View Full Version : Opiod Deaths Spike in Ohio, Coroner runs out of room.
Averageman
05-23-17, 16:07
http://pittsburgh.cbslocal.com/2017/05/23/ohio-coroner-space-opioid-deaths/
Coroner, Dr. Kent Harshbarger, says they have already expanded the cooler once last year because space for 36 wasn’t enough, it now holds 42.
“If this pace continues, I’m not really sure what we’re going to do,” Dr. Harshbarger told the Trib. “It’s full every night.”
In February the coroner’s office also ran out of space due to the opioid epidemic.
Dr. Harshbarger said then that he was considering renting space at funeral homes in the community to handle the overflow.
He also reportedly rents refrigerated trailers that can be brought in when deaths spike.
“I’m looking at 2,900 autopsies, 2,000 of them overdoses,” Dr. Harshbarger told the Trib.
So who goes in to this thinking "yeah I can do some opioids and come out just fine!"
My bet is they are getting a big shipment of stuff laced with fentanyl. A very small amount of it will kill you. Some drug manufacturers are compressing a fentanyl mixture into Oxycodone pill shapes and their QC is lacking. One pill will get you high and the next pill has enough fentanyl to kill 4 people.
Stupid question, but why do we need autopsies if the COD is known??
Outlander Systems
05-23-17, 16:58
The only time autopsies aren't performed is when it's a high-profile Conservative SCOTUS Justice, if they die at a weird occultish hunting retreat.
Ohhhhhhh try the veal!
Stupid question, but why do we need autopsies if the COD is known??
Stupid question, but why do we need autopsies if the COD is known??
So they can tell us all how much this epidemic costs when the time comes to go raising taxes.
My bet is they are getting a big shipment of stuff laced with fentanyl. A very small amount of it will kill you. Some drug manufacturers are compressing a fentanyl mixture into Oxycodone pill shapes and their QC is lacking. One pill will get you high and the next pill has enough fentanyl to kill 4 people.
Stop that. Big pharma knows what's best for you. Take your pills and shut up.
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This just in from the Depraved States of America...
I'm with lowprone and TAZ,, I don't care nor think our $$$ should be wasted on autopsies. If I were in charge EMT wouldn't even respond to the 911 call. Narcan? BS! Let them die. Refrigerator my ass. Dig a hole and spread some lime on them to cut down on the flys. When the hole gets full dig another one.
Outlander Systems
05-23-17, 17:51
I'm with GH41.
Don't Chase the dragon and day azz won't catch a scalding.
RetroRevolver77
05-23-17, 18:00
If they OD they should just let them rot where they fell. Seems like a self correcting problem.
I'm with lowprone and TAZ,, I don't care nor think our $$$ should be wasted on autopsies. If I were in charge EMT wouldn't even respond to the 911 call.
Agreed.
Calling it an "opioid epidemic" is disingenuous. Opiates aren't the problem. Street drugs laced with fentanyl are the problem.
titsonritz
05-23-17, 19:03
They are good junkies now.
I'm with lowprone and TAZ,, I don't care nor think our $$$ should be wasted on autopsies. If I were in charge EMT wouldn't even respond to the 911 call. Narcan? BS! Let them die. Refrigerator my ass. Dig a hole and spread some lime on them to cut down on the flys. When the hole gets full dig another one.
With the epidemic of ODs the cost of narcan has gone up 10x in price and is nearly always on backorder. I've often joked that we need to go to a 1 and done policy. You get 1 dose of narcan 1 time, you OD again you die.
Stop that. Big pharma knows what's best for you. Take your pills and shut up.
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I'm not talking about pbarma. I'm talking about the illicit drug makers. From what I've heard the fentanyl is coming from China.
I don't understand why everyone doesn't get that "opiods" are "opium" and there is no such thing as a non addictive opiod. It's all basically heroin and it's like nobody ever saw a movie made in the 70s and doesn't understand how much heroin and other opium derivative drugs will destroy your life.
It's like every few decades the entire nation forgets how much heroin and cocaine will absolutely f up your life.
Calling it an "opioid epidemic" is disingenuous. Opiates aren't the problem. Street drugs laced with fentanyl are the problem.
Ummm, no. I'm familiar with many "now deceased" people who only did opiods. Mixed drugs are definitely shifting into the next gear but you can kill yourself with nothing more than plain old oxy.
https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates
That chart is misleading. Deaths involving prescription opiates aren't deaths by prescription opiates. The third chart merely indicates overdose deaths that included some amount of opiates, while not indicating the frequent presence of literally every other substance those people could get their hands on. It's easier for coroner's to write "overdose - opiates" than "suicide by everything."
Prescription drugs taken as directed aren't that dangerous.
That chart is misleading. Deaths involving prescription opiates aren't deaths by prescription opiates. The third chart merely indicates overdose deaths that included some amount of opiates, while not indicating the frequent presence of literally every other substance those people could get their hands on. It's easier for coroner's to write "overdose - opiates" than "suicide by everything."
Prescription drugs taken as directed aren't that dangerous.
The problem is most addicts don't take prescription drugs "as directed" and it's really easy to get addicted to opioids. And chart notwithstanding, I'm personally familiar with "more than a few" people who died from overdosing on regular oxycontin. I also knew people who killed themselves with a few other opiate brand drugs as well, none of them were suicides.
Addicts will take whatever they can get whenever they can get their hands on it, but that's not your average pain patient who is being demonized by the current "War on Opiates." There were actual, serious problems with the original formulation of Oxycontin, let's not forget. Same with the original Fentanyl Patch. New prescriptions for those are almost non-existent.
Before everyone jumps on that bandwagon, let me offer some real talk here. To be sure, most of these folks that are being mocked absolutely made a bad choice and decided to commit a felonious act to get high.
But there are some, people who if they were members here would be respected as BTDT types. They come back all sorts of f'd the hell up and wind up in the VA system where they are pumped full of the crap for legitimate reasons. Then VA cuts them off after they are hooked. Then they look for the next fix. Not to get high, because at that point one doesn't really get the euphoria that much, but rather to stave off the withdrawals which are a horror show you don't want to see. The VA does a really poor job at taking care of those guys and they are often left to their own devices.
Before you throw out that self righteous blanket of condemnation, think about those soldiers that I just described and have a little compassion. I can write about that because I know a couple.
MountainRaven
05-23-17, 22:47
So are we arguing against increased spending for mental health issues, now?
I know December 2012 was a while ago, but I didn't think it was that long ago.
Soulezoo gets it. Personal anecdote time; Ignorant medical professionals see red and go all hulk-smash when they hear the word Norco. Ask my re-dislocated collar bone how that "exam" felt.
Averageman
05-23-17, 23:19
Before everyone jumps on that bandwagon, let me offer some real talk here. To be sure, most of these folks that are being mocked absolutely made a bad choice and decided to commit a felonious act to get high.
But there are some, people who if they were members here would be respected as BTDT types. They come back all sorts of f'd the hell up and wind up in the VA system where they are pumped full of the crap for legitimate reasons. Then VA cuts them off after they are hooked. Then they look for the next fix. Not to get high, because at that point one doesn't really get the euphoria that much, but rather to stave off the withdrawals which are a horror show you don't want to see. The VA does a really poor job at taking care of those guys and they are often left to their own devices.
Before you throw out that self righteous blanket of condemnation, think about those soldiers that I just described and have a little compassion. I can write about that because I know a couple.
I've spoken to someone within the VA system that claims many of her patients picked up there addictions in the military.
I'm not sure about all of that, but I've seen some people I have worked with who picked up a habit while down range.
The need to keep the numbers right might influence some to be a little liberal with the painkillers.
The desire to not let the team down might lead someone who is experiencing significant pain to take more and more to keep going.
Addicts will take whatever they can get whenever they can get their hands on it, but that's not your average pain patient who is being demonized by the current "War on Opiates." There were actual, serious problems with the original formulation of Oxycontin, let's not forget. Same with the original Fentanyl Patch. New prescriptions for those are almost non-existent.
Yes, correct. Despite being promoted as a "non addictive opiate" it was anything but. That is how a LOT of people ended up with an addiction and when the Oxy went away to moved on to any form of opiate "including heroin" that they could find.
Most didn't start out to be drug addicted people with destroyed lives, but that was the end result assuming they didn't just die. The problem is all opiates, regardless of how you synthesize them are still opiates and all have the capacity to be far more addictive than your management skills. If you are particularly susceptible to addictions or if you are just trying to manage incredible pain it can be a very precarious balancing act that most people lose eventually.
Sure there are people who can get pain pills, recover, get back to work and never want to take a pain pill again unless they actually have to. But what we are seeing is that kind of person is the exception and not the norm and "non addictive opiate" is a huge oxymoron.
Down here in South Florida we are awash in NJ imports in "recovery programs" and they all tell basically one of two stories. Either they got hurt in something like an auto accident and the "pain pills" got the better of them until they couldn't function without them and they spent a year or two simply building a tolerance and taking larger and larger doses OR they screwed around with Oxy or some similar opiate as it if was just another "recreational drug" and the next thing they knew they had f-ed over their life.
And because they no longer no what they are doing, having little control over their addictions (despite being in recovery) and generally make poor decisions about the amounts they can handle they die pretty regularly down here and unintentional overdoses are very, very common.
Before everyone jumps on that bandwagon, let me offer some real talk here. To be sure, most of these folks that are being mocked absolutely made a bad choice and decided to commit a felonious act to get high.
But there are some, people who if they were members here would be respected as BTDT types. They come back all sorts of f'd the hell up and wind up in the VA system where they are pumped full of the crap for legitimate reasons. Then VA cuts them off after they are hooked. Then they look for the next fix. Not to get high, because at that point one doesn't really get the euphoria that much, but rather to stave off the withdrawals which are a horror show you don't want to see. The VA does a really poor job at taking care of those guys and they are often left to their own devices.
Before you throw out that self righteous blanket of condemnation, think about those soldiers that I just described and have a little compassion. I can write about that because I know a couple.
I know some guys who were just in car accidents and IMO got screwed over by their doctors who prescribed some serious shit pain pills. Probably could have toughed it out with Tylenol #3 but they are pretty quick to hook you up with some form of "safe opiate" while they coordinate with their buddy who does the physical therapy thing.
If you are banged up enough that you are being kept in the hospital then sure, supervised meds and whatever is needed. But if you are sent home and given three bottles of various opiods with the instructions to "take as needed for pain" then you really want google what you actually have and check the levels of addiction. And if it says "moderately addictive" or worse, think twice.
Stupid question, but why do we need autopsies if the COD is known??
Legality, insurance, integrity. Determinination based on suspicion isn't much more than a WAG if the body isn't discovered mid-fix. Pathology tox panels are nearly the cost of full autopsies, and independent kits don't detect analogues. I'd like to see change effected to shift manner from accidental to intentional, but that would only worsen the abandonment problem!
Averageman
05-24-17, 07:01
http://www.vocativ.com/431436/fentanyl-heroin-addiction-russian-roulette/
This game of heroin Russian roulette has become the reality for addicts over the last couple years since drug dealers began mixing heroin with highly potent fentanyl-class substances. Because they’re both cheaper and more potent, fentanyl and it’s numerous cousins have become the ideal ingredient to mix with heroin for both dealers and addicts alike.
Variations on these deadly opioid cocktails — including a mix that has recently made headlines, called “gray death” because of its resemblance to concrete powder mix — have claimed thousands of lives all over the United States and pushed the country’s ongoing opioid epidemic into grim new territory. A study by the US Centers for Disease Control and Prevention concluded that death rates from synthetic opioids increased 72 percent from 2014 to 2015.
Reports of gray death began surfacing six months ago in Georgia and Alabama. The original mixes consisted of heroin, fentanyl, and a relatively new designer drug called U-47700, or “pink,” with the amount of each ingredient varying from case to case. The drug has evolved over the last six months, as some mixes now include acryl fentanyl, butyr fentanyl, or carfentanil. Some don’t have U-47700, but all forms of it are deadly. Even scarier: Just because a heroin mix isn’t gray death doesn’t mean it can’t kill you, as the only real difference between gray death and some of the other heroin mixes is that it’s gray.
I'm glad nobody here has had a family member get caught up in this. It's not fun, take my word for it.
I was fortunate to get my stepson help before he died from it. He is now a functional productive member of society.
I suffer from chronic back pain from a surgery gone wrong. Another surgery is most likely in my future but I will resist as long as possible. Constant pain 24/7. However, I made the determination that being on pain pills, even at low doses, wasn't what I wanted. I could have Oxy by the 55gal. drum if I wanted. But I don't. I was on them for several months while waiting for the surgery and afterwards. Surgeon gave me a CSF leak that put me back in hospital and was very slow to heal. Still have a nice sac of fluid and scar tissue causing problems as well as reherniation. When I realized my pain was no longer going to recede and I was stuck with what I had, I decided time was over for pain meds. Was so fed up didn't even wean. Cold turkey. Not fun but my determination made the process(most likely) not as bad as could have been. Still was a rough 3 days, but I wasn't despondent or emotional, I was phuckin' determined. Broke that shit and haven't looked back.
Anyone on pain med. for an extended time is going to become dependent. The issues arise when it is time to taper/wean and they decide to like pills more than a normal body chemistry. My physician handling my meds.(non-narcotic, non-addictive sleep "helpers"; chronic pain can cause sleep issues) and I have talked in depth about the opiod problem. Since I don't ask for pain meds. and MRI's show definite issues, he knows my pain is real and I'm not a pill head. The subterfuge, trickery, and lying he sees from junkies is unbelievable.
What all these junkies have done is made it hard for true pain sufferers. MD's are now so worried of getting a rep. as a pill mill, that they are forced to be more strict and skeptical of anyone(regardless whether true or not) saying they are in pain. This in turn has most likely led to those that need it either not getting it, or being forced to jump through hoops to get/keep a script.
sevenhelmet
05-24-17, 09:27
Opiates scare the hell out of me. I was prescribed 50 Percocet for a shoulder arthroscopy back in 2005. Fifty. I took just one the day after my surgery, and within 20 minutes I had stopped caring about the world, my shoulder, or anything else. Woke up the next morning, realized how far gone I'd been, and flushed the rest. Never again. The recovery pain wasn't that bad, despite what everyone had told me. Then I got something like 30 Hydrocodone for a vasectomy in 2012. A freaking vasectomy! It's a little tender for about 5-7 days, stay on the couch for 3, wear compression underwear and don't lift anything heavy for a couple of weeks. Easy recovery. Flushed the pain meds. In 2014 a military buddy fell on some stairs and cut his hand badly. His prescriptions made it look like he'd had his leg sawn off. He told the doc he wasn't in pain, but got prescribed hydrocodone anyway. He didn't take them.
I realize there are legitimate reasons out there for opoid prescriptions, and it's a complex issue with no "one size fits all" answer. But it also seems- from my admittedly limited perspective- that opoids are being over-prescribed by the medical professionals.
Yes, correct. Despite being promoted as a "non addictive opiate" it was anything but. That is how a LOT of people ended up with an addiction and when the Oxy went away to moved on to any form of opiate "including heroin" that they could find.
Most didn't start out to be drug addicted people with destroyed lives, but that was the end result assuming they didn't just die. The problem is all opiates, regardless of how you synthesize them are still opiates and all have the capacity to be far more addictive than your management skills. If you are particularly susceptible to addictions or if you are just trying to manage incredible pain it can be a very precarious balancing act that most people lose eventually.
Sure there are people who can get pain pills, recover, get back to work and never want to take a pain pill again unless they actually have to. But what we are seeing is that kind of person is the exception and not the norm and "non addictive opiate" is a huge oxymoron.
Down here in South Florida we are awash in NJ imports in "recovery programs" and they all tell basically one of two stories. Either they got hurt in something like an auto accident and the "pain pills" got the better of them until they couldn't function without them and they spent a year or two simply building a tolerance and taking larger and larger doses OR they screwed around with Oxy or some similar opiate as it if was just another "recreational drug" and the next thing they knew they had f-ed over their life.
And because they no longer no what they are doing, having little control over their addictions (despite being in recovery) and generally make poor decisions about the amounts they can handle they die pretty regularly down here and unintentional overdoses are very, very common.
I'm always shocked at how quickly tolerance and dependence occurs. I've seen a few cases that go from small to huge doses very quickly.
Averageman
05-24-17, 10:22
I got had kidney stones while deployed and worked around it until the pain was to severe to deal with anymore.
They were happy to give me morphine until the stone passed, due to the large size of the stone and my unwillingness to leave country for treatment in Germany, I toughed it out until the stone passed. All told about 30+ days on morphine or Oxy, luckily for me I never became dependent or had any withdrawal symptoms.
I will say though that morphine is a very, very seductive drug. From dealing with the most intense pain I have ever experienced in my life, to feeling like I was floating on a cloud in minutes. I can see how someone might develop a taste for that.
Steyr- Some excellent observations. Mainly, most people do not have the willpower/ability to manage long-term(past a month or so on daily dosing) pain meds. For me, it is a combination of factors. Unfortunately/fortunately, my body metabolizes opioids at an unbelievable rate and I do not receive the same effects as most. Discovered this when I was 12, broke an arm, and the pain meds. did not work at pediatric dosages. When the MD increased the dosage, I never felt "high" but did receive some relief. I've had 13 broken bones, 3 major surgeries, and almost 200 stitches and staples.
Have dealt with pain meds. mucho. My body chemistry has made it difficult in that they just don't work like normal on me. I haven't had a pain med. in months, but I could take 30mg. of Oxy and most likely no one would be able to tell. Both a blessing and a curse. They don't work as well on me so why would I want to take them? Flip side: when I'm injured, I don't get the relief most do from the pain meds. Even with all this, my body still will feel the need after long periods of use. The dichotomy of my body and pain pills as well as my many times taking and stopping easily, has made me somewhat "hardened" to the addiction side.
For me, and only me, because it is such a complex issue, it boils down to choosing my family, the pain, and the good atmosphere(no pills) it brings to my life versus living in a fog and what that would do to me and my family. Not only that, but my religion teaches me to be a better man and can't do that being a junkie. How the phuck someone can choose a pill over family is beyond me. In this crazy world, my kids and wife are better off with me in pain but not on pills. My children need a father that is all there and my wife needs a husband with his shit wired tight. They deserve it. Becoming a pill head is selfish. Priorities. I really have little sympathy for addicts.
I What all these junkies have done is made it hard for true pain sufferers. MD's are now so worried of getting a rep. as a pill mill, that they are forced to be more strict and skeptical of anyone(regardless whether true or not) saying they are in pain. This in turn has most likely led to those that need it either not getting it, or being forced to jump through hoops to get/keep a script.
Not many physicians care about their rep as a "pill mill", but they do care very much about the state prescribing regulations that are popping up state-to-state these days. There are some very real potential penalties that are involved in prescribing opiates outside of the parameters that some state congressman thinks is how drugs should be prescribed. I say "potential" penalties because the silly part is, despite the legislation, enforcement is almost always by state medical boards, which are notoriously lenient in dealing with physician transgressions.
For my part, I deal with acute pain in postoperative patients, and most of that is minimally invasive surgery, so I'm serving a different patient population - one with real pain, but usually not very much of it. My prescribing habits haven't really changed at all.
Voodoochild
05-24-17, 12:07
They had better be worried about being a pill mill especially when the DEA comes knocking. They could very well be charged in some deaths if it is determined they are just signing off on a perscription like it's a bathroom pass.
Not many physicians care about their rep as a "pill mill"
Have to disagree on this one. My wife has practiced in four states. Most of our friends are MD's. Cover the spectrum of specialties. Once the drug using community finds out an MD will write scripts without too much hassle, word travels. Seen it happen multiple times. We jumped around getting med school loans paid off which gave us the opportunity to travel and look around. Now we are settled in one place and it took about 6 months for the junkies to find out she wouldn't play their game. None of the places we have lived, with the exception of WV, have been places thought of as having serious drug problems. As in, we were not in high risk areas.
Could be that your patient population/area has not been affected as dramatically as others. Maybe I'm wrong.
I have an uncle who was an iron worker and fell off a building many years ago. Needless to say he was messed up and has never been the same. He has been on all kinds of pain meds for years and is totally dependant on them now. Moreover as time goes on the meds do less and less to help him,
I have a cousin on the other end of the spectrum who has battled heroin addiction and has been hospitalized for overdoses before.
That said I don't personally have an emotional stake in this subject. My sentiments are similar to much of what has already been said. If someone chooses to try heroin recreationally just because they want to get high and it kills them - too bad, they chose to play chicken with a freight train. I do think that it's sad for people who turn to these kinds of drugs as a coping mechanism - maybe they don't know of other options or can't afford therapy/psychiatry or what have you - and once they're addicted the drive to keep using ultimately kills them.
Moose-Knuckle
05-25-17, 03:43
Nevermind.
They had better be worried about being a pill mill especially when the DEA comes knocking. They could very well be charged in some deaths if it is determined they are just signing off on a perscription like it's a bathroom pass.
Worried about their reputation as a pill mill. And deaths caused by misprescribing wouldn't have anything to do with the DEA. The DEA would likely just pull their drug license and let the state carry the ball on the deaths. Stuff like that in the past, even deaths, would usually go to the state's medical board, which would usually do little in the way punishment. In today's environment, it's more likely that such deaths would get the attention of local prosecutors with the doctor being indicted rather than just getting a slap on the wrist. State medical boards are still pretty lame when it comes to punishing doctors. Far more likely to get sanctioned for sexual improprieties with patients than misprescribing opiates.
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