In every heroin victim I still see my brother

[modrepub]

Each time Chera Kowalski saved someone’s life in front of me, I thought of my brother.

Chera is the librarian at McPherson Square who uses Narcan to revive victims who overdose in the park, in the heart of Kensington’s opioid crisis. Each time I saw her bang open the library doors and race out to the grass, I wished my brother had been on that lawn.

But John died against a bus stop fence on Long Island in 1999 on his way back to a halfway house. Buses passed by. No one stopped. My oldest brother was 34 and had been battling addiction since college. First alcohol, then cocaine. Later, after five years of sobriety, pain meds prescribed after neck surgery. At the end of his life, heroin.

At least once paramedics had to restart his heart. Doctors had told him that if he did not stop abusing alcohol and drugs he would be dead in six months. He did not last that long.

That December day by the bus stop, his heart stopped again. “Accidental overdose,” read the report from the Suffolk County medical examiner. In his system they found alcohol and heroin.

<snip>

I see my family’s pain writ large in Kensington. Nowhere is the opioid crisis more visible – in open-air drug markets, on library lawns, in abandoned churches, all along the avenue. On corners crowded with people who themselves are the center of some family’s private struggle.

You can’t spend more than a few months in Kensington without concluding that as well-intentioned as the city’s – and country’s – response to the crisis is, it’s still shaped by stigma and shame. It still relies on backward treatment programs like the detoxes my brother powered through again and again, only to relapse. It shies too often from evidence-backed solutions like medically assisted treatments, and yes, safe injection sites, which at least keep people alive, and usher more into treatment, and offer neighborhoods relief from the daily trauma.

The conversation has come far. We recognize addiction as a disease, as a public health crisis. But still, the stigma surrounding addiction persists. Nearly two decades after my brother’s “demons” were eulogized as much as he was, we still argue about the very vocabulary surrounding this devastation.

You can’t spend more than an hour in Kensington without realizing what’s happening there is a humanitarian crisis as much as a public health one. For that, you only really need to listen to a few minutes of one of Elvis Rosado’s Narcan training sessions, which he holds up and down Kensington Avenue. Elvis, a light of hope among many in Kensington, will explain how to recognize an overdose from fentanyl, the synthetic opioid that is now the biggest killer. The deadly drug does its work instantly, compressing the person’s lungs, and causing the air to come out in a rush. Fentanyl victims, Elvis said, sometimes touch their lips in shock, then fall.

Such an intimate gesture. A last terrible acknowledgment of everything that brought them there, and everything about to be lost.

http://www.philly.com/philly/columnists/mike_newall/in-every-heroin-victim-i-still-see-my-brother-20170824.html

One of several articles on the heroin epidemic going on in Philadelphia. Sad stories but ones that need to be told.

[TubbersUK]

1. K & R n/t

[Warpy]

2. Fentanyl scares the hell out of me

I hated using that shit when I was a nurse and I hate it even more now that I'm not. Yes, it's a good drug for a lot of people who can't take other opiates, especially terminal pain patients who find relief with the patches, but it is such dangerous stuff. The line between relief and sending someone to la-la land is a pretty fine one. I've use Narcan in the hospital mostly on people on fentanyl pumps.

The two drugs that most need to be tightened up at the manufacturing level are fentanyl and timed release oxycodone (Oxy Contin is only one brand). The latter is misprescribed and sets people up for drug dependence. The former kills them when they get there and turn to street drugs because the doctors have cut them off.

I'd like to see more people out there carrying Narcan. I'd like to see it over the counter, honestly. It won't save everybody. It will save more.

[modrepub]

3. If it's scary to you as a trained professional

it must be absolutely terrifying to the librarian briefly discussed in the opening sentences of this article. What was going on at that particular library was absolutely mind blowing. Hats off to the library staff for dealing with this nightmare.

http://www.philly.com/philly/columnists/mike_newall/narcan-nbc-media-heroin-kensington-mcpherson-square-library-20170602.html

Just a tidbit from the link:

On her last three shifts at the library in McPherson Square, Chera Kowalski has helped save the lives of three people overdosing on heroin.

She and the other librarians at the Kensington branch had told me two weeks ago that they feared that when the weather warmed, the crisis on the library lawn would grow worse than they could imagine.
It has.

Kowalski, 33, who keeps the overdose-reversing drug, Narcan, behind the circulation desk, has run for the spray as many times in the last week as she did last month. In two months, she has helped save eight people. It is becoming as much a part of her daily routine as finding reference numbers and helping students log on to a computer.

[tymorial]

4. I agree with you

There also needs to be more resources available to.address the needs of those who are already deep into addiction and dependence beyond legislation designed to reduce availability to prescription opioids. Laws which limit prescribing have had the negative effect of people turning to street drugs to maintain their habit. People who switch are at an increased risk of overdose. Addicts will only quit when they are ready, I know this to be true juat like every other addict. It frustrates me to no end seeing these laws knowing that addicts will turn to heroin with no idea the strength or how to dose. They are going from a refined medication made with strict guidelines to a drug that van vary greatly . Many times some of these people are just maintaining to prevent from feeling bad and Suboxone could save their lives.

I do not believe Suboxone is the ultimate answer but it is a tool that could be used if physicians were more aware. It is certainly over prescribed in some instances and people stay on it way too long and end up in another cycle but it could save millions.

I treat addicts everyday and I know the suffering out there. I hate the over prescription of opioids but I hate the legislation too because so many politicians are using the crisis as political currency. The option crisis has become the new "tough on crime". Heavy on rhetoric , short on substance.

I am off my soapbox now.

[neeksgeek]

5. This is the part the "war on drugs" people don't get

They don't see "people who themselves are the center of some family’s private struggle."

[Duppers]

6. Please crosspost in GD for more eyes.

I lost a dear sweet friend to heroin. I didn't know he was using, but did suspect cocaine because of his fast weight loss. He was brilliant, fully employed, and never missed work.

This sad addiction/ affliction/humanitarian crisis needs regulation of supplies not condemnation and scorn.