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pangstrom posted:The rest of the panel seems surprisingly decent. You have to be loving kidding me: quote:Bertha Madras, deputy drug czar to President Bush, told National Public Radio that users shouldn’t have access to naloxone because “sometimes having an overdose, being in an emergency room, having that contact with a healthcare professional, is enough to make a person snap into the reality of the situation and snap into having someone give them services.” Madras told another reporter: “It is not based on good scientific data … It’s based on what some people would consider the right thing to do. But the studies supporting it are so sparse it’s painful.” https://www.theatlantic.com/health/archive/2014/12/the-fight-for-the-overdose-drug/383467/ quote:Bertha Madras, deputy director of demand reduction for the White House Office of National Drug Control Policy, called San Francisco’s consideration of such a [safe injecting] facility “disconcerting” and “poor public policy.”
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May 13, 2017 00:51
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big cock Salaryman posted:if you're wondering, there is a more potent opioid antidote than naloxone, it's called diprenorphine and they sell it in kits along with the carfentanil for large animals. it is a weird drug, i believe it's a mixed-agonist-antagonist so while it will pull someone out of carfentanil death it may get an opioid-naive person high? not alot of data on its use. Honestly, unless a carfentanil bomb lands in The Tracks in the middle of the night, we're okay -- most people are pretty easy to intubate and only once have I had no vents left (and that was brief). Generally speaking, the biggest problem with naloxone is that it's too effective with the run-of-the-mill overdose. At some point people decided to slam in 2mg with anyone who needed to be reversed, when the actual initial dose is one-fiftieth that. But hey, it comes in 2mg vials for a reason, right? And then you have people barfing and crapping all over the place (I once opened a door to a room and saw a ninety-pound woman in her early twenties stand up on the bed, bend over, pull up the back of her gown, and spray liquid poo poo on a wall that was four feet away), plus other more serious complications like post-obstructive pulmonary edema. The medics and some nurses, though, treat naloxone like a solely punitive measure instead of a life-saving device.
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May 13, 2017 01:02
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Serious question relating to the approach of giving addicts a safe/clean/free place to use. How would this work for people with kids in America? Is there free childcare included with this service?
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May 13, 2017 01:09
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Danknificent posted:Serious question relating to the approach of giving addicts a safe/clean/free place to use. I've no idea whether they allow or bar children at supervised injecting sites in other countries, but either option is still clearly superior to not having the sites at all.
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May 13, 2017 01:17
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jabby posted:still clearly superior to not having the sites at all. Well, you say that. And I'm inclined to agree, at least for addicts who don't have kids. But for those that do, I'm just trying to think this through. The childcare providers would have to be mandated reporters; so if parents actually went and made use of that childcare, that would result in a lot of hotlines and a lot of kids being taken into protective custody. So even if there was that option, a lot of parents wouldn't use it. So what would they do? Leave the kids unsupervised, which would lead to hotlines? Or leave the kids with someone else? If they have someone trustworthy, that works. If they don't, then they're taking a new risk, one which also has potential for hotlines. It seems like a lot of risk and hassle for parents to make use of something like that, and I imagine a lot of addicts would rather just stay home. Walking into one of these places with your kid would be like raising your hand and saying "That's what my life was missing; CPS," That's not to say these services couldn't do good, but addicted parents are a major subset of the addict population, and it's not clear to me how this could work for a lot of them. I don't know how many of them would see using in a safe environment in exchange for losing their kids as a net gain, and if they have to jump through hoops/take risks with their kids to use it, why not just stay home and keep doing what they're doing? Just thinking out loud.
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May 13, 2017 01:41
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No, that's a reasonable thought - the hard question is, do we decriminalize/legalize for everyone EXCEPT those who put others in danger with their usage? Including addicts with kids? I don't really care if my neighbor wants to spike some heroin every night, provided it means he's not out harming anyone, or abandoning his kids in the process. I'd feel bad for him and would wish he'd seek help but ultimately that's his choice. So maybe an awareness campaign - "If you are an addict and want to use safely, we will help you. If you have kids and want to use safely, we will help you but your kids will be put into CPS/foster care until you can demonstrate that you've been clean and in some sort of program for X months. If you have kids and continue to use, and you get caught, your kids will still be put in the system and you will be prosecuted for child endangerment." There is no perfect solution - some people will always buck the system. But if it gives parents with an addiction an option, let's try it.
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May 13, 2017 07:44
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perhaps one can have their kids if they have enough rapport in a methadone program to have take-home doses so they dont drag their kid to the clinic every day? this also demonstrates several months of passing drug tests and generally taking poo poo seriously and not using needles
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May 13, 2017 09:25
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KingEup posted:You have to be loving kidding me:
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May 13, 2017 22:01
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Danknificent posted:Well, you say that. And I'm inclined to agree, at least for addicts who don't have kids. But for those that do, I'm just trying to think this through. This is just a catch-22 with no perfect solution. If an addict makes themselves known to services and they have kids, those services have to assess whether or not the child is in danger. You can't not do that, even if it will inevitably put some addicts off presenting themselves. The best solution of course is to provide as much support as possible with housing, welfare, healthcare, addiction management etc. to enable addicts to keep their kids with them and the kids to be safe.
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May 13, 2017 22:07
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jabby posted:The best solution of course is to provide as much support as possible with housing, welfare, healthcare, addiction management etc. to enable addicts to keep their kids with them and the kids to be safe.
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May 13, 2017 22:32
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tetrapyloctomy posted:There is part of me that would love for you overseas docs to come visit me at work to see what it's like here, but a larger part of me is just so embarrassed by how poorly Americans treat ... anyone who isn't themselves, really. hell you dont even need to be at a hospital to see it. free viewing everywhere
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May 13, 2017 23:02
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big cock Salaryman posted:hell you dont even need to be at a hospital to see it. free viewing everywhere Remember that time a wealthy suburban community tried to get rid of a statue of Jesus as a homeless guy on a bench because they initially didn't realize what it was, then because they were pissed off at the implications that they'd do exactly what they'd tried to have done?
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May 13, 2017 23:12
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tetrapyloctomy posted:Sadly, not approved for use in humans. poo poo, we get it as 0.4 mg up here in Canada. Even that'll wake someone way the hell up if they're down on morphine or hydromorphone or whatnot. Takes two or three vials to reverse a fentanyl shot though. It's kind of funny seeing the number of people these days who come in saying they want to get on suboxone to get off the 'heroin.' So I test their urine, and without exception the 'heroin' is just fentanyl, as in it's the only opioid in their system. No carfentanil yet, thank God.
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May 14, 2017 01:06
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Albino Squirrel posted:poo poo, we get it as 0.4 mg up here in Canada. Even that'll wake someone way the hell up if they're down on morphine or hydromorphone or whatnot. Takes two or three vials to reverse a fentanyl shot though.
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May 14, 2017 01:38
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I have to wonder why the dealers aren't honest about it. It seems like they could make more money selling it as fentanyl rather than cutting it with a bunch of poo poo and passing it off as heroin. You don't even need to inject it, which would make the market even larger.
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May 14, 2017 02:14
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Konstantin posted:I have to wonder why the dealers aren't honest about it. It seems like they could make more money selling it as fentanyl rather than cutting it with a bunch of poo poo and passing it off as heroin. You don't even need to inject it, which would make the market even larger.
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May 14, 2017 02:44
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tetrapyloctomy posted:The high reportedly is fantastic, but very short duration, which is why it's common to use fentanyl plus midazolam for conscious sedation when, say, reducing dislocation hips and such. Yea, in Vice's documentary on fentanyl abusers pretty much everyone on it would rather be on heroin because they could go longer without getting sick.
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May 14, 2017 08:51
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Someone tested drugs supplied by users at a safe injection site in Toronto and found that 80% of the cocaine and methamphetamine contained fentanyl. http://www.torontosun.com/2017/05/15/safe-injection-site-tests-show-approximately-80-of-drugs-contain-deadly-fentanyl
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May 20, 2017 23:05
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fentanyl deaths in Massachusetts averaged about 5 a day last year.
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May 21, 2017 04:04
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The tide continues to rise on this insanity- now two addiction counselors at a halfway house were found dead of fentanyl overdose. https://www.washingtonpost.com/nati...2ddb_story.html
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May 24, 2017 18:57
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Dmitri-9 posted:Someone tested drugs supplied by users at a safe injection site in Toronto and found that 80% of the cocaine and methamphetamine contained fentanyl. What the gently caress? Why would Coke and meth have fent cut into it? I don't mean to sound too conspiratorial but I can't think of a reason a dealer would do that. That's something you do if you want to kill people.
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May 24, 2017 19:00
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empty whippet box posted:What the gently caress? Why would Coke and meth have fent cut into it? I don't mean to sound too conspiratorial but I can't think of a reason a dealer would do that. That's something you do if you want to kill people.
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May 24, 2017 19:22
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empty whippet box posted:What the gently caress? Why would Coke and meth have fent cut into it? I don't mean to sound too conspiratorial but I can't think of a reason a dealer would do that. That's something you do if you want to kill people. Helps increase the chance of you getting addicted.
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May 24, 2017 20:52
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According to reports it's been popping up in an apparently non-insignificant amount of MDMA in Toronto also. One theory is dealers aren't exactly the most safe when it comes to cross-contamination (i.e. it could be accidental). And with something that potent that's loving spooky. Regardless, it's been occasionally killing club kids lately. https://www.thestar.com/news/gta/2017/04/08/1-dead-four-others-in-hospital-following-ecstasy-overdoses.html Mr Luxury Yacht fucked around with this message at 05:29 on May 25, 2017 |
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May 25, 2017 05:24
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Yeah, speedballs are popular in my hospital's catchment area. And as stated, I'm going to guess street-level dealers aren't all that concerned with cross-contaminated product.
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May 25, 2017 15:09
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Maybe it's just a harder story to write about and/or the condition is less-reliably recorded but it seems like there should be a lot of brain damaged people who almost-fatally OD'd.
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May 25, 2017 16:53
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Funny you should mention it ... I'm sure there are better data out there than some intensivist spitballing "90% of overdose survivors in the ICU," but it certainly doesn't sound too great, does it.
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May 25, 2017 17:08
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lol fentanyl. That's weak poo poo. Here in New Hampshire people are overdosing on Carfentanil. Which is 100x stronger. Its sole purpose is for tranquilizing large game such as elephants. http://www.unionleader.com/social-issues/Officials-Six-carfentanil-OD-deaths-in-NH-this-year-05242017 
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May 25, 2017 17:27
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tetrapyloctomy posted:Funny you should mention it ... What the gently caress? How is this not a bigger deal? Everyone talks about the tragedy of OD deaths, but apparently we're creating a exponentially greater number of brain-damage victims? They were already desperate and addicted before, adding in brain damage seems like a slow death sentence for them and everyone in their communities. And now the GOP wants to cut Medicaid by 800 billion...
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May 25, 2017 19:35
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There's a good amount that "survive" an OD and end up being in a coma with little to no brain left and needing a breathing machine. They'll "live" in a nursing home until an infection from a pressure sore or pneumonia gets them. There aren't any good statistics about how many people end up like this and they may not eventually be included in the number of overdose deaths.
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May 25, 2017 19:38
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the black husserl posted:What the gently caress? quote:Senator Jim Lankford (R-Oklahoma) was speaking to Chuck Todd about the CBO report this afternoon. When Todd asked him about CBO’s esitimate that 23 Million people would lose healthcare under Trumpcare, his response was (and I had to rewind to make sure I heard it correctly) “That really doesn’t bother me” Our Government-NOT OUR PROBLEM *rolls around on money
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May 25, 2017 19:39
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Lote posted:There's a good amount that "survive" an OD and end up being in a coma with little to no brain left and needing a breathing machine. They'll "live" in a nursing home until an infection from a pressure sore or pneumonia gets them. There aren't any good statistics about how many people end up like this and they may not eventually be included in the number of overdose deaths. People don't realize this enough. You go into the ICU for any reason you are hosed unless proven otherwise. It's a last ditch effort to keep you alive and oftentimes ends in that same sad scenario of slow, painful decline and inevitable death by inches. I can't see fentanyl being intrinsically more prone to causing anoxic brain injury than other opiates, the mechanism is the same. The difference is the circumstances of the overdose, time down and the wildly variable potency that makes ODing so commonplace ODs are the number one source of brain death and spare parts for the transplant machine at my hospital. We are a rich white people hospital so not a lot of ODs are dumped on our doorstep, but we get more than a few ICU transfers for neuro eval or MRI or what have you from the less rich less white parts of the state that had overdoses on some flavor of opiates. It's always tragic and miserable for everyone involved. The transfers are the worst because coming here gives the family false hope and these people are usually young and for the most part healthy-ish. A lot of the time we just keep their organs alive long enough to be transplantable.
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May 25, 2017 21:06
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tetrapyloctomy posted:Funny you should mention it ... They are treating fentanyl like a drug problem but they should be treating it like an industrial contaminant or chemical weapon and crack down on the super labs that are making this stuff.
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May 25, 2017 22:34
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Dmitri-9 posted:They are treating fentanyl like a drug problem but they should be treating it like an industrial contaminant or chemical weapon and crack down on the super labs that are making this stuff. No, this won't help. It is not something you need a 'super lab' to make, and even a kilo of fentanyl or worse, acetyl/carfentanil is enough for millions of doses. The only solution that will ever actually work is the end of the war on drugs. If people could take these drugs in safe environments, knowing what they were getting and its potency, there would be zero or close to zero overdose deaths. Opiates are not some loose cannon that you simply can't control - they are made that way by prohibition and the drug war.
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May 25, 2017 22:38
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Dmitri-9 posted:They are treating fentanyl like a drug problem but they should be treating it like an industrial contaminant or chemical weapon and crack down on the super labs that are making this stuff. The "super labs" are in the same places that legitimate fentanyl &c come from. Namely, China, India, etc. Cracking down on precursor manufacture basically made qualuuddes go away entirely but I don't see that with fentanyl or anything else as there are legitimate uses for those drugs as well as for their precursors.
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May 25, 2017 22:58
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pangstrom posted:I don't really know the street scene but seems like you would at least sell them as speedballs. Sometimes dealers don't really know what they have and fentanyl is cheap as heck to make though so that's probably part of why it's showing up in everything. Cross-contamination is a massive, massive issue with something as strong as fentanyl, though. You can be killed by somebody opening a bag of it in the same room as you. That stuff does not gently caress around. It doesn't take much of it at all accidentally finding its way into something else to make people die. Aside from the opioid epidemic police in some places now just carry naloxone everywhere they go because fentanyl is so deadly. Get a call for an overdose, find a dead person, get a bit of fentanyl in your system, now you're dead too! Hurray! With it becoming increasingly common it's actually kind of horrifying.
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May 25, 2017 23:32
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ToxicSlurpee posted:Cross-contamination is a massive, massive issue with something as strong as fentanyl, though. You can be killed by somebody opening a bag of it in the same room as you. That stuff does not gently caress around. It doesn't take much of it at all accidentally finding its way into something else to make people die. Aside from the opioid epidemic police in some places now just carry naloxone everywhere they go because fentanyl is so deadly. Get a call for an overdose, find a dead person, get a bit of fentanyl in your system, now you're dead too! Hurray! With it becoming increasingly common it's actually kind of horrifying. That's a little extreme, but the stuff is dosed medically in micrograms. Look up the phenazepam threads in TCC if you want an idea of what a great idea it is to eyeball something that potent.
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May 25, 2017 23:36
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Rhandhali posted:The "super labs" are in the same places that legitimate fentanyl &c come from. Namely, China, India, etc. There are a hundred research chemicals you can't get any more because they are controlled in both China and the US.
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May 25, 2017 23:39
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That literally happened to an officer somewhere in my region recently. I'll have to find the news report though.
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May 25, 2017 23:41
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Carfent isn't a drug problem, it's a chemical weapons problem.
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May 25, 2017 23:45
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