“I’m a shit bag,” he says to me. “I’m supposed to be taking my boy trick or treating tonight. I can’t fucking believe I did this. You said I wasn’t breathing? After all I’ve been through to die like this. Fuck me. I’ve got shit for brains.” The young man got out of jail an…
Grade A
The man kneels in the grass next the pickup truck that has its door open. He vomits. The fire department is standing over him. “Citizen Narcan found him in the truck passed out, squirted him with two doses and then took off when we got here,” a firefighter tells me. I see the two 4…
Fentanyl Safety
Finally! The Federal Government has listened to the experts and released sensible evidenced-based recommendations on safety for first responders when encountering fentanyl and fentanyl analogues, including carfentanil. Fentanyl Safety for First Responders The document issued yesterday by the White House National Security Council is the product of their Federal Interagency Working group with collaborative support…
Hope
The call is for an overdose in the stairwell of the apartment building. Fire has arrived just before us – they have propped the front door open. I enter with my house bag over my shoulder and carrying the cardiac monitor in my right hand. There is no one in the dim lobby to direct…
Falsehood Flies
“Falsehood flies, and truth comes limping after it, so that when men come to be undeceived, it is too late; the jest is over, and the tale hath had its effect.” – Jonathan Swift This quote came to me from a respected toxicologist after reading some news accounts of public safety response to possible fentanyl overdose…
Katrina Journal
In view of Hurricane Harvey and the rescue efforts now underway, I am posting notes from my journal when I was posted in Gulfport, Mississippi in the aftermath of Hurricane Katrina. Day One: Waiting On the morning of September 17, we meet at the office and a chair van driver takes us up to the…
Multiple Naloxone Administrations
One of the main reasons opioid overdose deaths have been increasing is the rise of fentanyl sold either combined with heroin or in place of heroin. Fentanyl, which is 50 times stronger than heroin, has a stronger affinity for the opioid receptors in the brain than heroin. Toxicologists have said that while naloxone is still…
Nocebo Effect
While headlines of deadly Fentanyl creating Haz Mat scenes and causing first responders to be hospitalized continue to dominate the news, on July 10, 2017 with little fanfare, the US Institute for Occupational Health and Safety removed the statement “skin absorption can be deadly” from its Fentanyl page. You can read their safety recommendations here:…
Couples
The call is for a possible overdose. A tall attractive young woman in leopard skin pants, and a Ginger from Gilligan’s Island hairdo, meets us at the apartment door. She is high. Her balance as she sways in front of us is so bad it is making me dizzy just looking at her. “Thank you…
Mother and Son
The woman with the cellphone stands outside the car. She explains that the male in the car has been smoking crack, taking benzos and doing heroin for several days. I ask if he is breathing. She says yes, but he is asleep right now. When she picked him at his friend’s house in their suburban town…
Narcan Man
In troubled times in the metropolis, the unexpected rise up and battle the evils that enslave civilizations. Today, such a tale is playing out on the streets of Hartford. Behold…Narcan Man! Few of us were paying attention when it started to happen. We get called for a overdose at the bus stop, possibly not breathing….
Empty Wallets
EMS responders go through more wallets than pickpockets. Unresponsive person in an alley. We need to ID them. Check for a wallet. Dead person in a hotel. Got a wallet. Unresponsive in car. Check his pockets. You are looking for the driver’s license, but you can’t help but notice how much cash they are carrying…
Hello Kitty
Spring is here and the city parks are littered with heroin bags, the small glassine envelopes that contain the powdered heroin and sell for $4 or $5 a bag. The users sit on the park benches and tear the bags open and snort the fine powder or go down to the pavilion by the pond and…
Narrative
Upon arrival found a 22 Y/O female unresponsive lying on the floor of her bedroom with her father performing CPR on her. He states that he last saw her alive a hour ago and then found her on the floor unconscious before calling 911. He states she has a history of heroin abuse and there is a used needle…
Killing Time
A new legal strategy is to charge drug dealers with homicide when one of their customers fatally overdoses and it can be proven the customer bought the fatal drug from the dealer. In Rhode Island this week a 25-year-old dealer was convicted of selling $40 worth of “Diesel” to to a 29-year-old customer who died 4…
Fountain
In Connecticut we are in the midst of hospital wars. It is a very competitive market and all of the hospitals fight to attract patients. You can see it on the billboards that line Interstates 91 and 84 with hospitals proclaiming themselves the best at heart care, stroke, trauma care or declaring they are the…
Don’t Use Alone
61 people died of heroin overdoses in Hartford in 2016 (according to numbers released by the state Medical Examiner’s office on friday), up from 37 in 2015. Based on the first six months of the year, the state estimated 888 people would die statewide, but when the final numbers came out last Friday, the number…
Happy
I ask my patients who are addicted to heroin how they got started. Many tell the same tale. Injury. Prescription for Percocet or Oxycontin. They got addicted. Prescription either went away or couldn’t keep up with their growing tolerance. They started buying pills on the street. Then they learned heroin was cheaper and worked even…
Snowbank
It is six in the morning and we get called for an overdose outside. The address is not a surprise — a side street off Park. Yet when we arrive, we find no one. We are about to clear when a police officer who has also responded finds a backpack in the snow and sure…
A Life Saved
A 24 year old man from one of Hartford’s suburbs had his life saved by a newspaper. He got into heroin five years ago through, in his own words “stupidity.” While many get into it through injury, a doctor’s prescription exposing them to opiates, taking too many, becoming addicted, getting cut off or needing…