war on drugs – Page 2

Remember Speed Kills

Remember Jimi Hendrix, back in the 60s? Believe it or not, he was a contributor on the anti drug album “First Vibrations, Speed Kills” in 1969. Apparently, he didn’t learn much from that ’cause he died from a drug overdose a year or so later.

Then there was Janis. She died of a heroin OD in 1970.

Canned Heat sang Amphetamine Annie (Speed Kills) in 1970. Bob Hite died of a heroine/cocaine binge in front of his band mates. (An interesting jam session read.)(1)

And John Belushi. He died of a speedball. Speedballs are a concoction of heroine and some type of amphetamine shot into a vein.

Public outcry after Belushi’s death essentially pushed the speedballs and amphetamines off the map.

For awhile.

Well, speedballs are back.

You know what history teaches us?

It teaches us that people don’t learn a damn thing from history.

Your grumpy Uncle/Brother Dave.

http://ultimateclassicrock.com/canned-heat-bob-hite/

The Government is Out to Get Me

The Attorney General, Jeff Sessions, is out to get me. Well, maybe not me specifically, but anybody and everybody that is complying with the law in regards to drug prescribing and distribution. What I just said is not paranoid hyperbole.

Sessions has designated 12 federal prosecutors to go to cities that have a high impact from the “opiod epidemic”. These prosecutors are to seek and destroy anyone deemed to be prescribing opiod narcotics, and profiting from the process. Their targets include doctors and other health care practitioners, pharmacists, hospitals, clinics and just about anybody or anything that is legally involved in the drug trade.

In his own words in a speech to the Columbus Police Academy in Ohio, he stated, “If you are a doctor illegally prescribing opioid drugs for profit or a pharmacist letting these pills walk out the door… we are coming after you,” Sessions declared. The Opioid Fraud and Abuse Detection Unit, as Sessions referred to the 12 attorneys, will … work in conjunction with the FBI, Drug Enforcement Administration and Health and Human Services to identify and arrest the violators.(2)

Now, why is that? There have been drug crises ongoing in this country and most of the developed world in one form or another, forever. Why would the government decide that the opioid epidemic is worthy of it’s attention, as opposed to, say, methamphetamine, peyote, heroine or marijuana?

Because of the Willie Sutton Syndrome. The bank robber that replied that he robbed banks because that was where the money was.

You see, all of the aforementioned entities are regulated, licensed and insured out the wazoo. Which means that they can be further regulated with licenses, permits, fines and the like. To a point that money may actually be collected.

So, do you think the War on Drugs has produced anything of substance, yet? No. In fact, the only thing the War on Drugs has produced has been a dependent culture and extreme expense to the taxpayers for detention and incarceration, rehabilitation (failed and otherwise), dependent support, medical expenses and on and on.

But, are these legal entities actually responsible for the “opioid epidemic”? Even the liberal New York Times doesn’t think so. “… opioid addiction, now made more deadly by an influx of illicitly manufactured fentanyl and similar drugs.” (1) Overwhelmingly, these drugs are obtained illegally. They may be stolen, purchased on the street from nefarious sources or obtained by malingering (presenting false symptoms for the express purpose of obtaining these drugs).

It doesn’t matter, the government has finally realized that they are more likely to collect their fines from someone making a 6 figure income and dependent on said government for the “right ” to practice their vocation than someone that is on welfare.

One drug dealer’s opinion from your grumpy-drug-dealing Uncle/Brother Dave.

1. https://www.nytimes.com/interactive/2017/06/05/upshot/opioid-epidemic-drug-overdose-deaths-are-rising-faster-than-ever.html

2. http://www.rollingstone.com/culture/news/jeff-sessions-targeting-doctors-profiting-off-opioid-epidemic-w495603

Drug Deal Gone Good

2/4/2018

A guy was on a motorcycle, evading capture by the county sheriff’s deputies for suspected drug offenses. In his hasty, not-so-reckless and excessively speedy operation of the vehicle, he wrecked the motorcycle which he had stolen and ran on foot to evade capture. He jumped a fence, lost his footing, slid and rolled down a hill to the edge of the interstate highway. He jumped up and tried to run across the freeway.

Yup, tried.

A car, traveling at about 70 mph and he collided. Not a full impact. The passenger mirror hit his elbow and left torso in a glancing blow.

As the deputy inventoried his possessions, they found brass knuckles, a loaded gun, methamphetamine and wads of cash.

This was a drug deal that didn’t go well for the guy but did go well for everyone else.

But, he does get the opportunity to add to his collection of big house tats.

From your grumpy Uncle/Brother Dave.

Weary

Saving the Tax Payers Dollars

2/3/2018

The use of radio-controlled-ankle-collar home incarceration versus jail has been around for a while and is, to say the least, controversial. They, the people responsible for these programs, claim a daily cost of $700 for the ankle collar and $3,000 for the jail time.

First, I want to know why it costs $700/day for the ankle-collar when a computer and a GPS satellite are doing all the work?

But, the other issue I have is in regards to my first patient of the day. This guy was given permission to come to the hospital from his parole officer about 10 am. He showed up, with a complaint of chest pain (in a healthy 30 y/o) at 11 pm. He admitted that he went to visit his son during the 13-hour unaccounted for interval.

And, he wasn’t wearing an ankle collar. His tests showed that he had also been doing something other than visiting his son, like doing meth.

I guess it is good that we are saving money on these scum bags using radio-controlled-ankle-collar home incarceration, even though they circumvent the system. No matter what the system. I could only guess how many positive drug tests I’ve seen over the years in jailed patients. So, $700/day versus $3,000/day to use drugs while serving time is saving the taxpayers dollars.

From your grumpy Uncle/Brother, Dave.

Weary

Robo-tripin

7/2017

Robitussin is an over-the-counter cough medication which contains the drug dextromethorphan. This is a response to a recent e-mail I received on the subject.

I’ve previously mentioned some of my experiences with “robo-tripin” patients. I’ve been seeing this for many years now. The article is pretty good, except for one aspect. (1) In my experience, chronic dextromethorphan/codeine use does not induce aggressive behavior. It might lower inhibitions like alcohol but it is very different from the rage/anger/aggression of amphetamines (speed, cocaine, meth, crack…). It’s my opinion that this incident was caused by poor upbringing, bad entitlement and racial attitude and homophobia if dextromethorphan was the only drug on board.

Dextromethorphan has been available over the counter for 50 years or more. The fact that dextromethorphan differs in structure from codeine by 2 hydroxy (one oxygen attached to 2 hydrogen) groups became known on the streets and users found that they can get similar effects using dextromethorphan (legal and available without a prescription) as codeine (requires a prescription) by just increasing the dose.

Codeine-like drugs have way overtaken valium-like drugs as the most common prescribed drug in America. They are not stimulants but depressants in their general mechanism of action.

Codeine and its synthetic variants, hydrocodone, methadone, hydromorphone and oxycodone, are legal for the person to whom the prescription was written. There is a billion dollar industry in the US for legal and illegal codeine obtained in various ways.

For instance, a team may go to a medium-large town and break into a doctor’s office. They forge scripts found in the office and distribute them to street people to have filled. “Organizers”, kinda like what Obama was (but not necessarily implying Obama pushed drugs), go to derelict areas of a town and recruit low life types to hit the Emergency Departments with feigned and real complaints. Casts are cut off freshly broken extremities and the person is sent to the ED as if it was a fresh injury, then to the next ED and so on. Salvation Army and like shelters, food kitchens, and welfare housing are recruitment centers for these people.

The Urban Dictionary is indispensable, entertaining and scary. Slang used by kids changes, sometimes daily. I would venture to guess that 90% of the population below the age of 19 know of this use of dextromethorphan. Those that disagree just don’t realize the kid is lying.

Here is my most often told story of Robo-tripin.

One evening at work, a respiratory therapist came to me and said, “Doctor, you need to come to see this patient now. He isn’t breathing very good.”

I checked the patient out and sure enough, he wasn’t breathing at all! We quickly grabbed an Ambu bag and started to breathe for him. During my exam, I noted that he did have a pulse but was otherwise unresponsive. To determine unresponsiveness, the examiner inflicts painful stimuli and notes the response. Yup, I can make anyone wince and sometimes it’s even part of my job. He had no response. This was a young guy, 19-20 or so. So I said, “Looks like I’m going to have to intubate this fella.” At this point, I knew that he was in a coma but didn’t know why.

To intubate a patient, I put a plastic tube down their trachea which allows us to breathe for him/her until we can identify and hopefully reverse the problem. So I take my handy dandy laryngoscope (with decoder ring optional), which is basically a flashlight with the bulb at the end of a tongue blade extension at right angles to the handle, and insert it into the oral cavity. This guy’s muscles were flaccid and he offered no resistance. The blade-like portion is used to move the tongue out of the way (seems a problem with us humans that our tongue seems to get in the way of life all the time) and allows the provider a view of the vocal cords. The mission is to pass the plastic tube between the vocal cords when they open and into the trachea just below. The vocal cords are touched by the tube as it passes through.

Under normal circumstances, when that happens a nerve is stimulated and it sends a signal to the brain that results in a violent and forceful cough response. Think eating cookies and accidentally inhaling crumbs into the windpipe. In a comatose patient, the response does not happen.

Well, Robotrucker here, responded when I touched his vocal cords. He reached up (none of the others nor I expected this comatose patient to respond at all) and smacked the tube and laryngoscope from my hands and sat up. “Don’t do that!”, he exclaimed. He walked out of the ED under his own power about 45 minutes later.

This was an extremely unexpected event, but it has since happened to me several times. Something about this laryngeal reflex pops them right out of a coma. Not every time mind you, and not every patient is lucky enough to be found in time.

Life in the emergency department from your grumpy Uncle/Brother Dave.

http://theconservativetreehouse.com/2012/05/24/update-26-part-2-trayvon-martin-shooting-a-year-of-drug-use-culminates-in-predictable-violence

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