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Opiate effect on brainRichard Knox, NPR “All Things Considered” 02 January 08:

Every year, overdoses of heroin and opiates, such as Oxycontin, kill more drug users than AIDS, hepatitis or homicide.

And the number of overdoses has gone up dramatically over the past decade.

But now, public health workers from New York to Los Angeles, North Carolina to New Mexico, are preventing thousands of deaths by giving $9.50 rescue kits to drug users. The kits turn drug users into first responders by giving them the tools to save a life.

One of the new rescue operations is located off a side street behind St. Peter’s Episcopal Church in Cambridge, Mass. Clients enter through an innocuous-looking door and climb a flight of wooden stairs to the Cambridge Cares About AIDS program for harm reduction.

The group says its mission is to provide prevention, education, advocacy and support services to the economically and socially disadvantaged.

At CCAA, drug users can obtain condoms, sterile needles, syringes and other resources to reduce their vulnerability to disease and death. Health educators also cajole their clients to undergo HIV and hepatitis testing, urge them not to share needles, and find them slots in detoxification programs and methadone treatment.

Drug Used as a Nasal Spray

On one recent wintry morning, health educator Eliza Wheeler teaches a 34-year-old client named Elissa how to rescue her friends from a fatal overdose.

“All right, Elissa,” Wheeler says in a getting-down-to-business manner. “The first thing I’m going to do is ask a series of questions about your current drug use. So, we’re going to talk about just the last 30 days.”

Elissa has been on methadone for six years, but she confesses that she used heroin a couple of days in the previous month because she was under a lot of stress.

Like most long-term heroin users, Elissa has had scary experiences with overdoses – her own and others’. Once, her partner became unresponsive after taking a mixture of heroin, benzodiazepine pills and alcohol, she says.

“He was not breathing, which is why I called the ambulance,” she says. “But I managed to wake him up before they came, and they didn’t take him away. He went out and convinced them he was OK.”

Many times, drug users and their friends don’t call 911, which is why overdoses are so often fatal. They’re afraid the police might come, and they could get arrested — or lose their housing or custody of their children.

Signs of Overdose

Wheeler runs through the signs of heroin overdose for Elissa.

“There are some clear signs, like people turning blue,” Wheeler says. “Sometimes, there’s like a gurgling sound and nonresponsiveness, of course. And there are some less clear signs, like people being in kind of a heavy nod — kind of being really sedated — not breathing very often. We usually say 12 breaths a minute is key. So, if people are breathing less than that, it’s time to really be concerned.”

Wheeler says stimulation — rubbing hard on the breastbone or the upper lip — can sometimes bring an overdose victim back to consciousness. If that doesn’t work, call 911 and start blowing air into the person’s lungs, a modified form of CPR called “rescue breathing.”

That’s when it’s time to open up the overdose rescue kit, Wheeler says, ripping open a plastic bag and taking out a small box containing a vial of medicine.

“This is what the box looks like,” she says. “Attached to the box is a little apparatus that makes it into a spray. It’s just a nasal spray. There’s no injection.”

“That’s so wonderful!” Elissa says, looking visibly relieved. “I had thought it was a shot.”

The nasal spray is a drug called naloxone, or Narcan. It blocks the brain receptors that heroin activates, instantly reversing an overdose.

Doctors and emergency medical technicians have used Narcan for years in hospitals and ambulances. But it doesn’t require much training because it’s impossible to overdose on Narcan.

The Cambridge program began putting Narcan kits into drug users’ hands in August. Since then, the kits have been used to reverse seven overdoses.

New data compiled for NPR by researcher Alex Kral of the consulting firm RTI International show that more than 2,600 overdoses have been reversed in 16 programs operating across the nation.

Kral estimates that is at least 75 percent of all the reversals that have occurred so far among several dozen U.S. programs, many of which are new.

John Gatto, executive director of the Cambridge program, says such dramatic results are unusual in the world of substance abuse treatment and prevention.

“In the work that we do, oftentimes the results are very intangible,” Gatto says. “This is amazing to be involved in something that literally can save people’s lives. Why wouldn’t we do it?”

Program Has Critics

But Dr. Bertha Madras, deputy director of the White House Office on National Drug Control Policy, opposes the use of Narcan in overdose-rescue programs.

“First of all, I don’t agree with giving an opioid antidote to non-medical professionals. That’s No. 1,” she says. “I just don’t think that’s good public health policy.”

Madras says drug users aren’t likely to be competent to deal with an overdose emergency. More importantly, she says, Narcan kits may actually encourage drug abusers to keep using heroin because they know overdosing isn’t as likely.

Madras says the rescue programs might take away the drug user’s motivation to get into detoxification and drug treatment.

“Sometimes having an overdose, being in an emergency room, having that contact with a health care professional is enough to make a person snap into the reality of the situation and snap into having someone give them services,” Madras says.

Study Confirms Benefits

There is not much research on the effect of Narcan kits on drug abusers’ behavior, but one small study suggests that overdose-rescue programs reduce heroin use and get some people into treatment.

Karen Seal, an author of the study, says the study showed rescue programs have a tremendous impact.

“It was one of those great studies where we just all walked away and said, ‘Whoa! This is terrific!’” says Seal, of the University of California, San Francisco. “I mean, by our sheer interaction with these folks around these life-saving behaviors, we’re actually creating some real positive change here.”

And health educator Wheeler says putting overdose-rescue kits in the hands of drug users sends them a positive message.

“There is a real potential culture change among drug users because of Narcan,” she says. “Because, from my experience, I feel like drug users internalize a lot of stigma that’s out in the world about them. They come to believe that dying is just part of this life that they’ve chosen.”

Wheeler says it doesn’t have to be that way.

Despite the rescue program’s critics, it has not generated the kind of controversy that surrounded needle-exchange programs. Those programs seek to prevent drug users from getting HIV or hepatitis by sharing dirty needles and syringes.

So far, Narcan rescue programs have sprung up in big cities and rural areas around the country with little or no opposition.

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Glenn BeckConservative television personality Glenn Beck is absolutely outraged because he went to a hospital emergency room in an upscale area (where the President of GE is treated, no less), and was made to wait in the ER for 40 minutes. Even after he got into a bed, for two horrifying hours he was given no pain medication, and he was ignored by hospital staff.He even cried, trying to get attention, but it didn’t work. What does an incredibly annoying, self-important, arrogant and pompous television personality have to do to get some medical treatment these days, anyway? Beck complained about “massive, massive pain”, and complained that a large orderly did not help Mrs. Beck get him up out of the chair. He requested oxygen, but that request was denied.

He says he has hospital stories from that stay that will “melt your brain”. He compared his hospital experiences to the movie “Saw“. He felt that there was “no reason to live”.

Eventually the situation was put into perspective for us by Beck’s employer, CNN, when they compared Beck’s experience to that of Edith Rodriguez.

Last year, [Rodriguez] was on the floor of a Los Angeles hospital emergency room vomiting blood, and witnesses say no one did anything to help her. Her boyfriend actually called 911, which refused to help since she was already in a hospital. Rodriguez died in the emergency room.

CNN is absolutely correct. Glenn Beck could have died right there in the ER, from his life-threatening case of …..

Hemorrhoids?

You’re kidding, right?

Okay, that’s just plain funny. Becky needs to man up and stop acting like a whiny little sissy girl, ROFL.

If anyone can stomach watching this ass-clown whine incessantly about his horrifying hemorrhoid hospital experience, here’s the video he made (yeah, he actually made a video so we could point and laugh at him – thanks, Becky!)


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Sources:

The Philadelphia Inquirer: Beck’s hemorrhoid horror

CNN: Five things not to do in the ER


Originally posted on Adventures in Frickintardistan

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CNN:WASHINGTON (CNN) — Workers who are legally prescribed marijuana to treat illness can still be fired from their jobs, following a ruling Thursday from the California Supreme Court.

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Medical marijuana user Angel Raich, 41, had her pot confiscated while her case was appealed.

The 5-2 decision upheld the job termination of Gary Ross, who flunked a company drug test shortly after being hired at a telecommunications firm.

A state referendum that allows people to use medical marijuana with a physician’s recommendation are immune from some state criminal drug possession charges. But the state high court said such legal protection only goes so far.

“Nothing in the text or history of the Compassionate Use Act suggests the voters intended the measure to address the respective rights and duties of employers and employees,” wrote Justice Kathryn Mickle Werdegar. “Under California law, an employer may require pre-employment drug tests, and take illegal drug use into consideration in making employment decisions.”

The court agreed with RagingWire Telecommunications’ contention it had a right to fire Ross because any marijuana use is illegal under separate U.S. law. The company said its work across state borders could put it in legal jeopardy from federal labor standards involving the conduct and production of its work force.

The U.S. Supreme Court has said the Bush administration can prohibit the backyard cultivation of pot for personal use, because such use has broader social and financial implications.

A federal appeals court last March said medical marijuana users can be subject to arrest and confiscation of the material, under federal anti-drug laws.

The issue is being closely watched because of the obvious conflict between state and federal laws over the use of medical marijuana. Various courts have said the federal Controlled Substances Act does not violate state autonomy.

The latest case involves Ross’ back problems stemming from injuries sustained when he served in the U.S. Air Force. He received a physician’s recommendation to use pot in 1999 and presented a card certifying his use of the narcotic when he took the employment drug test in 2001.

Ross said his condition does “not affect his ability to do the essential functions of the job” his former employer hired him to do, according to his original complaint.

The Sacramento-based company said its no-tolerance policy applies to all workers, since potential “abuse of drugs and alcohol” could lead to “increased absenteeism, diminished productivity, greater health costs, increased safety problems, and potential liability to third parties,” according to the company’s lawyers.

Ross’ job performance was not at issue in the case.

The state supreme court said the law allowing use of marijuana for some patients is “modest” in scope, limiting the rights of some patients.

The U.S. Supreme Court ruling in 2005 for the Bush administration giving it broad authority to crack down on illegal drug use was criticized by patient rights groups and the movement to legalize marijuana.

“Congress’ power to regulate purely activities that are part of an economic ‘class of activities’ that have a substantial effect on interstate commerce is firmly established,” wrote Justice John Paul Stevens.

Under federal law, the Controlled Substances Act prevents the cultivation and possession of marijuana, even by people who claim personal “medicinal” use. The federal government has argued its overall anti-drug campaign would be undermined even by limited patient exceptions.

That high court case involved a separate lawsuit from a pot patient from Oakland, California, who has a variety of medical conditions, including a brain tumor. Angel Raich had her pot confiscated and was not allowed to use it while her case was appealed.

The Drug Enforcement Administration began raids in 2001 against patients using the drug and their caregivers in California.

Along with California, 11 other states have passed laws permitting marijuana use by patients with a doctor’s approval: Alaska, Colorado, Hawaii, Maine, Montana, Nevada, New Mexico, Oregon, Rhode Island, Vermont and Washington. Arizona also has a similar law, but no formal program in place to administer prescription marijuana.

California’s Compassionate Use Act permits patients with a doctor’s approval to grow, smoke or acquire the drug for “medical needs.”

Users include television host Montel Williams, who has multiple sclerosis.

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