Hot Take?

Stop sending EMS to respond to overdose calls, Ohio councilman says
Some Ohio councilman wants to find a way to stop sending EMS on OD calls because the city is spending too much money on Narcan.

http://www.ajc.com/news/crime--law/...-ohio-councilman-says/7C7Ct6Bjv716ei4JmY34GL/

 

I really dont know where to start with this

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Please tell me AJC is satire like Duffle Blog or Onion? No? Well, shi.......

 

At first I thought, no way, but then I realized EMS has nothing to do with this. If the state or county or municipality we work for narrowed the scope of our services, that would just become part of our jobs. Eventually, those of us who'd been around long enough would remember how busy EMS used to be when we responded to all 911 calls.

 

No AJC is the local news paper from Atlanta, Ga it's a legit news site


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Drug abuse with lethal drugs is a self limiting problem.

If we aren't there to "save them" (this time/again) then the problem will cease to be a problem.

Seems as though the world may be a better place without some people... just sayin'.

The current climate of healthcare abuse and exponentially growing costs cannot be sustained forever. Eventually the chickens will come home to roost.

(To be clear I'm talking about repeat offenders, high drug call districts, etc... problem areas. Not a granny who ODs on Amlodipine or a kid who downs a bottle of ASA... I'm talking about adults who continue to make poor choices with no repercussions.)

 

So how do we determine who lives and who dies?

If they look like a dirtbag, "sorry no Narcan for you"?

If it's a kid, they can has resuscitation?

Sorry. But that's BS. As medics, it's not our job to judge. And every person who's overdosed is someone's kid. Or brother or sister. Or mom or dad.

Think about it.

Seriously. Think about a poor choice your or your friends or family member may have made. Then think about some paramedic showing up and judging if their life is worth saving.

That leaves a bad taste in my mouth and if you really think that perhaps we as a profession should consider letting some people die based on poor decisions, you need some help.

 

All I am saying is that Darwinism is simple.

I have little sympathy for someone who would repeatedly go out of their way to knowingly harm themselves just because they know that at their demise someone will be there to rescue them, so that they can do the same thing again tomorrow.

That is completely different than doing something once or twice or three times, or making a mistake or having an accident...
These people are parasites on our society. Contribute nothing and demand everything.

On top of that, it's not free.
I am not in the "healthcare is a right" category.
I would not deny someone healthcare, but I decline to pay for it in some cases.

I'm not to judge anyone... if I show up I'll do my job. I'd rather have never been dispatched in the first place.

 

Following that logic, why do we treat ANY medical problems at all? Why not just let the genes for hypertension and heart disease and diabetes and risky behavior all die out?

Except that isn't how addiction works. These people have a mental illness that prevents them from making rational choices. And a majority of them recover and live productive lives.

The type of utilitarianism you are advocating is a very slippery slope, and I would argue has no place whatsoever in modern healthcare.

 

That's not a daily choice, and they aren't smoking, snorting, and shooting up things that are known to be immediately detrimental to their health.

That argument is apples to oranges.

 

I understand that my opinion may be an unpopular one.

I lost my father to substance abuse. I nearly lost my mother who still battles today. Currently, I have a brother who is having an issue with meth and heroin who consistently wreaks havoc on the emotional investment of the family.

Don't lecture me on addiction. You're entitled to you opinion, but I am deeply intimate with substance abuse.

Modern medicine? Modern times are wrought with a lot of things that are different than say, old timey medicine? Every junky deserves to live because every life is precious?

Do you feel the same about other tragedies of our lifetime? Everyone can't be saved.

 

Ok, then why don't we at least apply your approach to everyone with a BMI over 30 and who uses alcohol and other things that are known to be bad for them? It would be logically consistent. Illicit drugs certainly aren't the only risk factors for expensive health problems.

You might think yourself an expert on substance abuse just because you've been affected by it, but you'd be very wrong.

 

The

The key word was immediately.
The abuse of illicit drugs has immediate effects, and we utilize a lot of resources on it.

I'm not an expert on substance abuse, but I know enough to know that you can't help people who don't want to help themselves.
And I am not a proponent of spending an exponentially increasing amount of manpower, resources, and money on this particular issue.
If you want to hit a drug house with some squatters and quit breathing for the 6th time this month perhaps someone should just let you escape that from which you're running from.

As I said, I know my opinion is an unpopular one. Many folks have the bleeding heart for every tragedy of mankind's own doing.

 

It has nothing at all to do with having a bleeding heart. It's about having an opinion based on reason vs. emotion.

Just so I understand:

Let people die from an easily reversible cause for which we have a cheap, readily available antidote even though the choices that led to their situation were arguably not even completely freely made - because darwinism.

But, lets keep spending massive amounts of resources on people who willingly make themselves susceptible to "accidental" trauma by speeding and not wearing seat belts and all sorts of other tomfoolery, as well as on those who make other poor lifestyle choices that they know are likely to eventually lead to expensive chronic diseases. Because darwinism?

Seems logical to me.

 

Well we aren't talking about those other causes of illness and disease. Again apples to oranges.

It seems as though you are the emotional one.

You'd probably hate to hear how I feel about those on dialysis who don't care for themselves, with diabetes who don't manage themselves, and all those other wonderful self induced illnesses of which people continue to do harm to themselves and worsen their conditions- ever dependent on someone in medicine to bail them out for their continued poor choices while expecting someone else to foot the bill.

My point is, in regard to the topic of this thread, that I am against throwing unlimited resources at this problem, whereas if they were allowed to do what they do without so much intervention they would cease to be a problem. Thus, self limiting.

Fear not, in our society your viewpoints are more likely to play out. We will continue to pour resources, equipment, money, and careers as well as other lives that could be actually be helped away to tackle this problem.

Until we as a society decide enough is enough, or until we have a major disruption in our society and the rules of comfort and convenience go out the window.

It's all good. We can disagree.

 

Mixed views on the matter. I agree it's a slippery slope and I don't see much of a difference between the drug addict the the COPD patient who gets intubated once a month and contiues to smoke while refusing to wear oxygen. Seems illogical to condem one and not the other.

However opioid addiction is a pandemic that is a huge drain on society and there should be consequences for actions. Just because it's a simple and cheap antidote doesn't mean it should be treated as a free pass. Should all those treated with narcan due to illegal drugs be arrested and forcibly enrolled in a rehab program? Should you get unlimited chances? Don't know the answer.

Wish they had a long acting opioid antagonist shot, i.e months, that could be utilized.

 

Right, the answers... I don't know.
I only know the current model is unsustainable.

And I agree with the councilman in the article.

No more free rides, and put the fear in them that they may not be saved.

 

I'm the emotional one? "I know you are but what am I?" Lol

Look, I'm the one pointing out the logical inconsistency in your position and trying get you to explain your rationale. Your are the one who has offered an opinion without any supporting justification other than personal anecdote.

Of course it is fine if we disagree, but if you are going to participate in a discussion with professionals about an important issue of the day, then you should be able to support your opinions.

The way to fix the problem is clear. Decriminalize all substances and start treating addiction as a health problem that requires treatment rather than as a criminal and moral issue that requires punishment.

Prohibition has never worked, and we've known for at least a few decades that our drug policy was a failure, and the fix has been staring us in the face the whole time. But because the government derives so much power from the war on people with a chronic disease called addiction, they've worked hard to convince us that these people are a threat to us and that it is therefore in our best interest to give up many of our rights and much of our money so that the government can protect us from the victims of that mental illness. And the tens of millions of low-information citizens continue to cheer it all on, even though the problems with the approach are so obvious.

Until we completely revamp our drug policy in this country we'll keep chasing our tails by imprisoning people with mental health issues and arguing over ridiculous ancillary issues such as how many chances an addict should get before we stop treating them with nalaxone.

 

Good morning, Remi.

There's about as much a chance of a revamp of our drug policies as there is of us to start letting these people go without emergency resuscitation.

I gave you rationale... it costs more and more and more everyday, wastes valuable assets that could be used more wisely elsewhere, and contributes to EMS abuse, provider burnout, and wastes hospital resources as well.

Turn off the faucet. Drug abuse is not a medical condition akin to cancer or heart diesease.
I don't know why you're so insistent on people not paying their own medical bills and being allowed to do as they wish as they waste our resources without repercussions.

I don't personally believe everyone deserves to be treated so special, and that those who are a burden on society and contribute nothing should be on the bottom of the "treated special" list (if there was one). I believe in personal accountability and responsibility.

 

While I agree with the overall generalization of your post, I can't say I agree that addiction is a disease; I feel it's a choice. That is, they choose their addiction, healthy or not.

You can choose to smoke cigarettes in lieu of kicking meth, heroin, cocaine, etc. A slightly less healthy, albeit still ultimately unhealthy choice. Either way, they're their choices.

I do like--and have for sometime--the idea of decriminalization in The States. I think it's long overdue and would ultimately (ironically) force accountability upon the "addicted" masses. It also sends the message to the "addict" of it being their choice.

All in all, I'm enjoying the discussion you and @SandpitMedic are having. Good dialogue, y'all.