It is estimated that there are some 6 million people that are abusing some substance (legal & illegal) – other than alcohol & tobacco . For the past 100 yrs the per-cent of the population abusing these substances has always been more than 1% and less than 2%. We sort of have a equilibrium between those becoming addicted and those dying from use/abuse/over dose of these same substances.
There is a movement afoot that would make Naloxone auto-inject pens readily available… providing them to first responders and allow Pharmacist to administer/sell like any other vaccine they provide.
Let me first state.. that every life is precious …but.. if the person doesn’t have that same feeling about their own life.. how far should society go to help protect these people from themselves ?
It is common knowledge, that all or nearly all of these people have some sort off mental health issues.. demons in the heads… monkeys on their back.. so throwing them a “life saver” by using Naloxone without following up with mandatory mental health therapy, methadone clinic or Suboxone clinic.. are we just providing them with the opportunity to keep repeating the cycle?
We are Pharmacists… around 1970 the BNDD/DEA started us being “cops”… about a decade ago.. we are not “shooters” with vaccines and now many bureaucrats want us to be EMT?
Imagine this scenario … a person walks up to the counter.. and states “.. my friend is has OD’d and is out in the car in the parking lot…. I need that drug to give him for a overdose …”.. Ok.. that will be $300… “.. I don’t have any money…”… does he have insurance ?… “I don’t know.. …all I know is that he is DYING OUT IN THE PARKING LOT …”
So with this dilemma … does the Pharmacist provide the $300 worth of Naloxone.. and then try to figure out how to get paid …? Turn the request down and call 911.. you know when seconds counts… help is minutes away … lock down the pharmacy and go out in the parking lot.. to administer the drug…. instruct the friend how to use the auto-inj and hope they do it right ?
So we create a cycle where have this revolving door of people ODing and they use Naloxone and revive.. they end up with a Ambulance run/cost , ER visit/cost and maybe a couple of days in the hospital/cost… Are we going to disrupt the equilibrium in the size of the pool of people that are abusing some substance? Does this mean that the per-cent of the population abusing some substance could surpass the 2% that we have not exceeded in over 100 years ? We are currently spending an estimated $8,500/person/year on the war on drugs.. Is this a constant ? For every 0.1% increase in the per-cent of the population abusing some substance .. that is 330,000 people and at a cost of $8,500 each.. that is nearly THREE BILLION on top of the 51 BILLION that we already spend in fighting this war on drugs.. in 2012 we spent abt $900/person on all prescription medications. So we are currently spending about TEN TIMES more money in trying to keep drugs out of addicts hands.. than trying to provide 98% of the population with their needed medications… How does that math work for you ?
If we just provide Naloxone to people who OD and don’t mandate follow up mental health therapy, methadone clinic, or Suboxone clinic.. are we really helping anyone.. are we really helping our society as a whole ?
Filed under: General Problems
Food for thought….If we are required to carry naloxone in our stores and above scenerio happens…1) say we do help and administer…do we get fired for giving out a 300.00 med w/o payment or rx 2) if we don’t administer but call 911 instead and person dies, are we then held liable for wrongful death because we had the antidote and didn’t do anything???. Back in the really old days, someone came in with chest pain, acute asthma attack, or diabetic issue, we never hesitated to pull something off the shelf after asking them what they took, if they weren’t our customer till ambulance got there. Nowadays, everyone is so sue happy, no way Jose. Wait for the first responders.
We all know the vast majority of OD”s/unintended or otherwise go unreported. The main notables are celebrities or those unaccustomed to the morbidly and mortality of combinations of mu agonists and benzodiazepines. Heroin is something of a unrelated anomaly as it is far from pure/unregulated/adultrated. Cocaine too is largely impure or ultra potent. Impure ‘blackmarket’ street drugs are often adultrated or contain almost anything toxic. We cannot lump together illicit drugs with those legal and pharmaceutically pure.
Great article and thought provoking. I would think mental health and follow up care must be provided. All overdoses should be investigated.Thank you for information that hits the point.
Naturally, the amount of abuse will climb proportional to the population and the ingenuity of those readily willing to make a huge profit from this feel good society and the greed inherent in this epidemic. The authorities can’t incarcerate everyone to solve this lucrative business. It makes little sense to spend more on punishment than education. A progressive society like Europe has other policies that may enlighten our people to tax and regulate a populace willing to pay for the “sintaxes” they will illicitly do anyway. With localities near bankruptcy , perhaps something less draconian than 20 years in prison is more humane.
This dilemma is of logic, is a form of reasoning that, though valid, leads to two undesirable alternatives. Does the pharmacist close the pharmacy ,one undesirable decision and help the dying overdosed guy, that will be doing the same thing in a couple of weeks , or second undesirable decision call 911 when minutes count.
Well I would help the overdosed guy dying in the parking lot just out of compassion for life. But does the overdosed guy see life as I do so precious ,probably not or this overdose would never have happened.
So I run out there help this dying guy and give him his life back while my own doctor has dropped me saying he can no longer write the medications I need to live a somewhat normal life because of the chronic pain that haunts me.
Was this life of mine with never ending chronic pain a choice of mine, no but its just the way it is so I push forward. Hoping and praying I will find yet another doctor to take over my pain care. And life goes on like it or not. I wonder why is it this guy is dying in the parking lot when he has no chronic pain just some mental disorder that needs treatment. I think to myself what could be so bad that he would put his life at risk , but just don’t have the answer ,thing is he’s alive to live yet another day. I hope he gets the help he needs and I move on down the road a bit to the next victim of mental disease. God help us all find some kind of answer to these questions flowing thru my mind and thru our country.