In this post, I will explain how opioids affect the brain, what steps you should take to reverse an overdose, how naloxone works and where it can be obtained, and what to do in the immediate aftermath of overdose. How Opioids Kill Opioids kill by shutting down our breathing or slowing it to a rate…
The third and deadliest wave of the opioid epidemic began in 2013 with the increasing adulteration of the heroin supply with illegally produced fentanyl. Fentanyl is a synthetic opioid manufactured in laboratories. Fentanyl was approved by the US Food and Drug Administration in 1968. It is a pain killer, with a rapid onset and a…
I recently had a patient who still had his discharge papers on him from a recent trip to the ED following an overdose. The instructions were fairly simple. Please do not use fentanyl again. If you are looking for any sponsors or help we do recommend that you purse Narcotics Anonymous. He admitted that he…
I recently worked with the New England High Intensity Drug Trafficking Area (HIDTA) Health and Public Safety Analysts to put together a Naloxone training video aimed at Connecticut first responders, the type of video that can be played during roll call at the start of a shift. It was great working with the HIDTA people…
Earlier this month in Connecticut law enforcement arrested two men from Maryland for having 15,000 blue Fentanyl pills hidden in Nerds and Skittles candy wrappers. This was not the rainbow fentanyl (multicolored pills), just regular blue counterfeit oxycodone 30’s hidden in candy packaging to elude law enforcement. Nevertheless, news coverage following their indictment this week…
The DEA recently warned Americans about rainbow fentanyl, multicolored pills, powders and blocks containing fentanyl that the agency said were “a deliberate effort by drug traffickers to drive addiction amongst kids and young adults.” We haven’t seen the rainbow pills in our area (Connecticut) although we have seen quite a lot of blue and purple…
The patient is lying under the slide at the playground jungle gym. It is a blistering hot day and this may have been the only shade she could find. She is unresponsive, cyanotic and breathing agonally. Her pupils are small. From the hard lines on her face and poor dentition, I surmise a life outdoors…
“You need to get that checked out,” I said. “I’m not going to the hospital. They treat me like shit there.” “I’m sorry they do, but that’s not getting better.” The woman has a nasty necrotic ulceration in her AC that has eaten away the skin and some of the tissue underneath. It is black…
The CDC recently released data from their 2020 State Unintentional Drug Overdose Reporting System (SUDORS), which describes the drugs involved in and circumstances surrounding drug overdose deaths in 28 states and the District of Columbia. It is available for download here: https://www.cdc.gov/drugoverdose/databriefs/pdf/SUDORS_Data-Brief_Number_1.pdf Four points from the report are crucial to understanding the death epidemic. 1. …
Our unconscious patient’s chest heaves again and he coughs up another gob of high flying trapeze pink froth that splats on the ambulance bench seat where seconds before my partner’s knee had been. As he secures the IV, I check the patient’s pupils. Midsize, unreactive. No one home. Ten minutes before, bystanders who found the…
A podcast I did recently on the Addiction and Recovery Network of the Life Change Center has now posted. https://recoveryandcompany.podbean.com/e/a-paramedics-dispatches-from-the-front-lines-of-the-opioid-epidemic-part-1-episode-14/ https://recoveryandcompany.podbean.com/e/a-paramedics-dispatches-from-the-front-lines-of-the-opioid-epidemic-part-2-episode-14/
I spoke on a panel a few weeks ago about safe injection sites, (SCS) also known as overdose prevention centers and supervised consumption spaces. These are places where drug users can use in a clean, safe environment under the watchful eyes of trained individuals, some medical personnel, other people who may have used themselves in…
The best TV show of all time to me is The Wire, a five-season drama about the city of Baltimore and the battles on its streets between the police and the drug dealers. The drama is crisp, the dialogue is authentic and there are no simple answers offered. The same people who did the Wire…
In EMS, we can’t take pictures of the dead. We can write about them, but we have to change the details so the person cannot be identified. I have done this on many occasions. In my head I have a photo gallery of the fallen in this opioid poisoning crisis. The photos are not blurred,…
According to the latest data from the Connecticut Medical Examiner’s office, 2021 opioid deaths rose 11% over 2020, marking the third year in a row of increases. Opioid deaths have increased in 8 of the last 9 years in the state. Fentanyl deaths have increased every year, with Fentanyl deaths representing 93% of all opioid…
I have been interviewed quite a bit over the last year both as a result of my book, Killing Season: A Paramedic’s Dispatches From the Front Lines of the Opioid Epidemic, and my role as part of the state’s overdose surveillance system. There have been times when I thought I was truly eloquent, but when…
You are on scene of an overdose. You have just resuscitated a man who was apneic and now admits to snorting heroin he was given by a friend. He just got out of jail and hadn’t used for over two years. You explain both the danger of the fentanyl that is on the street in…
When my book Killing Season came out, Amazon chose it as one of the best nonfiction books of April 2021. The book was also profiled on CSPAN books and I was interviewed by major networks including the BBC and ABC. I was hoping for a review in the New York Times Book Review, but no…
From July to November 2021, the Connecticut Poison Control Center (CPCC) received 39 reports from emergency medical service (EMS) responders of overdose patients with opioid toxidrome syndrome (depressed consciousness, apnea or agonal breathing and pinpoint pupils) who EMS resuscitated with naloxone, but who afterwards stated they only used marijuana and denied opioid use. Three of…
As many are aware, recently in Hartford there was a tragic fentanyl overdose at a Hartford middle/secondary school that resulted in the death of a 13-year old and two other 13-year-olds being transported to the hospital after being “exposed” to fentanyl (Police: Teen who overdosed on fentanyl at Hartford school has died). The news reports…