement, the DEA warned.

The DEA unveiled a new public service announcement that warns officers of the dangers of fentanyl if they encounter it, The Washington Times reports. 

The video features two New Jersey police officers who accidentally inhaled fentanyl while trying to seal a plastic bag.

“A bunch of it poofed up into the air, right in our face, and we ended up inhaling it,” said one of the detectives.

“I felt like my body was shutting down,” said the other detective, describing effects of the drug that made him feel like he was dying.

The DEA reports that more than 700 people have died due to fentanyl use between 2013 and 2014.

DEA Executes Search Warrant at Prince’s Home As Part of Opiate Investigation

Prince, via Wikipedia.

Prince, via Wikipedia.

By Steve Neavling
ticklethewire.com

The DEA executed a search warrant on Prince’s Paisley Park home Tuesday as part of a federal investigation into the untimely death of the music icon.

Hollywood Life reports that investigators are trying to determine who prescribed the medication to Prince, who died on April 21 after an apparent overdose on opiates.

Authorities are hunting down Prince’s medical records and any other related information.

 “Detectives are revisiting the scene at Paisley Park as a component of a complete investigation. No other information is available,” said the local Sherrif’s Office tweetedTuesday afternoon.

The official results of the autopsy have not yet been released.

FBI-Produced ‘Chasing the Dragon’ Tackles Heroin Abuse Among Young People

By Steve Neavling
ticklethewire.com

To tackle the alarming increase in heroin and opiate abuse that is reaching every demographic, the FBI has produced a “searing film” with testimony from overdose survivors, the Washington Post reports. 

The documentary, “Chasing the Dragon,” was produced at the request of FBI Director James Comey, who has taken personal interest in the film.

Comey also plans to meet with school officials in the Washington region today to discuss the rise in prescription opiates among young people.

The rise in heroin use is linked to the increasing number of people who have access to prescription painkillers.

About 46,000 people die annually from drug abuse, about a quarter of which are related to heroin.

“The numbers are appalling and shocking — tens of thousands of Americans will die this year from drug-related deaths and more than half of these deaths are from heroin and prescription opioid overdoses,” said Acting DEA Administrator Chuck Rosenberg. “You will see in ‘Chasing the Dragon’ opioid abusers that have traveled a remarkably dangerous and self-destructive path. I hope this will be a wakeup call for folks. Please pay close attention to this horrific epidemic. Help reverse it. Save a life. Save a friend. Save a loved one.”

Medical Privacy Laws Hampering Law Enforcement’s Efforts to Crack Down on Drug Deaths

Steve Neavling
ticklethewire.com

Law enforcement is struggling to crack down on growing drug abuse because of a lack of recent data on drug deaths, especially from heroin overdoses, NBC News reports.

The problem, which was raised at a gathering of law enforcement Wednesday to discuss drug abuse, is that patient privacy laws are making it difficult for authorities to gather information on patient deaths.

“I don’t care about the names of the individuals, I just need the numbers!” Philadelphia Police Chief Charles Ramsay said at the Police Executive Research Forum.

Information also is lacking on what is sometimes referred to as “drop-offs” at emergency rooms.

Of particular concern is opiate-related deaths because of large spikes in the past two decades.

Heroin Use Increases Despite Deadly Consequences; Prescription Pills May Be to Blame

Steve Neavling
ticklethewire.com

Despite the dangers of heroin, people are increasingly turning to the drug, CNN reports.

But why?

It’s relatively inexpensive, readily available and becomes the next step for pain pill addicts.

A government study found that heroin use more than doubled in the past decade to 355,000.

“Heroin is pummeling the northeast, leaving addiction, overdoses and fear in its wake,” James Hunt of the DEA’s New York Office, said.

People die from heroin all the time. But on Sunday, we learned of the death of a high-profile figure, Philip Seymour Hoffman.

OTHER STORIES OF INTEREST

 

DEA: Doctors Not Taking Pain Killer Abuse Seriously Enough

Steve Neavling
ticklethewire.com 

Doctors are largely responsible for the high rate of pain killer abuse because they don’t take the risks seriously enough, the DEA said Thursday, Bloomberg reports.

“This drug has got a hold of this society and it’s killing us,” Joseph Rannazzisi, deputy assistant administrator in the DEA’s office of diversion control, said at a FDA advisory meeting in Silver Springs, Md. “There’s so many prescriptions out there and I’ll tell you why. The medical community, in my humble opinion, is not taking this drug seriously.”

The FDA is debating the DEA’s request to reduce how long doctors can prescribe hydrocodone pills.

The request also would bar physicians assistants and nurse practitioners from prescribing pain killers, Bloomberg reported.