The news has finally caught on to the heroin problem in Bloomington

[Warrior1354]

I have a good friend on the Indianapolis Fire Department told me he dealt with 10 overdoses in one week alone from heroin. And that was just at his station. One run they went on he came acrossed three people at the same time overdosed in a car. This literally is an epidemic.

 

[Dr.Midnight]

My cousin died from a heroin overdose not too long ago. She was, without a doubt, the brightest in the family, yet she refused to work, banged whatever bum offered her a place to stay, and chose to get strung out on drugs. How people can make such poor choices is beyond me.

 

[Denny347]

Until we address the causes of addiction, it will only get worse. We've had this discussion before and I've said my piece then. I've seen an Ohio community suggest 3 strikes rule for administering Noxilone. There was plenty of support in the comments section. I say to that, if you sit and watch a person die while having the means to prevent that death, you are a piece of ****. There will NEVER be a time where I will not help a person live if I am able.

 

[2ADMNLOVER]

If we could get all the bleeding hearts outta the way for long enough this " problem " will solve itself in short order .

 

[Denny347]

My cousin died from a heroin overdose not too long ago. She was, without a doubt, the brightest in the family, yet she refused to work, banged whatever bum offered her a place to stay, and chose to get strung out on drugs. How people can make such poor choices is beyond me.

I am so sorry. We cannot think in our terms when regarding an addicts behavior. Opiod addiction changes the brain chemistry. The brain then considers the drug as important as air. It's a horrible way to live, tearing down the strongest of people.

 

[Denny347]

If we could get all the bleeding hearts outta the way for long enough this " problem " will solve itself in short order .

How so?

 

[hoosierdoc]

So a guy in his 20s needs to have a heart valve replaced due to heroin and bacterial endocarditis. He needs dialsysis and is on a ventilator. He did not need narcan.

would some of you be in favor of spending $250,000 on him because he didn't need narcan? Just trying to see what level of care you'll withhold and at what point in the addiction.

 

[2ADMNLOVER]

How so?

The users will die off which saves the rest of us tax dollars .

 

[2ADMNLOVER]

I am so sorry. We cannot think in our terms when regarding an addicts behavior. Opiod addiction changes the brain chemistry. The brain then considers the drug as important as air. It's a horrible way to live, tearing down the strongest of people.

Can anyone explain why some folks get addicted and some don't ?

 

[churchmouse]

So a guy in his 20s needs to have a heart valve replaced due to heroin and bacterial endocarditis. He needs dialsysis and is on a ventilator. He did not need narcan.

would some of you be in favor of spending $250,000 on him because he didn't need narcan? Just trying to see what level of care you'll withhold and at what point in the addiction.

Lets look at this as they do the people on the list for organ transplants.
It is my understanding (please correct if wrong) that if there is indications of abuse or even other health issues you are dropped off the list.
Would not this addiction set you aside for some of these things.
I am not agreeing/disagreeing just curious as to procedure.
If someone is a life long alcoholic and destroys their liver/kidneys would giving them another set to ruin be a good idea.
Again, just thinking out loud.

 

[hoosierdoc]

For organ transplant my understanding (outside my wheelhouse) is that the precious resource is prioritized to those most likely to benefit. That takes into account age (or life expectancy remaining) how sick you are (can't be too sick or you might die right after getting it), or have active drug abuse problems that put them at risk of rejection. Smoking does the same thing. If we had a glut of excess organs they would reduce the barriers I'm sure. Drug addicts can't be relied on to follow post-transplant medication regimens and lifestyles. So I think it's more of being a good patient than punishing vices.

 

[churchmouse]

For organ transplant my understanding (outside my wheelhouse) is that the precious resource is prioritized to those most likely to benefit. That takes into account age (or life expectancy remaining) how sick you are (can't be too sick or you might die right after getting it), or have active drug abuse problems that put them at risk of rejection. Smoking does the same thing. If we had a glut of excess organs they would reduce the barriers I'm sure. Drug addicts can't be relied on to follow post-transplant medication regimens and lifestyles. So I think it's more of being a good patient than punishing vices.

This makes sense.
Now....as to your question on a 250,000 procedure that most likely the addict will not be covering does this same thinking apply.
I am not saying it should or should not. And not wanting to put you on the hot seat either. I have heard this same argument from a few folks lately. Still trying to wrap my head around it.

 

[Leadeye]

This problem got worse when the illegal side of Drugs Inc. found it was more lucrative to just use chinese chemicals that could be obtained legally and cheaply. The buzz in dc is how many programs and how much funding, Drugs Inc. is going to get an increasing size of the national pie.

Drugs Inc, the legal/illegal partnership.

Always follow the money.

 

[hoosierdoc]

I bet we spend way more money on futile treatments for grandma and grandpa. If this is about saving money, focus on the paper money, not the change

if it's moral choices, then by all means, cast the first stone

 

[BigBoxaJunk]

I bet we spend way more money on futile treatments for grandma and grandpa.

When my dad died at home in 2008, he was a DNR, but the paramedics pushed us to allow them to shock his heart, and when I said no, they insisted on doing CPR. I didn't stop them and they worked a good little while before they called it. In hind-sight, I'm sorry I let them do the CPR (it's way more violent than you see on TV). I knew my dad was dead and I was concerned that they'd get a heart beat and take him in to spend the last days of his life brain dead and hooked to a ventilator. I'm glad that when he went, he went.

When my FIL died in the hospital, he was also a DNR, but the hospital hooked him to a ventilator anyway in ICU. We had them take him off the ventilator and stop the drugs and he died in minutes.

I'm not sure why those measures were taken when both men were DNR. I have been told that EMTs would rather transport a patient and have the ER doc pronounce the death, but I don't know if that's true. I think with my FIL it may have just been a mistake. I think if I ever get a tattoo, it's going to be a big DNR on my chest.

 

[2ADMNLOVER]

I bet we spend way more money on futile treatments for grandma and grandpa. If this is about saving money, focus on the paper money, not the change if it's moral choices, then by all means, cast the first stone

How moral is it to STEAL money (taxes) from folks to keep paying for the sob's that won't do for themselves ?

 

[BigBoxaJunk]

How moral is it to STEAL money (taxes) from folks to keep paying for the sob's that won't do for themselves ?

Wait, are you talking about the addicts or the old people.......or both?

 

[hoosierdoc]

When my dad died at home in 2008, he was a DNR, but the paramedics pushed us to allow them to shock his heart, and when I said no, they insisted on doing CPR. I didn't stop them and they worked a good little while before they called it. In hind-sight, I'm sorry I let them do the CPR (it's way more violent than you see on TV). I knew my dad was dead and I was concerned that they'd get a heart beat and take him in to spend the last days of his life brain dead and hooked to a ventilator. I'm glad that when he went, he went.

When my FIL died in the hospital, he was also a DNR, but the hospital hooked him to a ventilator anyway in ICU. We had them take him off the ventilator and stop the drugs and he died in minutes.

I'm not sure why those measures were taken when both men were DNR. I have been told that EMTs would rather transport a patient and have the ER doc pronounce the death, but I don't know if that's true. I think with my FIL it may have just been a mistake. I think if I ever get a tattoo, it's going to be a big DNR on my chest.

usually it's a legal thing. Now (not sure when it changed) you need to have a signed "out of hospital DNR" form and have it handy when 911 shows up. There is only a short time to do or not do, and if the forms aren't readily available they are going to start CPR. Was 911 called while he was ill and then he arrested before they showed up? There's a lot of legal issues with not resuscitating someone when EMS was summoned, and they error on the side of trying to save the person unless it's crystal clear with paperwork and all family present is in agreement.

I've had people show up listed as DNR but the only family that showed up said to do everything possible. then the POA shows up and is pissed at us for intubating them. There's no way for us to know the dynamics or how many offspring/next-of-kin are around and who is the legal representative in the moment. When in doubt we do what we can and setup a family conference when people can gather.

when you're in the hospital as a DNR and discharged, that DNR is now revoked. It has to be re-established each time, and at discharge. I will often suggest intubating someone that's DNR under certain conditions. If they are DNR because they have a bad heart but come in with an accidental overdose, well just support them until meds are gone and then pull them off the ventilator. Or a pneumonia and should get better in a few days.

Nothing is clear cut. EMS won't transport someone without electrical activity now. Studies have shown better for the patient to be worked in the field since they have the exact same drugs and equipment as I do, and wasting time to transport doesn't help. If they can get a pulse back in 30 minutes they'll bring them in. At 30 mins they usually call to get permission to stop CPR.

 

[hoosierdoc]

How moral is it to STEAL money (taxes) from folks to keep paying for the sob's that won't do for themselves ?

I think you'd be surprised at the number of drug addicts who have jobs and pay taxes.

Are you referring to Medicaid charges? Because if they are uninsured it's not your taxes, it's the docs and hospitals that eat the loss.

 

[BigBoxaJunk]

usually it's a legal thing.

That makes sense, my dad had been ill for a long time, on dialysis and declining, and he had his DNR forms with him all the time.

With my FIL, it was more sudden and his DNR had been done many years before and we didn't have it with us in the hospital.

When I was in the ER with my FIL the day before he died, the police brought in a young man on a gurney and put him in the room right across from us. I knew right away that it was the guy who was best buddies with my son when they were young. He'd been in and out of trouble for a long time, and we finally had to tell him not to come to the house. This time he'd beat up his father and stole his truck. Later they'd found him OD'ed, and brought him in unconscious. At one point, a nurse asked if they were ready to "wake sleeping beauty". It was clear that they knew the guy well, and they got him in restraints before giving him the narcan. I heard the nurse tell the doc a bit later that the narcan didn't wake him, and they evidently gave him more, or something else, since I heard them fighting with him when he did wake up. I think there were all together three OD'd people in the ER in the 10 hours that we were there. Like Churchmouse said, the heroin thing won't fix itself, and I don't know what the answer is either.