An old friend of mine who still works the road full time confided in me that he was again having a crisis of faith. We have often talked about burnout, each of us having periods when we found it a struggle to uphold the highest standards of patient care. Not the medicine part, which is…
There has been much speculation about why fatal overdose deaths have been declining nationwide. Here are some of the reasons mentioned in a plethora of articles: 1. Increased Availability of Naloxone 2. Expanded Addiction Treatment 3. Shift from Injecting to Smoking and Other Safer Practices such a as Not Using Alone 4. Impact of Opioid…
Saturday morning my partner and I walked down to the pavilion by the pond in Pope Park to check out the heroin (fentanyl) bags that are easily found in the grass and on the pavilion floor, along with discarded syringes and other paraphrenelia. At least once a month I like to go down there to…
A man likely in his thirties buys $10 worth of cocaine from a Park Street dealer and then buys a bundle (ten 0.1 gram bags) of fentanyl from another for $15. He buys the fentanyl to keep withdrawal at bay and he buys the cocaine to give him the energy to collect enough cans and…
The monthly CDC provisional overdose death data was released on Wednesday, again revealing a continued decline in the nation’s overdose deaths. The data which covers a rolling 12-month period from January 2024 to December 2024 shows a 24.6% annual decline in reported deaths and a 28.7% decline from its peak rolling 12-month reported death high…
In February I wrote about opioid epidemic opportunists who were playing on people’s fears to make profits. Among them are the OPVEE people who are targeting police departments to try to get them to help market their high-dose nalmafene, a long lasting opioid antagonist that medical professionals believe is both unnecessary and dangerous. These opportunists…
There are two kinds of people in the world. Those who park head first and those who back in. The numbers of those who back in are increasing every day. Like most in the older generation, I park head first unless there is an unusual situation. If I am in a lot when I know…
Tomorrow is Thursday and I am sad that The Pitt has finished its season 1 run of 15 episodes and there are no new episodes to watch. While I have a few criticisms of the show, overall, I thought it was the best medical TV show ever and among my top 5 favorites of any…
Medetomidine, an animal sedative, appears to be replacing xylazine as a significant adulterant in fentanyl and perhaps other drugs. According to reports from Philadelphia, one of the areas where xylazine first gained prominence, medetomidine was in 87% of samples of fentanyl in November 2024 compared to just 42% of samples which contained xylazine, while at…
This week, Attorney General Pam Biondi claimed President Trump had saved 119 million lives in the first 100 days of his administration through the nation’s drug seizure activities. Later in the day, in a cabinet meeting, she claimed the number of lives saved was 258 million. This claim is based on the US seizing 22.2 million…
Johnson & Johnson, say it isn’t so. I just finished listening to No More Tears: The Dark Secrets of Johnson & Johnson, by investigative reporter Gardiner Harris, who takes down the corporation that has long had a reputation as one of America’s finest and most ethical companies. Listen to this: “Fifteen years into one of…
A child finds a needle in the park. He accidentally sticks himself with it. This entails a trip to the ED and great worry from his family but fortunately no permanent harm comes from the episode. What do we do about the problem of used syringes left in public places? There is an interesting article…
I am proud to announce my latest book, The Friends and Family Guide to the Opioid Overdose Epidemic: Including How to Recognize and Treat an Overdose, will be published on August 26, 2025 by Johns Hopkins University Press. You can preorder at this link: Order Now Here’s the description from the publisher’s site: A practical…
“We need a lot more naloxone than ever before. The drugs are so powerful today some people need 20 milligrams”. I hear this or versions of it in many of the opioid task force meetings I attend around the state. No, I say. The research I have based on over 20,000 EMS run forms shows…
A mayor in California has proposed giving free fentanyl to his city’s homeless to kill them off. California mayor wants to give homeless people ‘all the fentanyl they want’: ‘Need to purge these people’ “Quite frankly, I wish that the president would give us a purge. Because we do need to purge these people,” Lancaster…
The latest CDC provisional overdose fatality data is out and continues to show nationwide decline in fatal overdoses through October of 2024, down 26.5% over the last 12 months and 27.6% from its June 2023 12-month high, declining to a level equivalent to May 2020 (shortly after COVID hit). It should be noted that more…
The call is for a seizure. A 9-year-old boy with epilepsy falls off the couch and is observed seizing, with full tonic-clonic activity. His mom shouts for the boy’s older sister to call 911, and then she goes to her purse and takes out the medicine his doctor prescribed for him. She sticks the nozzle…
This week I attended a meeting in the Governor’s office in the state capitol to advocate for a bill creating the state’s first overdose prevention center. I was one of a group of eight meeting with the Governor’s chief of staff. Our group included two mothers who had lost their sons to overdose and were…
You are dispatched for an overdose. You find a 48-year-old homeless man sitting on a park bench, eyes closed, nodding forward. You give him a little shake and he opens his eyes and looks up at you. You ask him if he is okay and he says he is all right. He says he took…
Back in 2016 when the opioid epidemic was starting to heat up, I started paying attention to the heroin bags laying on the ground. The bags were Small glassine envelopes that hold 0.1 grams of powder (mix of opioids like heroin or fentanyl and cut with adulterants like sugars, baby formula, etc) when full, often…