Quick statement about my town,and naloxone.

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gtrplayer
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I will get right to the point. In July of this year (2016), we had already had more overdoses than we did in the previous 10 years, and all were contributed to an illicit opiate and a needle. This past week, October 3-7, we have had over 12 more overdoses. I used to hate those who overdosed because doctors see that, and are afraid to Rx any pain medication- well, some of them are.

Anyhow, in our community paper this past Tuesday, there was an article that mentioned the local YMCA was going to be giving a free training class on "Opioid Overdoses and Reversals." On the surface, that looked fine. After re-reading the article, I realized it said that "those in attendence will receive a free "reveral kit", and be given proper instructions at to how to use it.

Those of you who are my friends here, like Goat, know that I think this is a God awful idea. It simply spreads the wrong message by saying, hey, we've got naloxone here, if you overdose, I'l shoot you up with the reversal drug. I was sicked to see that. I know some people will come along and tell me I'm being too harsh since these addicts can not help it. Fair enough in regards to the addicts not being able to help it- but what about those of us who have to live in neighborhoods where this stuff happens frequently? Property value goes down as the hooligans and drug addicts move in and ruin the neighborhood.

Lastly, and I am 100% positive that this will make me catch heat: After the first time that medical personal rush to the scene to reverse an illicit opiate overdose (I say illicit due to the filter), the person who overdose should, at the very least, be ticketed. Firefighters are trained to fight fires, although the majority of them are also darn good paramedics.

In summation, I find this whole even deplorable (sorry Donald Trump for using your absolutely ridiculous word there). If an addict knows that they have naloxone laying by, what is going to keep them from pushing the envelope to the point they do need a naltrexone shot? It is really sad. We have homeless families here in my town who sleep under bridges when it's cold, have no air conditioning when it's hot, and live absolutely miserable lives. We not help these people first, before we start helping the out of control drug addict? Also, insurance or not, I believe each overdose victim should have a voluntary medical stay at the hospital for 72 hours- the same amount of time that A person who self-harms themselves through cutting their skin or threatens to kill themselves all the time.

Yes, Naloxone will save people. Most likely, the same darn people that have already been saved before. If the patients dont learn, lock them up so they can go through their withdrawals and come out a better person.

OK, that was my rant for this morning. I am sure if anyone ansers this, they will most likely disagree with what I had to say, and that is fine. I will not budge on my belif system regarding addicts who constaly tie up the first responders, even though the first responders have other runs they need to be on.

Yes, an addict's life matters. However, it is the addict themselves who are putting themselves in harms way. I sympathize with those who are in the grips of addiction to opioids, but disagree with our community having town hall meetings with the sole purpose of showing how to check the airway, and administer narcan.

Again all thoughts and comments are welcome. If someone can prove me wrong, I will redact my statement. Just a heads up, though. If you ask me something corny, like: "what if it was your siser who was overdosing?" I will tell you right now- spare youself. All of us are adults. If she chooses to become a junky, which I very highly doubt, that is on him or her. Nobody makes anybody binge on H.

Ok, lets see how many people I made mad now.

goat
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re:

  I say after the first life saving dose of narcan the user needs a time out in jail where they would be given a long acting opiate reversal implant.  Many are recieving anywhere from 2 -15 narcan hits.   

  what i find sad is listening to scanner traffic when a od happens and the police have nowhere to drop any children on scene.......how frightning for a child of any age...

gtrplayer
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Couldn't agree more

Even though the consensus is beginning to switch to "this is a disease, not something they want to do", I whole heartedly agree with what you said. I have even suggested that, just like any other person who harms themselves and requires police, or ambulance, assistance, these people need to be treated as a threat to themselves and spend 72 hours under the watchful eye of trained medical staff.

Naloxone is not the answer. It's simply a safety net for those who want to push their limits and see how h igh they can get. These people need to be placed in a sober living community and learn to live without the H, because sooner or later, it will bury them.

 

gaucho
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UK perspective

Here it is considered common sense to issue two pre-filled syringes of naloxone in case of accidental overdose, and it is encouraged by Government, with the proviso it be used to stabilise the patient until arrival of emergency services.

It is considered to be a huge success and as having saved many lives. The scheme is being expanded. The literature dealing with this, available at all doctor surgeries and needle-exchange scheme pharmacies, is quite different in tone to the rather pessimistic view (and the way of life of opioid dependents, which applies to a minority, but a visible one) taken by Gtrplayer - it is considered a huge success and a potential life-saving initiative; nothing I have seen or read disputes that, and the kind of idiot junkie with the devil-may-care attitude isn't my experience of most opioid users, who are generally ordinary people holding down often rather high flying and lucrative employment in the Law, accountancy & similar professions, and that the comic-book junkie is a minority, only because they are the ones seen on the streets.

goat
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ohio

  dayton ohio has issued narcan to the metropark rangers.  people are not happy as the junkies will go do their thing in the parks knowing if they od help is near.  I dont see junkies here in florida like up north.
 I know they are here but its more low key.  

gtrplayer
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This could happen, right?

Ill admit, I hate the fact that so much of my towns resources are going to making sure these people feel secure enough to overdose multiple times in a month with no punitive action taken against them. The junkies who continue, day after day, to cause a diversion of ambulances and law enforcement to them as opposed to an 80 year old who has fallen don't even get billed for the ambulance run. Not that junkies usually care about matters pertaining to money other than, "can I afford my next fix yet, or do I need to steal another stereo?" Which got me thinking; if junkies carried naloxone (they don't because others, do) what are the odds that one of them wouldn't just jab the other one with naloxone to upset their junky buddy who just shot up? Pretty slim, but funny to think about.

 

Rocker Dan
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Getting much worse

The problem is not getting any better,it is getting much worse even since this post started and now it seems that the entire state of Ohio will be taking court action aginsist the major drug companys who marketed Oxycontin and Oxycodone.I do not know nor do I pretend to know what on Gods green earth we should do. As far as the Narcan debate most all of the solutions above are really "spot on." But we have to understand that we the pain people are being grouped with "the other ones"even if we do not like it!!! We cannot just say to ???$* with them,because weather we like it or not,we ARE being picked on by our own doctors and that is that!!! I have to go to the ropes every two months with my doc and like it or not my doctor(and other peoples doctors)are using the "Narcan people"As an exsamle in order to "thin out the heard."I finaly jumpped up to my feet and yelled at my doctor and read him the riot act as to do with the current state of afairs.I really like my Doc but I will be damned if he thinks for one second I will fall for strong arm tactics to cause my dismisal from his program. We must be well read as to what is on the new's and able to debate any and all storys.Keep in mind most doctors are truly trying to "thin out the heard" and our rights are shrinking every day in every way.....Keep on keeping on!!!      Peace, Rocker Dan

 

gtrplayer
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 This case needs to be thrown

 

This case needs to be thrown out. Desperate moves by a few desperate states does not establish a cause/effect relationship. Show me medical records that prove someone who overdosed on H ever had a valid prescription, in their name, for an opioid. I want to see the toxicology reports as well. 

Unfortunately, there are too many families who will latch on to these lawsuits because they all want to believe that someone other than their loved one is to blame for their demise. 

Munchkin
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I think it is a little

I think it is a little heavy-handed for people who dont suffer from addiction to make comments on things they don't know the first thing about. First of all having narcan readily available and the thinking it is going to cause addicts to push it more is a simple untruth. No addict ever wants a hit of narcan. They do not want their dosed reversed..at all..ever..I can assure you so thinking they are going to use more and more and even more recklessly just because they have narcan around is simply false. As a user myself I have pushed the envelope on many occasions with no narcan in sight. Dying doesn't even occur to me, it never crosses my mind as a fear at all. Maybe if it did I would go to greater efforts to stop..but that's neither here not there. Regarding the comment about going through withdrawals, that isn't even remotely a deterrent. Like a woman and childbirth you simply forget the pain. I spent 8 months in jail and after a grueling detox that lasted days and days and 8 days spent in a real hospital..what did I do when I got out? I used..didn't even wait until the next day, I used that night. The thought of possibly having to get sick and starting the process over again was of absolutely no consequence to me. 

As far as the junkies moving into your neighborhood and driving down your property vaule, I have news to you. Addicts are everywhere in every neighborhood, lower, middle or upper class it simply doesn't matter. Just because its more transparent in lower class neighborhoods or the inner city doesn't mean it doesn't exist in other neighborhoods. What makes a street addict any different than the soccer mom that is strung out on benzos, the college professor that pops pain killers in the closet or the wall street executive that binges on amphetamines and crystal? Absolutely nothing. Just because one can maintain a functional lifestyle doesn't make them any less of an addict than someone sleeping behind a dumpster. I live in an upper-middle class neighborhood, long island in NY.

I am not posting this for comments on how selfish I am or any other cliche platitudes, nothing you can throw at me that I haven't already heard. But think about this. I started out like many regulars on this board. A bad car accident that led to a spinal fusion, pins in a badly broken leg and I was left with massive amounts of chronic pain. I was prescribed opiates(oxycontin and dilaudid, but I also tried hydrocodone, morphine and fentanyl patches) and I took my opiates as prescribed for quite a while..I'm talking close to 8 years before any issues started. One day I remember my pain wasn't controlled anymore, I was getting frequent bouts of excruciating breakthrough pain that my meds weren't touching, my doctor refused to increase my dose so I took matters into my own hands. I started doubling up and you know how that goes. I was out two weeks early so started buying pain pills on the street. That became too expensive and if the person you were getting them from was out you were out of luck until the next month. So I turned to the illegal opiate out on the street..easy to find, cheap as heck and the best pain killer I ever tried. So before everyone wants to sit in judgment of addicts..think that it could happen to absolutely anyone of you. I take responsibility for the way my life is. I don't blame anyone. I didn't have a problem for a long time and I turned to the street because the pain relief wasn't effective anymore needing me to escalate my dosage. Maybe if I had a more compassionate doctor things would be different. And lets not forget overdoses from prescription opiates are at an all time high. Every overdose that ties up ems is not necessarily a street overdose..you can bet someone somewhere consumed too much oxycodone, Xanax, morphine, fentanyl..whatever.

Just something to think about and making comments about narcan that are simply not true is simply reckless in my opinion.

gtrplayer
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While I sympathize with what

While I sympathize with what you went through, I still stand by what I wrote. If your chronic pain was not being controlled, and your Dr did not want to increase your meds, why not try to find a different doctor? At what point does someone decide, "%?#$$ it, I'll just try shooting xyz into my vein"?  

Local police are routinely being sent out to the same addresses, same people, and same results every time. 

Tux
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Munchkin

Excellent post. Your story is the perfect example of how several people who are (were) on a controlled regimen of pain meds for their chronic pain lost the management, or control of their pain due to a (possible) change in their physiology, and the doctor didn't investigate the cause, just assumed the patient "wanted" more pain meds. The patient then finds the meds wherever they can, eventually turning to stronger substances and it's out of their control. As you said, you don't concern yourself with self-preservation, now it's not only pain relief, but the feeling that comes with the substance use. Psychological addiction.

This is a side of addiction that I have never seen discussed. I try to see the world from the other person's shoes, and while I've never been addicted to anything in my life, I can certainly see your point of view, and I am sorry it has worked out this way for you.

Before anyone jumps on me, please be aware of this particular issue and the ramifications. I believe it would make a useful discussion of how some addiction happens, becasue no one ever focuses on this aspect of it.

I can think of at least one person on this board who regularly takes more pain meds than is prescribed because they think that will control their pain, (it doesn't) and they have posted this usage more than once. They seem to be angry at their doc for cutting their dosage, and refuse to take any &*&? from the doc. To that person, I say this: Do you want to die? Are you aware that the more opiates you take, the better your chance to stop breathing? Do you have a narcan kit at home? I do. My doc's office requires (and supplies) it for people taking opiates, and instructed two people on how to use it, in case they can't wake me up. Have you ever been talking with someone and fell asleep talking to them because of your opiate medication? Can't keep your eyes open? That's an overdose.

I read about a h addict many years ago, who use to call an ambulance before he took his dose, because he knew he would stop breathing, and at least they could get there in time to revive him. How messed up does that sound to us non-addicts?

While narcan kits do save lives, and I can also see how frustrating it is to people who aren't addicts to see the same people being saved over and over again, it's really not our decision to make. It would be interesting to see how the decision to implant a person with continuous release nalaxone would play out in court, because that's where it would end up. It reminds me of the "mandatory" birth control that was ruled by judges for women who 1. had too many kids, 2. couldn't take care of their kids or 3. had a mental problem and shouldn't have kids. Who makes that decision?

It's heartbreaking to see people overdosing over and over again. What if you accidentally over-dosed on your opiate medication? Should you then be required to be implanted with continuous release narcan from then on? If you saw an overdose, would you call 911? Would you do it a week later? I know seeing this isn't easy, but being the one to make the decision of who lives or dies... could you live with yourself?