Tuesday, April 5, 2016

Those Overdoing From Fentanyl-related Drug Overdoses Not Alone: Can Addicts Be Responsible?


Let's stop mincing words and face the facts. According to a new report from the Centers for Disease Control, most Ohioans dying from fentanyl-related drug overdoses are not alone when they overdose. Also the CDC found the rise of fentanyl, an opioid, was the primary factor in the nearly 18 percent increase of Ohio's 2014 overdose deaths Those 502 Ohio deaths were up sixfold from 2013.

More people died from drug overdoses in Ohio than breast cancer, Parkinson's disease or prostate cancer in 2013, according to U.S. Centers for Disease Control and Prevention numbers.

Do you know what fentanyl is? Fentanyl is an opioid narcotic analgesic used in the management of chronic severe pain or in cancer treatment. It is generally used intravenously in hospitals. However, the fentanyl transdermal patch is a topical adhesive strip that slowly administers the pain medication fentanyl through the skin.

Claims say that fentanyl is about 81 times stronger than morphine or 50 to 100 times more potent than heroin. On the street it’s usually added to heroin to create a stronger high. The main concern is the fact that heroin users do not realize the dangers of fentanyl. Additionally, they usually don't understand the drug is in the heroin and instead are swayed to try that brand of heroin after hearing about the drug’s potency.

Ray Isackila, counselor and team leader of addiction treatment at University Hospitals Case Medical Center in Cleveland, said, “Heroin with illicit fentanyl laced into it makes it stronger, cheaper and more desirable on the street. People hear about this new heroin or this super strong heroin that someone is selling and they want it.”

The CDC made recommendations, some of which the state has already begun, such as boosting the quality of information on overdoses from emergency departments and getting an alert if there's a spike.

According to the CDC study, 72 percent of fentanyl-related deaths occurred with some type of bystander present and EMS was present for 82 percent of deaths.

However, naloxone was only administered to about 41 percent of people, possibly because some were pronounced dead when EMS arrived, administration wasn't reported, or it was a “missed opportunity.”

The report’s recommendations focused on targeting public health response to those counties and high-risk groups as well as enhancing public health surveillance.

“We need to remember there needs to be a comprehensive approach. We need to continue to do what we’ve been doing, but redouble some efforts,” Ohio Department of Health Medical Director Mary DiOrio said, noting the importance of continued efforts to increase awareness of naloxone.

(Jona Ison. “Report reveals Ohio overdose victims rarely die alone. Gannett Ohio
March 24, 2016.)


Important Witnesses

People can even buy fentanyl online without a prescription, and some sites suggest doctors who may prescribe for the substance. I even saw fentanyl lollipops for sale. At least one site compares fentanyl prices at Target, Kroger Pharmacy, and Safeway with an online coupon ($137-$195 cash price and coupon savings making cost $49.02-$52.01).

We all know doctors and pharmacists are important witnesses who can stop fentanyl abuse. The good medical professionals do.

Officials in southern Ohio hope a new amnesty program will help curb drug-overdose deaths.

Consider the witnesses to overdose at the scene ...

Ross County, Ohio, is taking new measures. The Overdose Amnesty Program offered by Ross County authorities applies to witnesses of drug overdoses who call for help.

“Heroin is not worth dying over,” said Ross County Prosecutor Matthew Schmidt. “Law-enforcement officials in this county would rather see addicts get help than get arrested. We would rather see lives saved than lives lost.”

In Ross County, emergency callers can ask for amnesty on misdemeanor drug charges, such as drug possession, possession of drug-abuse instruments, permitting drug abuse and drug-paraphernalia charges. Drug traffickers will not be eligible for amnesty.

“This is not for drug dealers,” Schmidt said. “You won’t be able to avoid charges.”

(“Ross County offers amnesty to witnesses of drug overdoses.” The Columbus Dispatch
January 02, 2016.)

Statewide? Reps. Robert Sprague (R., Findlay) and Denise Driehaus (D., Cincinnati) hope that promising some immunity from prosecution will convince drug users not to fear calling 911 when someone overdoses before their eyes.

House Bill 249 (Aaron's Law) is an extension of Ohio’s Good Samaritan Law. It was introduced and referred to committee on June 11, 2015, by lawmakers. Aaron's Law was the latest in a series of legislative efforts to get ahead of Ohio's heroin and prescription-painkiller epidemic.

This so-called “good Samaritan bill” — which would exempt someone from drug charges if he or she called 911 when a friend overdosed — failed to pass in the previous Ohio General Assembly session. Some lawmakers fretted it would enable drug abuse.

But sponsors say they hope lawmakers have learned enough to pass the bill this time around.

Click here to sign an online petition to support the bill: https://www.gopetition.com/petitions/hb-249-aarons-law-good-samaritan-law.html

You may wonder why more actual witnesses to overdose don't report the details. A study in the International Journal of Drug Policy found heroin users generally had a positive attitude towards assisting peers who had overdosed. 

However, a number of factors and circumstances contribute to witnesses often experiencing resistance to or ambivalence about responding. These things included the following:
  1. A witness's own high,
  2. The difficulty in assessing the seriousness of the situation,
  3. An unwillingness to disturb someone else's high,
  4. Uncertainty about the motive behind the overdose,
  5. Whether the victim does or does not want assistance, and
  6. Fear of police involvement.
(Torkel Richert. “Wasted, overdosed, or beyond saving – To act or not to act? Heroin users’ views, assessments, and responses to witnessed overdoses in Malmö, Sweden.” International Journal of Drug Policy. Volume 26. January 2015.)

To end, my plea to "face up" comes in the form of a direct comment about opioid overdoses, especially about the deadly fentanyl-related drug overdoses that kill so many. Addicts on the scene – those at risk and even remotely responsible for the safety of others – you must report the crime and identify whoever laces heroin with fentanyl. Failure to do so will continue to promote death and irreparable destruction. For God's sake, administer naloxone but also report the criminals dealing the deadly mistures.

You become an accessory to potential murders when you fail to act. I understand that the substance can override all else, even your conscience; however, your own addiction is something you must deal with immediately or else you will become a predator yourself. Saving a life is the most noble act of a human. Do the right thing. Families of overdose victims live with indescribable grief not knowing the circumstances of the actions that took their loved one's life. You can help them live.


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