BushyFromOz

The aggressive methamphetamine patient

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So after 3 years and no post, I've successfully resurrected 1 dead thread and started another....

 

Anyway, Methamphetamine has become a big story here over the last few years, (the jokers would say we don't have Methamphetamine problem because everybody has it)

. And unlike you Heroin epidemic of the late 90's, to late 2000's where they were nice and peacefully asleep and a little bit cyanosed and they would generally wake up with some oxygenation and some Narcan and be pretty OK with things, these mongrels are often wound up like spring, especially the polypharm OD's and sometimes even the synthetic Marijuana user. It became such a problem we are now giving high dose IM ketamine to knock them down as Midazolam was ineffective,

Just interested to hear whats happening in other places,  are you dealing with it, and are you seeing secondary problems such as serotonin syndrome/rhabdo/renal failure/MI often?

 

There.. my contribution for the next 3 years ;)

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Meth isn't a big thing in my area.  I'm in heroin central.  Heroin, heroin and more heroin.  It's cheap, plentiful and potent.  At one of the ERs where I'm working we get pretty regular drive up for the unresponsive respiratory arrest from heroin OD.

The few meth patients we have seen can get pretty scary pretty quickly.  They'll flip like a switch and become wicked violent.  Ketamine has worked well as, similar to your experience, midaz wasn't doing much.

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Heroin is making a bit of a comeback. With the State and  Feferal Police forces looking at amphetamines so kucg, good ole heroin is a cheaper low key option.

Its pretty amazing how many meth users i mett who were heroin users who changed drugs in the late 2000's when heroin was becoming more expensive.

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All of our folks used to be prescription opioid abusers.  We've been clamping down on prescription narcotics for a while now.  While we still get some folks who are angling for narcs from the ER it doesn't happen nearly as often as it used to.  When oxys and percocets became more expensive due to decreased supply they started going to heroin.  Or going back to heroin.

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On 01/11/2017 at 12:34 AM, paramedicmike said:

All of our folks used to be prescription opioid abusers.  We've been clamping down on prescription narcotics for a while now.  While we still get some folks who are angling for narcs from the ER it doesn't happen nearly as often as it used to.  When oxys and percocets became more expensive due to decreased supply they started going to heroin.  Or going back to heroin.

Actually, thats a good point. You cant sill buy codeine based products over the counter here for a few more months. I wonder how much substitution will happen afterwards

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Codeine products OTC?  Interesting.  How does that work?  How's it regulated?  Sounds like it's going away from your statement.

Abuse issues with this kind of availability?

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Not well regulated im afraid. A pharmacist can dispense it if you provide identification, but its open to and does get abused, which is why it's being closed. I'm not sure where that fits into the heroin trade, as the heroin epidemic was before my time in the job.

 

My gut feeling is Dr shopping tends to be people with chronic pain who have then become addicted, where the earlier heroin epidemic was more based in recreational drug use, but i have nothing to back that statement with.

Edited by BushyFromOz

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