MountainMornings

Had a short talk with Bob yesterday about Philip Seymour Hoffman. And we both thought it’s a shame, but not for all the general reasons everyone’s been talking about, like his life and character and talent. Because ever since some 19th Century chemist decided he could change morphine into heroin –  thereby making it much more euphoric, easier to administer, lasting longer and with lower dosages – people have been overdosing on this drug. A drug that is still used medicinally in the UK…because for really sick, terminally ill people, there is literally nothing like it. It is the opiate on steroids! For many years people, I mean ordinary brothers and sisters, mothers and fathers, black, white and brown, have been dying for/on heroin for over a century.

What’s different is that now another celebrity has died of addiction. But really, what’s different? A bag of heroin costs about $10 and an oxycodon pill costs $40, so that’s different. PSH had the money to go out and buy a week’s supply of heroin, he didn’t have to perform a sex act on the street to get high, so that’s different.

Doctors are encouraged to “Treat Pain,” nurses have us rank our pain on a scale of 1 to 10, in fact in some states if a doctor or NP doesn’t “treat our pain” he/she can be sued. There are whole buildings being built to deal with pain management in health centers across America. So in the same way we’ve become aware of the dangers over overprescribing antibiotics, doctors need to become more aware of the addictive powers of pain killers. Because for some of us, as Jim Carrey said of PSH: “For the most sensitive among us the noise can be too much.” 

I might say after knee surgery, “That pill makes me feel funny,” so I stop taking it. But the addict, probably 10% of the population, has a part of the brain that recognizes that narcotic in a primal center of their neural cortex, the addict says, “More please.”  Someone I knew well once said, “There are no 50 year old junkies.”

But here is a conversation we need to start in DC. Why not make Naloxone (aka Narcan) available over the counter? This is a miracle drug which can bring a dying, overdosed person back to life, and instead of waiting until an EMT or ER doc is available to administer it, which is often too late, why can’t families and friends of addicts purchase the drug as a nasal spray to keep in their home? Well they can in a program in MA, oh God I love that state! I knew it when they went for McGovern!

The problem has become more urgent: Heroin overdose deaths in the U.S. nearly doubled over the last decade, from 1,725 in 1999 to 3,278 in 2009, according to the Centers for Disease Control and Prevention. During the same period, deadly overdoses from opiate-like drugs, including painkillers, have nearly quadrupled, from 4,030 to 15,597. Naloxone works by blocking certain drug receptors in the brain. It has no effect on alcohol or cocaine overdoses but can be used against such painkillers as OxyContin, Percocet and Vicodin. http://www.huffingtonpost.com/2012/04/26/naloxone-drug-overdose-antidote_n_1456531.html

There was no one with PSH at the time of his overdose, so having Naloxone nearby may not have helped him. But once the rest of the country follows MA’s lead, we may get the chance to save more lives, because I believe recovery is possible. One day at a time. read more: http://healthland.time.com/2012/04/13/naloxone-debate-fda-hears-testimony-about-making-an-overdose-antidote-nonprescription/