breakingtime91, condolences for your loss.
breakingtime91, condolences for your loss.
Thanks guys I appreciate it. It really is something awful for the family to go through. I wish it was easier to reach people before they fell into the grips of heroin because it is nearly impossible for people to shake. It is also important to realize that it effects everyone, there is no stereotypical addict. We came from a good home, middle class, and with loving parents.
Wet doctors and what they should be doing... I'm not a doctor so I won't try to tell them what the correct treatment for a specific diagnosis is. I would like to see far more monitoring of patients and less high speed production line clinics. It's VERY rare to have a doctor who actually spends time with a patient and reply understand what they are about. Heck 90% of the time I see a doc they rarely read my charts or history. I have 2 family members batting pain killer abuse. Both get rx without any issues cause they swap docs, pharmacies... and work the system. Not once has any new doc asked why is this the 100000th refill?
Not sure what the correct answer is. You don't want to deny people who truly need the stuff from having it, but at the same time you don't want to create and then enable the addicts either.
Yes, there's a huge uptick in heroin use. I think the main reason is it's gotten incredibly cheap. Yes, there's a huge uptick in overdoses. I think the main reasons is it's being mixed with fentanyl and quality control among dope slingers sucks. Fentanyl apparently makes it both cheaper and more effective.Originally Posted by Nephrology
Ex: Came across about 30 bindles of heroin on a search warrant. 3 tested negative, nothing but filler. Some others barely tested positive. Some were nearly pure. So, Johnny Doper uses a bindle, gets no effects, figures it's a weak batch, doubles up the dose and grabs two nearly pure ones, results in Johnny flopping around a lot.
Absolutely - one of my good friends in college got hooked on heroin. He got really lucky - he was able to get clean by getting a suboxone pump implant (Basically long term maintenance methodone adminstered slowly over time by a device under his skin) and moving literally 5000 miles away (Oregon to Israel) to start medical school. He's been clean ever since, but it was hell trying to get him there. Actually about to graduate as a medical resident and start his critical care fellowship.
and again, my condolences for your loss. Addiction is a terrible thing and knows no bounds whatsoever...
It is all over the place here... Seeing it in seemingly normal kids too... It freaks me the fuck out, honestly.
Also, I'm the guy that passes out from the "shooting up scene" in pulp fiction. Or the blood draw scene in Trainspotting.
I pale at the thought of that shit, right now... Seriously... Needles! WTF!
There are 2 basic reasons why physicians rush through appointments/exams: 1) pure laziness (probably 5-10% of the time) and 2) massive massive numbers of patients (90% or more).
That said, where I work in the ED we are really stingy about giving out prescriptions. We'll push morphine through an IV all day long if it's clear they need it or give them PO pain meds if they don't need the IV. We'll even write for a take-home bottle of narcotics if there is a clear indication, but it is no-refill (can't get refills without seeing an MD anyway) and usually only designed for a short course - usually ~3 days or so, basically enough to get them to somebody else if they still need it.
I have a really hard time understanding how an outpatient practitioner would write for narcotics if there wasnt a super obvious reason for it (cancer/long term orthopedic problems/etc). In the ED it is usually terribly obvious when someone is there trying to get drugs and we usually say "no" and show them the door very quickly. If/when they complain, we introduce them to our friends at the Sheriff's Office. I know we have a lot more experience with those types than most, so maybe some smaller clinics get bamboozled, but most of them are pretty stupid and impatient. I am still a medical student and I can pick them out within 30 seconds of walking into the room....
That's some scary stuff, man!
I live and work in NH, a state of about 1.3 million total population. For 2015, we had about 115 traffic fatalities and 435 OD deaths. Among those OD deaths, about 85% were opiates. 160 were straight fentanyl, 32 straight heroin, and 43 were a mix of both. Fentanyl is DESTROYING our user population.
I'm not smart enough to know exactly how people get doing the dirty-boogie, but the signifant changes in availability of pharmaceutical grade opiates has to contribute. Regarding OD's specifically, the Dominican trafficked "heroin" is a strong contributor. Most of our product comes through a couple of cities in northern MA, where the drug trade is dominated by a network of folks from the DR. This group is notorious for mixing or more frequently substituting straight fentanyl and selling is as China white. We don't see much, if any, black tar.
Anything I post is my opinion alone as a private citizen.
I am not in Law Enforcement but I do work in EMS. Where I am at heroin is on the rise. I went a couple of years in a busy system and never gave Narcan, now I give it every shift. It has crossed into every level of society as others have mentioned. In my area it seems to be coming in with the migrant field workers.
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