This is not to lead to talk of opiate abuse

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goat
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 I wanted to share a news story wanting your thoughts...this could save many lives

 

http://nbc4i.com/2016/02/01/ohio-cvs-stores-will-start-selling-life-saving-[filtered word]-antidote-over-the-counter/

sandi123
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My husband is a police officer and EMT and daughter

Is an EMT, and I think that this is a phenomenal thing! Allowing people access can literally make the difference in whether someone lives or dies, before EMS or the police can get there...

gtrplayer
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This is a bag of worms to be, to be honest.

Hey Goat! Hey Sandi! Since I don't know Sandi very well, yet, I will tell her a little bit about my hometown and the problems we are facing. I know, Goat, you already are aware of that through our PM's.

Around a year or so ago, a Dr's office one county over got raided because they were actually running pill-mill. The type where people show up by the van load, no insurance cards accepted, go in, pay X amount for the script, and leave with said script. They actually had a sliding scale as to how much certain things was going to cost- and these Dr's were in their 80's. Long story short, they got greedy. Really, Really greedy. Needless to say, after the raid, my town was flooded with junkies (just calling it as I see it, sorry if it offends anyone). I had been at a pain clinic for over 9 years when this happened, and due to this pill mill (I did not go to the pill mill- never even knew it existed until it was on the news), I was kicked from my pain management group because I was on Klonopin, which they had known the entire time I was a patient there, and they never, ever had a problem with it. After the pill mill group got arrested, and every single one of them was sentenced to some form of extremely lenient jail time, it was nearly impossible to have your pain treated.

Speaking as a legitimate pain patient of ten years, the very fact that something like this happened in Indiana made it next to impossible for those of us with documented procedures, documented MRI's, even referrals from top notch physicians, to receive pain care. I got lucky in the sense that I was only without meds for about a month before I finally went to my regular dr, and he got me in to see a newer pain dr here in Indiana. So, what does this have to do with Goat's original post? I'll tell you.

After the pill mill shut down, our streets were flooded with a deadly substance that is an opiate, begins with H, and will be blocked by the filter if I attempted to type it on here. At one point, my town alone was averaging around 8 opiate overdoses (non-prescribed opiate, of course) per week. It got so bad that a local agency here in town set up a coalition for sober living, or some ridiculous thing like that, and they convinced my town's common council to pass legislation requiring all paramedics, sheriffs, andpolice officers to carry Narcan/Naloxone. In theory, it sounds great. The police or paramedics show up, save a life, and then what? The cycle repeats itself over, and over, and over. I will probably catch grief for this, but I do not care: if a junkie knows they can overdose, and the first responders will bring them back from the dead, how does that encourage the person to stop using? I stated on a Facebook page that I was sorry, but this does nothing except to prolong the problem.

Do I want to see people die? Of course not. However; I also don't want people to believe they have a free pass to be an idiot with opiates. The number of opiate overdoses, in my county, since the police/all first responders, started carrying narcan/naloxone has not gone down at all. Thank God, it hasn't increased, either, but what good are we really doing if we continually save someone who is constantly overdosing? There are some who will never hit rock bottom until they die. In the meantime, these people who continually overdose on an illegal opiate still try to get legal opiates to tide them over, which just makes the chronic pain situation worse than it was before.

I can feel the hate coming my way before I even post this, but I'm going to say it even if no one else does.

If you overdose on an illegal opiate once, and are brought back- consider yourself lucky, and run with knowledge that you would be dead had a first responder not been there. If you overdose a second time, maybe using naloxone on you just isn't a good idea. It's just another way to support someone's habit.

With that being said, I have a picture to post regarding chronic pain that I took Monday night, while at the ER with my nephew. He was running a 104.3 F fever, and for the first time in a long time (those of you who remember me taking care of my grandma, and being fed up with the drug seekers causing us to lose valuable time while she was in renal failure and CHF might remember my agitated posts back then), the waiting room was empty. At 12:45am, Tuesday morning, there was not a single soul waiting to be seen, and I will post the reason in a seperate thread so as not to hijack Goat's thread.

Regards,

Josh

gtrplayer
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Unable to upload a new image

So, I will post it here instead. Hopefully it works this time. I accidentally uploaded my latest MRI report, and had it on the site for about 30 seconds before I realized what had happened. Oh well, live and learn. To Kirby, and the other admins, I am sorry for not making this "thumbnail" size. I wanted it to be big enough to read and catch people's attention. You should be able to download this image, or enlarge it simply by clicking on the image.

Again, I agree 100% with the hospital's approach to chronic pain. If you have a chronic pain Dr, and are in pain, call your pain doctor's office. There will almost always be an "emergency" number if you must reach your pain specialist. However, I am at my 2nd pain management group (decent group by the way, I like the way they conduct their business with a no BS attitude), and both my first, and this pain group have stated the same thing to me regarding pain: Unless it's in your chest, appendix, or some form of a headache you've not experienced before and may be having a stroke- pain is not a true medical emergency. When it comes to pain- just avoid the ER's, please. As bad as my pain has gotten at times, I knew that I was not going to die from it, and easily made it through the worst chronic pain flare ups, without having to see an ER doctor.

 

 

sandi123
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Hi Josh

You will get no flack from me, regarding your feelings or your comments.
I live in NYS, suburbia, and we are experiencing a huge problem with the very same illegal opiate.
While I am glad that my husband and daughter are and have saved lives with the use of narcan, and I am proud of that, I mostly agree with the rest of your sentiments in substance, I do know of a few instances locally where family members of addicts have used Narcan sucessfully to save their loved one. In three of those instances, two were long term drug abusers, recently(within days)released from their most recent stay in rehab, who subsequently used and od'd.....two of the three were readmitted into longer term rehab, one continued to abuse, and has since od'd twice more in the last two months.
I also know for a fact, my area is experiencing an increase in illegal opiate deaths at a rate that is downright scary.
I don't know what the answer is, but I do know as a parent, if it were my child with a drug problem, I would want access to have something available to try to help save my child from an overdose, but you can bet that it would be the first step in getting them every avenue of treatment available mandatory, not just a temporary way to enable their ongoing abuse.

sandi123
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If more hospitals adopted policies

Like this one, you would see far less ER trips for pain treatment....
Kudos to the hospital!

gtrplayer
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Hey Sandi! I am glad to hear

Hey Sandi! I am glad to hear that your family members were successfully brought back via the use of Narcan(or naloxone, whatever we want to call it).

I did not want to come across as some "holier than thou" type of person- I'm not that way at all. I just spent so dag gone many nights with my grandmother complaining she couldn't breathe (effects of end stage renal disease, as well as congestive heart failure) in the ER, and while they did "fast track" her 90% of the time, I couldn't help but feel as though the drug seekers were causing a delay in her treatment which she desperately needed. I hope this does not come across as me being "wishy-washy" on my stance regarding Naloxone, but over time, I have kind of developed the feeling that the first time someone overdoses, they should receive narcan to save their lives. However; Ive probably seen one too many "Drugs, INC", especially the one that focused on trying to give practically everybody who might see someone overdosed, vials of narcan to administer. If we, as a society, would quit taking the "band-aid" approach to addiction, we might actually improve not only the lives of addicts, but when addicts are clean, the communities seem to be cleaner, too. 

My "proposal", regarding Narcan, would be very straightforward and simple: If you are administered Narcan, you must commit to a minimum of 3 months towards achieving sobriety. The problem with that is, while posessing these narcotics is illegal, there is nothing illegal about overdosing. Sure, we all know that for people to overdose on this substance that Narcan reverses, they surely would have possessed the drug prior to OD'ing. Yet, through various loopholes in our ridiculous war on drugs, there is no way to prove that the person who has overdosed ever actually possessed the substance,or if the person was "given" the substance unknowingly. So, as much as I would love to propose a mandatory stint in rehab after someone has to give you Narcan, I just don't see it happening.

Unfortunately, I am afraid that illicit opiate users will view having OTC narcan avaiable to them as some sort of "fail-safe" method of protection. The only person I know, personally, who has ever overdosed was my grandmother- and it was on Fentanyl. I told her anesthesiologist, at her doctor's request, that she can in no way be given Fentanyl, because after they used it on her about 3 months earlier for a colonoscopy, it took her 3 hours to "come to", and she was shaking like banshee. (Do banshee's shake, or just howl?)

The dr placated me with the same routine I'm sure thousands of anesthesiologists tell worried family members; "if there is a problem, I'll be right there to take care of it. You don't need to worry." Well, turns out the A whole left the hospital after grandma was wheeled to recovery, and he failed to respond to his pager for 90 minutes. I kept telling the nurse to give her narcan, and while she agreed it was needed, she could do nothing without the anesthesiologist's orders. Heck, I even went to the ER, and the ER dr told me he could not get involved. 90 min later, they administered several doses of Narcan, but it was too late. The fentanyl brought on a massive stroke, along with the worst vomitting episode I have ever seen, and for the next two years, we watched this poor lady we all loved get treated like a 2 year old. She never regained her memory of who we were (her family), said some of the most outrageously offensive things to people that made no sense, and just in general, lived a horrible life for her last 2 years through no fault of her own.

I got off topic, but wanted you to know that while our circumstances are different, we have both had loved ones need narcan. It can be a temporary life-saver, but in the grand scheme of things, it does nothing but reassure an addict that they can push their limits, knowing that if something happens, one of their friends just has to stab them with a vial of narcan. I usually despise, with a passion, talking about overdoses, and drug abuse. Unfortunately, if Narcan becomes available OTC, I have a feeling it is something I am going to be forced to write about, a lot.

I really hope more people chime in on this subject, because I would be very interested in hearing other's views on this. My city went from one that people strive to get to (and I am not bragging, I did nothing to "earn" my way to this city other than being born), to one where people have become afraid to be out late at night for fear of being approached by the wrong person (beggars, mostly). When an addict desperately needs his/her fix, they are unpredictable. For that very reason, if I see someone who I just know is going to ask me for money (to support their habit), I will make every attempt to avoid said person. I am not saying that i look down on drug users- maybe it's not their fault if we subscribe to the addiction as a disease side of the argument, but I can't think of any other diseases that were actually caused by the person with the disease making a horrible life choice.

Rehab, not narcan, is the only way to beat this thing that is engulfing our cities and destroying countless lives. Unfortunately, with our absolutely whacked out medical system, and their weird views on what constitutes "proper treatment", I fear addicts will just be forced to live in addiction- unless someone decides to make a statement and buy as much of the Narcan as possible, in an attempt to basically make narcan unavailable. In which case, the problem ends up solving itself, unfortunately, through what basically amounts to Darwinism. 

Personally, I will not be purchasing any OTC narcan for any reason. To continually save someone is to give them a false sense of security, and then it's people like you, and me, who are not drug abusers, who are looked to to try to save an overdosing person. I still say "everybody gets one", in regards to narcan administration, especially if it's an honest mistake. However, if it hapens twice, that person is basically telling us "I didn't learn from last time". 

Or, a much simpler approach would be to raise the cost of OTC narcan (not prescription, I know many pain patients carry narcan just incase they have a bad reaction to their pain meds), and make the cost of OTC narcan so high that people will have to decide if they want to forego their next fix in order to get their "overdose insurance", or just get their fix instead. I know I have typed A LOT,  but my thoughts keep evolving as I type this.

Sandi, my name is Josh by the way, so feel free to call me Josh on here. You, and Goat are practically the only two people who keep this site active. So, by all means, if we can carry this conversation on longer, I am all for it. I know we have some Nurse practitioners, pharmacists, even doctors, who visit this site. Unfortunately, the majority of them do not post, despite the fact that we would all love to hear from them!

Take care, I'm going to get my 4 hours or sleep!

Josh

 

goat
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Josh

Good reply Josh.  I moved from southern Ohio in 92 and it has rapidly went down the tubes. Ohio residents used to load a van full of patients and drive to Florida and hit up a few clinics and now since that has been stopped they are turning to illicit opiates just as your reply stated.

Like I shared in my pm, I have a hometown group on FB with over 9000 active members and every couple days there are drug related crimes,car chases,murders and ODs. You have given me some good points to share with them concerning this new policy.  Stay healthy everybody.

sandi123
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Josh

It was not my family members who needed the narcan, but rather use it in their career fields, one a police officer and EMT, and the other an EMT/training as a paramedic....
I agree with everything you said, in regard to having orc narcan, potentially becoming a fail safe to continue to abuse opiates, illegal or otherwise. It is a bandaid, and I tend to think that mandatory, inpatient programs, with strict compliance testing and monitoring is the real answer.
We have a society today, where we are willing to throw bandaids at problems,rather than heal the wound..
Unless and until we stop making excuses for bad life choices and decisions, and stop applying bandaids , and wasting billions of dollars that would be better spent on addressing the real problem, poor decision making, failure to accept responsibility for our decisions, we are left with bandaids.
I am not 100% behind the addiction is a disease theory, never have been. While I do believe that there is some generic factors that play into abuse of substances, there is still the personal responsibility in making the decision to use in the first place.
I grew up in a family where both parents and several relatives are alcoholics....for me, that meant that I needed to be aware that alcohol could become a problem if I allowed it to become one, so I never did.
I would like to see others input on this as well. It would make interesting reading and discussion.

gtrplayer
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Sorry for mistakingly saying it was your family members:(

Hey, Sandi,

I very, very, sincerely apologize for misreading your post and posting that I was glad your family members were saved. I have no idea why my brain interpreted it that way, but it was my mistake, and for that, I apologize and admit to it. Please accept my apology, as it was most definitely not intentional.

I am 100% with you in regards to addiction being a disease. If anything, and this (in my opinion only) would be a huge stretch, I would think an addiction problem should be classified more as a disorder as opposed to a disease. Admittedly, I should know more about the differences, and what makes one a disorder versus a disease, but I haven't been doing as much medical reading lately.

I also believe that genetics might play a factor to some extent, but for the sake of conversation, let's consider the following: you stated that you grew up in a family where both parents were alcoholics. Therefore; wouldn't that make you much more susceptible to becoming an alcoholic? However; most of the people I know that come from homes where alcohol was a problem tend to avoid alcohol at all costs. While we are on the topic of alcoholism; if alcoholism is in our genetics (I'm putting myself in your shoes now, as well, despite not having any drinkers in the family- my father's dad was a raging alcoholic, and dad will have nothing to do with alcohol), and alcoholism is considered an addiction, which is considered a disease in the medical community- are we now predisposed to become addicted to any sort of addictive substances? I know there has been a lot of contributions to medical journals in regards to alcoholism, addiction, and all that fun stuff. However; it seems as though every time a well respected Dr publishes an article to support or dispute the disease theory, another well respected Dr will conduct a study using the same protocol as the previous Dr, and get different results. It's so common to see contradictive articles online, even in the medical journal sites, that I honestly think that we, as a whole, have no real definitive idea as to what causes some people to become addicts, whereas others can use their medication responsibly, or enjoy a single glass of one once a month.

I think to blame it on genetics alone would be entirely too premature and a rush to judgment. Heck, we may never fully know the scientific cause of addiction, but I think all of us with common sense have to come to the same partial conclusion that this disease is always caused by a lack of judgment and a poor personal choice. As I type this out, something else just popped in my head so I'm going to include it, although it breaks the continuity of this read.

My sister has diabetes. My grandmother had cancer. My father has polycystic kidney disesease. None of them did anything to cause their disease. My sister didn't shut down her pancreas. My grandma never smoked, or even drank alcohol, and my dad has always lived a clean life, even steering away from things as simple as NSAIDS. So, in my head,these types of medical issues are diseases; things that the person afflicted with had absolutely no control over. An addiction, however, always starts with someone using something they either should not use, or they overuse (abuse) something they were given the OK from their Dr via a prescription, to use.

I know that last paragraph does not flow with the rest of the post- but at the moment, I have to type it as I think it, or I will forget it. It x*#&s having ADHD, and not receive treatment for it. However, I think ADHD is a disorder, as well as my panic disorder for that matter, because each can be controlled with proper medication.

And again, I sincerely apologize for misreading your initial post and stating it was your family members that were saved. I can not stress that enough, and I feel terrible for making such a stupid mistake.

Hope all is well with you, and I'll check back to see what you post next. To the other pharmer visitors out there; Please join this discussion, whether you agree or disagree with what any of us have stated. Who knows, maybe reading someone else's viewpoint could open my eyes to other ways of viewing this?

gtrplayer
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Replying to Goat

I hear you, Goat. It seems that once this substance enters the community, the entire community goes downhill. I've seen teachers, counselors, even doctors arrested over this substance.

That is crazy that people would load up from Ohio to get to Florida in order to obtain certain substances. I remember a few years back when Florida was being used as the "test rat" for prescription monitoring, and it seemed every other day there was a report on the national news of a pill-mill bust in Florida. I firmly believe that, regardless if these Dr's have a spotless record with no prior run ins with the law, they should be dealt with severely. Even though all of the dr's here received prison time, the majority of them were given credit for time served, and released on probation after agreeing to surrender their medical license. Clearly, there is preferential treatment given to Dr's, as opposed to the street dealer, and it's simply not fair. For every bad doctor that creates a DEA case, ten more doctors become paranoid to prescribe medications that they know their patients need.

I'm not laying all of the blame on the doctors, but lets face it; there has to be a gas station in order to get gas (that's my best metaphor I guess). Matter of fact, as I stated in response to Sandi, I'm having a hard time obtaining my ADHD meds again. So, my parents were asked to come to my next appointment with me so the Dr could get their view on whether or not I had ADHD. I think my Dad summed it up best, after not speaking for 45 minutes and just listening to the dr, when he said, "OK,so there are bad doctors out there, we all know that. But you are telling me that you are too afraid to prescribe the medication he needs because a few doctors went completely crazy with their practice? Aren't you the Dr.? Don't any of you guys have the courage to stand up to the DEA when questioned and show them that you have documentation and testings showing that he is in this or that category?" He also then went on to explain how, if he approached his job at Chrysler, as the Head of Quality Inspection, in the same manner that dr's are approaching the DEA questioning their every move, Chrysler would have went out of business many years ago.

Not sure that really added anything, but, I'm having a hard time keeping my thoughts together. I usually post later at night now because that's when I"m calmest, and can make more sense:)