Seekers who are good actors!

Frankly find the idea of addiction being a 'disease' fully ridiculous. Its called irresponsibility and total lack of appreciation for life. Anyone who has so little respect for life that they feel the need to dull it away with any type of drugs, prescription narcotics or otherwise, disgust me and will never gain an ounce of sympathy. I've heard and seen plenty of sob stories from addicts; many of which are legitimately tragic. I've heard and seen even more cope with equally tragic life situations without the person having turned to such self pity and self induced misery.

Again, no sympathy.
 
What, exactly, is your background in medicine and/or addiction?
 
Very wrong business.

If there are physiological tendencies towards a physical dependence to a substance I'm more than happy to qualify that as a disease.
 
spike91 said:
Frankly find the idea of addiction being a 'disease' fully ridiculous. Its called irresponsibility and total lack of appreciation for life. Anyone who has so little respect for life that they feel the need to dull it away with any type of drugs, prescription narcotics or otherwise, disgust me and will never gain an ounce of sympathy. I've heard and seen plenty of sob stories from addicts; many of which are legitimately tragic. I've heard and seen even more cope with equally tragic life situations without the person having turned to such self pity and self induced misery.

Again, no sympathy.
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Jesus Christ....and I thought I was a bitter, harsh judge of my fellow man. I may not have much sympathy for drug addicts, but I do at least manage empathy for most of them.
 
spike91 said:
Frankly find the idea of addiction being a 'disease' fully ridiculous. Its called irresponsibility and total lack of appreciation for life. Anyone who has so little respect for life that they feel the need to dull it away with any type of drugs, prescription narcotics or otherwise, disgust me and will never gain an ounce of sympathy. I've heard and seen plenty of sob stories from addicts; many of which are legitimately tragic. I've heard and seen even more cope with equally tragic life situations without the person having turned to such self pity and self induced misery.

Again, no sympathy.
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You are obviously uneducated on the topic. What is legitimately tragic is that we have health care providers like you who are not intelligent enough to look past their own stereotypes.
 
A reminder for everyone, just because you don't agree with a person's viewpoints does not mean that our "Be Polite" rule is not in effect.
 
ffemt8978 said:
A reminder for everyone, just because you don't agree with a person's viewpoints does not mean that our "Be Polite" rule is not in effect.
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My threads always get like this! did you miss me?
 
why toradol?

DCAP-BLS-TIC said:
I had a patient complaining of the "worst headache" he's "ever had". So bad that he was "seeing squiggly lines". We get there and he literally has a book bag full of prescription bottles for various drugs, probably about 30-40 bottles, all of them being full/unopened except for his Oxycontin. Pain scale a 13 out of 10, of course.

We get to the ER only to find out that he had been to that same ER just the day before for the exact same complaint.
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Why would an addict say they are allergic to Toradol? Im a new EMT so sry if this is a dumb question. :unsure:
 
platypus said:
Why would an addict say they are allergic to Toradol? Im a new EMT so sry if this is a dumb question. :unsure:
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its not a narcotic but it is used for pain, so the seeker is trying to limit the choices of the health care provider to opiates.
 
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platypus said:
ahhhhh okay! thanks :)
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There's a few allergies that seekers use, another one is allergy to tylenol. tylenol one of the common drugs oxycodone is mixed with, in the form of Percocet (5mg oxycodone+ 325mg acetaminophen)

abusers don't like tylenol containing drugs like percocet due to the "bunk" which is the extra volume in the pill that is the acetaminophen, because they cannot crush and snort it.
 
Tone said:
There's a few allergies that seekers use, another one is allergy to tylenol. tylenol one of the common drugs oxycodone is mixed with, in the form of Percocet (5mg oxycodone+ 325mg acetaminophen)

abusers don't like tylenol containing drugs like percocet due to the "bunk" which is the extra volume in the pill that is the acetaminophen, because they cannot crush and snort it.
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Actually, many people snort percocets. A Percocet 10 (10/325) contains 10 mg Oxycodone Hydrochloride and 325 mg Acetaminophen, both can be easily crushed down and then snorted by abusers. This is actually quite common.

The only pharmaceuticals that you will find that have methods to impede using the drug by any other route than PO are the new Oxycontins and Xanax to the best of my knowledge.

Hydrocodone contains Tylenol as well, as do many drugs.. this has never stopped anyone from "snorting" it.
 
spike91 said:
Frankly find the idea of addiction being a 'disease' fully ridiculous. Its called irresponsibility and total lack of appreciation for life. Anyone who has so little respect for life that they feel the need to dull it away with any type of drugs, prescription narcotics or otherwise, disgust me and will never gain an ounce of sympathy. I've heard and seen plenty of sob stories from addicts; many of which are legitimately tragic. I've heard and seen even more cope with equally tragic life situations without the person having turned to such self pity and self induced misery.

Again, no sympathy.
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Actually your sentiments are quite common, but surely a medical association with some 200,000 plus members can't be all wrong.

According to the AMA (American Medical Association)

When scientists first started to study drug abuse, people addicted to drugs were thought to be morally flawed and lacking in willpower. This view has shaped society’s response to drug abuse, treating it as a moral failing rather than a health problem, resulting in punitive rather than preventative and therapeutic actions. Due to groundbreaking scientific discoveries, we now recognize drug addiction as a brain disease that can be successfully prevented and treated.
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quoted from:
http://www.ama-assn.org/ama1/pub/upload/mm/388/sci_drug_addiction.pdf

Indeed bad choices are often the moral door opened by some that lead them into the hall of misery we call addiction. Who here is without making a bad choice once in their lifetime? Surely one bad choice should not condemn a soul to forever suffer without chance of redemption. In these cases sympathy is not needed, but empathy is. All I ask here is that you take a look at some of the research into addiction and then you may be able to have a better understanding of what this problem is.
 
medicRob said:
Actually, many people snort percocets. A Percocet 10 (10/325) contains 10 mg Oxycodone Hydrochloride and 325 mg Acetaminophen, both can be easily crushed down and then snorted by abusers. This is actually quite common.

The only pharmaceuticals that you will find that have methods to impede using the drug by any other route than PO are the new Oxycontins and Xanax to the best of my knowledge.

Hydrocodone contains Tylenol as well, as do many drugs.. this has never stopped anyone from "snorting" it.
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I like the PO methadone mix as a way to limit IV use.

It is mixed with narcan which is inactivated by gastric acid. So if you eat it, you get the PO dose and effect. If you crush it and try to take it IV or snort it, the narcan inhibits it.

Absolutely brilliant. Chemistry at its finest.


As food for thought, many psych or recently recoined neuropsych issues including PTSD have a similar pathophysiology as addiction behaviors. Which would logically be concluded that if a person does not "believe" in addiction as a sickness, you couldn't "believe" in many neuropsych disorders. Which might I add by the way behave very similar to parkinson's disease.

That is sort of limiting.

Having said that, I recognize that the life stressors that lead many to addiction cannot be solved by medication or surgery. The psych folks call it "extrinsic" factors. However, there is some convincing anthropology research (can't post a link I only have a paper copy) that people with high level of social support suffer less from psych illnesses and have lower remission rates.

Like any disease, I conclude that the key to fighting addiction is prevention and then fighting the disease at the source. Which is largely extrinsic. Medicating people without such social support is little more than palliative therapy.

again, if you can't fix it, do what you can to make the person feel better is my opinion. If you had a person dying of a traumatic injury or chronic disease, we would not hesitate to palliate them with narcotics. What really is the difference between them and addicts who society is not willing to spend the money to help? They are all dying.
 
medicRob said:
Actually, many people snort percocets. A Percocet 10 (10/325) contains 10 mg Oxycodone Hydrochloride and 325 mg Acetaminophen, both can be easily crushed down and then snorted by abusers. This is actually quite common.

The only pharmaceuticals that you will find that have methods to impede using the drug by any other route than PO are the new Oxycontins and Xanax to the best of my knowledge.

Hydrocodone contains Tylenol as well, as do many drugs.. this has never stopped anyone from "snorting" it.
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I have to re-correct you on this one. In theory you could crush and snort any pill, but percocet really are not the preferred choice.

Common use for an addict would be to snort a 40mg oxycontin at one time, approximately.

To get the same dose of oxycodone that would be 4 or 8 percocet pills, depending on whether they are 5 or 10mg.

Try crushing even just 4 percocet pills and look at the amount of powder created, its a line the size of a pen. Won't work for the nasal route.

That's why they say they have the allergy to tylenol. It's also why oxycontin is so highly pursued, due to its very high oxycodone density allowing for nasal use.
 
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Tone said:
I have to re-correct you on this one. In theory you could crush and snort any pill, but percocet really are not the preferred choice.

Common use for an addict would be to snort a 40mg oxycontin at one time, approximately.

To get the same dose of oxycodone that would be 4 or 8 percocet pills, depending on whether they are 5 or 10mg.

Try crushing even just 4 percocet pills and look at the amount of powder created, its a line the size of a pen. Won't work for the nasal route.

That's why they say they have the allergy to tylenol. It's also why oxycontin is so highly pursued, due to its very high oxycodone density allowing for nasal use.
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@Tone I work with junkies on a regular basis, your points are irrelevant.

First off, 1 percocet 10 = $7.50 on the street, so 4 really isn't a problem, versus an oxycontin 40, whose price on the street is $40 a pill. These individuals are merely using a cellophane and a lighter to crush them down fine, constitute them into multiple lines, and snort them.

Moreover, Oxycontin is not pursued due to it's low oxycontin density, it is pursued because of it's high oxycodone content. Furthermore, if this were the case, the individuals would just say they had liver problems to try to get straight oxycodone 5 mg or 10 mg.

9 out of 10 addicts I encounter that are addicted to pills admit to having snorted: Percocet and Hydrocodone.. Fact.
 
medicRob said:
@Tone I work with junkies on a regular basis, your points are irrelevant.

First off, 1 percocet 10 = $7.50 on the street, so 4 really isn't a problem, versus an oxycontin 40, whose price on the street is $40 a pill. These individuals are merely using a cellophane and a lighter to crush them down fine, constitute them into multiple lines, and snort them.

Moreover, Oxycontin is not pursued due to it's low oxycontin density, it is pursued because of it's high oxycodone content. Furthermore, if this were the case, the individuals would just say they had liver problems to try to get straight oxycodone 5 mg or 10 mg.

9 out of 10 addicts I encounter that are addicted to pills admit to having snorted: Percocet and Hydrocodone.. Fact.
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first off I don't know where you are getting your prices!

I'll take the time to explain the nasal route to you because you obviously do not understand how these people are using pills. Yes, people do snort percocet, but they are primarily users who don't know what they are doing.

The nasal route is chosen by users because it is a faster route of administration. When users crush and snort pills containing higher amounts acetaminophen than oxycodone, the oxy absorption is reduced due to the surface area in the nares that is occupied by acetaminophen.

Thus, slowing the absorption to a rate slower or equal than PO. It also causes nasal congestion.

Point: educated users use pills with no "bunk".
 
Tone said:
first off I don't know where you are getting your prices!

I'll take the time to explain the nasal route to you because you obviously do not understand how these people are using pills. Yes, people do snort percocet, but they are primarily users who don't know what they are doing.

The nasal route is chosen by users because it is a faster route of administration. When users crush and snort pills containing higher amounts acetaminophen than oxycodone, the oxy absorption is reduced due to the surface area in the nares that is occupied by acetaminophen.

Thus, slowing the absorption to a rate slower or equal than PO. It also causes nasal congestion.

Point: educated users use pills with no "bunk".
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I'm not quite sure you grasp concentration. I can make 325mgs of APAP have a much smaller surface area than 5mgs of hydrocodone depending on how I manufacture it.

The reason oxycontin is preferred is because when you crush a time release pill, you end up with a much higher concentration of med than otherwise.

I can't imagine a scenario where nasal insulation would be similar to a PO onset time, APAP or no APAP. Snorting three lines vs one is rarely a deterrent to the user. MOST true addicts will snort whatever they can get their hands on.

Some of the preference will be region dependent as well. The docs around here RARELY write for oxy, so we see more hydrocodone w/APAP than anything, followed closely by chewing fentanyl patches. Although, there seems to be a trend towards methadone for severe refractory pain.
 
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