Moderator EMEDPA Posted December 5, 2014 Moderator Share Posted December 5, 2014 Is it just me or is there a lot more heroin use now than 2 years ago? It also seems like the potency of the available heroin on the street is increasing. there has been talk of heroin being mixed with fentanyl to stretch out supplies of "real" heroin, resulting in many more ODs. part of this is likely due to our success in cutting down on writing vicodin/percocet/etc for every hangnail/back pain/dental pain, so there are a lot fewer rx opiates available on the street. I have had 2 really bad heroin ODs dropped at the door of the satellite facility I work at just in the last week. both were ashen with resp rates 6 or less and both required very high dose narcan (4+ mg) to bring them around. one last night still took an oral airway and bagging after 2 mg of IV narcan. I was getting ready to intubate her. it took another 2 to bring her around. then she had unopposed meth on board and required a B52 for behavioral control before the medics could cart her away to our main facility. thoughts? experiences? Link to comment Share on other sites More sharing options...
gbrothers98 Posted December 5, 2014 Share Posted December 5, 2014 We have been seeing quite a bit of heroin use now for well over a year. Recently had the fentanyl and heroin combo with increased OD. Etiology is several things. Less prescription drug abuse because clinics and prescribers along with state medical boards are tightening opiate prescription. The other etiology is that opium production in afghanistan and other areas we used to have a significant military presence in has dramatically increased. Planting the poppy now that US subsidies and presence are gone is the only way subsistence farmers can survive. Plus the warlords and other bad guys we drove out, came right back in, set up shop and started back exploiting the situation. Have they started dispensing narcan direct to law enforcement yet? There are programs in New England that are dispensing the narcan direct to users. Last, oxy, vikes, percs all come in easy to manage doses. Heroin comes in a baggy or other such distribution packet. So addicts are left to figure out how much to use. They invariably use too much. Plus most dont move direct to IV injection. They start with a snort or a smoke then bam with the iv smack, never get a chance to upregulate and adapt. We have had several major arrests around here, large groups, 1000s of bags of heroin involved, big business, all migrating up from the metro Boston and NYC areas. Likely just a drop in the bucket is getting intercepted. GB PA-C Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted December 5, 2014 Author Moderator Share Posted December 5, 2014 We have been seeing quite a bit of heroin use now for well over a year. Recently had the fentanyl and heroin combo with increased OD. Etiology is several things. Less prescription drug abuse because clinics and prescribers along with state medical boards are tightening opiate prescription. The other etiology is that opium production in afghanistan and other areas we used to have a significant military presence in has dramatically increased. Planting the poppy now that US subsidies and presence are gone is the only way subsistence farmers can survive. Plus the warlords and other bad guys we drove out, came right back in, set up shop and started back exploiting the situation. Have they started dispensing narcan direct to law enforcement yet? There are programs in New England that are dispensing the narcan direct to users. Last, oxy, vikes, percs all come in easy to manage doses. Heroin comes in a baggy or other such distribution packet. So addicts are left to figure out how much to use. They invariably use too much. Plus most dont move direct to IV injection. They start with a snort or a smoke then bam with the iv smack, never get a chance to upregulate and adapt. We have had several major arrests around here, large groups, 1000s of bags of heroin involved, big business, all migrating up from the metro Boston and NYC areas. Likely just a drop in the bucket is getting intercepted. GB PA-C I didn't think about this. I think you are probably right. Link to comment Share on other sites More sharing options...
DiggySRNA Posted December 6, 2014 Share Posted December 6, 2014 Have they started dispensing narcan direct to law enforcement yet? There are programs in New England that are dispensing the narcan direct to users. They started giving out narcan to law enforcement and EMTs in the Boston and Quincy area because of the increase in OD cases. Isn't it also in the works for CVS/Walgreens to offer narcan? Link to comment Share on other sites More sharing options...
Moderator ventana Posted December 6, 2014 Moderator Share Posted December 6, 2014 locally they are finally getting the pill pushers (the docs that just write and write and write) to stop writing..... The supply of easy pills from the doc's that then flood the streets, is drying up..... next easy step is the "good stuff" Link to comment Share on other sites More sharing options...
medic25 Posted December 6, 2014 Share Posted December 6, 2014 We had the same batch of fentanyl/heroin that GBrothers had, with the expected spike in overdoses and deaths. Some of my local FD's told me they were having trouble keeping narcan in stock it was being given so often. Doing EMS chart reviews, I found to fatal overdoses from the same home in the course of a couple of months; both under 40, both opiates. Our state also recently passed legislation making narcan a BLS treatment, and allowing PD or any other entity to administer it even if they aren't part of the EMS system. Link to comment Share on other sites More sharing options...
medic25 Posted December 6, 2014 Share Posted December 6, 2014 http://www.nytimes.com/2014/12/01/nyregion/prices-increase-for-antidote-to-heroin-overdoses-used-by-police.html?_r=0 Not surprisingly, the pharma companies have started ramping up the price of narcan now that it's becoming increasingly popular with first responders. Link to comment Share on other sites More sharing options...
Recommended Posts
Archived
This topic is now archived and is closed to further replies.