Hot Take?

Harleyjon

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People who have not fallen into an addiction have no idea of what it is. It does not matter if it is titled a disease. What does matter is that choice is thrown out the window once one has succumbed to it. The point of delineation between falling into addiction and having succumbed is very grey and the time frame can vary greatly. For some people it may take years to develop a full blown addiction and for others the first involvement with the object of their desire can spiral them deep into addiction immediately. No matter the time frame once someone falls into addiction the ability to chose is lost to the sense of "this is the answer to my situation, and nothing else will work". For some people life is very difficult to bear, so difficult that the idea of something that will ease the pain by even the smallest amount is worth any and all consequences. The thought that "this might kill me" is not even in the equation or it is simply a passing thought. Anyone who thinks that an addict considers that the thing of his addiction would kill him or that something such as driving drunk is "dangerous", obviously has no understanding of addiction. There are two forms of addiction The Physical and The Mental. Physical addiction is when the body develops a need for a substance and the body experiences physiological reactions to the lack of something. This happens after some sustained period of use of some substance. Mental addiction is something altogether different however. Mental addiction is manifest as an obsession which blocks out all other thought processes. The addict can only focus on one thought "I MUST have this thing" it will fix me. There does not need to be any rational thought process behind this thinking, it is what it is. All addictive behavior begins with the mental obsession.

The only way to arrest this "THING" is with a complete psychic change. To try to "scare" someone into stopping addictive behavior is a fools play. I have no idea for sure but I would be willing to bet a lot of money that most if not all of the contestants on that TV show Intervention are continuing their addictive behavior. No one is going to make any change in their life unless they want to. When it comes to addictive behavior, generally the only reason someone makes a decision to change is because their "fix" no longer fixes things (and has not for a very long time). An addict will chase a shadow of a dream for a long time because maybe the next time "it will work"

There is a whole lot to this subject it could (and does) fill volumes. the problem is that nobody other than an addict will ever understand it and they don't totally grasp it either.
 

Bruce Gormley

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I would think that knowing this, would-be 911 callers would just call EMS directly, and then what would you do. I know i'd respond.
 

Salty Fox

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I haven't even passed my registry yet, so I can't claim a deep insight into EMS or any sort of experience outside of the fact that I know some addicts personally, but the concept that we wouldn't treat people who needed it seems to imply a deficit of compassion antithetical to what I believe EMS is supposed to stand for.

I understand that a lot of people in this business become jaded after being exposed to the worst that humanity has to offer on a daily basis, but are we not called upon to be better than that? Denying your EMS providers a chance to help everyone they can seems like a slippery slope.
 

FirstResponder

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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/stop-sending-ems-respond-overdose-calls-ohio-councilman-says/7C7Ct6Bjv716ei4JmY34GL/
I'm not sure how the replies to this post have even gotten to the point where this has become a discussion... What's scary about this "discussion" is that it primarily involves EMS personnel...who are entertaining the idea that certain circumstances (or patients) shouldn't be helped. This is a conversation for people outside of EMS. Outside of healthcare. Those are the people who are supposed to be wasting their time debating over who should live or die, which problems are more important than other problems etc. Whether or not you feel certain people are a "burden to society" or if they meet your personal standard of "responsibility and accountability" has absolutely nothing to do with your responsibility- to HELP them. We can go on and on about the problems with addiction treatments, the amount of users who don't stay clean etc. We can go on and on about whether or not an addiction is a disease, and even throw in a "REAL disease" that we have to deal with in our families, and how that's "more important" than a drug addict's problems.
Or we can choose to step aside from the ignorance and leave that to the general public. I'm shocked at the hot takes people have with the use of narcan and drug addiction in general. Not from the general population, but from the people who they call when they dial 911. Who cares how many times you've been to the same location for the same patient? Until you come up with a solution that doesn't involve punishing people for needing help "too many times," you can keep doing your job and treat these emergencies for what they are: emergencies.
 

ChewyEMS13

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What about the hard-of-seeing grandmother who takes a wrong medication, or maybe too little? Poor Grandma Eugene is lumped into the same legal category as John the Junkie shooting heroin? Because as far as I know, both scenarios are OD's?
 

Mike Hammer

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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.
That's a tough stance. Complicated topic..I'm not sure if most people who aren't compromised in another way are just going out of their way to harm themselves for the fun of it. Sounds like you have some rough connection to the topic...Mostly I wanted to say I'm sorry you've had to have so much substance abuse so close in your life. That's tough stuff!
 

FirstResponder

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Curious to see if anyone has evolved over the past year or so in terms of their positions on this topic?
The "No More Narcan" thing is still tossed around a little too frequently. Are there still people out there who think this is comparable to cutting somebody off at the bar for being too drunk? Or is that just an ignorant few?
 

Virgil

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Appleton firefighter, father of 3 is shot and killed by patient they brought back with Narcan



I can understand the sentiment, but I'm too uneducated on statistics for this to form a full opinion. Also, how did they not pat him down right before or right after they administered it?
 

DesertMedic66

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Appleton firefighter, father of 3 is shot and killed by patient they brought back with Narcan



I can understand the sentiment, but I'm too uneducated on statistics for this to form a full opinion. Also, how did they not pat him down right before or right after they administered it?
It’s not extremely common for anyone in my area to pat down patients.
 

Virgil

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It’s not extremely common for anyone in my area to pat down patients.
In general, I can understand that. But in the case of an overdose, from whatever narcotic, I would have thought it would be SOP on either PD's part or EMS to pat the patient down for needles or additional narcotics.

And if not, doesn't that exacerbate the problem? If this guy were to go shoot up his choice of drug 20 minutes later, first responders have to return and utilize more time and resources. Seems like throwing buckets of water out of a sinking ship.
 

9D4

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In general, I can understand that. But in the case of an overdose, from whatever narcotic, I would have thought it would be SOP on either PD's part or EMS to pat the patient down for needles or additional narcotics.

And if not, doesn't that exacerbate the problem? If this guy were to go shoot up his choice of drug 20 minutes later, first responders have to return and utilize more time and resources. Seems like throwing buckets of water out of a sinking ship.
In my area, SOP was a LEO would do a pat down.
Now, I've never seen it happen, but I doubt anyone I worked with would've been cognizant enough to do that themselves if PD happened to arrive a significant amount of time after us, myself included; but I worked in Phoenix, so arguably it was a few minutes response time for either group, so it wasn't a thought that ever crossed my mind.
I'm still curious about how many people would agree with the old line of thinking and that it's their choice. I'd like to say I can see both sides, but I definitely agree more that it is a necessary evil.
What I'm really, really curious about is how many medics actually talk to these patients when they're cognizant enough. I'd argue for more training in the mental health department; be able to treat the physical symptoms and have some slight bit more understanding for the mentally underlaying conditions.
I'm by no means advocating that EMS should be counselors; not their pig, not their farm. We should always be patient advocates though, a better understanding of psychiatric conditions could encourage that. If we present ourselves with a giant chip on our shoulder that they're wasting our time, of course they'll pick up on that and not listen to a single word when someone encourages them to get clean; they're picking up on the fact that someone else doesn't care and just wants them to get clean to stop wasting their time.
That being said, yes it is an epidemic, yes it uses a ton of resources. Something needs to be done to curb it, but arguably the issue with an epidemic; it's an epidemic. It's large scale, it's hard to combat. That's part of the nature of the beast.
Overall, yes there should be accountability on their end. That's not my place to figure out, though on what that entails.
If we get really into it, some places have tried force rehab after hospital admittance. I do recall seeing a story a long time ago though, that someone had a poor reaction to prescribed pain pills and she was forced into the program by the hospital psychiatrist. The alternative method of "force" that's used is the very obvious criminal charges.
Ultimately, this isn't an easy question to answer. Medics get a chip on their shoulder that they have to go see their frequent flyer "again," a private prison group waiting in the wings to increase their population, or a forced rehab that's unfortunately has the same issue as anything else, which is human error.
Ultimately it falls down to an ethical question; resources or human life? Until the day comes when there's a massive drug policy reform, which is very much necessary, I'll answer for myself that I'd choose human life.
Interestingly, someone brought up Portugal, which I love. Decriminalization occurred their in 2001 I believe. Overdose rates are about 3 out of 1,000,000 citizens. They treat addicts with a small fine and a mental health referral.
Excerpt from an article in regards to it;
"Portugal decriminalised the use of all drugs in 2001. Weed, cocaine, heroin, you name it — Portugal decided to treat possession and use of small quantities of these drugs as a public health issue, not a criminal one. The drugs were still illegal, of course. But now getting caught with them meant a small fine and maybe a referral to a treatment program — not jail time and a criminal record.
Among Portuguese adults, there are 3 drug overdose deaths for every 1,000,000 citizens. Comparable numbers in other countries range from 10.2 per million in the Netherlands to 44.6 per million in the UK, all the way up to 126.8 per million in Estonia. The EU average is 17.3 per million."
Link to articles I mentioned
Forced rehab:
Portugal rates:
 
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