By Terry Gotham
I know that sometimes I can seem all doom & gloom about the state of the drug-consuming universe, but once and a while I happen upon something that justifies my concern. This letter by Dr. Leon Gussow, published in the Emergency Medicine News (March 2017) journal is one of those things.
The filtration of fentanyl & fentanyl analogs into the recreational opiate supply has pushed us into a place where the simple “opiate overdose” prognosis in emergency rooms & EMT visits is no longer simple. Previously, treating an opiate overdose involved a single dose of narcan/naloxone, with a few hours of observation before the patient was back on their feet. The patient was then assessed for discharge and removed from the workload of the emergency room if released. This allowed even severe opiate overdoses to be handled in a timely, almost mundane fashion, if the EMTs were timely and the staff was experienced. But as Dr. Gussow explains, this is no longer the case.