Recreational Drugs of Choice for Different Regions

[MAC4NH]

Everyone has answered calls for drug abuse and overdoses. Lately I've been wondering which drugs are the biggest problems in different regions. I know that in my state, the drugs of choice vary based on region and socio-economic status.

The reason I got interested in this is that in the city where I work, I started hearing about a substance called "dip" about six to eight months ago (no, its not smokeless tobacco). I eventually had a patient with a habit and asked around about what it actually was. The user dips a cigarette or joint into a formaldehyde solution and smokes it. It gives a high but over time it causes brain damage (go figure) and can cause violent episodes similar to PCP (for dip calls at least 3-4 PD units are routinely sent in a city that rarely sends PD for EMS calls). As the user does more and suffers more brain damage, they lose temperature regulation while they're on it. The patients feel very warm and they can develop rapid malignant hyperthermia and can literally die in minutes from overheating.

Most of my colleagues in the suburbs have never heard of this and it seems to be limited to the cities for the time being.

I have 2 questions to the forum:

1. Have you heard or dealt with this particular drug?

2. (More importantly) What is the biggest problem drug in your region? How does it affect your patients and your care? I feel this is important because your drug problem today could be someone else's next year and we should exchange information on what's out there.

Tell me your experiences.

 

[Ridryder911]

I used to see this in the late 70' s ? They used to also use jet fuel as well.

The few I seen was either delusional and or respiratory problems. One I had to place on vent, and was hospitalized a long time.. don't remember the outcome though.

R/r 911

 

[MAC4NH]

One of the ER nurses on my last one told me about the hyperthermia. Right now it's limited to the inner cities but I can imagine it spreading.

 

[Jon]

I've heard of this... as well as "wet"... or a joint soaked in PCP.

 

[mycrofft]

Never heard about it. Crank is king.

Acute psychotic reactions: Consider “dip dope” intoxication .
Journal of Emergency Nursing , Volume 28 , Issue 5 , Pages 432 - 435
S . Mendyk , D . Fields

http://www.jenonline.org/article/PIIS0099176702000399/fulltext

 

[mycrofft]

Scanned the article.

Not very helpful for field treatment, mostly try to keep them at bay while you attend to any trauma they incurred, and anticipate the malignant hyperthermia and attendant rhabdomyolysis (cath 'em and it will test postive for lysed blood and may be quite red, but it's from muscle, not blood, and bodes ill for the kidneys, much like some extensive burn patients).

 

[MAC4NH]

Mycrofft,

Thanks for the link. It was very informative. The authors of the article are from my area so it seems to be localized to the New Jersey area at this time. They're also right that we really don't see much of it in the winter. The article confirms jon's post that its actually a different delivery system for PCP.

Going back to part 2 of my original post, does anybody out there in other regions have unusual or atypical forms of drug abuse like this that you can educate the rest of about?

 

[mycrofft]

I remember the Sixties........

Yeah, guys high on opium plus something else coming in ecstatic, singing, despite being OC'ed. All have been ethnic Hmong or SE Chinese.

 

[LucidResq]

I can't really say from personal experience what I consider to be the worst drug problem in this area because I'm not in the field, but from what I've heard both cops and medical folks say, meth is a huge emerging problem. Not only are they seeing psych cases, overdoses and various incidents of meth-related accidents and violence, they're seeing the negative effects on innocent bystanders as well. I was told by one cop who has been on countless busts over the years, that every single meth lab he's busted had small children living there, and they were always abused or neglected in one way or another. Not to mention the hazmat of meth labs posing threats to children, neighbors and public safety folks.

 

[HeavyCrow]

Area here on the coast in carolina has had bad batch of heroin going around for 8 months, with 6 or 7 deaths attributed to it. Thats mostly in larger towns/cities. The rural areas (my wife is Sheriffs Deputy in a mostly farming county) are just totally eat-up with meth heads and meth labs...now "portable meth labs" are the big deal (Remember scene safety!!!), stuff cooked in cars/trucks with campers/RVs. Talk about "junk in the trunk". I havent seen or heard of any new drugs/mixes/weird source of ingestion. But the crackheads have learned to fake breathing problems/asthma when their high starts to wear off so they can get abuterol treatment...opens that lower airway so they get one final "kick".

 

[Robby1974]

Meth in Vegas

I haven't seen this here yet but it's good info to be looking for. Vegas seems to be a hot spot for anything "crazy". But yeah Meth...we have lots of meth labs here. People in vegas are crazy about it too. They'll be cookin meth with their 2-3 young kids right there in the house with them.

Edit: and...The new thing here is the portable meth labs also. Someone will order one of those PODS things or get an old u-haul and cook meth in that. Store the thing in the back of their house or in the desert somewhere. It's bad in Parumph (next town over from vegas) because it's rural and easy to hide. Sucks havin to drive out there too...nice break though.

 

[yowzer]

It typically /is/ PCP that the joints are dipped in, not literal embalming fluid (Or that + PCP). Usually goes by 'sherm' up here.

The biggest drug problem, though, by several orders of magnitude over crack, meth, heroin, etc: Alcohol.

 

[gillysaurus]

Meth is a HUGE problem in my county, if not the whole state. One of my first rides we had a suicide due to meth. There's a lot of meth-related violence in these parts, too. It's a sad drug that clearly affects a lot of people around here.

A lot of the real meth heads have gotten very creative about their meth production, too. Just recently a cop told me about how the druggies will empty fire extinguishers and fill them with the chemicals used to make meth. Then they will just leave the extinguisher out by the highway for a while to "cook" and then come and pick it up later. It sounds so crude, but it's amazing what these people can come up with!

Can you imagine a car hitting one of those, though? What an explosion...

 

[mikie]

Well I prefer meth... or are we talking about our patients? Cause they do too.

 

[AlaskaEMT]

It typically /is/ PCP that the joints are dipped in, not literal embalming fluid (Or that + PCP). Usually goes by 'sherm' up here.

The biggest drug problem, though, by several orders of magnitude over crack, meth, heroin, etc: Alcohol.

Bingo! I was waiting for someone to speak up and explain that it's not embalming fluid they dip their cigarettes in... it's PCP. This is nothing new, people have done this for decades.

 

[So. IL Medic]

Hey Mac. Southern Illinois is another fun place for meth calls and not just od's. I've had a house full of 6 kids, ages 1-5, exposed to meth from the kitchen lab, house fires from meth labs, a couple pts that were bending over their cooker when it went off in their face, a great call with a rolling meth lab in an older mini-van that ignited - two in back with burns and exposure and a driver that went through the windshield when the flaming van crashed so that was trauma and exposure fun.

Also, we have had an increase in dumbasses overdosing by eating fentanyl patches. That seems to be big in the 18-25 y/o range lately. The college crowd is also finding out that taking a few xanax before bar hopping isn't so brilliant.

Stupidity is job security.

 

[mycrofft]

WE have a partial solution for meth labs and pot farms in CA:

Brush fires.

 

[Grady_emt]

Crack, Heroin, Meth, GHB, PCP, X, and Meth as well.

Even within our zone, there are different drug tendancies. The "Bluff" a high-crime, poverty ridden area that is heavy in crack and H, Buckhead and Midtown are wealthier areas and thus the choice drugs are usually Coke, PCP, X, and occasionally LSD.

 

[MagicTyler]

Our biggest drug problem is ETOH. You hear a man down call along hwy 89 or winona you can prety much bet on the fact its a drunk trying to get back to the reservation. And when I say drunk, I mean someone with a really altered mental status, who is just basicaly sloshed. Sad, but its what everyone in this community sees on a very regular basis.

 

[Megs_h13]

Here in Lloydminster, Alberta/Saskatchewan (Canada) our drug problem is cocain. Ah the drug of choice such a wonderful thing haveing a 200 pound man freaking out.

I have only heard of "dips" we have yet to deal with that here, thank goodness.