Let’s Not Keep Meds From Chronic Pain Patients Because Dr. Nick Keeps Killing Celebrities.

Via wikimedia.

Opinion by Terry Gotham

This article goes out directly to the party people & Burners who think they can party like rockstar gods. While the measure of any varsity party person is the ability to handle multiple types of substances concurrently, that game has become intensely more dangerous in the last 5 years. In case you missed it, the coroner’s reports on Tom Petty & Dolores O’Riordan’s deaths came back. The lead singer of The Cranberries & one of the most distinctive voices of a generation is suspected of killing herself via fentanyl poisoning. And Tom Petty’s toxicology is so startling, I’ll just quote TMZ  (yes, it’s been corroborated elsewhere put the pitchforks down) directly:

Tom’s autopsy report shows the singer was on several pain meds, including Fentanyl patches, oxycodone (Oxycontin), temazepam (Restoril), alprazolam (Xanax), citalopram (Celexa), acetyl fentanyl and despropionyl fentanyl. The reason doctors prescribed the meds was because of a number of medical problems, including emphysema, knee problems and a fractured hip.
~Tom Petty Died From Massive Accidental Drug OD. TMZ.com 1.19.18

In the immortal words of Alex Shulgin, that is a “heroic” cocktail. For all my psychonauts and chem nerds out there, Kevin Shanks has an exceptional review of the chemicals here. For people out there that might not be too familiar with pharmacology, I’d like to explain why this combination of drugs is terrifying and a perfect example of the crisis currently afflicting all 50 states. While many have seen that pile of substances and flagged it as an “opiate overdose,” in a lot of toxicology reports, autopsies revealing multiple drugs are categorized in similarly incorrect ways. Some counties would flag it as a synthetic opiate overdose, while others only bucket many different types of opiates under the umbrella term “drug overdose.” Still others might even classify it as a benzo or Xanax overdose. While New York City differentiates between fentanyl and heroin in its reporting, this is not the norm. And that is a huge problem. Especially now that it’s easier than ever to be on half a dozen different drugs.

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Do No Harm: Initial Prescription Details Influence Chance of Opiate Dependence

By Terry Gotham

One of the biggest problems with writing about the War on Drugs is the almost exclusive focus on problems. There’s this myth that drug use is a combination between a ratchet & Russian roulette. It’s going to keep getting worse, and it gets harder and harder to “not be addicted” the longer you do it. This continued narrative is believed widely (just ask your family at Easter dinner), while being only lightly supported with evidence. Harm reduction & physician/client education is surprisingly effective at mitigating a lot of the factors that contribute to this “it’s probably going to kill you” problem, but outside of needle exchange/safe injection sites & drinking water while partying, complex harm reduction ideas rarely make it into non-academic circles. So, I’m going to start talking about constructive, modern ideas and research that have been either theorized, published or put into practice, about how to fight this deluge.

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