Author Topic: National crisis: fentanyl & other super-opiate overdoses  (Read 28479 times)

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Online mariomike

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Re: 3 people dead from suspected fentanyl overdoses at Winnipeg home
« Reply #125 on: December 13, 2016, 21:28:41 »
British Columbia

The fentanyl crisis in B.C. is not slowing down and paramedics say they are not receiving enough resources from the province to fight overdoses properly.
http://www.metronews.ca/news/vancouver/2016/12/13/bc-paramedics-call-for-more-resources-to-fight-overdoses.html
B.C. Emergency Health Services says it has already added 10 ambulances and 54 paramedics since January

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Offline MCG

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Re: 3 people dead from suspected fentanyl overdoses at Winnipeg home
« Reply #126 on: December 13, 2016, 21:47:24 »
I bet Darwin would have a different suggestion to the problem.

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Re: 3 people dead from suspected fentanyl overdoses at Winnipeg home
« Reply #127 on: December 13, 2016, 22:07:38 »
I bet Darwin would have a different suggestion to the problem.

Without wanting to sound too much like an *** I was thinking the same. It seems like a self-correcting problem of sorts to me
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Re: 3 people dead from suspected fentanyl overdoses at Winnipeg home
« Reply #128 on: December 13, 2016, 22:20:54 »
I didn't usually mind the ODs, because most were skinny.

It was these people who challenged me more.  :)
« Last Edit: December 14, 2016, 10:40:56 by mariomike »
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Re: 3 people dead from suspected fentanyl overdoses at Winnipeg home
« Reply #129 on: December 23, 2016, 12:34:04 »
Users overdose minutes after cashing assistance cheques: Surrey paramedic
https://ca.yahoo.com/news/users-overdose-minutes-cashing-assistance-012743771.html

We used to call it, "Welfare Weekend". 

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Offline CBH99

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Re: National crisis: fentanyl & other super-opiate overdoses
« Reply #130 on: December 23, 2016, 15:31:25 »
I'm glad you guys said it first, as I didn't want to sound as cold hearted as I usually do.

Seems like a self correcting problem...
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Online Colin P

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Re: National crisis: fentanyl & other super-opiate overdoses
« Reply #131 on: December 23, 2016, 15:34:57 »
Turns out my friend's younger brother is one of the OD deaths, nice guy but doing drugs and OD.

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Re: National crisis: fentanyl & other super-opiate overdoses
« Reply #132 on: December 11, 2017, 15:27:39 »
OD in a CVS Pharmacy in Detroit. Watch his friend panic and try to give medical care, a Pharmacist with no Narcan, an EMS crew who has seen this a million times and great commentary from the person filming it who knows exactly what is going on.
https://www.youtube.com/watch?v=PtMZyFggnoA

Nice touch at the end by the patient, who was an inch away from death, to remember to raise his arms in victory for cheating the reaper today. EMS will see him at his next OD.
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Online mariomike

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Re: National crisis: fentanyl & other super-opiate overdoses
« Reply #133 on: December 26, 2017, 13:56:42 »
Job security,

People are now smoking a combination of meth and crystallized bug spray.
http://wjhl.com/2017/12/26/wasp-dangerous-new-drug-mixture-causes-psychotic-episode-for-lawrence-county-man/

Like, who hasn't?

Or, they just do the Fentanyl and get it over with already.
« Last Edit: December 26, 2017, 14:05:47 by mariomike »
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Offline ModlrMike

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Re: National crisis: fentanyl & other super-opiate overdoses
« Reply #134 on: December 26, 2017, 15:10:00 »
Meth now seems to be the drug of choice in Winnipeg. Yes, let's go back to opiates. Much easier to deal with.
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Re: National crisis: fentanyl & other super-opiate overdoses
« Reply #135 on: December 26, 2017, 15:19:38 »
Meth now seems to be the drug of choice in Winnipeg. Yes, let's go back to opiates. Much easier to deal with.

Yeah - can't cause as much trouble when sleeping...

MM
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Re: National crisis: fentanyl & other super-opiate overdoses
« Reply #136 on: December 26, 2017, 16:36:07 »
I always tell the nurses that the sweet spot for overdose treatment is "sleeping AND breathing".
WARNING: The consumption of alcohol may create the illusion that you are tougher,smarter, faster and better looking than most people.
Every normal man must be tempted, at times, to spit upon his hands, hoist the black flag, and begin slitting throats. (H.L. Mencken 1919)
Zero tolerance is the politics of the lazy. All it requires is that you do nothing and ban everything.

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Re: National crisis: fentanyl & other super-opiate overdoses
« Reply #137 on: December 26, 2017, 16:44:34 »
True that...had one that went old school last week - ate 20 T3's and some gabbies...sawed logs all night, but needed a narcan drip to keep the rate up.

MM
MM

Remember the basics of Medicine - "Pink is GOOD, Blue is BAD, Air goes in AND out, Blood Goes Round and Round"

I may sound like a pessimist, but I am a realist.

Offline CBH99

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Re: National crisis: fentanyl & other super-opiate overdoses
« Reply #138 on: December 26, 2017, 21:18:13 »
Hi guys,

I hope someone here can correct me if I'm wrong in my thinking, as this topic is absolutely outside of my lanes & educated knowledge base.

As many of you know, I work as a civilian investigator for the Alberta Solicitor General's Office, the branch that oversee's many agencies of provincial law enforcement.  (Corrections, Alberta Sheriff's, Provincial Peace Officers, Commercial Vehicle Enforcement, Conservation Enforcement, etc)

Recently it was brought to my attention that a Correctional Peace Officer, whose near-death is being kept quiet due to the circumstances, overdosed on opiates.

My initial impression and opinion (arrogant in hindsight, I fully admit) - was "Ugh, another druggie...great" and all of the opinions that come with that line of thinking.  People who can't make a decision to stay clean, f**k up their lives, and we as a society feel a need to come to their rescue.  Great.

Yet as we looked into his past, it turns out he wasn't a druggie at all.  He was a hard working, nice, clean cut guy who had been with us for several years.  After sustaining a serious & painful knee injury, his doctor had prescribed him opiate-based medication to help with the pain.  This officer used the medication between surgeries, and continued to work without any red flags.

Several months later, the officer realized that when he tried to stop taking them and ween himself off, he couldn't.  He went to his MD, who immediately took him off of the opiates as he had 'become addicted', and started to prescribe him something else instead to help him ween his addiction.  Long story short, this was the beginning of a very quick spiral downwards, in which the officer eventually began using small doses of Meth to fulfill his addition to the opiates.  He was embarrassed and ashamed of this, and kept it successfully hidden from his co-workers for several months.

Recently, and the reason we became aware of the situation, was there was a work related incident, which unfortunately unravelled quite a lot going on with this young man.  My initial attitude was completely wrong, and as I dug deeper & deeper to build the file, I realized this wasn't the kind of person I thought he was, and my attitude is now a total 180' than what it was when I first started looking into this.  (Looking at him now compared to how he looked when he started with us, is almost like looking at 2 different people)

*I don't really know why I'm writing this, other than it seems relevant to the discussion.  And I don't know what my final point is, other than I guess I've recently been enlightened to the idea that not all of these druggies are druggies by choice - something I was arrogantly dismissive of in the past.
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Offline ModlrMike

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Re: National crisis: fentanyl & other super-opiate overdoses
« Reply #139 on: December 26, 2017, 23:33:32 »
The problem with opiates are many, and not easily discussed in isolation. Drugs like hydromorphone are incredibly effective, but are also quite addictive. But we know this going in - notwithstanding what the initial sales pitches said. Used as directed, for a short period of time, they're safe. However people use them in unsafe ways despite what we tell them. They take too many, too often in the mistaken belief that they're innocuous drugs, or that we're just trying to scare them.

One of the other issues surrounds pain control in general. We call them pain killers, when they are more properly pain relievers. We should never obliterate pain, particularly with opiates. You run the risk of incurring up regulation of the pain receptors, leading to narcotic hyperalgia, or in other words it takes a smaller insult to cause more pain. This leads to greater use of opiates, and the never ending cycle of addiction. In addition, the public has a perception that you need to be pain free. I go to great lengths to try and dispel this myth every day. Feeling pain is normal and healthy. It is actually more difficult to become accredited to prescribed opiates if one accepts that feeling some degree of pain is reasonable.

That's just a little insight int acute pain. Opiate use in chronic pain is a much harder beast to tame.
WARNING: The consumption of alcohol may create the illusion that you are tougher,smarter, faster and better looking than most people.
Every normal man must be tempted, at times, to spit upon his hands, hoist the black flag, and begin slitting throats. (H.L. Mencken 1919)
Zero tolerance is the politics of the lazy. All it requires is that you do nothing and ban everything.

Offline dapaterson

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Re: National crisis: fentanyl & other super-opiate overdoses
« Reply #140 on: December 26, 2017, 23:45:15 »
At the same time, the hysterics over opiates mean that they can be under-employed in palliative care, where addiction is much less of a concern.  (Redirection of drugs remains a significant issue there, though).
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Re: National crisis: fentanyl & other super-opiate overdoses
« Reply #141 on: December 27, 2017, 00:29:17 »
I had a patient freak out a couple weeks ago because I was going to give them a small dose of fentanyl when I was reducing a fracture they had...thank you MSM  ::), now something that's effective and safe under controlled circumstances are hard to use because these asshats have scared the public.  Had the same problem with propofol and ketamine as well, courtesy of the same idiots doing "public service announcements".

Much like Mike alluded to, I take issue with people thinking that life should be anaesthetic - pain is a normal function of things, it tells you there is a problem or changes in it tell you things are getting better.  Some of these drugs have other issues too - as part of them leaving the system, many cause a pain flare up that lasts about 30 minutes (if they're quick onset/offset, Demerol for instance) that makes people freak out and take more.  Our ER triage systems also need to be revamped somewhat - pain is not a vital sign, contrary to what many people want to tell you, since vital signs are OBJECTIVE signs of how your body is doing physiologically, whereas pain is completely SUBJECTIVE (see this https://www.youtube.com/watch?v=5rWs_tncktU).  When a triage acuity number is placed based solely on that modifier (person with completely normal vital signs but 10/10 pain) and therefore how that symptom is managed, you start a vicious cycle of problems and expectations...which sometimes leads to yelling, screaming, gnashing of teeth and sometimes people being not so politely removed from the ED.  My first two complaints against me when I started in civilian medicine were from people insisting they needed narcotics for their issues (well, one of them was the Mommy of the adult child demanding I give them narcotics - RED FLAG).


Long story short, this was the beginning of a very quick spiral downwards, in which the officer eventually began using small doses of Meth to fulfill his addition to the opiates. 

Small point - meth is a stimulant, whereas opiates are narcotics...they have opposite effects.

 :2c:

MM

MM

Remember the basics of Medicine - "Pink is GOOD, Blue is BAD, Air goes in AND out, Blood Goes Round and Round"

I may sound like a pessimist, but I am a realist.