^^^That is scary, especially that the drug overcomes the fright instinct and people go back to it despite a near death experience. Most people don't tease a cotton mouth a second time.

It would be interesting to know the timeline and mechanics of why he keeps overdosing -- whether these were single doses or the culmination of binges.

I live in Ohio. So many people get hooked because of pill pushing doctors. Starts as a root canal or back injury, they get oxy or benzos, boom, two months later they are an addict.

Edit: these are the hardest possible drugs to get off of too.

To quote him "it was just really good dope". So ya the whole not knowing what strength stuff you are getting or what it is cut with. That's pretty much why everyone over doses. It might be true that they go to rehab and so they have a weaker tolerance but most know all that. I mean these people are addicts. They know a lot about heroin and they know a lot of people that have over dosed. Most aren't trying to die. If they knew exactly what they were getting I think very few would die

Marek Svatos (34 yo former nhl player) autopsy shows what is called an overdoes, but is actually a deadly drug interaction. (Benzo plus opiate or alcohol) Aka the Heath Ledger combo.

When I entered rehab, I was on 2-3 mg of benzos by day and about 15 shots of vodka by night. My counselor said I was within a few months of death.

most overdoses are from fentanyl or the even more outrageous carfentanil which is laying waste to ohio at the moment. both drugs are far stronger than h, so that even a miniscule amount could be too much. another issue at play is that, for lack of a better wording, drugs differ in the amount of initial "punch" they contain. by this I mean how hard the ish hits initially. h is actually pretty low and even if recklessly taking too much, the person should be ok. the other 2 are not so forgiving so even a small amount above a persons tolerance is highly dangerous.

and then ofc, there is all the other crap that can be in street drugs and how they interact.

and another pretty simple concept, once you put in too much, you cant take it out.

yes that happens. and some ppl tend to be compulsive. its rarer than the other things mentioned itt. true down and out addicts tend to save their ish bc they need to make it last as long as possible. if junkie is high, or "better", then most arent stupid enough to waste the ish they are gonna need later.

^^^^Thanks. That jibes with some compulsive behavior suggested in text messages of the person in question, and who hadn't reached the point of having to conserve his stash.

"I live in Ohio. So many people get hooked because of pill pushing doctors."

A few reasons for this.

1) There are some pill-mill docs who will write for insane amounts for no reason. They generally end up in jail, eventually. Unfortunately, they've done a lot of damage before then.
2) Back when I was training in the 1980's, there was a HUGE push to be liberal with pain meds. This was primarily due to a horse**** letter to the New England Journal of Medicine that claimed there was no risk with pain meds in terms of addiction. Drug companies pushed narcs insanely, pain became a 5th vital sign (which is completely bull****) and the race was on.
Note that it was a ****ing letter to the editor -not a clinical trial, not a study. Decades later, the writers said something like "my bad" - which of course made it all better
3) In line with the above, the feds made pain control a maximum priority, with financial penalties if patients felt their pain wasn't properly controlled. In my groups case, the hospital that holds our contract used this as one of the metric to determine whether or not our contract would be renewed. Happily, this has changed, after CMS has announced that "gee, this maybe wasn't a great idea. Our bad."
4) Another thing that's been a huge help is our having a database that shows if a patient has been written for controlled substances in the last year. We're required to use it, and it's a good thing. Before you were guessing, and it seemed unfair to assume someone was drug seeking. Now we know.

I had a wisdom tooth pulled and was give a script for 30(!) percocet. I used one, which I probably didn't need. 80% of the world supply of opoid drugs are consumed in the US - I doubt we have 80% of the worlds pain. Patients demand percocet for finger sprains. Until recently, doctors were heavily incentivized and told in training that this was OK. It's not, and the pendulum is swinging back in the other direction.

MM MD

I got a cortisone shot in my foot. Doc said it would continue to hurt. Script was for 30(!) hydros, I didn't need the ONE I took. I seriously wondered if it was an invitation to come back for seconds.

I haven't meant to be coy in this thread, opener was a serious question. But a year and a half ago we lost our 19 year old.

Sorry to hear that. I felt indestructable at that age.

I graduated pharmacy school in 2007 and even then we were told to quit being so stingy and suspicious with opiods. Undertreated pain was (and still is I believe) the #1 patient dissatisfier. Something like 80% of patients with chronic pain were unhappy with their therapy and viewed their healthcare providers as obstacles or unsympathetic. I guess the people got what they wanted.

+1

Read Junkie by Burroughs if you want to understand what your 19 year old was going through. It's really frank about the lifestyle of addicts.

a question from a dentist -

say you discovered a primary care provider who has been writing someone insane amounts of pain meds, say 120 10mg percocets every 2 weeks, and you have no reason to think this person has any sort of condition that would merit it, if there even are any that would. what would your course of action be.

fwiw i give 12 5mg norco for an extraction.

I read that decades ago, but I don't think it was my son's situation. He was hooked but he was a freshly minted addict. I don't think he was full time yet. Didn't make it that far.

Man Bill I'm not sure I could deal with that, my heart goes out to you and your family. Gonna hug my adult kids a bit tighter this Christmas.

Condolences Bill.

Truth is that opiods are not really damaging to the human body. People can abuse them for decades. It's the ancillary that really kills. Needles, impurities, doses, mixing with benzos, etc.
For example, "treatments" like methadone and suboxone are just substitution of one opiod for another. It's a harm reduction strategy.
Once marijuana is legalized, the next drug to de-criminalize will be an opiod.

I'd report it to the pharmacy board. In Nevada, we have a number to call that will trigger an investigation, and I'd have no problem doing it.

MM MD

nowadays heroin is often cut with fentanyl+filler to cut costs w/o harming the effective dose, its extremely easy to OD on something like this as fen is extremely potent and a slight miscalculation during cutting is lethal

Pharmaceutical grade opiods are very hard to OD on. In the netherlands they have legal heroin 3x a day for long time addicts and the OD rate is pretty much 0.