Saturday, August 18, 2018

Synthetic drug overdoses: a national crisis, or the ultimate cure?


I was saddened, particularly as a retired pastor, to read of the mass overdose crisis in New Haven, Connecticut, a few days ago.

This mass, rapid-fire overdose event was a sped-up version of what is happening across the US as local and federal governments struggle to reduce the colliding impacts of opioid, methamphetamine, cocaine and other addictions.

. . .

In 2017, drug overdoses killed nearly 200 people per day, according to Centers for Disease Control and Prevention (CDC) data released this week, a new record driven by the deadly opioid epidemic.

Since K2 was first detected in the US in 2008, clusters of overdose outbreaks have become more and more common. About 56 people overdosed from K2 in Brooklyn in May; 100 people overdosed in Lancaster county, Pennsylvania, in July 2017 and 40 people overdosed in Dallas, Texas, in May 2014.

Sometimes K2 is laced with the powerful opioid fentanyl, but investigators including the federal Drug Enforcement Agency (DEA) said they have not yet found any in the New Haven sample.

Officials said there have not been any deaths from this batch of K2, but they fear the long-term consequences of a drug that causes hallucinations, vomiting and a rapid heart rate.

K2 is also known as synthetic marijuana because it interacts with cannabinoid receptors in the central nervous system to produce psychoactive effects. But K2 is much more potent and is an unpredictable mix of differing concentrations of different chemicals that are poured or sprayed on plant material.

Despite the mystery of each batch, K2 is appealing to drug users because its cost is low, its chemicals aren’t detected on standard drug tests and its changing mixtures make law enforcement efforts more complicated than with purer drugs such as marijuana.

“It’s just a daunting, daunting thought for the future,” said Costello. “This is a much bigger problem and a much bigger threat to national security than other things.”

There's more at the link.

Yes, it's tragic:  yes, it's sad:  but it's also pretty much unavoidable, at least by traditional methods such as cracking down on the drug manufacturers and dealers, and expecting police or health services to cope.  They can't.  The problem's too big, and it won't go away, because the demand for the drug(s) won't go away.  Users won't or can't learn, and they don't get scared enough to stop . . . and so the crisis goes on.

I begin to think that the only way to solve the problem, or at least reduce it to manageable proportions, is to issue an edict that when people overdose (or use contaminated narcotics) to the point of becoming unresponsive, they should not be helped, but allowed to suffer the consequences of their actions.  We simply don't have enough police and emergency medical services personnel to cope with the situation, so let's stop trying.  Rather, let's direct our efforts to education, deterrence, and helping those who are getting into drugs before they get too far into trouble.  They, at least, hold out the hope of some return on society's investment of time, money and effort in them.  Those who are too far gone down the slippery slope . . . they don't.  There have been far too many cases of addicts being saved from an overdose by a timely dose of Narcan, who later the same day had to be rescued in the same way all over again.  They won't stop.  They can't stop.  Therefore, is it heartless or cruel to say that we should allow them to endure the inevitable consequences of their own choices, and allow nature to take its course?

There are those who protest that this is unconscionable:  that even the worst addicts, those needing resuscitation more than once per day, can be saved.  I agree that some of them (a very, very few of them) do hold out hope, like this man.  However, I venture to suggest that most don't.  Who's going to make the judgment call?  And how can we explain to the sober, contributing-to-society citizen who's had a heart attack, and is desperately waiting for an ambulance, that he's going to die, because the EMS crew that should be taking him to hospital are instead administering Narcan to yet another addict who's going to turn around and do exactly the same thing again?  To my mind, there's no contest as to which emergency deserves the higher priority . . . but right now, EMS isn't allowed to make that distinction.  I believe it's time that changed.

What say you, readers?

Peter

20 comments:

  1. Part and parcel of this is to decriminalize drug use and distribution.
    Right now a buyer can't be sure what they are purchasing.

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  2. I've no doubt that they were some adverse reactions to the synthetic marijuana but I'm skeptical on the number of "overdoses". Particularly so when reading of victims who "overdosed" and then went back for more. Only to "overdoes" again.

    That stuff is a nasty business that has some unpleasant side effects with psychotic episodes and paranoia very common.
    https://spiceaddictionsupport.org/side-effects-of-spice-use/

    My suspicion is once people began making the associations then mass hysteria took over. Then the first responders and media went into the after action reporting mode.

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  3. This is not a problem that is going to be solved. First, it's not "a problem." but a condition of society that not everyone thinks is bad: Gromit is far from being unique, and many people feel that drug abuse, like violent sports, is just one of a number of Darwinian filters that are appearing as population rises. Further, the "solved" part depends on so many variant definitions and viewpoints being accepted by those with authority and responsibility, that you would be just as likely to develop a good policy by lottery as by debate.
    This all brings to mind the old saw about Germans and Austrians, who each will view a close battle and declare, one that it is serious but not hopeless, and the other, just the reverse.

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  4. Sport Pilot, part of the problem, now that NARCAN has been in widespread use for the last 4 years or so, is that Druggies know they're safe. Seriously. OD right in the middle of the street, get NARCANed, right back up and ready to OD yet again.

    Many EMS personnel saw NARCAN as the golden savior. Now they see it and other anti-psychotics and other anti-narcotics as enabling the overdoses. There's a quiet rumbling amongst the community about 'slowing the roll' (not respond so quickly to OD calls.

    Here's my answer. NARCAN should come with a small tattoo needle. Insert NARCAN, tattoo person. After 3 tattoos, no more. End of the line.

    Legalizing it isn't the solution. Junkies are always seeking out stronger, harsher, more powerful drugs. Junkies actually are more attracted to a particular 'brand' or 'mix' if it picks up the notoriety of a few deaths or an increase in OD potential.

    Let them. Let them die. They are unhappy. Recidivism rates from 'cured' druggies are horrifyingly large. Let them die.

    People also tend to think these drugs are like alcohol. No, they are not. Lethal dose of Alcohol, straight drinking alcohol, is quite a large amount. Morphine, Heroin, Fentanyl, all have significantly lesser tolerances between 'working' and lethal dosage. Fentanyl and Carfentanyl both have their lethal dosage levels at just a bit over their useable levels. There's not a lot of wiggle room from pain relief and kicking the bucket.

    Pardon my French, but screw them. It's like, quite frankly, dealing with someone who's given their soul over to evil. Talking and helping them does nothing. It is only if they choose to change from evil to good can any change be made. Same with drugs, especially the more powerful ones.

    And it's not doctor-prescribed drugs that are the issue. It's jerks and idiots who are using good drugs for bad reasons. That's the problem.

    Also, don't say that 'You used to be able to buy it over the counter.' Yes, it was at one time sold over the counter. And it was a big problem back then. Opium Dens, Insane Asylums, Bedlams, all full of people who had major drug problems. Quite frankly, the ostracization of over-use of drugs contributed to families kicking out and cutting ties with their 'afflicted' members, who either went into state-run institutions or crawled off and died. Cutting ties, refusing to help, to aid, to support, and the problem, either alcoholism or drug dependency, disappears quickly.

    Time is up. The great social experiment of supporting drugs and illegal drug users has been a huge failure. Let's try something else. Let's try complete punishment and elimination of illegal drug users from our society. Whether we banish them, let them die, whatever. We need these people out of our nation.

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  5. @Beans. You are incorrect about Fentanyl. Used properly in a hospital setting for things like immediate post op pain or burn/trauma pain, it is a quite effective medication for short term acute pain control. Carfentanil, on the other hand, is 100 times more potent. It was developed to sedate elephants. It has no legitimate medical use in humans.

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  6. I had a cousin with a drug problem. For decades, he was the bane of my aunt. In and out of jail, constantly doing something illegal, or unethical, for money, and eventually the recipient of a free hip to replace the young hip damaged by years of drug abuse.

    He was clean for awhile - even found God - but I always had the suspicion it was jailhouse religion, and he started using again.

    Eventually, his new hip was too damaged by drug use, and his efforts to have it too replaced was denied by the government. This left him in a wheelchair, and the drugs finally killed him.

    With him, the final solution to his drug problem was death. It would have been much kinder to allow him to overdose, when he was young, and my aunt would have had years of peace.

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  7. I'll go ahead and be the turd in the punchbowl here.

    Exactly how much in the way of public resources should be allocated to each citizen, comrades, before their share is exhausted?

    The town I grew up in, in coastal MA has 3 overdoses per day, on average. I don't live there anymore because I moved my family out to get away from the junkies (and MA communism). Sometimes it's the same person, twice in a day. For some reason, Narcan, which is quite inexpensive, isn't available to individuals, though fat people can get insulin if they need it to stay alive and not get better.

    Am I sick and tired of paying for insulin for fat people who ate their way into diabetes? Why the F can't they put down their damn fork? You ever notice how many people on public assistance are obese? How broke can they be?
    Hyperbolic, but hopefully you get the idea. I don't hate the obese or junkies. I hate what they do to themselves and others to maintain their habits. I don't like paying for other people's statins. There should be a limit to how much anti-cholesterol medication the public has to support.

    Again, hyperbole.


    My mom went out in an ambulance over 20 times in her last 5 years. It kept her with us for her last 5 years. How many times is too many, for keeping her with her family? Should she be tattooed with a number, as Beans alluded to? Maybe on her forearm. Or perhaps a nice gold star, so the ambo crew knows to slow their roll?

    Again, hyperbolic.

    I'd suggest going to an AA meeting if you want to see how junkies avoid relapse. The problem is more complex than simply going to Freehab and then AA, rinse repeat as needed. I can understand frustration and a sense of losing the fight, of helplessness.

    Oh, FWIW, since I speak portagee from marrying a Brazilian, I know that the majority of narcotic trafficking in my old home region is controlled by Cape Verdean gangs, made up almost exclusively of illegal aliens. MY wife used to go to church with their families. The police can't crack down on them, though, as that would be racist. A young cop, father of two just got gutshot and killed a few weeks ago for trying. As I said, solutions are more complex than most appreciate. What should be done, or could be done has to be done under the law, and behind that, there's still moral issues to deal with. End of the day, EMS workers still have to look in the mirror.

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  8. I hit this one on Wednesday.

    https://raconteurreport.blogspot.com/2018/08/once-again-heres-your-opioid-epidemic.html

    Short answer:
    https://www.youtube.com/watch?v=nFCuyLwhUzM

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  9. Paul - Let the addicts die. Execute the dealers. Deport or kill the illegals. All of them. That's the cure.

    Step one is getting rid of Leftist judges and electing the Right people.

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  10. Here's a thought; these people are overdosing because they don't know that what they are buying.

    End the Drug War.

    It's been going on, in various forms, since the end of WWI. In that time it has cost a mountain of money, and made a great many vile people very rich. It has eroded our civil rights; it is the primary excuse for no-knock warrants, for dynamic entry raids, and for asset forfeiture laws. It encourages the government to spy on us.

    If there were signs that we were winning, there might be an argument for it. We aren't.

    Furthermore both the Drug Warriors and the Drug Advocates have done so much flat out lying in support of their various positions that the only way to tell which drug actually pose a significant threat to society is to legalize all of them and then check again in ten years.

    Abandoning the drug war would greatly reduce the number of overdoses, by eliminating those caused by uncertainty about drug contents and potency. It would cut the legs out from under a great many shady enterprises. Drug gangs could go legit or die (always assuming the fool government didn't TAX the drugs so excessively that a black market was still viable).

    I don't use illegal drugs. Even were they legal, I am not attracted to them. None of that matters. In my lifetime the greatest excesses of authoritarian idiocy have been associated with either the Drug War or Environmentalism.

    Finally; if the Drug War has caused even on chronic pain sufferer to have to go without effective pain medication, then the whole thing is barbarism. No number of hypothetical junkies saved from their own stupidity justifies that.

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  11. What Drug War?

    We've carpet-bombed no one, sent fleets and armies to no where.

    There's been no War on Drugs. Nor even a low-intensity conflict on drugs.
    We have copious evidence of what a war looks like, and there's been nothing like that, not once, in a century.

    We've waged a pretty serious assault on the Bill of Rights, but regarding Drugs, this isn't even a minor inconvenience. We go after people not wearing seat belts with more vigor, but that's not a war either. It's just a revenue stream.

    When we start shooting down drug planes headed for our airspace, strafing smugglers at the boundary of international waters, and executing smugglers and dealers on the spot, either coming in at the border, or when caught dealing inside the country, then we'll actually be at war. I know this because we don't read enemy troops their rightr and handcuff them; we drop white phosphorous and high explosives on them, and shred them with artillery and bombs.

    Give a holler if it ever happens; so far, we haven't done it for even two minutes any time in a hundred years.

    If we did, I suspect that not only would we win, but it would be over in about an hour.

    But arguing to stop something we've never had is ludicrous.

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  12. Aesop;

    You have a point, BUT. There are far too many people in jail for non-violent drug "offenses". That ain't cheap. The need to perform no-knock searches and dynamic entry raids was sold to the public (and the courts) as a necessity of the Drug War. Doctors who treat patients with chronic pain (as well as, doubtless, a few liters) are hounded in the name of the Drug War. Asset Forfeiture was sold to the public as a necessity if we wanted to 'get' the drug dealers.

    Need I really go on?

    I'm not calling for an end to anything LIKE an actual armed conflict. I'm calling for an end to an excuse. It's past time we took the money ostensibly spent on enforcing the Drug Laws and did something more constructive with it. Setting it on fire would be a step up. It's time we sent nine out of ten of the Drug Warriors a pink slip. It's time we told Law Enforcement "Knock, present a duly issued warrant, and be polite, or DON"T GO. It's time we told municipalities "If you have so little money that you can't keep the streets repaired, that's a problem. But if you're supporting bike paths and happy reading time at the Library, and a host of other luxuries, DON'T STEAL TO SUPPORT IT.

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  13. Paul, Dammit!, I have no problems supporting people who are just... well... running down. But druggies who have been saved over and over again? Sorry. Clean up and get on with one's life and then accidentally od on prescriptions because one's kidneys are funky, okay, I'll cut slack on that (I've seen that happen, which is a sucky thing.)

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  14. I'm so sick of K2! I work as a nurse in a local prison. We house mainly minimum and medium security prisoners. We see at least 4-5 people high on K2 per week. This past year, we had 2 people die. They have no desire to stop using.

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  15. @Beans -
    A councilman in economically depressed steel town Middletown, OH, proposed a three strikes law. Middletown is featured in the bestseller Hillbilly Elegy. It was never implemented, but opiate overdoses jumped from 511 in 2016 to 577 in the first half of 2017.

    After the first two overdose rescues, the person would perform community service for the equivalent amount of money used on the lifesaving response.

    The third strike is a bit more controversial.

    "If the dispatcher determines that the person who's overdosed is someone who's been part of the program for two previous overdoses and has not completed the community service and has not cooperated in the program, then we wouldn't dispatch,” said Dan Picard, Middletown city council member.

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  16. Spoken like a good christian.

    Well done

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  17. As long as everyone is banding about solutions to a complex problem, here's my take. Mental health......the majority of the druggies are mentally depressed. What caused their depression? The majority of the depression comes from being molested in their childhood. Some of the cure, partially, is to kill off the molesters. Hang them in the village square, let their bodies rot over a couple of months. Doing that would "save" a few of the druggies.

    Steve

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  18. What a slippery slope. First the came for the addicts, but I wasn't an addict. Then they came for....

    Alcoholics, STD's, Obesity, Smokers, Sedentary, etc.

    When does it stop?

    I certainly understand the sentiment. The costs to society are very high, but that slope can be vicious.

    Think about it before taking that step, please.

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  19. I'm fine with leaving the alcoholics right in the gutter too.
    Ditto anyone who's too fat to get themselves out of the house without a crane and a fire department battalion task force and heavy rescue team.

    However, I've yet to see someone so messed up by STDs, smoking, or being a couch potato they couldn't get to the hospital without assistance. And there's also the point that, unlike narcotics, food, cigarettes, and sex are all legal, for the most part.

    But if a lifeguard pulled the same jackwagon out of a riptide twice on the same day, he likely wouldn't go out for them a third time.

    That's all we're talking about.

    So either let them commit suicide, or put them on a mental health hold, and dry them out for 6 months.
    After either approach, it will self-correct.

    And @C.S.P. Schofield:
    Nothing you described has anything to do with a War On Drugs.
    So again, we're back to correct terminology.
    You're against laws restricting drugs.
    Try arguing that point.
    There is no "War On Drugs".
    The first clue should have been that the Air Force isn't running B-52 Arc Light raids on drug cartels. More's the pity.

    So if we're going to have a War On Drugs, let's have a War On Drugs.
    You're taking them?
    No problem.
    Treason still carries a death penalty.
    The recidivism after that gets enforced drops to around 0%.
    Check with Singapore, and get back to me.

    But making Straw Man arguments against something we're not doing, as an excuse to stop not doing it, just doesn't fly.

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