Heroin opiate epidemic (photo)

Tom Biddle, Paramedic|December 15, 2016

Much of what follows is observations directly by me or information received and/or read from numerous sources. Some is opinion which you may or may not agree. This is about initiating a discussion about a crisis without precedence which can affect your safety in numerous ways. This was typed very quickly with minimal editing so I may not cover as much as I would like but I tried to keep it as short as possible. It may be difficult for some people to understand who may have never had any exposure to someone using Heroin. Many people have family members or know someone or a story about someone who is a Heroin user. Many have died and many more will die. In many places more people die from Heroin overdoses than die from car accidents. There is a national discussion about this epidemic and the causes, possible solutions to reduce it, and the costs among others. I will primarily use the term Heroin below but this subject is related to any opiate whether a pill or Heroin.

A little background on me to back up discussing this subject. I have been an EMT (Emergency Medical Technician) since 1985 and a Paramedic since 1994. I work as a part-time Paramedic for Schuylkill EMS, Western Berks EMS, and City of Allentown EMS for over 20 years. In the past I also worked for Advanced Life Support Systems (ALSS, former county-wide Paramedic service for both Schuylkill and Carbon Counties), Shenandoah ALS, Pottsville Area EMS, Schuylkill Haven Area EMS, and the former Good Samaritan Regional Medical Center. I was an Army Reserve Medic. I am a Firefighter with Pottsville Fire Department, Yorkville Hose Company. I am beginning to become one of the old-timers because a vast majority of EMT’s/Paramedics/Firefighters are doing EMS/Fire for less time than me and/or are younger than me.

Needless to say I get around. Have treated thousands of patients over the years in all of the communities of Schuylkill County and many communities in the surrounding counties in both urban and rural settings. Have also treated hundreds of overdoses. You name the drug, substance, or material and I have probably seen it and its’ effects on patients and their families. Whether it is alcohol, marijuana, cocaine, crack, meth, bath salts, LSD, prescription drugs, opiates, Heroin, etc. It is being smoked, snorted, injected, inhaled, ingested, taken rectally, you name it people find a way to get substances into their bodies that don’t belong there.

Heroin use is rampant. Many previous drug users would do so in some private setting. Heroin is being done everywhere and anywhere, in public and in private, both inner city and rural areas. Children and adults can stumble upon used needles in any setting being exposed to the risk of Hepatitis and HIV/AIDS. I have treated Heroin overdoses in bathrooms at fast food restaurants, sitting in cars in traffic, after a car accident caused by the overdose, sitting in a restaurant at a table, public parks, numerous public restrooms, on the steps of a Church (actually that was two people overdosed together), in workplaces, etc. I can’t remember all of the places and situations because they are so numerous.

Now some observations and opinions. There is a lot of information that you can review to discuss this issue, become educated, and form opinions about this epidemic. Much of this issue is racially charged and can be difficult to discuss as anything to do with racism can be. Much of your opinion on this epidemic will come from your family history, background, job, and political beliefs to name a few. Many people’s opinions of someone different than them comes from their parents, how or where they grew up, and their own life experiences. How you feel about drug abuse or certain types of drug abuse can be tied to racism. It can also be tied to your political beliefs. You can see this by the way different politicians/parties respond to different issues related to drug use/abuse.

Heroin is mostly a white person’s drug. I can’t remember the last black person I treated who overdosed on Heroin. Heroin abuse is now a national discussion because it is affecting mostly white people and is tied to many white’s inherent racism. Two years ago the Governor of Vermont’s entire State of the Union address was about the Heroin epidemic in their lily white state (Vermont is ~95+% white). Heroin addiction is now being discussed as a disease that needs treatment. When it was crack addiction or many of the other drugs that were predominate in blacks it was a lock the criminal up mentality and not treat the addiction. This has helped fuel the explosion of the prison population/business of corrections.

Most of the Heroin use can be traced to people being prescribe Opiate pain medicine by Doctors and being exposed to the effects on their body and/or mind and triggering an addiction response. The 1990’s began the treat the pain mentality in medicine pushed by big Pharma. Eighty (80!) percent of Heroin users started out using prescription Opiate pills for some type of pain that then progressed to abuse. Many Doctor’s inherent racism has helped fuel the crisis in the white population because of their stereotyping a black person as not being in pain but looking to get pills to sell them! Because of this a majority of Opiate pills are prescribed to white people fueling the white Heroin epidemic.

Try to have pain treated with anything else EXCEPT an Opiate pill to prevent the possibility from becoming a Heroin addict. A number of people only need to try an Opiate pill or Heroin once and they are hooked! They either end up as a life-long addict or dead! Very few people are successful at drug rehab. I have treated numerous overdoses of people shortly after they got out of either inpatient rehab or finished outpatient rehab attempts.

The “War on Drugs” is struggling to keep pace with this epidemic. This is basic supply and demand. Taking down dealers is like a game of Wack-A-Mole where you arrest one and two more pop up to keep pace with the demand. It appears one of the best options is to treat the addiction to reduce the demand. Of course, at all levels of government, if the War on Drugs was won, if that is even possible, there would be many people out of jobs. The sound bites on the War on Drugs sound much better than the sound bites on getting treatment for addicts.

It appears we are struggling at every level to spend our way out of this problem. Prisons are overcrowded everywhere with addicts and/or dealers. Police are in a constant state of cat and mouse trying to arrest all of the dealers.

A Heroin overdose can stop someone from breathing very quickly. Many times it is almost instant and they pass out with the needle still in their arm. There is an antidote to treat an overdose that develops into unconsciousness and/or respiratory distress/arrest. It is called Narcan or Naloxone. You can now buy this over the counter without a prescription. Anyone can administer this to someone via spraying it into their nose. It is easy to administer with no needles involved. The person has a response to this in under a minute and many times wake completely up and are back to their “normal” whatever that may be. I have had cases where another family member has given someone Narcan prior to my arrival and woke the person up and saved their life. Some Police departments are also carrying Narcan.

The other issue with Heroin is that it is “cut” with almost any substance imagined to increase its’ volume for greater profitability for the drug dealer. There is no FDA standard on Heroin, no standard dose, and no standard cutting substance. A person who takes their normal amount may get a greater dose of Heroin and/or what it is cut with leading to an overdose.

Heroin users come from all walks of life and socio-economic status. I have been in the worst of the worst of houses and some of the highest end mansions in the best developments to treat overdoses. There are cases of the stereo-typical “junkie” and many cases of “professional” people who go to all kinds of jobs every day.

I have attached some links in no particular order to information on Heroin that I quickly found with some searching. The statistics are amazing. It has developed into a national, state, and county crisis. With minimal effort you can find a large amount of information on this subject. You are either directly affected by it via family or friends or indirectly via shared cost, risk of needle exposure/disease, risk of an accident from an under the influence person, or risk of being a victim of a crime to fuel the addicts need for money to get their fix.

Due to statistics there are probably some number of Opiate users who are your family, friends, or co-workers. And also probably some who are Heroin users. Many people hide it well. Some don’t.

I don’t begin to claim to be an expert or have the answers to this epidemic. As a Paramedic I see the numerous effects of it. An honest assessment of where we are now and education of people must happen so some better solution can be found.

What is being done now is NOT working!

http://www.nsc.org/RxDrugOverdoseDocuments/proactive-role-employers-can-take-opioids-in-the-workplace.pdf

http://www.nbcnews.com/storyline/americas-heroin-epidemic/how-heroin-crisis-sparked-police-revolution-n571551

http://www.huffingtonpost.com/news/heroin-epidemic/

http://www.foxnews.com/health/2016/04/24/whats-behind-heroin-epidemic.html

http://www.npr.org/tags/168899563/heroin

http://www.drugfreeworkplace.org/prescription-opioids-free-employee-education-video/

http://www.paxpartnership.org/docs/Community%20Engagement%20and%20Awareness%20of%20the%20Heroin%20Epidemic.pdf

https://www.justice.gov/usao-ndoh/heroin-epidemic

http://www.letsfaceheroin.com/

http://www.cdc.gov/vitalsigns/heroin/

http://www.ncbi.nlm.nih.gov/pubmed/24871348