opioid emergency response

[shootingstar]

From a local firefighter who recently left our fire dept.

I watched the opioid crisis from the front lines. I'm glad I'm leaving | CBC News

I have not yet asked my sister if she has dealt with opioid patients yet. Well, actually I don't ask about types of patients. She  works in a smaller hospital in a small town outside of Toronto where there is some  wealth but probably some hidden problems...like anywhere else.

In our city (1.3 million), it is a big enough problem. I have no idea of  demographic profile of patients in our city vs. Toronto, Vancouver opioid cases.  However am told some were former labourers or different jobs in the resource industry, etc. where their conditions/injuries sometimes caused on the job,  resulted in chronic pain and things eventually led from legitimate  painkillers into opioid which sometimes gets mixed  with near lethal /illegal additives and compounds their recovery.

 

[ChrisL]

It’s a huge problem that may not be getting the publicity it deserves. Fentanyl deaths due to accidental OD’s are common.   A pitcher for my local pro baseball team died from an opioid OD two years ago.  A professional athlete at his prime, not some junkie on the streets. 
 

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

[Prophet Zacharia]

3 hours ago, ChrisL said:

It’s a huge problem that may not be getting the publicity it deserves.

Are you following the Perdue Pharma court cases at all? It’s interesting, because multiple States keep challenging settlement offers as being insufficient to address the damage the pharmaceutical company did by intentionally minimizing the addictive properties of their drug (and then turned a blind eye when prescriptions skyrocketed beyond reason). But then Heroin is far cheaper than OxyContin on the street once the addiction takes hold. And fentanyl seems everywhere now, my region had a huge streak of OD deaths a few years back.

Interesting CDC graphic in changes in opioid prescriptions over past decade:
 

 

[donkpow]

The opioid problem is still an official federal health emergency.

[JerrySTL ★]

When the Mexican drug cartels (with Chinese help) found it more profitable to make opioids, they flooded the market with it. Ironically the US and State governments attempts at stopping the problem might be making things worse. People with serious pain issues are being denied prescription drugs and therefore going to drug dealers. The quality control of the drug dealer's product is bad with the drug being way too strong. Gone are the days of cutting heroin to make a bigger profit as strength doesn't matter anymore. In fact a lot of heroin has Fentanyl added to make it more powerful. Overdoes are very common with illegal opioids.

[donkpow]

7 minutes ago, JerrySTL said:

People with serious pain issues are being denied prescription drugs

For quite a while I have wondered why the pharmaceutical companies had continued to distribute opioids and encourage their use in the medical community. I know it's profit but you could make massive profits with a safe pain killer. Tylenol being the prime example. Frankly everybody knows opioids are addictive. Ever since forever. Laudanum being a good example. I saw a small story about one of the companies has created a pain med that mimics opioids in the ways that matter most with none of the addictive side effects. That's what we need. 

The addictive characteristics is an interesting study. Opioids flush from the system quickly. That crash is one of the major contributors to addiction.

[Zealot]

1 hour ago, donkpow said:

For quite a while I have wondered why the pharmaceutical companies had continued to distribute opioids and encourage their use in the medical community. I know it's profit but you could make massive profits with a safe pain killer. Tylenol being the prime example. Frankly everybody knows opioids are addictive. Ever since forever. Laudanum being a good example. I saw a small story about one of the companies has created a pain med that mimics opioids in the ways that matter most with none of the addictive side effects. That's what we need. 

It’s been my personal experience that there are no non-addictive pain killers that work as well as the opioids. I don’t take them, even when prescribed, as a rule. But when I have taken them, they do effectively bring pain levels down. 

[Zealot]

It’s kind of like steroids. People use them because they do work. You get out of them what you believe you will. 

[Razors Edge ★]

1 minute ago, Zealot said:

It’s been my personal experience that there are no non-addictive pain killers that work as well as the opioids. I don’t take them, even when prescribed, as a rule. But when I have taken them, they do effectively bring pain levels down. 

Pretty much what I have heard. A real challenge to develop drugs that work well and are not addictive

[Wilbur ★]

I don't watch Sky News but this seems unbiased.  Not sounding too good on the US side either.   

 

 

[donkpow]

I don't know, has the US government actually solved a problem?

(Asking for a Canadian fellow.)

[Wilbur ★]

Just now, donkpow said:

I don't know, has the US government actually solved a problem?

(Asking for a Canadian fellow.)

Admittedly, the solved to caused ratio is shameful. Sorry, but I am the arbiter of truth.  

[Razors Edge ★]

14 minutes ago, donkpow said:

I don't know, has the US government actually solved a problem?

(Asking for a Canadian fellow.)

We thought we had the Nazis beat

[donkpow]

1 hour ago, Wilbur said:

Admittedly, the solved to caused ratio is shameful. Sorry, but I am the arbiter of truth.  

That's no reason to be blatantly rude. 

[MoseySusan]

On 1/13/2022 at 5:40 AM, JerrySTL said:

When the Mexican drug cartels (with Chinese help) found it more profitable to make opioids, they flooded the market with it. Ironically the US and State governments attempts at stopping the problem might be making things worse. People with serious pain issues are being denied prescription drugs and therefore going to drug dealers. The quality control of the drug dealer's product is bad with the drug being way too strong. Gone are the days of cutting heroin to make a bigger profit as strength doesn't matter anymore. In fact a lot of heroin has Fentanyl added to make it more powerful. Overdoes are very common with illegal opioids.

Can I get some sources for these? 

[Bikeguy]

25 minutes ago, MoseySusan said:

Can I get some sources for these? 

One search found this... https://www.uscc.gov/sites/default/files/2021-08/Illicit_Fentanyl_from_China-An_Evolving_Global_Operation.pdf

[Bikeguy]

On 1/13/2022 at 5:37 AM, donkpow said:

The opioid problem is still an official federal health emergency.

https://www.cbp.gov/newsroom/local-media-release/cbp-officers-south-texas-ports-entry-post-significant-increases-0

That's just what was found...

[JerrySTL ★]

1 hour ago, MoseySusan said:

Can I get some sources for these? 

https://reason.com/2021/11/24/should-we-blame-pharmacies-or-the-government-for-opioid-related-deaths/

https://reason.com/2021/07/28/how-drug-warriors-made-the-opioid-epidemic-deadlier/

https://www.nationalgeographic.com/tv/shows/trafficked-with-mariana-van-zeller/episode-guide/season-01/episode-02-fentanyl/vdka21301209

 

[Razors Edge ★]

On 1/13/2022 at 7:40 AM, JerrySTL said:

When the Mexican drug cartels (with Chinese help) found it more profitable to make opioids, they flooded the market with it. Ironically the US and State governments attempts at stopping the problem might be making things worse. People with serious pain issues are being denied prescription drugs and therefore going to drug dealers. The quality control of the drug dealer's product is bad with the drug being way too strong. Gone are the days of cutting heroin to make a bigger profit as strength doesn't matter anymore. In fact a lot of heroin has Fentanyl added to make it more powerful. Overdoes are very common with illegal opioids.

I watched some documentary that showed them manufacturing the fake stuff in Mexico and then smuggling it here.  It was NOT A SCIENCE, and there was no way those drugs were remotely something anyone should be taking.  Regardless, the market is there, and the smuggler merely had a big baggie of pills, and those were EASILY hidden in the vehicle coming into the US.  

It's going to be very difficult to control the supply side of things, as these new drugs are cheap to create, easy to transport, and pack a much greater "bank for the buck". We've seen how "whack-a-mole" doesn't seem to have any lasting impact on the drug lords.  God knows we killed plenty, and they've killed many many times more of each other.  I still remember Scarface from my teenage years. That was almost 40 years ago and was set over 40 years ago. Wow.

Interesting too is how when you do change supply downward, but leave demand the same or growing, it just brings MORE money into the situation with a bigger incentive for new bad actors to get into the market of creating drugs. 

[Dottleshead ★]

Hey @donkpow, you've gotten a lot cuter.  I'm assuming you're off the opiods?

[Dottleshead ★]

So I'm going to be the first to say it -- well ok the maybe just the LOUDEST -- society is going to hell.  I'm glad I don't have kids.  I have no investment in the human race anymore.  Just gonna shut my yap hole, shove it with Twinkies and maybe go out with diabetes.

[Razors Edge ★]

3 hours ago, Dottles said:

So I'm going to be the first to say it -- well ok the maybe just the LOUDEST -- society is going to hell.  I'm glad I don't have kids.  I have no investment in the human race anymore.  Just gonna shut my yap hole, shove it with Twinkies and maybe go out with diabetes.

Stop watching TV and reading your FB! You'll be fine.  There are 6 billion or more folks behind you in line.

[Dottleshead ★]

47 minutes ago, Razors Edge said:

Stop watching TV and reading your FB! You'll be fine.  There are 6 billion or more folks behind you in line.

Screw that.  Cheese would be proud even if they weren't home made. 24 for $10.49

https://www.costco.com/chattanooga-moon-pie-double-decker-pies%2c-chocolate%2c-2.75-oz%2c-24-count.product.100578259.html

[Razors Edge ★]

24 minutes ago, Dottles said:

Screw that.  Cheese would be proud even if they weren't home made. 24 for $10.49

https://www.costco.com/chattanooga-moon-pie-double-decker-pies%2c-chocolate%2c-2.75-oz%2c-24-count.product.100578259.html

I've never been happy with a non-homemade moon pie.

[Dottleshead ★]

45 minutes ago, Razors Edge said:

I've never been happy with a non-homemade moon pie.

I don't know if I've ever had one?

[Razors Edge ★]

4 minutes ago, Dottles said:

I don't know if I've ever had one?

Do you like the mass-produced ones?  I find them "stale".

[Dottleshead ★]

9 minutes ago, Razors Edge said:

Do you like the mass-produced ones?  I find them "stale".

You mean those ones that have been sitting in a drug store aisle for like 8 years?  Depends.  If the sawdust is a bit on the moist side I can do it.  Otherwise I'm going to need a trash can or a huge glass of milk.

[Road Runner]

I have a whole prescription bottle full, given to me after my recent root canal.  Still haven't tried one.  Saving them for an extremely rainy day.  

[MickinMD ★]

It's a major problem.

When my surgeon operated on my rotator cuff, he prescribed exactly three Percocet pills to help me sleep the first three nights after the operation.  He said, "If you feel pain the fourth night, take Tylenol and deal with it."

A wise man!  Unlike too many doctors, he wasn't taking a chance on me getting addicted to Percocets by over-prescribing them.

I had weird semi-sleep dream reactions to the first two and flushed the third one.

[Square Wheels]

I took two Percocet.  When I was in my 30s, I had my nose septum fixed, and uvula removed.  I was in pain.  They gave me a bottle or Percocet.  They said take one, if that doesn't work, take another.  So I did.  About an hour later I was vomiting.  I've never taken a pain killer since.

[Razors Edge ★]

37 minutes ago, Road Runner said:

I have a whole prescription bottle full, given to me after my recent root canal.  Still haven't tried one.  Saving them for an extremely rainy day.  

 

35 minutes ago, MickinMD said:

Unlike too many doctors, he wasn't taking a chance on me getting addicted to Percocets by over-prescribing them.

 

1 minute ago, Square Wheels said:

hey gave me a bottle or Percocet. 

This story is repeated 100,000 or 1,000,000 times across the US.  What happens is either some percentage of those folks get pulled in and hooked, or some percentage have them in their medicine cabinets where others can get pulled in and hooked.  It remains one of those weird spaces where - unlike pot or coke - the path into addiction was through the medical industry, and often as part of a profit driven prescription model.  

Pain is not going away, but we need better guardrails around how to deal with it - both in acute and chronic cases.  I worked with a guy who hurt his back in a motorcycle crash.  Younger than me, and the list of drugs he had been prescribed over the years (and the surgeries) was pretty eye-opening.

For the amount of folks who have become addicted and/or died from prescribed drug ODs, it is likely a surprise to us to see how many folks in positions of responsibility are not in jail or heavily fined and/or still practicing or managing Pharma companies.

[donkpow]

You haven't had a Moon Pie until you caught one from a float in a Mobile Alabama Mardis Gras parade. You ain't.

[Wilbur ★]

The CDC says the US now tops 100,000 overdose deaths per year, up 42% in the past year. 72.9% are opioids.   The vast majority being walked across seemingly open borders.  Good luck y'all.