Safe Injection Sites

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I wrote an op-ed this month that was published by the Hartford Courant. Insight: I See What Heroin Does. Let People Shoot Up Safely Included was a checklist: 5 Things to Know About Heroin Addiction I read an article a few days later that said that when called an “overdose prevention site,” as opposed to […]

Epinephrine in Cardiac Arrest

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The use of epinephrine in prehospital cardiac arrest showed no difference versus placebo in determining favorable neurological outcome according to a long awaited randomized controlled study published yesterday (July 18, 2018) in the New England Medical Journal. The trial showed epinephrine produced a higher rate of survival at 30 days than placebo, but that was […]

Veins

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Kelly is as dispirited as I have seen her. “My veins are shot,” she says. “I can’t even get high.” IV users use 1 cc syringes which have a very small needle they only need to slip inside the vein. When they pull back and get blood they know they are in. They push the […]

Pulmonary Edema in Opioid Overdose

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She finds him in the bathroom at seven in the morning and knows immediately he is using heroin again. Three weeks ago, they moved east from Seattle. She had a job offer and it also represented a chance to get him away from his junky friends. After three times in rehab, she didn’t think she […]

Slipping Out

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The man is trembling, sitting on the bed in the spare motel room down by the highway. Sometimes, these rooms are filled with the patient’s worldly belongings, but this room seems to only have the bed, a dresser, a chair and the TV. The man is in his late fifties, a portly man with white […]

Diploma

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The man is on the nod, the only thing keeping him up is the fence he is leaning against. When the police officer tries to extricate him from the fence, he falls back and the officer has to lower him to the ground. I set my red bag down to get out my ambu-bag, but […]

Naloxone’s Effect on Opioid Use

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Does access to naloxone influence an opioid user’s decision to use? That is the crux of a recently published (on-line) economics paper, The Moral Hazard of Lifesaving Innovations: Naloxone Access, Opioid Abuse, and Crime, which argues that increasing access to Naloxone sanctions risky behavior, unintentionally increases opioid abuse, leads to greater crime, and may increase the […]

Hartford Opioid Crisis Interview

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One of my EMS coworkers and a budding journalist Sean Freiman interviewed me recently about Hartford’s Opioid Crisis with a focus on the heroin bags. Click on the picture to view the interview.  

Rescue Breaths or Compressions in Overdose?

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  Should unresponsive overdose victims receive rescue breaths or chest compressions from lay bystanders? If a person is apneic but not in cardiac arrest, failing to give rescue breaths may lead this person to fall into cardiac arrest. But, if the person is apneic and in cardiac arrest, failure to do quality chest compressions, will […]

Follow Up

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Overdose on Babcock Street. In an alley behind a building. Fire is there before us. A familiar scene. As I approach I can see them hunched over the patient, the bag valve mask out. They have already given her four of narcan. I stand over them looking at the patient. I can’t see her face […]

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