The call is for an overdose in the stairwell of the apartment building. Fire has arrived just before us – they have propped the front door open. I enter with my house bag over my shoulder and carrying the cardiac monitor in my right hand. There is no one in the dim lobby to direct […]

Great article in the November 2017 edition of the  American Journal of Emergency Medicine about the  controversies surrounding the dangers of carfentanil, fentanyl and other fentanyl analogues.  The physician authors, John B. Cole and Lewis S. Nelson, take the Drug Enforcement Agency (DEA) and the media to task for sensationalizing the dangers to responders of these synthetic opioids. […]

The patient is “a skin popper.”  She injects heroin into her skin rather than snorting it or injecting it directly into her veins.  Her arms are covered with sores in various stages of ulceration from old scars to open weeping sores.  example of skin popper The ambulance crew is there not for an overdose, but for […]

The state of Massachusetts just passed an emergency protocol change requiring all paramedic ambulances to carry non opioid pain management alternatives, including Ibuprofen PO, Acetaminophen PO and Ketorolac IV or IM.  Acetaminophen IV is optional.  The changes are to take place January 1, 2018. Massachusetts Pain Management Protocol Emergency Non-Opioid Pain Treatment Options Update Here […]

The Connecticut Office of Emergency Medical Services (OEMS) in conjunction with UConn John Dempsey Hospital has just released a free 1 hour on-line EMS CME: The Opioid Overdose Epidemic: The EMS Role. The auto-narrated program discusses the background of the opioid epidemic, Connecticut death statistics, Connecticut CORE initiative, the science of addiction, the dangers of […]

Across the nation harm reduction workers are going out in the street, meeting heroin users face to face and testing their powdered drugs for fentanyl.  They are not afraid because they know that touching fentanyl cannot kill you.  They do take precautions.  They wear nitrile gloves when they dip the tester strip into the powder.  If […]

539 people in Connecticut died of accidental drug intoxication deaths during the first six months of 2017, which projects to 1078 for the year, an increase of 17.5% over 2016, according to the state Medical Examiner’s Office. Fentanyl continued to fuel the rise in deaths. Fentanyl was present in 322 deaths during the first half […]

In view of Hurricane Harvey and the rescue efforts now underway, I am posting notes from my journal when I was posted in Gulfport, Mississippi in the aftermath of Hurricane Katrina. Day One: Waiting On the morning of September 17, we meet at the office and a chair van driver takes us up to the […]

One of the main reasons opioid overdose deaths have been increasing is the rise of fentanyl sold either combined with heroin or in place of heroin.  Fentanyl, which is 50 times stronger than heroin, has a stronger affinity for the opioid receptors in the brain than heroin.  Toxicologists have said that while naloxone is still […]

You carry four 100 mcgs vials of Fentanyl in your controlled substances kit.  How much would those vials be worth on the street? Let’s do the math. 100 mcgs of Fentanyl is the equivalent of 10 mgs of Morphine. Morphine is 50% as strong as heroin. Morphine is the equivalent of 50% pure heroin. A […]