# EMS addiction



## Tone (Jul 7, 2010)

So I bet some of you dorks on here were expecting this thread to open like; 

"I love working EMS and just cant stop"

I actually thought Id start my first post with a more serious topic. EMS employees who are serious hard drug users. 

Based on the sheer number of EMT's out there, probably more than you might think.  Ever look at the person to your right or left in the truck and think:

"is he/she looking a little bit caked out today?

What support systems does your service have in place to deal with this issue? hopefully you don't just accuse and exile them with a complete lack of evidence....


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## Sassafras (Jul 7, 2010)

Hmmm.   Now I'm curious.  I think I'll look over my SOPs again.


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## TransportJockey (Jul 7, 2010)

EVerywhere I've worked the SOP essentially reads "If your partner is stoned out of his gourd, tell mgmt ASAP"


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## MDA (Jul 7, 2010)

jtpaintball70 said:


> EVerywhere I've worked the SOP essentially reads "If your partner is stoned out of his gourd, tell mgmt ASAP"



But if he's a little stoned, it's cool. Haha.
I haven't seen this a lot in my area. Or I just don't notice it.


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## Shishkabob (Jul 7, 2010)

If I think my partner is under the influence of drugs, in any amount, they're getting kicked out of the truck.


Luckily, my current partner has the same view on drugs as I do, so I don't foresee it as a problem with us.


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## n_shapley (Jul 7, 2010)

Do EMS workers not get random drug testing????


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## medic417 (Jul 7, 2010)

n_shapley said:


> Do EMS workers not get random drug testing????



Depends on the company.


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## zmedic (Jul 7, 2010)

Bigger problem then drugs I'd say is alcohol, especially with the volley departments. Where I used to do EMS there was a volly FD that had someone show up to drive their ambulance after having a few beers. I know people drink during their time off, but as much as you want to go on the call stay home if you have ETOH in your system.


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## Veneficus (Jul 7, 2010)

n_shapley said:


> Do EMS workers not get random drug testing????



Everyplace except one IFT company I worked for very briefly did random drug testing and yearly testing on all employees. 

People who were found to be positive for a host of drugs they could not produce a prescription for were instantly suspended pending confirmation testing. If found positie on confirmation were fired immediately.

I know both nurses and paramedics who were caught stealing narcs. The nurses both were put on probation by the state board of nursing, and now work for a different facility. The medics had their certs revoked for life by the Dept of public safety. All were fired from the employer that caught them.

I agree ETOH is a much bigger problem. It is neither tested for and in the early stages, easily concealed. I have known several coworkers of all levels who would go to the bar right after work every shift. The employers (EMS, industrial, and hospital) had rules regarding no alcohol between 8-12 hours before shift, but drinking right after a shift usually meant they would meet the time restraints.


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## akflightmedic (Jul 7, 2010)

Great first post...insult, then pose a question.

What a way to set the "Tone".

I reserve further judgment until I see more posts as something smells foul.


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## Stephanie. (Jul 7, 2010)

I wish our service would do a random drug test.. I know several people that wouldn't be employed here anymore.

But nothing is mentioned in our policies.


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## rockwood (Jul 7, 2010)

*emts and drugs*

I don't know about yall, but my rescue squad (all volunteers) doesnt drug test but if we knew someone was coming to a shift high then we would not let that happen, just like if someone came to a shift with alcohol on their breath.


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## Stephanie. (Jul 7, 2010)

rockwood said:


> I don't know about yall, but my rescue squad (all volunteers) doesnt drug test but if we knew someone was coming to a shift high then we would not let that happen, just like if someone came to a shift with alcohol on their breath.



Well I was always told you can cover the alcohol smell on your breath up...


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## TransportJockey (Jul 7, 2010)

Stephanie. said:


> Well I was always told you can cover the alcohol smell on your breath up...



Oh you can, pretty effectively too. Done it a time or two to fool parents... er... I mean so I've heard it can be pretty effective


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## mycrofft (Jul 8, 2010)

*I know you weren't talking to me.*

Roger, AK


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## firetender (Jul 8, 2010)

*You know what I think?*

I wouldn't even begin a discussion with you on that subject Tone until you've been participating in this Forum for a while and had established yourself as having an intent to contribute. 

You're asking very sensitive stuff without us having any idea who you are or where you're coming from or where you'd take the info we share.


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## octoparrot (Jul 8, 2010)

We need to remember that drug use is easy to hide if they're good at it. I've seen a few great medics drug/drink themselves out of a career because they couldn't ask for help. Since we're trained to be the help its often hard for people to ask for help when it involves something as sensitive as drug/etoh/ivdu abuse. When i spot someone or suspect someone is using/drinking on the job, its my safety at risk as well as a standard of care issue. It's serious stuff but I think i read somewhere that EMS has a very high potential for drug &etoh abuse.


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## fortsmithman (Jul 9, 2010)

In my paid on call/volly service if any member were to show up drunk or stoned then they are immediately terminated as a member of the service no exceptions.  As well our members cannot consume any alcoholic beverages while on call.


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## Tone (Jul 9, 2010)

firetender said:


> I wouldn't even begin a discussion with you on that subject Tone until you've been participating in this Forum for a while and had established yourself as having an intent to contribute.
> 
> You're asking very sensitive stuff without us having any idea who you are or where you're coming from or where you'd take the info we share.



Ok fair enough. 

Ive been reading a bit on here from time to time. Who I am is a full time paramedic, five years on the road. 

The reason I threw the dork comment out there is because thats how I feel in the workplace. I walk into work and people ask, what did you do on your days off? 

Im hearing replies like: 

"oh i played baseball and went to bed at 11pm! Man i was tired..."

Or something like, 

"I went to wal-mart, got some new blinds, put them up all in the same day!"

How about: "well I took out 800$ after we got paid, picked up an 8 ball and hit it hard on monday and tuesday. Had sex with 3 different girls in 2 nights, just came in to work on zero sleep and took a new clean uniform from supply, cause ive been living in my truck for the past 2 weeks.  But hey I did go to the gym last night.  (hypothetical example)

My point is, there are lots of people without varied life experience in EMS. I feel that at least my coworkers, the majority who probably came through college paid for by trust funds and lived upper middle class. Would not have a constructive view of addictions/abuse recovery. (cue the stories of everyone on here saying how they worked 3 jobs to pay for school) 

The whole PTSD and incident debriefing really is a joke. If anyone fell into some serious addictions/ abuse issues, at least the system I know would probably just ridicule them and gossip behind their back about it. 


Does anyone on here have a supportive addictions program in their workplace?


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## somePerson (Jul 9, 2010)

kinda of topic, but before I worked as an EMT I didnt even know what dip was, now it gets me trough a 48 staying up and running calls non-stop.


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## akflightmedic (Jul 9, 2010)

Tone said:


> I feel that at least my coworkers, the majority who probably came through college paid for by trust funds and lived upper middle class. Would not have a constructive view of addictions/abuse recovery.



Quite naive really. I have never known addictions/abuse to discriminate amongst its victims. Have seen all walks of life exeperience abuse/addictions, just some hide it better or have better support (enablers) which cover it for a while.

Where do you work that all your coworkers are trust fund babies AND in EMS???


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## firetender (Jul 9, 2010)

Statistically, medical professions have a high rate of substance abuse. The easier access the practitioner has to controlled substances, the easier it is to abuse them. A medic so inclined has easy access to his/her patient's drugs. Alcohol, as a legal intoxicant is right up there in its overuse.

This elephant in the living room is something most do not wish to talk about. Still, most quietly witness it. What would you say? 10%? 20%? of medics go on occasional benders of one form or another? Some don't come back.

The thrill of the hunt. That's hard to duplicate off duty. Some form of sedation keeps you mellow 'til you need to call on the adrenaline again when back in the saddle. Or maybe, "Hey! I need to not think or be responsible for a while!" (Pick your excuse. How many have you heard, how many have you offered?)

Whackers, Adrenaline Junkies, we've got a million names for them, but there's the other kind, too. The ones like you and me who one day get real tired of feeling the pain of others because sometimes it sets in, or maybe just get kinda sick of losing so damn many in a row, or maybe wants to deaden the desire to strangle that partner! 

So we act off it and find solace in some substance. But it could be actions, or ways of being as well; like being abusive to a partner, cold to the pain of loved ones, or take charge in everything we do. It's all about continuing the rush; that's the story at its core.

We're not supposed to have doubts, but the field, by its very nature, generates them. Sometimes, they get overwhelming.

The part that's missing is the part where we build a culture that will allow those affected with the opportunity to express their root conflicts honestly and without the fear of derision by their peers. 

Connection is the best high of all!


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## Meursault (Jul 9, 2010)

somePerson said:


> kinda of topic, but before I worked as an EMT I didnt even know what dip was, now it gets me trough a 48 staying up and running calls non-stop.



That's very on-topic, actually, even if the OP wanted to hear about more interesting drugs.

Anyone else use smokeless tobacco? For that matter, anyone smoke (consider switching to smokeless, if quitting's not on the table)?.


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## clibb (Jul 9, 2010)

Tone said:


> Had sex with 3 different girls in 2 nights



You can get fired for that!!!?? :blush:

In a conference that I went to I was told that there is a huge amount of Methamphetamine abuse on Oil Rigs. Now Oil Rigs do have medics..........



somePerson said:


> kinda of topic, but before I worked as an EMT I didnt even know what dip was, now it gets me trough a 48 staying up and running calls non-stop.



I started chewing through hockey. I've done it for almost 5 years and I'm trying desperately to quit. I chew something called Snus, it's a Swedish Tobacco. It'll be tough, but I'll be able to make it. Plus they don't let us chew on the bus here.



MrConspiracy said:


> That's very on-topic, actually, even if the OP wanted to hear about more interesting drugs.
> 
> Anyone else use smokeless tobacco? For that matter, anyone smoke (consider switching to smokeless, if quitting's not on the table)?.



I've had friends that have tried that and they said it's harder to quit smokeless tobacco then it is to quit cigarettes.


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## ExpatMedic0 (Jul 9, 2010)

Tone said:


> How about: "well I took out 800$ after we got paid, picked up an 8 ball and hit it hard on monday and tuesday. Had sex with 3 different girls in 2 nights, just came in to work on zero sleep and took a new clean uniform from supply, cause ive been living in my truck for the past 2 weeks.  But hey I did go to the gym last night.  (hypothetical example)



OMG dude stay out of Mr.Browns Journal.
PS: last time I checked in my area an eight ball of solid stuff was street value $120. What happened to the rest of the $800


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## akflightmedic (Jul 9, 2010)

You price compare? I just buy wholesale, much easier...

As for the rest of the 800, how do you think the girls entered the equation?


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## DrParasite (Jul 9, 2010)

Tone said:


> How about: "well I took out 800$ after we got paid, picked up an 8 ball and hit it hard on monday and tuesday. Had sex with 3 different girls in 2 nights, just came in to work on zero sleep and took a new clean uniform from supply, cause ive been living in my truck for the past 2 weeks.  But hey I did go to the gym last night.  (hypothetical example)


well..... take out the "picking up an 8 ball", the rest of it sounds like a pretty good time.  In fact, I used to date a girl who kept calling me homeless because i would go from work to her place and back to work, keeping spare clothes in my car.  in fact, a single guys dream can be 3 girls in 2 nights (even better if 2 of them are at once), and topping it off with a decent workout.  where is the problem.


Tone said:


> Does anyone on here have a supportive addictions program in their workplace?


we do.  my hospital has an EAP (employee assistant program) to help with addictions.  But you need to go to them, they can't catch you and then you claim you have a problem.

I know people who are addicted to cigarettes, caffeine, as well as  adrenaline junkies.  I also know people who will go out on an alcohol filled bender for a weekend after a bad weekend.  I am sure there are others who are addicted to drugs, sex (infidelity is sometimes a problem), exercising, and food.  I am sure there are others, but I know teachers who go out, business people, and government workers who all did the same thing (I should know, we were alternating who was going to buy the next round at the bar).

addiction spans all social classes, from poverty to super rich, from east to west.  whether it be a trust fund or a welfare person, you have addicts.  I know plenty of college students that are alcoholics or drug addicts; but I know plenty that are "functioning" alcoholics, where are different than many of the addicts that seem to be a drain on society (used to date one of those too).

If you know someone who has a problem, say something.  but if they don't want to get help, and it doesn't affect their job performance or yours, then unfortunately your hands are tied.  and unfortunately, it's like that in jobs everywhere.


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## clibb (Jul 9, 2010)

DrParasite said:


> well..... take out the "picking up an 8 ball", the rest of it sounds like a pretty good time.  In fact, I used to date a girl who kept calling me homeless because i would go from work to her place and back to work, keeping spare clothes in my car.  in fact, a single guys dream can be 3 girls in 2 nights (even better if 2 of them are at once), and topping it off with a decent workout.  where is the problem.
> we do.  my hospital has an EAP (employee assistant program) to help with addictions.  But you need to go to them, they can't catch you and then you claim you have a problem.
> 
> I know people who are addicted to cigarettes, caffeine, as well as  adrenaline junkies.  I also know people who will go out on an alcohol filled bender for a weekend after a bad weekend.  I am sure there are others who are addicted to drugs, sex (infidelity is sometimes a problem), exercising, and food.  I am sure there are others, but I know teachers who go out, business people, and government workers who all did the same thing (I should know, we were alternating who was going to buy the next round at the bar).
> ...



I'm not sure what you label as an "alcoholic" but a bunch of college kids that have fun for a couple years are not alcoholics. 
Also, caffeine is an addiction most of us have. From coffee to Coca Cola. 

I label alcoholics who ALWAYS drink. They loose their job, house, and family due to it. Not that they are alcoholics because they go home and have a glass of wine (which is healthy for the heart) at night.


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## akflightmedic (Jul 9, 2010)

clibb said:


> I'm not sure what you label as an "alcoholic" but a bunch of college kids that have fun for a couple years are not alcoholics.
> Also, caffeine is an addiction most of us have. From coffee to Coca Cola.
> 
> I label alcoholics who ALWAYS drink. They loose their job, house, and family due to it. Not that they are alcoholics because they go home and have a glass of wine (which is healthy for the heart) at night.



Ahhh, but those few years of having "fun" is that not sowing the seeds for future addictions or am I off base because every single one of them can quit any time they want, plus they do not have houses, careers or families to lose yet (the majority).


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## Tone (Jul 10, 2010)

firetender said:


> Statistically, medical professions have a high rate of substance abuse. The easier access the practitioner has to controlled substances, the easier it is to abuse them. A medic so inclined has easy access to his/her patient's drugs. Alcohol, as a legal intoxicant is right up there in its overuse.
> 
> This elephant in the living room is something most do not wish to talk about. Still, most quietly witness it. What would you say? 10%? 20%? of medics go on occasional benders of one form or another? Some don't come back.
> 
> ...



Good post. thanks!


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## Tone (Jul 10, 2010)

Stephanie. said:


> I wish our service would do a random drug test.. I know several people that wouldn't be employed here anymore.
> 
> But nothing is mentioned in our policies.



Thank you for basically proving my point. You WISH your service would do a random drug test so that people you work with get terminated. 

How about, you wish your department had a comprehensive addictions/ PTSD counseling program to help your coworkers currently battling addiction! 

I know a medic who usually rails two 80s every night or morning to get to sleep. This girl has recurring flashback nightmares almost every night of a specific call. 

Stephanie, you WISH your department could implement drug testing and get her fired? Your attitude is exactly what I am talking about.


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## DrParasite (Jul 10, 2010)

clibb said:


> I'm not sure what you label as an "alcoholic" but a bunch of college kids that have fun for a couple years are not alcoholics.
> Also, caffeine is an addiction most of us have. From coffee to Coca Cola.


you don't think college students can be alcoholics?  wow, that's like saying a person isn't an addict if they only use drugs on the weekends.  You need to open your eyes, or actually spend time talking to and addition counselor on a college campus.  and contrary to your belief, caffeine is a drug, and people can become addicted (ever get headaches because you skipped your morning coffee?).


clibb said:


> I label alcoholics who ALWAYS drink. They loose their job, house, and family due to it. Not that they are alcoholics because they go home and have a glass of wine (which is healthy for the heart) at night.


You have obviously never heard of a functioning alcoholic.  these are the people who have a job, family, and house, and still have a huge dependence on alcohol or drugs.  These are where most of your white collar and college addicts tend to fall, and how they keep it hidden from everyone else.

I don't wish addicts would get fired, but I would rather not have to work with them in public safety if they aren't interested in getting help for their problem.


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## Aidey (Jul 10, 2010)

Just because someone isn't an alcoholic doesn't mean there isn't a problem. 

My company has an employee assistance program, and like the person above, you have to go to them first. If you get caught or in trouble and try to hide it you aren't eligible. I know of at least one person who was fired for trying to hide a DUI arrest, and there have been a couple others over the last few years who have had alcohol or drug (pain killers) problems. I know one of them isn't working for us anymore, but that was because the EAP will only help you so much, if you keep relapsing the company can eventually say enough is enough. 

Technically no one is supposed to use tobacco products of any kind while on duty, but it really isn't enforced too well, which is a shame because it looks horrible when the employees are standing next to the ambulance smoking, ugh. 

If you suspect your partner is under the influence, or unable to work for some reason you are to report them to the supervisor immediately. If you know your partner is under the influence and don't turn them in you can get in a lot of trouble too. I know there is also a help line you can call and report someone anonymously, but I think that is for less immediate issues. Like someone is drinking too much, but isn't drunk on duty. 

We don't have random drug testing that I know of. Everyone is tested for hire, and then also if you get into any sort of accident or sustain an injury. I would like to see random testing, but I have no idea if it will ever happen.


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## Veneficus (Jul 10, 2010)

Tone said:


> Thank you for basically proving my point. You WISH your service would do a random drug test so that people you work with get terminated.



It is not uncommon for medical or public safety professionals to have high demands for those participating in their respective field. There is also an overwhelming illusion that these practicioners of not normal humans, but some divine entity or larger than life hero figure.

While some conceal from view and others fall from grace, I can tell you I have seen a higher rate of substance abuse among medical students than I have EMS professionals. 

adderall is the most common drug of choice, being cheaper and easier to get than cocaine. (a distant second) THC is also very popular in the earlier years where the textbook takes up most of the time. 

Caffeine, nicotine, and alcohol, barely register on most radars despite the fact a large number almost chain smoke, or have theraputic caffeine levels at any given time and probably high levels of physical dependence. Not a day goes by without somebody having a drinking party and while not everyone goes to every one, (multiple class levels, etc) some do frequent more than their fair share it appears.

There are also other destructive behaviors used to deal with the stress. Gambling, prostitution, or other forms of risk taking. 

It is commonly said "it is better to die than fail," as after a couple of years in addition to the social consequences, economically, short of hitting the lottery a person is pretty much ruined forever. At $250,000 borrowed, the monthly loan payment is $1400 on average for 20 years, which cannot be reduced or forgiven by bankruptcy. You can see where there is a great deal of stress even before a person starts worrying about what happens to patients. Many of those addictions and habits will carry over after school as a majority of people admitted do graduate.

"Your doctor will see you now... "



Tone said:


> How about, you wish your department had a comprehensive addictions/ PTSD counseling program to help your coworkers currently battling addiction!



Nope, I am old school.

PTSD is a disease of the 20th and 21st century. (please spare me the propaganda , I studied and actively stay involved with, paleopathology, the history of disease in human populations)

It is a physiologic response to constant stressors which people had coping mechanisms for throughout history. In the modern world, those mechanisms have been removed or are broken by sociological norms. For example, during the industrial age, it wasn't uncommon for injured workers to drink themselves into a stupor, and wake up and go to the factory the next day hungover or still under the influence. If the person was hurt or damaged something, their position was forfeit and they lost everything until they found another employer. There was no workman's comp, partial/full disability. Survival forced people to pick themselves up.

Likewise, in the middle ages, death was so frequent that people actually distanced themselves from their children emotionally. However, such quality was made up for by quantity. Currently in parts of Africa and Asia, people still have 8+ offspring, expecting several to perish prior to reproduction. Doing so is impossible to do and maintain a western middleclass life.

So to pontificate, you cannot hope the world will be kind to you and your loved ones, you have to be proactive in making sure you can survive and maintain the life you want. (Don't think I mean build and defend a compound, I don't) But it is not the responsibility of others to teach people about death and loss. Ignoring the responsibility of being aware of what really goes on in the world or insulating oneself from the brutality of it does not make one "deserving" or "worthy" of treatment.

One thing military people seem to be keenly aware of, "beware of the old soldier/sailor" for (s)he has not fallen from wounds nor the stressors of the profession. They are tough.   


And the market favors termination. (i don't agree, but it is true)

For every fire/EMS job there are usually hundreds if not thousands of qualified applicants. Employers simply do not have to spend money on retaining employees. Couple that with the average time anyone spends at a single EMS job and that means employers are spending money to keep a person 5 years tops.  




Tone said:


> I know a medic who usually rails two 80s every night or morning to get to sleep. This girl has recurring flashback nightmares almost every night of a specific call.



She will master her stress, or it will master her. if the latter, i am sorry to say she will pay an fearful price. To quote something more artistic:

"Some will fall and some will live, will you standup and take your chance?"

Not everyone can be a firefighter, an EMT, a soldier, a doctor, an accountant, a fisherman, a lawyer, or anything else. In any job or profession, many will try, some will succeed. It is the soley the decision of the individual what price they will pay before they decide the job/lifestyle is not worth it. Rehab and therapy just resets a person before another breakdown. 

Like any disease, it is cured at the source, not the symptom. If eating McDs gives you a heart attack, the solution is not to eat it. If EMS is causing you to breakdown, the solution is to not do EMS.



Tone said:


> Stephanie, you WISH your department could implement drug testing and get her fired? Your attitude is exactly what I am talking about.




I'd like to think my opinion and attitude has a bit of depth to it not just a recitation of "don't do drugs or we don't want you as a hero". Not everyone will agree.


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## MDA (Jul 10, 2010)

Tone said:


> I know a medic who usually rails two 80s every night or morning to get to sleep. This girl has recurring flashback nightmares almost every night of a specific call.



That's pretty intense.

Career change might improve the quality of life and increase her life expectancy.


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## firetender (Jul 10, 2010)

Veneficus said:


> "Some will fall and some will live, will you standup and take your chance?"
> 
> Not everyone can be a firefighter, an EMT, a soldier, a doctor, an accountant, a fisherman, a lawyer, or anything else. In any job or profession, many will try, some will succeed. It is soley the decision of the individual what price they will pay before they decide the job/lifestyle is not worth it. Rehab and therapy just resets a person before another breakdown.



*If anyone wants to do a word count for him (I know he only has time to write, not to count!) and finds Veneficus has hit 1,000,000 words on this forum, I'll award Vene my NEXT book!* (He knows this is said with Aloha!)

I'm glad this all has come up. Vene gave a terrific overview of aspects of the medical profession that we all know about but rarely admit and it dips into a bit of historical perspective as well. 

He does, however, contradict himself in that, on one hand he says the way people coped was to just cope, implying a weakness in us today, and he ends up saying if you can't cope, get out. My position is that most of us are doing exactly that; coping in the best ways we know how. For some of us, we use extreme methods.

In my experience, EMS was and is a culture, not unlike the Cop culture. We, like them, have a "Code of Silence" when it comes to speaking of our peers' behavior. 

We observe things on calls that we would never admit are done to an outsider, but because we really know the stresses and challenges of the job, we "allow".

By nature, the position that we put ourselves in is the essence of risk-taking. The stakes are life and death; the ultimate stakes. We also put our sanity on the line because we are willingly placing ourselves into the position of not only witnessing, but participating in the pain of others. We have chosen to be *WITH *the suffering.

(As an aside, in a study in the late 1980's it was found the highest rate of suicide in the professional world was amongst dentists. It was traced back to their unrelenting relationship with pain.)

"Normal" people don't do what we choose to do. Most *can't!* Look around you and what do you see? Probably a balance just slightly more extreme than society as a whole. I'm going to make a broad observation. Tell me what you think.

Over the course of my career, I'd say I encountered two personality extremes in, not only EMS but allopathic medicine as a whole; "Sensitives" and "Flesh Mechanics".

Sensitives (S) are people like myself who have a tendency to look deeper and more philisophically and even spiritually at the field and the work we do. They are bent a bit more toward connection than technician. They often follow feelings rather than protocol. Experiencing their feelings, although rarely spoken about to others, is not so scary to them. That's what they think at first, anyway, but often having that crack open lets floodwaters in in which they drown. For some, EMS is a world that is quite rich in its challenges. They are the ones who got into the field as a heart-driven decision and have found life in it, even though at times its excruciatingly painful. 

Flesh Mechanics (FM) are on the heartless side, but not necessarily in a negative way. They are our Warriors, the ones who, consistent with the approach of allopathy as a whole, "battle" death. Their focus is on the job in front of them and performance to the best of their ability. Even though many may have entered the field led by their hearts, either by inclination or driven by the constant overstimulation they morph into hardened shells, highly competent but, let's just say, a little hampered in their ability to connect with other human beings; on or off-duty.

I'm going to peg each of these extremes as about 20% of the population of medics, so we're talking about 40% of our ranks live on the farther ends of the 60% norms who either move freely between the two states, consider the work a job and neither question nor deny their experience and just do it or are fulfilling their function as part of a broader life plan of which their work is more incidental than pivotal to their image of themselves.

And that's probably an important side-observation; the extremes of both groups would be, most likely, those who identify themselves with what they do. EMS attracts more of "those types" of people than mainstream "jobs".

I believe that it is within that 40% of personalities that the highest incidence of substance abuse occurs. For some it is a continuation of the risk-taking behavior. For others it reflects a continuing, non-physical exploration, for others diversion from their own extremes and for many in both categories, a means to just stop all the damn internal chatter! The reasons for abuse are no different, they just have slightly different driving forces.

Since this could turn into a really fruitful conversation, I'm going to plant this seed and see what you think before I play around with other aspects of the culture; would you say, for starters that my observation that 40% of us would fall into an "at-risk" category for extremes of abuse, whether it be substance or otherwise, is accurate?


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## MDA (Jul 10, 2010)

I'll do the word count if I can get a free copy too, haha.


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## Veneficus (Jul 10, 2010)

firetender said:


> *If anyone wants to do a word count for him (I know he only has time to write, not to count!) and finds Veneficus has hit 1,000,000 words on this forum, I'll award Vene my NEXT book!* (He knows this is said with Aloha!)



I didn't reach the post maximum  This is the closest to writing a book I will ever get probably, I ask your indulgence. 



firetender said:


> He does, however, contradict himself in that, on one hand he says the way people coped was to just cope, implying a weakness in us today, and he ends up saying if you can't cope, get out. My position is that most of us are doing exactly that; coping in the best ways we know how. For some of us, we use extreme methods.



I don't see a contradiction in what I said. People find ways to cope, sometimes they can, sometimes methods that work for some break down others. 

There is weakness, or rather insulation from stress and when modern people are faced with it (sometimes for the first time ever when they are in EMS and certainly on a regular basis) the old coping mechanisms are no longer socially acceptable, (which could cause you to get fired), because of the biological and economic impact on Western society. 

I think it was best said in a John wayne movie:

"He mostly drunk part of the time and partly drunk most of the time, but if you had 100 guys like him you could walk into hell and put out the fire."

if you tried to cope that way today, if you were caught you would be fired. If you decide to partake in certain substances today (which we actively search for) you will be fired. 

Today's "therapy" doesn't help anymore than those "old ways." Just like in history, only the removal of the injurious stimulous will remove the stressor.

I agree with your position in all aspects. (I just don't have your skill of saying more with less)


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## firetender (Jul 10, 2010)

Veneficus said:


> (I just don't have your skill of saying more with less)



Just want to comment that I NEVER have to struggle reading your posts, most are very insightful, some are brilliant and others offer a very valuable view into a broader perspective that many of us can benefit from. Or does "you never put me to sleep" say it better?


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## fma08 (Jul 10, 2010)

DrParasite said:


> you don't think college students can be alcoholics?  wow, that's like saying a person isn't an addict if they only use drugs on the weekends.  You need to open your eyes, or actually spend time *talking to and addition counselor on a college campus*.  and contrary to your belief, caffeine is a drug, and people can become addicted (ever get headaches because you skipped your morning coffee?).
> QUOTE]
> 
> :blink: Man, if our campus had one of those... I would have done so much better in math freshman year.


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## DrParasite (Jul 11, 2010)

fma08 said:


> :blink: Man, if our campus had one of those... I would have done so much better in math freshman year.


damn spell check at 4:30 in the morning lol


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## Jon (Jul 12, 2010)

If it becomes known in a way that affects patient care... the provider is going to be GONE, and his/her certs are going to be GONE too, most likely. This would be the partner getting stoned mid-shift, or diverting controlled substances.

If the provider A) shows up intoxicated, or B) is stoned outside of work, the current scheme seems to be that if they admit they have a problem and agree to get help, that work will bend over backwards to get them into treatment, and likely have a position for them when they return, likely with some conditions.

EMS providers are people too... we see lots of nasty stuff, and some of us use different things as coping mechanisms.


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## Tone (Jul 12, 2010)

Some pretty good posts in this thread, thanks everyone! 

Im intentionally keeping anonymous on emtlife so that I can actually post real experiences. I don't see much from people in terms of personal experience, I think that may be due to you have identified who you really are on here. 



Side topic on here:

Anyone ever researched/experienced the psychologically therapeutic benefits of MDMA?


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## Meursault (Jul 12, 2010)

Tone said:


> Anyone ever researched/experienced the psychologically therapeutic benefits of MDMA?



Wasn't aware of any, but do explain. This may have to go to PM, given that it's not particularly on-topic and recreational drug threads tend to bring out the people who missed their calling to law enforcement.


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## firetender (Jul 13, 2010)

*Go Fish! Elsewhere...*

now, you're p***ing me off!


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## Tone (Jul 13, 2010)

MrConspiracy said:


> Wasn't aware of any, but do explain. This may have to go to PM, given that it's not particularly on-topic and recreational drug threads tend to bring out the people who missed their calling to law enforcement.



youre saying cops do drugs? 

i dont really agree if you are, but from your experience you find this?


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## reaper (Jul 13, 2010)

I hope you are joking with that statement?


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## Tone (Jul 13, 2010)

MrConspiracy said:


> Wasn't aware of any, but do explain. This may have to go to PM, given that it's not particularly on-topic and recreational drug threads tend to bring out the people who missed their calling to law enforcement.



There is extensive research showing successful MDMA assisted PTSD psychotherapy. The drug has a very unique drug classification as an "entactogen"


3,4−methylenedioxy−N−methylamphetamine (MDMA) produces an experience that has been described in terms of "inhibiting the subjective fear response to an emotional threat" (Greer & Tolbert, 1998, p. 371) and increasing the range of positive emotions toward self and others (Adamson, 1985; Cami et al, 2000; Grinspoon and Bakalar, 1986). Several promising reports exist of the benefits of MDMA-assisted psychotherapy. (Adamson, 1985; d'Otalora, http://www.maps.org/research/mdma/moaccount.html; Gasser 1994; Greer and Tolbert 1998; Metzner and Adamson, 1988, 2001; Naranjo, 2001; Styk, 2001; Wolfson 1986) or based on an uncontrolled study (Greer and Tolbert 1986).


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## Shishkabob (Jul 13, 2010)

I had a patient die a couple of weeks back from an E overdose, skyrocketing his temp well above 108*


You'd be hard pressed to convince me that it's a good drug even in minor doses, when other, safer, drugs can, and do, exist.


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## Tone (Jul 13, 2010)

The problem is, the DEA criminalized MDMA for political gain. The 'scientific' study used to classify MDMA as illegal was withdrawn and the publisher admitted he used the wrong substance in the control tests. 

I know I'm going to have to quote sources on this. Standby, I can link some videos and sites as references if anyone is actually interested in this.


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## Shishkabob (Jul 13, 2010)

Right... the DEA is in it purely for political gain and not because it's a dangerous drug.



Patient, 3 weeks ago, dead, 108* temp. E.


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## Tone (Jul 13, 2010)

Linuss said:


> I had a patient die a couple of weeks back from an E overdose, skyrocketing his temp well above 108*
> 
> 
> You'd be hard pressed to convince me that it's a good drug even in minor doses, when other, safer, drugs can, and do, exist.



Fair enough, "E" is a street name for a pressed pill containing what is supposed to be MDMA, but probably contains a mixture of McPP, MDA, speed etc, etc. 

I am not talking about using E at a rave, thats very dangerous. Im talking about a milligram measured and purity tested dose of pure MDMA. Used in an appropriate environment to support psychological improvement. 


The danger you are referring to is only in the supply, as in the risk of contamination with other substances. MDMA itself in appropriate dose is research proven safe.


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## Tone (Jul 13, 2010)

Linuss said:


> Right... the DEA is in it purely for political gain and not because it's a dangerous drug.
> 
> 
> 
> Patient, 3 weeks ago, dead, 108* temp. E.



Much more dangerous Rx only meds are currently available than MDMA. Oxycontin has a much higher potential for abuse, overdose, and addiction than MDMA and its is widely prescribed. 


Far more people die from OC's than MDMA The difference is that its immensely profitable, and thus remains available.


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## Tone (Jul 13, 2010)

Linuss said:


> Right... the DEA is in it purely for political gain and not because it's a dangerous drug.
> 
> 
> 
> Patient, 3 weeks ago, dead, 108* temp. E.



Lets be honest, you have no idea what drug or combination of drugs caused your patient to go VSA.


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## Shishkabob (Jul 13, 2010)

Tone said:


> Lets be honest, you have no idea what drug or combination of drugs caused your patient to go VSA.



Really?

So there's no chance that I could have gone back to the hospital and spoken with the doctor / nurse that I brought the patient to and found out about the tox report, since he was the 5th OD I brought that night?




Well darn.


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## Tone (Jul 13, 2010)

Linuss said:


> Really?
> 
> So there's no chance that I could have gone back to the hospital and spoken with the doctor / nurse that I brought the patient to and found out about the tox report, since he was the 5th OD I brought that night?
> 
> ...



Not trying to fight about this one but, 

Tox screens cant determine between MDMA, MDA, McPP and piperzines. The mixup of drugs in street E is just that diverse. 

You think you patient died from an overdose of Pure laboratory quality tested MDMA?  There really is no way to tell what mixup of drugs caused the death.


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## akflightmedic (Jul 13, 2010)

Tone said:


> Lets be honest, you have no idea what drug or combination of drugs caused your patient to go VSA.



You are Canadian eh?


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## Veneficus (Jul 13, 2010)

*One day...*

I will  be hired by the secret government that runs the government. Hopefully as the chair of the death panel.

The conspiracy of withholding drugs for profit is old and tired.

I have written extensively here on the subject. But here is the summation.

In the world exists more than the US. Other countries are constantly on the lookout for cheaper meds or cheaper ways. If a cheaper way existed, some one some where would be using it.

Healthcare providers, especially in medicine, are a rather vocal bunch. When something works generally the practicioners fight for it. Look at methadone. Not only for rehab, but for terminally ill and cancer patients. It had benefits and it was demanded. The process is long, and not the most efficent, I'll give you that.

A cheap drug that a lot of people can use is preferable to an expensive drug that few benefit from or even afford.

MDMA was at one point until sometime in the 1980s available by prescription in the US. To treat "shyness" of all things. The harm it causes outweighs the benefits. It doesn't mean it has no benefits. 

The exact same issue arises with THC and even prior to that laudnum. It is not just abuse potential that makes a drug unfit for use.

One of the largest spenders on PTSD is the US military. I would bet my last penny if they even thought that something as cheap and easy as MDMA was the "cure" or treatment, it would be given out like candy.

Intending no disrespect, but rather than argue the uses of "prohibited drugs" on an EMS forum, get a degree in medicine or pharmacy and argue where it might actually make a difference. You will find however, the more you study it, the weaker the arguments look for most of the "banned" substances. 

Available treatments should be based on evidence stronger than popular or public opinion. When you look at how low on the totem pole "expert opinion" rates, "nonexpert opinion" should not even register.


As usual just my perspective.


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## Meursault (Jul 13, 2010)

Tone said:


> youre saying cops do drugs?
> 
> i dont really agree if you are, but from your experience you find this?



No, but nice try. I've  had previous run-ins on that issue with posters with a rather Judge Dredd-esque attitude. 



Veneficus said:


> Intending no disrespect, but rather than argue the uses of "prohibited drugs" on an EMS forum, get a degree in medicine or pharmacy...
> 
> Available treatments should be based on evidence stronger than popular or public opinion.



And that's why arguing for medical use of recreational drugs tends to fall flat.


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## Tone (Jul 13, 2010)

MrConspiracy said:


> No, but nice try. I've  had previous run-ins on that issue with posters with a rather Judge Dredd-esque attitude.
> 
> 
> 
> And that's why arguing for medical use of recreational drugs tends to fall flat.



I agree lets take the medical use out of the equation because you're right it wont ever become legal. 

Anyone actually used MDMA with success and improved their quality of life? 

I can say about 5 emergency responders I know who are living a better life and moved past some stress issues more efficiently because of it.


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## Shishkabob (Jul 13, 2010)

So tell me, then (and this argument pertains to mary-j and all the other drugs that, let's face it, drugees, want legalized)


Why is MDMA better then any of the commercially available, legal, and arguably safer, alternatives already out, to treat PTSD and other psych related ailments?


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## Meursault (Jul 13, 2010)

Linuss said:


> (and this argument pertains to mary-j and all the other drugs that, let's face it, drugees, want legalized)



People who have been drugged, as contrasted with those who do the drugging? Dragees?

Now that I've clawed my way back up to my usual level of snideness, that argument only pertains to the legalization of marijuana and other drugs for medical purposes. I believe the OP is considering criminalization in a more general sense. This will end poorly.

OP, what _are_ you trying to get out of this thread? It's fairly clear that even if posters here had interesting anecdotes, they're not likely to share them in public. If you're simply trying to encourage productive discussion and debate, you'll need to find a more conducive forum.


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## Tone (Jul 14, 2010)

Linuss said:


> So tell me, then (and this argument pertains to mary-j and all the other drugs that, let's face it, drugees, want legalized)
> 
> 
> Why is MDMA better then any of the commercially available, legal, and arguably safer, alternatives already out, to treat PTSD and other psych related ailments?


Its way more fun. 

I really don't think MDMA should be legalized. Most people would abuse it, they just don't have the intelligence or self control to know when to stop.

That said, the speed limit is something most people should obey. If you feel you can handle the risk, drive faster. You'll arrive at the destination quicker, but you are responsible for the outcome. 



MrConspiracy said:


> People who have been drugged, as contrasted with those who do the drugging? Dragees?
> 
> Now that I've clawed my way back up to my usual level of snideness, that argument only pertains to the legalization of marijuana and other drugs for medical purposes. I believe the OP is considering criminalization in a more general sense. This will end poorly.
> 
> OP, what _are_ you trying to get out of this thread? It's fairly clear that even if posters here had interesting anecdotes, they're not likely to share them in public. If you're simply trying to encourage productive discussion and debate, you'll need to find a more conducive forum.



Out of this thread I was just looking for entertainment! 

I figured people wouldn't post much up because they haven't remained anonymous and pretty much can't, and I was right. Either that or nobody on here has anything much to say about the topic.


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## ffemt8978 (Jul 14, 2010)

Or the fact that these types of threads usually end up with somebody becoming the focus of my complete and undivided attention.


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## Veneficus (Jul 14, 2010)

Like I said, I have written volumes on it here, in numerous threads.

Sometimes in reference to THC, but no matter what street drug is selected, the argument is still the same.

Caffeine is my drug of choice. 

Alcohol in limited quantities on social occasions.

Never had the desire or need to try anything else. If I did I would take a hard look at what was driving such a decision and remove it, surgically if there was no other way.

Not out of some moral conviction, but because I value my mental faculties and dexterity very highly and anything that would diminish them has always been in contra to my goals.


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## Meursault (Jul 14, 2010)

Veneficus said:


> Not out of some moral conviction, but because I value my mental faculties and dexterity very highly and anything that would diminish them has always been in contra to my goals.



Sounds like the conclusion Feynman eventually came to. Admirable, sort of.



Tone said:


> I figured people wouldn't post much up because they haven't remained anonymous and pretty much can't, and I was right. Either that or nobody on here has anything much to say about the topic.



Mostly the latter. Though you're right in that this is the most identifiable of my names.



Tone said:


> Out of this thread I was just looking for entertainment!


And this one, too? 
Shine on, you crazy diamond.


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## Tone (Jul 14, 2010)

Veneficus said:


> Like I said, I have written volumes on it here, in numerous threads.
> 
> Sometimes in reference to THC, but no matter what street drug is selected, the argument is still the same.
> 
> ...


 this is an assumption, you wont know unless you try.



Dr. Shulgin would tell you to be more open minded!


I really hope you know who he is......


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## Shishkabob (Jul 14, 2010)

ffemt8978 said:


> somebody becoming the focus of my complete and undivided attention.



I wuv you <3


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## firetender (Jul 14, 2010)

*Clearly!*



Tone said:


> Out of this thread I was just looking for entertainment!



an energy suck.


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## Melclin (Jul 14, 2010)

Tone said:


> The whole PTSD and incident debriefing really is a joke. If anyone fell into some serious addictions/ abuse issues, at least the system I know would probably just ridicule them and gossip behind their back about it.
> 
> 
> Does anyone on here have a supportive addictions program in their workplace?



We have a debriefing system of peer support and professional counseling available to employees of the service, as well as students and observers riding with the service. I've come into contact with it a few times because the peer support representatives get called out automatically after you've been to a nasty job, and they bring cookies which is always good. After that chat you can elect to talk further with them or professionals from the Victorian Ambulance Counseling Unit, all confidentially of course and they have a 24 hour support line. VACU resources are also available whether or not the complaint is directly related to ambulance work, and I'm sure addiction is part of that. How it would work if you were nicking drugs out of the DD locker, I'm not sure. 

I think compared to many other services, Victoria does it really well, although I'm sure it has its faults as does everything. I never heard a paramedic complain about peer support, and they complain about pretty much everything else, so that's certainly in its favour.



Linuss said:


> Right... the DEA is in it purely for political gain and not because it's a dangerous drug.
> 
> 
> 
> Patient, 3 weeks ago, dead, 108* temp. E.



People die of heroin overdoses all the time. Yet its a perfectly safe drug if you know how much you're taking. Far better for you than alcohol in both the long and short term, aside from its far greater addiction potential. The fact that people die from _misusing_ it does not prove that it is, in itself, dangerous. And it should not stop medical authorities from using it in a therapeutic sense if it is properly* indicated. 

(*I agree with you completely about the therapeutic mary-J legalisation. Its amazing how many people with long greasy hair and tie-dyed Phish t-shirts suffer from chronic pain, anxiety or phantom cancers. That said though, if THC has a genuine therapeutic role to play then it _should_ be available with similar restrictions to other drugs of dependence in a conventional route of admin, ie not rolling a joint and getting waster with your mates, in a pharmo pure form.)

Nor does the fact that its illegal make it _inherently_ dangerous. The fact that its illegal only proves that the drug was _associated_ at some stage, in some way with real or perceived damage to society. That doesn't mean that the drug is inherently dangerous. Heroin is used extensively as a very affective analgesic in the UK, yet its recreational use is still heavily restricted. Perhaps you could apply the same argument to MDMA. I'm not for it, I'm just saying don't necessarily write off the compound itself because it gets misused by certain sections of the population.


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## Veneficus (Jul 14, 2010)

Tone said:


> this is an assumption, you wont know unless you try.
> 
> 
> 
> ...



I won't know if a pharmaceutical agent has more positive effects than negative effects unless I try it? (I have no intention on self experimenting with anticancer or antiviral medications prior to being Dxed with either)

Will this somehow translate to a positive risk benefit analysis for other patients.

I took the time to look up Dr. Shulgin. It seems to me he was advocating for the product he and his friends was using. Not exactly unbiased scientific research. It would be like accepting research from a drug company marketing director.

His own research demonstrates there are hundreds of chemical analogs all of which have a different effect on different people under different circumstances. That is neither accurate or precise enough to treat masses of patients. it is basically a very devastating shot in the dark trying to hit a moving target. even the analog that works for 1 patient one day may not work the next.

What it does actually demonstrate is that having a medical practicioner develop individualized medications for an extremely small population who was preselected may lead to better treatment of those individuals. But we don't need MDMA to tell us that.

Do you think that a patient who self diagnosis, self prescribes, and self dispenses would not be happy with their treatment, even if it was just symptomatic? Once this person becomes addicted or dependant would they report or even try potentially safer medications? Would those medications have any effect after physical or psychological dependence?

Meclin,

What you mentioned about heroine was exactly the argument successfuly used to legalize methadone both in the US and EU. But there is evidence that the benefit can outweigh risks in legitimate medical populations (listed in my prior post)


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