Wednesday, July 20, 2016

Deadly Heroin with Elephant Tranquilizers? Smoking Cigarettes? Comparing Addictions


I make daily trips to a health facility nearby to visit my 95-year-old mother. While there, I can't help but notice employees who smoke making a fairly long walk to some tables at the edge of the facility to have a cigarette. The traffic back and forth to the smoking area is busy all the time. 

I am not making judgments on those with bad habits. Lord knows I have my own shortcomings. However, every day I feel so fortunate not to feel the need to smoke because I don't have to deal with the considerable threats to my health and the high cost of the product. I believe refraining from smoking has been one of the smartest decisions in my life.

I am able to say this as the 65-year-old son of a father who sold cigarettes and other tobacco products for thirty years. I was the only member of my immediate family who never smoked, and, ironically, I remember my dad begging me at a very early age never to start smoking. Many years ago when he sold cigarettes, little was known about the horrible effects of smoking cigarettes. Still, common sense made solid connections -- even in those days when smoking was "cool."

I understand the addictive qualities of nicotine. As a primer for those who don't understand how the substance works, here is a brief explanation from the National Institute on Drug Abuse:

Nicotine activates reward pathways of the brain. A key brain chemical involved in mediating the desire to consume drugs is the neurotransmitter dopamine, and research has shown that nicotine increases levels of dopamine in the reward circuits. This reaction is similar to that seen with other drugs of abuse and is thought to underlie the pleasurable sensations experienced by many smokers. For many tobacco users, long-term brain changes induced by continued nicotine exposure result in addiction.

Nicotine’s pharmacokinetic properties also enhance its abuse potential. Cigarette smoking produces a rapid distribution of nicotine to the brain, with drug levels peaking within 10 seconds of inhalation. However, the acute effects of nicotine dissipate quickly, as do the associated feelings of reward, which causes the smoker to continue dosing to maintain the drug’s pleasurable effects and prevent withdrawal.”

(“Is Nicotine Addictive?” National Institute on Drug Abuse. July 2012.)

Tobacco has always been a part of American history and heritage. Before research on the risks of smoking made it clear that smoking cigarettes caused many serious health problems, people accepted smoking as casual stimulation. Although it is now commonly accepted more as a nuisance habit than as a slow killer, the long-term effects of smoking are devastating.

How deadly can smoking be? The U.S. Department of Health and Human Services says more than 10 times as many U.S. citizens have died prematurely from cigarette smoking than have died in all the wars fought by the United States during its history.

The U.S. Surgeon General says about 480,000 Americans die each year as a result of smoking. But a new analysis suggests the true figure may be closer to 575,000.

The 21 causes of death that have been officially blamed on smoking accounted for 83% of the actual deaths among smokers who were tracked in a study published in the New England Journal of Medicine (2015).

Additional diseases – including breast cancer, prostate cancer, hypertensive heart disease and renal failure -- were responsible for most of the rest of the observed deaths. A very small number of deaths were due to things such as accidents and suicide, which have a more tenuous link to smoking.

(Karen Kaplan. “Cigarette smoking is even more deadly than you think, study says.”
 Los Angeles Times. February 11, 2015.)

I can only imagine how the need to smoke becomes a dominant force in a smoker's life. People who have stopped smoking tell me that the withdrawal make them very anxious, irritable, physically ill, and even extremely depressed.

Isn't the public perception about drugs and their effects amazing? We are shocked about those who choose to use substances such as opioid prescriptions and heroin that can cause immediate death, yet we tend to soften our attitudes about smoking cigarette.

I am guilty of this judgment. The latest extremely deadly substance is carfentanil, a substance used as an elephant tranquilizer. It is said that it’s 10,000 times more powerful than morphine. In fact, Dr. Kimberly Cook, director at the Akron Zoo says of it use,“It’s an incredibly dangerous drug. We’re concerned that even a drop could get in an eye, so we wear eye protection. We wear long sleeves. We wear gloves.”

The drug, itself, can be inhaled or absorbed through the skin, which means it may affect family members, passerby, and even emergency respondents.

As unbelievable as this may sound, in Ohio a current overdose spike has been attributed to a new combination of carfentanil and heroin. The mix makes the drug more potent, intensifies its effect, and therefore makes it so much more dangerous. Since July 5, 91 overdoses have been reported in Akron, of which eight had been fatal. Another person is currently on life support.
(Joe Hennessy. “Carfentanil and Heroin Overdose in Ohio.”  
The Monitor Daily Dayton. July 17, 2016.)

Hamilton County officials have started to see the drug as a serial killer. Public health surveillance of emergency rooms visits in Hamilton County revealed a significant increase beginning July 13. The following day, the Greater Cincinnati Fusion Center issued a warning that carfentanil was present in street drugs in Hamilton County, as well as in the Akron and Columbus areas.

"Our community has been devastated by heroin and fentanyl abuse,” says Hamilton County Coroner, Dr. Lakshmi K. Sammarco. “So many families have lost loved ones to this scourge. The fact that there is a new lethal drug that has been found on the streets of Hamilton County is frightening. Take this as a dire warning to all, if you choose to purchase and use any forms of heroin. No one knows what other drugs may be mixed in or substituted and you may be literally gambling with your life. Don't count on Narcan to be able to reverse the effects of carfentanil," she warns.

(Mike Samet. “Heroin Adulterant Creating Deadly Combination.” 
Hamilton County Heroin Coalition. July 15, 2016.)

Authorities warn that the life of every person that is a street drug consumer is now threatened by the new mix. Individuals who buy heroin off the streets have to take into consideration the fact that it may be combined with carfentanil, and they should stop and think of the possibly fatal consequences.

To make matters worse, health officials warn that Narcan, the overdose medicine that is sold in pharmacies without a prescription, may not be efficient in the case of this obscure combination. 
Where does carfentanil originate?

The current theory is that the drug originated from China, a country that is often used as a source of research chemical substances. However, Ohio state representatives said the drug could also be manufactured locally inside the community.

Yep …

People are knowingly or unknowingly taking heroin mixed with elephant tranquilizers. Shocking! Amazing! Unbelievable! How could those people take such substances and risk their lives? They are at great risk of dropping dead. These junkies are a scourge to society with their overwhelming addictions and risky behaviors … well, aren't they?

But, wait …

How many addicts will you see today drawing in smoke and nicotine from a cigarette and choosing to ride the slow train to destruction … to death? Maybe their “high” is vastly different from the effects of shooting heroin, but the addiction is real and could be just as detrimental.

I am in no way defending heroin addiction or taking substances containing unknown chemical mixtures. And, I don't like to see people smoke because I know they are hurting themselves. I accept it, but I don't like it. 

Furthermore, I think there is a lesson about drug addiction in this comparison of cigarette and heroin dependency. That lesson is this: “The risk for addiction you take is too great to begin experimentation or casual dependency – whether the substance is perceived as acceptable like nicotine or illegal like heroin. Whatever rewards you believe you derive from these drugs will eventually cause permanent damage.”

I beg you, young people, don't allow yourself to be injured by the thrill of risk or by the hype of peer pressure. Don't smoke and don't use opiates like heroin. In the long run, your rewards will come.


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