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Thread: Heroin Overdose Epidemic - what is your perspective?

  1. #21
    NYS is overwhelmed with heroin addiction, and it is disturbingly prevalent in public schools, even out here in "white bread" Long Island (the HS I graduated from 33 years ago is notorious for heroin use now by students). Don't know the solution, but I do know that the problem STARTED with folks addicted to prescription pain meds finding a "simple" way to meet that addiction. I've been prescribed opioids for pain four times (twice post-surgery, twice for back injuries) in the last decade or so, each time I was prescribed an ENORMOUS number of pills. I think I took a total of about four of those pills, the rest got flushed.

    I do know that it sucks having to worry about my kids getting peddled HEROIN at school - in my day, the "wild child" crowd would RARELY bring pot onto school grounds - and when they were caught, they were expelled. May be a clue there in how we respond to the current crisis - with the Mayor of Rochester, NY advocating tax-payer-funded medically-manned "shoot houses" so addicts can use their heroin safely...

  2. #22
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    Some of the "social Darwinism" chatter I agree with,

    But I just had a patient who was pimped out by her worthless fucking shitbag mom at 7 years old to support her heroin problem....worthless fucking shitbag mom then got her hooked on IV drugs at 11....

    Sometimes, people don't get a fair break....because of their own families...who should have never had kids.
    Last edited by 45dotACP; 06-24-2016 at 01:23 PM.

  3. #23
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    Afghanistan is the biggest producer of heroin / poppy in the world but not the biggest supplier to the United States. The majority of Heroin in the U.S. comes from Mexico.

    The Chinese may have been the origin, but what really got Mexican Poppy production going was actually WWII. The traditional sources of Poppy in Asia, both the the Golden triangle of SE Asia and sources in SW Asia were either enemy controlled or not readily accessible. The U.S. Encouraged Mexican farmers to grow poppy in the Sierras to meet the U.S. and allied demand for opioid pain meds like morphine.

    Speaking of pain meds, RX pain meds, particularly OxyContin are what started and has fueled the resurgence of heroin. There is a reason they call it "hillbilly heroin".

    Re the ODs, easy access to NarCan may be part of the problem but it think Fentanyl and its popularity as a cutting agent for heroine is a big factor in the OD deaths.

    https://en.m.wikipedia.org/wiki/Fentanyl

  4. #24
    I've had to interview more than one dead service member's family when their child OD'd on a cocktail of alcohol and fentanyl...

  5. #25
    Member Paul Sharp's Avatar
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    Sorry for your loss breakingtime91. Heroin is evil.

    During my time as an undercover I saw the trend slowly moving towards heroin. My group had moved into prescription drugs and the "party" drugs so I wasn't really seeing what the guys working street drugs were dealing with, until those worlds came together in heroin. When we would get to together to deconflict there would be a lot of, "Holy shit, you're working xxxx too?" Yeah, but we're working him/her for heroin. "So are we!". We started to see a trend... My last year in the unit we saw the soccer moms that were taking their kids ADHD meds, and the folks going from doc to doc getting their pain scrips filled, start to move towards heroin. It's cheaper, easier to get, with less hands involved in the transaction. As we started to pick off more docs selling scrips, it became more difficult for the opiate addicted people to get their drug of choice. I believe heroin filled that void. My contacts went from a doctors office in xxxxx to some dude on the west side of Chicago. It wasn't overnight but gradually we were no longer looking for the guy in the Tesla parked in front of the Whole Foods, now we were looking for the dude in a hoodie wearing a red St Louis Cardinals cap sitting on a bus stop bench across from a church.

    I think a couple things happened. Doctors, and staff started getting popped off for selling prescriptions. The ones that were involved but didn't get caught up yet, stopped before they got caught. Then legislation was passed that made it more difficult for folks to get opiates. The docs could no longer call in your opiate refill, you had to go see the doc to get a refill. The various docs and pharmacies implemented a computer system that allowed them to see that this patient just got a Vicoden refill from their dentist last week, so no vicoden for you. That source started to dry up fast. This created a void, heroin filled that void.

    The frequency of OD now has a lot to do with drug quality, misinformation, and voodoo BS the users pass along to each other regarding what to do when someone is OD'ing. With pharm grade opiates they knew what they were getting. There would occasionally be an OD due to opiates but that was rare and usually in conjunction with alcohol. With heroin, folks just don't know what they're getting. There is probably some heroin in there but there is also a lot of bad stuff. We had a string of deaths in Chicagoland after a bad batch of heroin came out of the westside. It didn't slow the end users down, they just tried all kinds of juju to figure out if the bag they just bought was the bad stuff or not. The other issue is strength, which also relates to purity/quality. For example, a guy has been buying a stick that's 1/3 heroin, 2/3 filler/bunk. He hooks up with a dude that sells him a stick that's 9/10 heroin? It's going to wreck him. Then his buddies decide the best way to bring him out of it, (if they don't freak out and leave him for a few hours before they actually do anything to help him), is something some guy at the Phish concert told them to do if they ever OD... By the time an officer or paramedic shows up with some Narcan, and can transport the guy to the ER, he's been under a long time. This contributes to the lethality of the ODs we're seeing.

    I think the way forward is education. Prohibition doesn't work, just like the thread about taxing soda. Come on man, do we as a society still believe you can hit someone with a stick to make them change behavior that's generated by internal issues? All it does is make them find ways to get what they want while avoiding the stick. If we figure out how to fix the internal issues they won't need the thing to fill that void. I always think about a CI that was sitting in my car constantly looking at his watch, getting more antsy by the second. Finally I said, dude settle down, you're starting to freak me out. He said, "I'm supposed to be in the gym in 20 minutes. I can't be late." I said okay dude, it's just a workout. We'll get you there as soon as this is done. He said, "you don't understand, I can't be late. It's what I do now instead of yayo." I said okay dude, we'll get you there but you had me worried. You're acting like you're using again. He said, "I'm always going to get high, now I get high on getting yoked." That was the moment I really got it, this is something legislation, and enforcement can't fix. This is an internal thing, that folks are going to fill one way or another until they figure out how to fix it.

  6. #26
    Quote Originally Posted by txdpd View Post
    There's a lot more heroin out there. Personally I think the problem is Narcan, it interferes with natural selection. Not all that long ago, an OD on heroin was a one time proposition. Now it's the same repeat customers. OD on heroin, fire department gives them a reversal in the field, then they want to fight because their high got ruined. If it's not already, Narcan is supposed to be an OTC medication.
    We have had several overdoses the past few months with a few fatals...one was an enlisted Airman from Seymor Johnson. Close by there is an agency that put out info on some crazy heroin that was really smoking people...its that bad.

    Bad heroin link: http://wncn.com/2016/04/20/nc-man-ar...oses-reported/

    We received training a couple weeks ago on narcan (naloxone) and we now have it in our cruisers...you know, first agency in area to have it and all that jazz...

    http://www.newsobserver.com/news/loc...e78801472.html

    ETA: the local methadone clinic...you should see people flocking to that damn place all day, everyday.
    Last edited by KeeFus; 06-24-2016 at 02:13 PM.

  7. #27
    Site Supporter Nephrology's Avatar
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    Quote Originally Posted by Eric Long View Post
    I suspect you had physiologic dependence, which is not addiction. I don't like to parse words, but those are important distinctions in this discussion.
    E
    What is the difference, exactly? I had pretty bad diarrhea, some fever, chills, sweats, insomnia etc that lasted ~48hrs. I was taking 80-100mg of oxycodone per day in the 10 days leading up to my abrupt d/c, ramping up from a starting dose of probably 20-40mg qd.

    I've needed some non-school reading for a while - thanks for the suggestion. I'll order it today.

    Quote Originally Posted by Paul Sharp View Post
    Sorry for your loss breakingtime91. Heroin is evil.

    During my time as an undercover I saw the trend slowly moving towards heroin. My group had moved into prescription drugs and the "party" drugs so I wasn't really seeing what the guys working street drugs were dealing with, until those worlds came together in heroin. When we would get to together to deconflict there would be a lot of, "Holy shit, you're working xxxx too?" Yeah, but we're working him/her for heroin. "So are we!". We started to see a trend... My last year in the unit we saw the soccer moms that were taking their kids ADHD meds, and the folks going from doc to doc getting their pain scrips filled, start to move towards heroin. It's cheaper, easier to get, with less hands involved in the transaction. As we started to pick off more docs selling scrips, it became more difficult for the opiate addicted people to get their drug of choice. I believe heroin filled that void. My contacts went from a doctors office in xxxxx to some dude on the west side of Chicago. It wasn't overnight but gradually we were no longer looking for the guy in the Tesla parked in front of the Whole Foods, now we were looking for the dude in a hoodie wearing a red St Louis Cardinals cap sitting on a bus stop bench across from a church.

    I think a couple things happened. Doctors, and staff started getting popped off for selling prescriptions. The ones that were involved but didn't get caught up yet, stopped before they got caught. Then legislation was passed that made it more difficult for folks to get opiates. The docs could no longer call in your opiate refill, you had to go see the doc to get a refill. The various docs and pharmacies implemented a computer system that allowed them to see that this patient just got a Vicoden refill from their dentist last week, so no vicoden for you. That source started to dry up fast. This created a void, heroin filled that void.

    The frequency of OD now has a lot to do with drug quality, misinformation, and voodoo BS the users pass along to each other regarding what to do when someone is OD'ing. With pharm grade opiates they knew what they were getting. There would occasionally be an OD due to opiates but that was rare and usually in conjunction with alcohol. With heroin, folks just don't know what they're getting. There is probably some heroin in there but there is also a lot of bad stuff. We had a string of deaths in Chicagoland after a bad batch of heroin came out of the westside. It didn't slow the end users down, they just tried all kinds of juju to figure out if the bag they just bought was the bad stuff or not. The other issue is strength, which also relates to purity/quality. For example, a guy has been buying a stick that's 1/3 heroin, 2/3 filler/bunk. He hooks up with a dude that sells him a stick that's 9/10 heroin? It's going to wreck him. Then his buddies decide the best way to bring him out of it, (if they don't freak out and leave him for a few hours before they actually do anything to help him), is something some guy at the Phish concert told them to do if they ever OD... By the time an officer or paramedic shows up with some Narcan, and can transport the guy to the ER, he's been under a long time. This contributes to the lethality of the ODs we're seeing.

    I think the way forward is education. Prohibition doesn't work, just like the thread about taxing soda. Come on man, do we as a society still believe you can hit someone with a stick to make them change behavior that's generated by internal issues? All it does is make them find ways to get what they want while avoiding the stick. If we figure out how to fix the internal issues they won't need the thing to fill that void. I always think about a CI that was sitting in my car constantly looking at his watch, getting more antsy by the second. Finally I said, dude settle down, you're starting to freak me out. He said, "I'm supposed to be in the gym in 20 minutes. I can't be late." I said okay dude, it's just a workout. We'll get you there as soon as this is done. He said, "you don't understand, I can't be late. It's what I do now instead of yayo." I said okay dude, we'll get you there but you had me worried. You're acting like you're using again. He said, "I'm always going to get high, now I get high on getting yoked." That was the moment I really got it, this is something legislation, and enforcement can't fix. This is an internal thing, that folks are going to fill one way or another until they figure out how to fix it.
    Great post - thanks for sharing.

    I will also add that when I was in my junior year of undergrad (2008-9) I had several students at my small liberal arts college die of heroin overdoses. The majority were likely fentanyl contaminated. Fentanyl is evil shit and the idiots who add it to their junk are clearly not doing it in a homogenous fashion. You get the wrong piece of the wrong batch and all of a sudden you have 4x the LD50 of fentanyl onboard plus whatever heroin/rat poison/garbage was in there too. I know for sure that is a big part of it but I don't know why this is new - fentanyl has been around for a while, and if anything its availability should be drying up with the FDA cracking down hard on Rxs.
    Last edited by Nephrology; 06-24-2016 at 02:19 PM.

  8. #28
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    I live in the overdose capital of the country, literally. I can't begin to count the number of people I know who have ended up on heroin. For that matter I've lost count of the people I've known who died on it. It's hit every demographic and seems to hit them equally. In my experience the problem comes almost entirely from the prevalence of prescription drugs, be it from pill mills, lazy doctors, or simple overprescribing. Until something is done about the way drugs are prescribed nothing is going to slow down the heroin epidemic.

  9. #29
    Quote Originally Posted by psalms144.1 View Post
    May be a clue there in how we respond to the current crisis - with the Mayor of Rochester, NY advocating tax-payer-funded medically-manned "shoot houses" so addicts can use their heroin safely...
    I believe I've seen studies that would suggest something like that would be a less-bad option to dealing with the issues that addicts face (e.g. OD'ing with no one knowing). Unfortunately it does nothing to solve the underlying issues.
    Last edited by scw2; 06-24-2016 at 02:28 PM.

  10. #30
    Member Kukuforguns's Avatar
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    Quote Originally Posted by Paul Sharp View Post
    Sorry for your loss breakingtime91. Heroin is evil.

    During my time as an undercover I saw the trend slowly moving towards heroin. My group had moved into prescription drugs and the "party" drugs so I wasn't really seeing what the guys working street drugs were dealing with, until those worlds came together in heroin. When we would get to together to deconflict there would be a lot of, "Holy shit, you're working xxxx too?" Yeah, but we're working him/her for heroin. "So are we!". We started to see a trend... My last year in the unit we saw the soccer moms that were taking their kids ADHD meds, and the folks going from doc to doc getting their pain scrips filled, start to move towards heroin. It's cheaper, easier to get, with less hands involved in the transaction. As we started to pick off more docs selling scrips, it became more difficult for the opiate addicted people to get their drug of choice. I believe heroin filled that void. My contacts went from a doctors office in xxxxx to some dude on the west side of Chicago. It wasn't overnight but gradually we were no longer looking for the guy in the Tesla parked in front of the Whole Foods, now we were looking for the dude in a hoodie wearing a red St Louis Cardinals cap sitting on a bus stop bench across from a church.

    I think a couple things happened. Doctors, and staff started getting popped off for selling prescriptions. The ones that were involved but didn't get caught up yet, stopped before they got caught. Then legislation was passed that made it more difficult for folks to get opiates. The docs could no longer call in your opiate refill, you had to go see the doc to get a refill. The various docs and pharmacies implemented a computer system that allowed them to see that this patient just got a Vicoden refill from their dentist last week, so no vicoden for you. That source started to dry up fast. This created a void, heroin filled that void.

    The frequency of OD now has a lot to do with drug quality, misinformation, and voodoo BS the users pass along to each other regarding what to do when someone is OD'ing. With pharm grade opiates they knew what they were getting. There would occasionally be an OD due to opiates but that was rare and usually in conjunction with alcohol. With heroin, folks just don't know what they're getting. There is probably some heroin in there but there is also a lot of bad stuff. We had a string of deaths in Chicagoland after a bad batch of heroin came out of the westside. It didn't slow the end users down, they just tried all kinds of juju to figure out if the bag they just bought was the bad stuff or not. The other issue is strength, which also relates to purity/quality. For example, a guy has been buying a stick that's 1/3 heroin, 2/3 filler/bunk. He hooks up with a dude that sells him a stick that's 9/10 heroin? It's going to wreck him. Then his buddies decide the best way to bring him out of it, (if they don't freak out and leave him for a few hours before they actually do anything to help him), is something some guy at the Phish concert told them to do if they ever OD... By the time an officer or paramedic shows up with some Narcan, and can transport the guy to the ER, he's been under a long time. This contributes to the lethality of the ODs we're seeing.

    I think the way forward is education. Prohibition doesn't work, just like the thread about taxing soda. Come on man, do we as a society still believe you can hit someone with a stick to make them change behavior that's generated by internal issues? All it does is make them find ways to get what they want while avoiding the stick. If we figure out how to fix the internal issues they won't need the thing to fill that void. I always think about a CI that was sitting in my car constantly looking at his watch, getting more antsy by the second. Finally I said, dude settle down, you're starting to freak me out. He said, "I'm supposed to be in the gym in 20 minutes. I can't be late." I said okay dude, it's just a workout. We'll get you there as soon as this is done. He said, "you don't understand, I can't be late. It's what I do now instead of yayo." I said okay dude, we'll get you there but you had me worried. You're acting like you're using again. He said, "I'm always going to get high, now I get high on getting yoked." That was the moment I really got it, this is something legislation, and enforcement can't fix. This is an internal thing, that folks are going to fill one way or another until they figure out how to fix it.
    When you look street price for drugs from 1970 and compare it to today's prices, you'll notice that the price of drugs (adjusted for inflation) is cheaper now after three and half decades of the war on drugs. Simple economics tells you that this means the supply of drugs now is greater than it was 35 years ago. So, yeah, the war on drugs is a big bust if the purpose was to decrease the supply of drugs in order to protect people from themselves.

    My true condolences to those here who have lost someone to drugs.

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