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Tag: overdose

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.

FBI’s Fight Against Rising Heroin Use Leads to Arrest of Man Linked to Overdoses

800px-HeroinBy Steve Neavling
ticklethewire.com

The FBI’s fight against the rising use of heroin led to the arrest of a man accused of selling the drug to people who overdosed in the greater New Orleans area.

Special Agent in Charge Jeffrey Sallet said the FBI investigation was in response to a recent rise in heroin overdoses, the Associated Press reports. 

The New Orleans Violent Crime Task Force led the investigation, which resulted in the arrest of 39-year-old Gary Hagan on Friday on a charge of distributing heroin.

As of Sunday, Hagan remained in jail after a $140,000 bond was set.

Other Stories of Interest

DEA Warns About Deadly Dangers of Carfentanil, An Animal Tranquilizer

dea_color_logo

By Allan Lengel
ticklethewire.com

The DEA has issued a public warning about the dangers of carfentanil, a synthetic opioid it describes as being 10,000 times more potent than morphine and 100 times more potent than fentanyl, which itself is 50 times more potent than heroin.  It  is designed to be used as a tranquilizing agent for elephants and other large mammals.

The agency said law enforcement has recently seen the presence of carfentanil, which has been linked to a number of overdose deaths around the country.

“Carfentanil is surfacing in more and more communities.” said DEA Acting Administrator Chuck Rosenberg in a statement. “We see it on the streets, often disguised as heroin.  It is crazy dangerous.  Synthetics such as fentanyl and carfentanil can kill you.  I hope our first responders – and the public – will read and heed our health and safety warning.  These men and women have remarkably difficult jobs and we need them to be well and healthy.”

Read the entire press release below:

Read more »

DEA Not Surprised After 17 Heroin Overdoses in Akron, Ohio in 24 Hours

800px-HeroinBy Steve Neavling
ticklethewire.com

Heroin continues to claim lives at unprecedented rates.

In the city of Akron, Ohio, 17 people overdosed on heroin, and one died, in a 24-hour period, WWJ reports.

Special Agent Rich Isaacson, of the DEA’s Detroit field division, said the trend is startling.

“It’s a huge problem in Akron, Ohio but it’s also a huge problem across the United States,” said Issacson. “There is not a community in southeast Michigan that hasn’t been hit hard by the opiate abuse problems, that’s including pain killers, like hydrcodone and oxycodone products as well as heroin.”

Isaacson said news of deaths don’t usually stop users.

“On occasion when there’s talk of heroin overdose deaths – or a series of heroin overdose deaths; sometimes as counter-intuitive as it sounds – that actually sounds attractive to a heroin addict because they know that if that heroin caused the death of another user, that must have been pretty strong heroin,” Issacson said.

The heroin epidemic is being blamed on the ubiquity of pain medicine.

Other Stories of Interest

DEA Head Warns of Alarming Increase in Overdoses from Synthetic Drugs

The use of synthetic drugs is reaching alarming levels.

The use of synthetic drugs is reaching alarming levels.

By Steve Neavling
ticklethewire.com

Synthetic designer drugs are causing an alarming number of overdoses, especially among young people, DEA head Chuck Rosenberg told a U.S. Senate Committee. 

The DEA has been trying to curb the use and delivery of synthetic drugs since they became increasingly popular in 2010. Trouble is, synthetic drug makers are churning out products faster than the federal government can ban them, Reuters reports. 

“For every one substance we’ve controlled, legislatively or administratively, there are 11 more out there that are uncontrolled,” Rosenberg said.

“We’re playing catch-up, and we need your help.”

Synthetic drugs include bath salts, counterfeit painkillers and cannabinoids that mimic marijuana.

Other Stories of Interest

DEA to Crack Down on Synthetic Drug That is Causing Deaths, Erratic Behavior

dea-badgeBy Steve Neavling
ticklethewire.com

The DEA is tackling yet another disturbing trend involving a synthetic drug that is causing hysteria and bizarre behaviors among users.

The substance is known as “flakka” and is similar to bath salts, Vice News reports. 

The drug is primarily manufactured in China and sold online under brand names like “Cloud Nine,” Scarface,” and “Lunar Wave.” The drug sells for about $3 to $5 and is often accompanied with a warning that it’s “not for human consumption.”

The drug mimics the effects of methamphetamine and other speed.

One reported user ran naked through the streets of Florida and tried to stab a cop with his own badge. In another incident, a Florida man ran naked from what he believed was a pack of vicious German shepherds.

In Broward County in southern Florida, a medical examine reported 63-flakka-related deaths since September 2014. Last summer, emergency rooms in the country admitted more more than 300 people for symptoms related to flakka.

Taking synthetic drugs is “nothing but a game of Russian roulette,”  chief DEA spokesman Rusty Payne told VICE News said. “The unknown should scare people. You don’t know where it came from, or the kind of lab it was manufactured in.”

Other Stories of Interest

DEA to Crack Down on Heroin Abuse with First-of-Its-Kind Program

800px-HeroinBy Steve Neavling
ticklethewire.com

Hoping to crackdown on the rise of heroin and opioid abuse, the DEA has launched a first-of-its-kind program to target drug-related crime.

The Tribune-Review reports that the pilot program will be established in the Pittsburgh and focus on finding long-term solutions.

That will involve working with health care and social services agencies.

Why Pittsburgh?

Local authorities have been shocked by the proliferation of heroin and drug overdoses recently.

“Heroin and pill overdoses are through the roof, and it’s making us in law enforcement look at some different approaches,” DEA spokesman Patrick Trainor said.

In Pennsylvania, heroin or opioid deaths have increased from 47 in 2009 to more than 800 in 2013.

It’s not year clear how the pilot program will work and what impact it will have on existing prevention and enforcement efforts.

Other Stories of Interest

Parker: The Continuing Rapid Rise of Seizures and Overdose Fatalities Involving Fentanyl

Ross Parker

Ross Parker

Ross Parker was chief of the criminal division in the U.S. Attorney’s Office in Detroit for 8 years and worked as an AUSA for 28 in that office.

By Ross Parker
ticklethewire.com

The CDC (Centers for Disease Control and Prevention) issued an alert this week about the continuing rapid rise of seizures and overdose fatalities involving fentanyl. As reported in this column last June, fentanyl is a fast-acting opioid , 50-100 times stronger than morphine, that is now being used by sellers to mix with heroin in order to increase the “high.” The problem is that the substance is so much more potent that users often do not know of this increase and have a greater risk of suffering a fatal overdose.

The danger posed by this development has risen dramatically in the last three years, and the increase in 2014 was at epidemic levels. DEA has responded with ramping up enforcement activity. Seizures have gone from 618 in 2012, 949 in 2013, to a staggering 4,585 in 2014. These seizures are concentrated in ten states, with Ohio having the highest number of seizures (1,245), followed by Massachusetts (630), and Pennsylvania (419).

Most of this rise has been from illegal manufacturing operations rather than diversion of pharmaceutically produced drugs, according to a report by the DEA Office of Diversion Control. The alert was reported in this week’s Medscape Medical News.

The CDC asked law enforcement to participate in expanded surveillance and record-keeping programs, along with medical examiners and emergency rooms, to report these seizures to local public health departments. It also warned law enforcement officers to take special safety precautions to avoid exposure to the drug either through skin contact or by inadvertently inhaling it.