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.

Continue reading

Lazarus Parties, Heroin & the Continued Evolution of Harm Reduction

I’m taking a quick break from my series on the History of Addiction & Society because I’ve been tracking a disconcerting story for the last week. You may have seen it posted by one of your more conservative/pearl clutch-y friends this week, and if not, expect it before election day.

A smattering of local coverage, based around Toledo, Ohio, describes a Lazarus or “Narc” party. Heroin users will do heroin with other users, and in case one of the users overdoses, a sober person who isn’t using, administers Naloxone, or by its common retail name, Narcan. The implication is that because a user was standing by with Narcan, that’s the actual problem. The presence of the OD reversal substance is emboldening heroin users. To test their limits, or to even try using it in different ways, like shooting it, instead of just snorting or smoking it. Instead of preventing death, some are attempting to claim it’s making some people’s use more adventurous.

To research the work I release here on Burners.me, I maintain a quiet presence in a lot of different circles, so a lot of the time, I get to experience how mutually exclusive groups respond to stories. Today, I saw both a pool of researchers, doctors, law enforcement officials AND a group of ravers, talking about the same story, this “Lazarus Party” story. Oh yea, and in case you didn’t go to Sunday School, it’s called a Lazarus Party, because Jesus raises Lazarus from the dead as proof of his Jesus-ness. But, here’s the thing. Are there any actual, confirmed reports of recreational users calling them Lazarus Parties? No, of course there aren’t. But there “might” be, especially if you believe poorly sourced news & blowhards with agendas. Just in case you don’t believe me, ask a member of each political party their thoughts on FBI Director Comey & his investigation, and you’ll see how easily facts can be distorted or ignored to suit a pre-existing bias.

Larry Clark -

Larry Clark – “Tulsa” (1971)

What was amazing about what I saw, was the same mixed field of ignorance, trolling and reason within two opposite populations of commenters. One was a thread where you saw users, scenesters, and sober party attendees, the other was  entirely by people with respectable, well paying jobs, in and around the substance use, abuse & control sectors. Having the same argument. It’s one thing when two of your hippie festival friends argue about the purpose of “Narc” parties, with the dude who has the Deep Mind Acid filter on his profile picture, correcting a burn out when it comes to how Naloxone is used. It’s quite another thing when an ER Coordinator makes the same correction to someone who works in a rehab program.  The two arguments raged all day. At the time of writing, the festie kid argument had died down, but the med/substance abuse professionals was still going back and forth, and did so long into the night. And you thought you took your job home with you.

The facts of the situation are slightly less terrifying. Because Fentanyl, Carfentanyl, U-47700, W-18 and an array of other substances are present in the recreational opiate supply, opiate users have begun to switch off dosing to ensure they’re not all high if someone OD’s. The reports elaborated that people were starting to do heroin in groups more, in response to the tidal wave of Fentanyl-exacerbated OD deaths currently plaguing North America. Of course, if more than 1 person is doing an illegal drug in a room, the media thinks it’s a party.

The inherent idiocy in this line of reasoning should be apparent to everyone who has watched fear mongering and confusion go hand in hand. Thankfully, every time I saw this discussion occur, the intelligent and sensible among those willing to comment rose to the occasion and reminded everyone involved that harm reduction and opiate usage patterns evolve with time. In this case, it looks like people are starting to understand the inherent dangers of their habit, and pivoting around them. Not because they want to do “more drugs” or have a party, but because they don’t want to die. This seems like a no-brainer, but it’s actually deeply subversive when it comes to the traditional line of reasoning that prohibitionists use.

chicago-vice

In both this case, and the example from last week, the idea that drugs take control of you, or that you can’t engage in rational thought while under the influence, was the central pylon in the argumentative infrastructure supporting the case that all drugs are bad and humans shouldn’t have the choice to consume substances, especially to excess. But the narrative that I heard from both elder ravers and MD’s who ran emergency rooms was just the opposite. These “Narc” parties are nothing more than opiate users understanding the conditions on the ground and attempting to prevent bad things from happen to people they care about. Which is the very definition of harm reduction. They know no one is going to stop doing heroin, even when it might be spiked or adulterated with a substance that could kill them.

This point was so well defended, that opiates don’t turn people into zombies, people actually started to understand individuals with physical addiction and a fear/aversion to withdrawal exist. They were looking out for each other, and will continue to do so. I got to see some excellent harm reduction advice dispensed by a forensic toxicologist, so I wanted to share it with y’all, in case this stuff was useful for you:

  • Don’t use alone. Use a buddy system, to have someone who can call 911 ( and give Narcan) in case you stop breathing.
  • Learn how to use Narcan if you plan on using street heroin.
  • Even if you know how to use Narcan, test your drugs.
  • Do the same for another addict.
  • Don’t inject at the same time. Stagger your injection times.

These seem like no-brainers to most of us, but sometimes it’s easy to forget. Phillip Seymour Hoffman forgot. So did Prince. We live in an age where adulterants are far more dangerous than even some of the most problematic recreational drugs. And users are recognizing that, leading them to consume with others, and to learn how to reverse overdoses. That sounds like progress to me. Not something to be afraid of, and certainly not a reason to remove Narcan from the hands of those that consume opiates. Let the people save each other, since the powers that be don’t seem all that concerned about saving them.