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Link Posted: 7/7/2017 9:58:39 PM EST
[#1]
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Quoted:
Cheaper in the long run cleans up the jean pool quicker
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Jean pool?  LOL.
Link Posted: 7/8/2017 5:37:45 AM EST
[#2]
Link Posted: 7/8/2017 5:49:11 AM EST
[#3]
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Because doctors were giving out way too many opioids and the Mexican drug cartels made a business decision to flood the US with more and cheaper heroin.

Herion and opiods abuse is ridiculously common now. I see people involved in it all the time who are not "typical junkies." It's even in high schools.
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Anyone who does H on purpose is a retard and deserves to die.  Knowing how dangerous and addictive it is I don't know why anyone would get involved with it.

Because doctors were giving out way too many opioids and the Mexican drug cartels made a business decision to flood the US with more and cheaper heroin.

Herion and opiods abuse is ridiculously common now. I see people involved in it all the time who are not "typical junkies." It's even in high schools.
Sorry...but they knowingly went down the path of heroin abuse...instead of trying to get help with their initial addiction, they knowingly started using a substance thats been known for decades or longer to be highly addictive and deadly.  It's not like that information is hidden...I feel bad for the families involved, but the actual users?  Not so much...As much as I try to find sympathy for heroin addicts, I just cannot.

The dealers ?  those fuckers should just be shot on the spot..
Link Posted: 7/8/2017 6:03:19 AM EST
[#4]
Good.
Link Posted: 7/8/2017 6:58:54 AM EST
[#5]
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Quoted:

The dealers ?  those fuckers should just be shot on the spot..
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Oh they're just capitalists.
Link Posted: 7/8/2017 7:55:45 AM EST
[#6]
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Quoted:
Not sure I agree %100 with that. Sometimes kids of junkies will injest or otherwise consume haroine. I think they should carry it. Their duty is to protect and save lifes. Anything that can help them save lives should be utilized.
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Don't worry, this will work itself out shortly if true. Dead junkies don't reproduce.
Link Posted: 7/8/2017 8:12:00 AM EST
[#7]


The sheriff explained that safety is his concern. When people who overdose are revived, they are often violent and are almost never happy to see the police.
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the pussification of LE over the years amazes me.
Link Posted: 7/8/2017 8:21:59 AM EST
[#8]
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Quoted:
And when a cop accidentally ODs on heroin in the process of dealing with a junkie I guess they will just have to wait for the medics? There is stuff so potent out there these days that the police will not knowingly handle it without hazmat suits.

Idiocy.
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Change dept policy to allow "personal" use of narcan.

Or charge the junkie with capital murder and go on with life.
Link Posted: 7/8/2017 8:24:42 AM EST
[#9]
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Guess what.

That didn't happen in a vacuum.  As with many things in the US, it can be laid squarely at the feet of the FedGov, through CMS.  

You can start by reading this article from The Atlantic.

And what's contained in that article dovetails exactly with my experience.  If you're not aware of Press-Ganey, or HCAHPS, those are survey/"quality"/Patient-Satisfaction tools that are used to measure "quality" and assist the goverment in "Value Based Purchasing" of healthcare through CMS (medicare/medicaid).  This push has been going on since the late 1990's.  (you can read more about HCAHPS here.)  Even JCAHO got into the act... they've had "pain management" guidelines out there for nearly 20 years.  

Here is a summary from a 2011 Webinar on the issue.

(These "quality measures" are really a method by which they can justify paying us less, but that's my cynical side talking...)

In fact, until it was taken out under political pressure (due to the now-undeniable-and-publicly-known fact that opiates are KILLING people, and that the "culture of pain" people have gone way-the-hell-overboard) in late November 2016, "Pain Management" (adequacy of pain control, from the PATIENT'S perspective) was part of CMS's "quality measures."  In other words, if you didn't give the patient the drugs they wanted, you got dinged on "quality" measures.  Those HCAHPS scores (pronounced "H caps") determine your reimbursement from Medicare/Medicaid.  

We are talking millions of dollars.  

Naturally, this caused hospital Administrators and Staffing folks to care a GREAT DEAL about those measures.  It determines the hospital's potential financial health, bonuses for executives, etc.  This trickled down to the regular physician level.  If a doc isn't creating high "patient satisfaction" scores (and make no mistake... we have to answer EVERY complaint that comes in, and manipulative drug-seeking patients know this), there can be "problems" at contract-renewal time.

The writing was on the wall for roughly 20 years... you piss off the patients, and you're going to be looking for a new job.  

Want to know how we got here?  

There it is.
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Quoted:
Because doctors were giving out way too many opioids and the Mexican drug cartels made a business decision to flood the US with more and cheaper heroin.

Herion and opiods abuse is ridiculously common now. I see people involved in it all the time who are not "typical junkies." It's even in high schools.
Guess what.

That didn't happen in a vacuum.  As with many things in the US, it can be laid squarely at the feet of the FedGov, through CMS.  

You can start by reading this article from The Atlantic.

And what's contained in that article dovetails exactly with my experience.  If you're not aware of Press-Ganey, or HCAHPS, those are survey/"quality"/Patient-Satisfaction tools that are used to measure "quality" and assist the goverment in "Value Based Purchasing" of healthcare through CMS (medicare/medicaid).  This push has been going on since the late 1990's.  (you can read more about HCAHPS here.)  Even JCAHO got into the act... they've had "pain management" guidelines out there for nearly 20 years.  

Here is a summary from a 2011 Webinar on the issue.

(These "quality measures" are really a method by which they can justify paying us less, but that's my cynical side talking...)

In fact, until it was taken out under political pressure (due to the now-undeniable-and-publicly-known fact that opiates are KILLING people, and that the "culture of pain" people have gone way-the-hell-overboard) in late November 2016, "Pain Management" (adequacy of pain control, from the PATIENT'S perspective) was part of CMS's "quality measures."  In other words, if you didn't give the patient the drugs they wanted, you got dinged on "quality" measures.  Those HCAHPS scores (pronounced "H caps") determine your reimbursement from Medicare/Medicaid.  

We are talking millions of dollars.  

Naturally, this caused hospital Administrators and Staffing folks to care a GREAT DEAL about those measures.  It determines the hospital's potential financial health, bonuses for executives, etc.  This trickled down to the regular physician level.  If a doc isn't creating high "patient satisfaction" scores (and make no mistake... we have to answer EVERY complaint that comes in, and manipulative drug-seeking patients know this), there can be "problems" at contract-renewal time.

The writing was on the wall for roughly 20 years... you piss off the patients, and you're going to be looking for a new job.  

Want to know how we got here?  

There it is.
Thanks for posting that.

Docs can't win.

Try to be responsible with pain medication so as not to get patients addicted: "Letting them suffer!" "Don't care!"

Try to adequately treat pain, giving the benefit of the doubt if not sure: "Irresponsible prescribing creates heroin epidemic!"
Link Posted: 7/8/2017 8:39:12 AM EST
[#10]
I kept it in my war bag. It never came out.

If you don't beat the rescue to the OD call then you don't have to deal with the B.S. until the medics show up.

My agency started giving out lifesaving awards for administering NARCAN. Some of the guys I worked with would almost fight with one another to be the one to shoot it up someones nose.
Link Posted: 7/8/2017 8:48:05 AM EST
[#11]
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Quoted:


At least there's one voice of reason in this thread. Do the rest of you really want us (the police) making value judgments on who we should try to save and who we should just let die?
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So how far does your thinking go? Think how many lives would be saved if cops were EMS/Paramedic trained and drove rescue units. Think how many would be saved if we only hired emergency surgeons to act as cops - or better yet, cancelled public education and had emergency surgeons driving around on call in mobile operating rooms. What if we pulled cops off of all nuisance/quality of life calls and put them on nothing but violent felonies? Why not pull cops off of law enforcement and assign them as mentors to people at risk for opioid abuse? That would help to save exactly the same population while diverting the same public servants.

Leaving aside Narcan, cops make those value judgments all the time. Every time a policeman shields a citizen or shoots back instead of cowering in the face of a violent threat, he has made a decision not to try to save the BG. Every time a cop retreats from a hostage situation to await backup, he has made a decision to allocate lethal risk between himself and the hostage.

The sheriff in the OP has made a decision about how to spend his budget. He's decided to place addicts behind every other expenditure. That's his call, just like deciding not to teach his men how to intubate and bag people who aren't breathing.
Link Posted: 7/8/2017 8:55:10 AM EST
[#12]
Link Posted: 7/8/2017 9:02:04 AM EST
[#13]
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Is an overdose of Narcan dangerous? What if you give a 70 pound child a dose of Narcan more suitable for a 220 pound adult?

I say leave medical treatment to medical professionals.
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Not sure I agree %100 with that. Sometimes kids of junkies will injest or otherwise consume haroine. I think they should carry it. Their duty is to protect and save lifes. Anything that can help them save lives should be utilized.
Is an overdose of Narcan dangerous? What if you give a 70 pound child a dose of Narcan more suitable for a 220 pound adult?

I say leave medical treatment to medical professionals.
According to the paramedic that taught the class when we were issued Narcan, there are no contraindications to administering Naloxone and it can't hurt the patient.  As for children, I have no idea.
Link Posted: 7/8/2017 9:55:08 AM EST
[#14]
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What if the medical professionals say that a person with a small amount of appropriate training can administer narcan? Then we're right back to the original argument.
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I'll throw out one more item. So even for EMTs to administrator intra nasal you need a medical control (physican who signs off on your training and SOPs). You think an individual physician will do that for a bunch of cops? When and where is that sustainment training. Every year cops have to qualify with their weapons, do other in service training depending on agency policies and state requirements. So cop/deputy gives narcan, has an adverse response or patient dies anyway from the OD and cop and department gets sued. It will happen! You think it will fly in court to say they were trained 5 years ago with no sustainment or follow up to show contined proficiently? Of course not. Also department may need to add something to their insurance coverage since their deputies are now performing medical procedures?

Finally the drug itself; narcan has been around as far back as I can recall, old drug. Used to cost pennies a dose. Not any more. A lot of drugs have gone up exponentially  (remember epi pen in the news). A nasal dose from one of my pharmaceutical suppliers cost about $151/dose (i just logged on to their web page and loooked). Injectable is about same depending on contracts, vendor and packaging type ect. How many does per squad car? How often does the drug expire, who is in charge of checking this and replacing as needed purchasing and inventory managment takes time too. Replacment be more often in a hot trunk vs. In air-conditioned ambulance.

So with all of this who pays for this? Is that in the Sheriffs department budget. I count hiring medical control, initial training and annual sustainment training (this probably means OT pay for officers and cost of trainers,ect), initial and replacement drug cost and maybe additional liability insurance coverage. I guess you could bill the junkie like the ambulance and hospital do - oh wait they don't pay so that will not work. Sounds cold to put a dollar sign on this but it's reality. Someone has to pay. Right now all of us are. Junkies ain't paying and your talking 10s of thousands of dollars to get going just to put the first dose in the squad cars. Then on going costs. This may sound like an over exaggeration or estimate but I assure you it's not and in a large agency significantly more.

This is something to consider apart from the moral argument. How much should cops be asked to do. Are they cops, medical providers or should they be both? I've been both at dififerent times in my life. My persoal view is let cops be cops and EMS be EMS. Cops should end at basic first aid that non medical providers are taught. CPR, AED and basic first aid. Leave prescription medication use, ACLS and more advanced procedures to EMS. In major metro areas EMS are within minutes of police, sometimes arriving before PD where I live. Even in the ruel area where I was a cop EMS was minues at most behind us in 90% of cases. Less time than it would have taken for me to go out to a car and get a bag of medical crap, fumble through it to find a box of predosed narcan, figure out if I should and can give it and give it. By that time EMS would have had the OD patient in the ambulace and a dose of narcan in them.
Link Posted: 7/8/2017 9:57:34 AM EST
[#15]
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If you think addicts have free will, you don't understand addiction on even a fundamental level, nor do you understand how people become addicted in the first place. This isn't surprising, and is what leads to the "fuck them, they made their choice, let the scum die" attitude.
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The first dose or drink is a matter of free will.
Link Posted: 7/9/2017 10:30:26 PM EST
[#16]
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I'm sure it varies from person to person, but everyone that I personally know that uses heroin (or used until they died) started with pain meds.  However, they weren't prescribed.  They sought them out illegally because they just liked doing drugs and pot wasn't cutting it.
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Most doctors are not stupid enough to get patients addicted. Most doctors care about their patients. But like anyone else, there are bad people doing the job. I know of a few arrested in the past few years for selling prescriptions locally. It happens.

As for the people I knew being addicted to opioids and missing them instead of being addicted to pain meds....you'd lose that bet.
I'm sure it varies from person to person, but everyone that I personally know that uses heroin (or used until they died) started with pain meds.  However, they weren't prescribed.  They sought them out illegally because they just liked doing drugs and pot wasn't cutting it.
So Pot IS a gateway drug?
Link Posted: 7/10/2017 5:13:36 AM EST
[#17]
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Quoted:
If you don't beat the rescue to the OD call then you don't have to deal with the B.S. until the medics show up.
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Link Posted: 7/10/2017 6:42:35 AM EST
[#18]
works for me
Link Posted: 7/10/2017 6:48:34 AM EST
[#19]
I'm Rick Jones, bitch.
Link Posted: 7/10/2017 6:51:51 AM EST
[#20]
I agree w/ the sheriff.  Let the police secure the scene and protect the medics that show up to administer medical help.
Link Posted: 7/10/2017 6:59:22 AM EST
[#21]
self correcting problem
Link Posted: 7/10/2017 7:07:30 AM EST
[#22]
Link Posted: 7/14/2017 1:21:47 PM EST
[#23]
Link Posted: 7/14/2017 1:41:41 PM EST
[#24]
Link Posted: 7/14/2017 8:51:44 PM EST
[#25]
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Yep.  It's out there, for sure.  It has been for a long time.  I remember when they quit making quaaludes because they were passed out like candy, and there was no real clinical application for them.  

EDIT:  I had the wrong person.  I had to refresh my memory.  It sounds like the doctors that were busted were selling pills for a living.  That's not really the same as someone with real pain getting addicted, while taking pills as prescribed.
Link Posted: 7/14/2017 9:02:42 PM EST
[#26]
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Cops have been administering narcan for awhile, where are these stories of people attacking them or the cops being unable to administer narcan so you need a medically trained EMT? Of course that's all bullshit to cover for making a policy decision to let people who could easily be saved die because they are probably (almost certainly, but the Sheriff may manage to kill one of his own deputies or a child exposed to the drug) drug addicts. 
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I was in EMS before I was law enforcement.

Narcan used to be given IV. It hit fast, and every fight I've seen from someone receiving narcan and screwing up their high came from an IV dose.

Last couple of years, I've only seen Narcan given nasally, (unless they're crashing too fast or are too far gone). Narcan administered nasally takes a little longer to kick in and for whatever reason, addicts dont wake up as angry.

But I've seen the fights from administering Narcan happen, this isnt like the tooth fairy or the easter bunny.
Link Posted: 8/1/2017 11:01:36 AM EST
[#27]
nvm
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