EMERGENCY ROOM VISITS – ILLICIT DRUG ABUSE TOP TEN

sententiously poppy.gifAccording to D.A.W.N. which stands for Drug Abuse Warning Network the top ten Emergency Department visits were surprising. Although this list is published openly, it does run about 1-2 years behind.

COCAINE………………………..OVER 448,000

MARIJUANA……………………..OVER 242,000

HEROIN………………………….OVER 164,000

meth-1.pngMETHAMPHETAMINE…………..ALMOST 109,000

ECSTASY (mdma)……………..ALMOST 11,000

PCP………………………………OVER 7500

INHALANTS……………………..OVER 4300

HALLUCINOGENS……………….OVER 3700

LSD………………………………OVER 1800

GHB………………………………OVER 1800

This data is from a reporting system in the United States. Many times, GHB for instance, is gone from detection upon arrival to an Emergency Room. Many inhalants cause death, therefore do not show up in the Emergency Room, but rather the Coroner’s venue. Many times the data is also regionally directed, for instance, in high methamphetamine areas, illicit use might be seen higher in the corresponding Emergency Departments.

http://ndapak.com/WP To round out this medical commentary today, the United States still has these top ten killers. ecg_evol1.gif

This data is from the 2004 National Center for Health Statistics, the latest full database.  Prevention is the key in almost all of these killers.  With the severe childhood obesity concern in the United States, these data may get thrown in the air, with new issues on top.  For instance, diabetes and asthma may replace the first and second positions due to the issues of childhood health management in general.

HEART DISEASE……………………………………………………………………………27.2%

CANCER…………………………………………………………………………………23.1

CEREBROVASCULAR DISEASES…………………………..6.3%

CHRONIC LOWER RESPIRATORY DISEASES…………5.1%

UNINTENTIONAL INJURY…………………………..4.7%

DIABETES MELLITUS……………………………..3.1%

ALZHEIMER’S DISEASE………………………2.8%

INFLUENZA AND PNEUMONIA……2.5%

KIDNEY DISEASES……………….1.8%

SEPTIC CONDITIONS……….1.4%

CHEESE – MARKETING HEROIN FOR YOUR KIDS “SAY CHEESE”

cheese-drug.jpgAs part of my background in pharmacy, emergency medicine, and toxicology, my eye is geared toward new illicit “marketing styles.” One of the latest, yet as usual, older than you think, is “cheese” heroin. This “starter pack” of heroin is REALLY heroin…the DEADLY kind of heroin…the good old toxic illicit heroin.

The difference is in the making of it. The manufacturers of the illicit drug geared for the teens is the mixture of heroin and Tylenol PM©. This multi-drug cocktail of acetaminophen, diphenhydramine (better know as brand name benadryl © and other companies brands) and of course heroin creates a deadly risk. Each item in this mix can be deadly.

As the famed Paracelsus, an earlier father of poisoning stated, “It is not the agent, but rather the dose of the agent. And everything therefore is a poison.”

Acetaminophen remains one of the most toxic poisons if taken in overdose and is the lead cause of death for many years in Europe, while diphenhydramine is again a unique poison in overdose. The anticholinergic side-effects of the drug in overdose creates elevated deathly temperature rise, hallucinations, cardiac instability, agitation, and even death. Heroin for years now continues to plague not only the U.S., but nations around the world. It has enormous addictive potential and leads to severe toxicity, criminality, and occasional deaths on the streets.

Say “Cheese” is a deadly form of a multi-drug extravaganza geared to entice, to addict, and to control your kids. Already in the last 1-2 years, especially in the Texas market, over 20 deaths have occurred. The product appears like Parmesan cheese in structure, yet kills with a vengeance.

paremsan
(grated parmesan)

Say “Cheese” is usually snorted. Why do drug abusers snort? It is because the absorption rate is good. But I have seen those individuals with chronic cocaine abuse, literally rot the nasal septum out…”look Mom, no septum!”

Post-mortem toxicology tests will reveal the deadly three drugs in this mixture…heroin, diphenhydramine, and acetaminophen.

“Cheese” is not a starter-kit for drug use. “Cheese” is a start-kit for deadly teenager activity.

cheese-drug.jpg SAY “CHEESE” MAY BE THE LAST PICTURE TAKEN……..

HUG YOUR KIDS TODAY!

WEST NILE VIRUS UPDATE – IDAHO LEADS NATION DISCUSSION CONCERNING PANHANDLE DISTRICT

IDAHO LED THE NATION IN 2006 AND WAS THE HARDEST HIT AREA IN THE USA FOR WEST NILE VIRUS.  996 cases of WNV were diagnosed in 2006 with 171 neuroinvasive type and 825 fever – and 23 deaths.  (neuroinvasive = meningitis, encephalitis, neuro complications during and after diagnosis)

As of June 2007, GEM COUNTY has identified the first positive mosquito pool in Idaho.

Hospitals, physicians, health professionals, and labs must report probable and confirmed cases.

PROTECT YOURSELF AND PROTECT YOUR KIDS THIS SUMMER. 

The biggest problem in the Northern Idaho region that I talked with Panhandle representatives about is the standing water drainage systems.

It appears that the Planning and Zoning, government maintainence such as roadways, and the health departments are NOT talking to each other.  The ground water grassy swales that are imposed are now the breeding grounds for such mosquito populations.  This water is stagnant until it filters down through the ground to protect our ground water.  The drains typically are set 8 inches above the level of the ground to allow overflow in heavy rains or runoffs, but this is the rub.  The swales stay wet.  Hopefully all parties will begin to plan for such health disasters at the early stages of future developments.  Revising the swales may need to become a priority.

Review WNV and WNV-birdflu-hunting at the these sites:

http://www.castmd.com/?p=35

http://www.castmd.com/?p=45

OR

www.cdc.gov

www.westnile.idaho.gov

 

YELLOW BELLIED MARMOTS AND CASTMD BATTLES OF EPIC PROPORTIONS

 

Manage albums

 

Those darn "yellow-bellied" marmots.  Yes, my wife and I did talk with the Minister of the Blog-O-Sphere last Saturday at the Shabby sale.  I was telling him, while my wife laughed WITH me, not AT me the infamous tales of the marmot wars going on at our home.

 

 

Manage albums

We live up on a hill.  It has always been peaceful.  Then one day, while playing my guitar sitting on the deck…I see what??  This big flowered plant in my wife’s garden area is shaking back and forth.  What??  Did my eyes deceive me??  Looking around the lawn and into the aspen trees, no wind was noted.  Then suddenly, like someone had yelled, “TIMBER” in my ears, the plant fell over..crashing into the lawn.  Now one might think I was crazy.  But, I carefully placed my guitar on the stool…walked over to the now fallen beautiful comrade.  Yup…eaten flat across…sharp dissection as with a scalpel blade…less bloody in vision, but more bloody in revengeful feelings.  Let the war begin! 

Manage albums

We had been having trouble with some of our plants and flowers.  It continued randomly until more lakeside building below us happened.  These marmots, cute, furry, and cuddly, are quite the resistant critter.  What to do.  One of the local varmint guys said, “All’s you can do is shoot ‘em.”  In the neighborhood I thought?  Hardly.  Plus, they’re stealthy and quick.  They watch for you.  A squeak from a door alone will alarm their defensive dive into the ground.

 

We saw an ad or product about keeping the varmints away.  They were these submarine-torpedo looking aluminum rods.  Standing about 20 inches tall and 2 inches in diameter, with batteries loaded, you push them into the ground.  At random times, a signal is sent shaking the earth…maybe similar to the new movie, Ocean’s 13.  Well, anyway, we had these avenger rods throughout our garden and greenery.  Day after day…the plants were felled like a clear-cut in the woods.  What were we to do…?

 

We thought there was a rather large family reunion of these varmints, marmots now called of the squirrel family…near one of our home-grown rock planters.  I paid my son and his buddies years ago, a dime for every rock bigger than their hands, to build these planters.  This area became ground zero.  So, the water hose it was, "water boarding," I thought.  We waited and stalked the critters.  Flushed for hours, trying to make their life miserable.  What did I see?  I swear to the Almighty, one of them sliding down the hillside, like kids on a Slip n’ Slide®!

 

Now knowing that my enemy was strong and well fortressed, it was time to talk with more professionals.  Well, my attention was directed to the smoke bombs.  These things are more powerful than Superman, more web entangling than Spiderman, and more dangerous than CatWoman.  So I purchased a sleeve of these poisonous smoke producing rods.  Well, off to the planning stage again, securing a savagely strategic plot against those critters.  No more buying flowers and plants redundantly.  Think of the money to be saved.  Early retirement I thought.

 

So, I carefully inspected the hillside.  Monitoring each and every move by these unwelcome visitors, THIS plan would become the "Mission Accomplished.” 

 

While holding my breath literally, I lit one of these smoke bombs and slid it into the hole.  Then number two into another, then number three, and lastly number four…like torpedoes being called from the master.

 

I thought this will be it.  Victory so close to grasp. 

 

After about three to four minutes, happily watching from my perched binocular position, an amazing universal, near existential experience was witnessed.  My whole hillside now smoked, not the four holes…but hundreds.  Like the exhausting sulfur gas fields of Yellowstone and Glacier, the property was steaming with this poisonous smoke. 

  

Within a few minutes, I thought, someone is going to call the Fire Department due to all the smoke.  Outlet after outlet, the rising smoke then diminished.  It was over.  The offensive was over.  My observation keen.  Success.

 

Call me crazy, but thinking back, I swear the smell of cigar smoke was amongst the gas-smoke smell.  Could those little furry varmints have been sittin’ back with a cold one, smokin’ a cigar in their cozy dens, watching the doctor’s next strategic play? 

 

The next morning, about three more plants had been felled…But soon, new construction left huge rocks and boulders about a block away.         

It seemed they found a new territory.

Manage albums

 

 BREAKING TV NEWS AFTER MY BLOGPOST: MARMOT INVASION

.

DRUG ERROR – COLCHICINE – POSSIBLY LINKED TO FATALITIES

THIS IS IMPORTANT INFORMATION FOR THOSE PERSONS SEEKING MEDICAL AIDES AND MEDICAL CURES.  (REFERENCE CITED.)  
 
 
 
 
(generic photos from tufts.edu and generic medicines)
 
 
HeraldNet
The Herald – Everett, Wash. – www.HeraldNet.com

Published: Saturday, April 28, 2007

Toxic drug at Portland clinic causes three deaths

Associated Press

 


PORTLAND, Ore. – Three people in the Pacific Northwest have died after receiving a drug that was erroneously made 10 times more potent than intended, the Oregon State Medical Examiner’s Office said Friday.

ApotheCure Inc., a drug-compounding pharmacy company in Texas, said an employee made a weighing error in the creation of the drug colchicine, which lead to the deaths. Colchicine is commonly used to treat gout, but in these cases it was being given intravenously to treat back pain.

The drug was sent to the Center for Integrative Medicine in Portland, where three people received injections of the defective batch of the drug this spring. All three people, two from Portland and one from Yakima, died between the end of March and beginning of April from the toxic levels of the drug.

The defective doses were sent only to the Portland clinic, ApotheCure said.

The Food and Drug Administration said it is investigating the case but believes the problem has been contained.

The Center for Integrative Medicine has since closed, and representatives from the organization could not be reached.

Colchicine works by stopping cells from dividing, which reduces inflammation in conditions such as gout, said Dr. Rob Hendrickson, associate medical director for the Oregon Poison Center. But in excess doses, the drug stops all cells from dividing – eventually leading to organ failure and death.

The medication is not commonly used anymore and the use as a back pain treatment is less common than for gout.

Gary Osborn, a pharmacist and certified clinical nutritionist for ApotheCure, said the situation could have been contained earlier, but the clinic did not contact ApotheCure until nearly two weeks after the first death. He said the second death occurred before the company was able to complete recalling the batch and sending them a new lot. He said this is ApotheCure’s first incident of this sort.

“We are kind of the leaders in the industry,” Osborn said. “But you know what people say, stuff happens.

 

Copyright ©1996-2007.
The Daily Herald Co.
ALL RIGHTS RESERVED.

 
 

POISON CENTERS AND TOXINS AND POISONINGS METH to METHANOL to MUSHROOMS – One Call 1-800-222-1222

This is the time of year when lawn chemicals, yard cleanups, and neighborhood events start to be exposed and available to little hands.  Certainly many chemicals, including pesticides, herbicides, fuels, and cleaning agents are ubiquitous in homes and garages.  But beware.  Many of these chemicals are poisonous and dangerous with regard to flammability, explosiveness, and chemical burns.

Each dollar invested in poison centers saves about seven dollars in expenses not needed if the patients go into their doctor, their clinics, or their hospitals.  This is a great public health service.

Over the years since the early 60's, the poison centers have become an integral part of the healthcare network.  Now with the terrorism issues, the poison centers have become an integral monitoring source of information, as many times calls come to the poison centers early and often, thereby making a grid of what is happening and where it is happening.

For instance, when the bad botulism toxin product that was being used by spas and clinics that were trying to save money by not buying and using the approved botulinum toxin brand, the poison centers were seeing a problem early.  Patients across the country, in pockets, were being paralyzed – not just the muscles of the eyebrow, forehead, and other smaller muscles.

The poison centers across the USA now have a single number.  Depending on your area code, your call will be forwarded to the center in your area, or the one contracted by your state officials.  For instance, Idaho calls go to Denver's poison center.  Alaska's poison calls go to Oregon.  Washington's poison center gets all of Washington State's calls.  This year that number will be around 150,000 calls!   Poison calls are answered by an expert group of pharmacists, nurses, Pharm Ds and have backup by physicians specializing in toxicology and poisonings.  It is the number that the experts in all fields, from dermatologists to kidney specialists, call when the patient has been poisoned, or is toxic from unknown sources, or when the patient doesn't act or change based upon "normal" disease states.

The goal of Poison Prevention Week is to reduce illnesses, injuries, and deaths due to poisonings; build safer communities; and reduce unnecessary health care costs for everyone.

 

Here are some ways to be poison cautious:

Obtain syrup of ipecac and keep it in your home – but use it ONLY if instructed to do so by a poison center or physician

Use child-resistant containers and remember, they are not childproof

Keep products in their original containers

Never call medicine candy or take it in the dark

Return products to storage areas immediately after use

Teach children about Mr. Yuk

Put Mr. Yuk stickers on all poisonous products  

Call the Poison Center for a free information packet and Mr. Yuk stickers  

Keep emergency numbers next to your phone:

1-800-222-1222

 

What is National Poison Prevention Week?

Public Law 87-319 authorizes the President to designate annually the third week in March as National Poison Prevention Week. This act of Congress was signed into law on September 16, 1961, by President Kennedy, after which the Poison Prevention Week Council was organized to coordinate this annual event. Congress intended this event as a means for local communities to raise awareness of the dangers of unintentional poisonings and to take such preventive measures as the dangers warrant.

(PC week and listing adapted from WAPC.org website with commentary from castMD.com)

The Cost of Cremated Ashes: Dad Nose Best A New Cocaine Substitute – Keith Richard’s Marketing Expertise’ – a parody of abuse

THE ROLLING STONE'S KEITH RICHARDS MAYBE SNORTED HIS DAD THE TABLOIDS HAVE COMMENTED AND THERE SEEMS TO BE CONTROVERSY REGARDING WHETHER IT WAS TRUE OR NOT.  CastMD CONTINUES TO DIG INTO THIS ISSUE WITH CLARITY AND REASON.  BUT INQUIRING BRAINIACS WANT TO KNOW THE NUMBERS……..SO HERE THEY ARE ! 

Theory:

Average cremation remains = 3700 grams

Crackdowns on producers and smugglers of cocaine in Colombia and the United States have caused the wholesale price of the drug to rise sharply, according to officials of the Federal Drug Enforcement Agency. A kilogram, 2.2 pounds, of cocaine that cost a dealer $15,000 six months ago now costs $25,000 to $30,000, Frank Chellino, a spokesman for the agency's Miami office, said. (NYT 4-5-07)

 

The common street selling price of cocaine hydrochloride powder is $80-$100 per gram. The purity of the drug is TYPICALLY diluted by dealers wanting to increase the volume of the cocaine to multiply profits. Popular "cutting" agents include lactose, inositol, mannitol, lidocaine, and even cornstarch, talcum powder, or sugar.  NOW YOU CAN CUT WITH DAD'S ASHES !!!

 

 

 

 

 Freebase cocaine is cocaine without its water-soluble component, or "base." It is prepared by prepping cocaine hcl with an alkali, and separating the cocaine from its impurities. The preparation of freebase cocaine involves the use of highly flammable solvents such as ether. "Crack" or "rock" cocaine is the street name given to freebase cocaine processed from cocaine hydrochloride to a base, then using a base and heating it to remove the hydrochloride. The resulting mixture is allowed to harden, then broken into small pieces or rocks, which can be easily smoked in a pipe. The term "crack" refers to the crackling sound made when the mixture is smoked.

Therefore:

30,000 dollars divided by 1000 grams is 30 dollars a gm wholesale.  Yet the retail prices vary, but about the 100 dollars a gram retail street value.

3700 grams of cremation remains is 370,000 dollars of cocaine equivalency in weight. 

The most popular method of use is to separate the powder into fine "lines" of approximately 1/4 gram, 4-6 inches long. A small straw is then used to "snort" the cocaine into the nose.

3700 divided by 1/4 gm per line is:

14,800 lines of cremation-dad cocaine-substitute ! 

Now, a direct cremation cost noted on the web was:

Direct Cremation Service : $625.00*

Therefore:

Cost of cremation divided by 3700 grams of cocaine substitute is 625 / 3700 = 0.1689 dollar/gram

SUMMARY:

IF YOU BUY COCAINE YOU WILL BE PAYING 80-100 DOLLARS RETAIL FOR ONE GRAM

USE CREMATION-DAD COCAINE-SUBSTITUTE  AND YOU WILL PAY ONLY 17 CENTS PER GRAM

IF YOU DO DRUGS, YOU DO THE MATH…BUT DON'T SNORT DAD-SNOW. 

 

 

 

GOING GREEN – AN ESSAY – THE WASTE BY THE PHARMA INDUSTRY AND ADVERTISING COMPANIES – WHERE IS AL GORE ON THIS?

Did you ever get a sample or starter pak of medicine from your doctor?  Usually, the pak will have one or two pills in a blister, nuclearbomb proof wrap, and then boxed with some expensive advertising.  When is enough, enough !  To top it off, the little pill in the blister pak in the little box is one of five or six other little highly advertised little boxes in a yet bigger box.  Then comes the literature that is mandated by the FDA to be put in each box or on the blister pak itself.  Then, with the leaving of the little boxes in the bigger boxes, pages and pages of highly detailed literature is presented and left with the doctor.  Only God or Buddha would actually know how much of this stuff ends up in the garbage.

 

And now, with the internet, WebMD, CastMD, Mayo Clinic, and other portals of Net-formation, why is all this waste appealing to the advertisers, the pharma companies, and the FDA subcommittees? 

If the waste would stop, more medicines could be used by clinics to help offset the high costs to patients for starter paks, courses of medicines, or to give to those without drug benefits…a rising number !  How about just a 5-10 point update on the med instead of pages of infitessimal fine print squished on multi-folded paper…What do you think FDA? 

Well, I hope Al and his Green friends read my essay today.  Maybe he could trade some of those "Green CO2 impression stamps" he bought to offset his private jet and give them to the FDA and the Pharma companies.  That way, the universe would be in drug balance, and we don't have to worry about trees, water, air, and the uninsured and underinsured.  ZZZZOOOOOOOMMMMMM, I hear his jet now………

BIOPHARMACEUTICALS AND GENERIC DRUG POLICY – GENERIC SAFETY EFFICACY PURITY – LEGISLATING WHEN A GENERIC IS A GENERIC?

 

Biopharmaceutical “generics” controversy continues on Capitol Hill.  Manufacturers say that the biopharmaceuticals cannot be guaranteed of safety, potency, and purity in the generic sense, since they are proteins and other biological type medications.  This is quite different from the many generic forms of other drugs, such as aspirin, penicillin, and other chemical drugs. 

Why is this such a big deal? 

Biopharm prices are considerable higher than chemical drugs.  Of the $252 billion dollars spent on prescription medicines in 2005, $33 billion was biotech-biopharm types of medicines. All med sales grow about 5-6 % per year, whereas the biopharm group grows about 3 times that rate. The top three selling biopharm meds were neupogen, epogen, and intron A – with costs at about 15, 20, and 22 thousand dollars per patient per year. Imiglucerase, an enzyme drug, will cost about 200,000 dollars per patient per year.  

Large carriers such as Kaiser and others are seeing astronomical increases in these drug costs.    Medicare estimates for drug plans estimated at 395 billion, now is over 650 billion over the ten years initial estimates. 

 In the generic marketplace, drug costs have been reduced about 50-70 percent in general.  However, this truly sensical process may be difficult to add to generic follow-through biotech group of biopharmaceuticals. How will the abbreviated new drug application be changed to allow “generic” or “follow-through” biotech biopharmaceuticals to progress faster to FDA approval?  Certainly, the savings for guaranteeing the purity, safety, and efficacy of the biopharmaceuticals may not be as great.  The big issue still remains whether the profits from “open season” on the off patent biopharmaceuticals will allow for continued research and development for newer and unique and orphan type biotech drugs that will save patients and save money.   

The baby boomers are passing through the biopharmaceutical turnstile now, and with growing numbers. 

How the 1984 Hatch-Waxman Act (Drug Competition and Patent Term Restoration Act) will change and what effect any change will have is to be determined as of yet.  This law allowed rapid development and approval of chemical drugs for generic distribution after patents expired on known brand name drugs. 

 

(Commentary by castMD with adaptation from:  Fuhr & Blackstone's article in Biotechnology Healthcare)  

 

BLURKER ADDICTION AND BLOGGER BEHAVIOR BLURKER ANONYMOUS SCREENING AND CONFIRMATION – NEED A PROFESSIONAL?

BLURKER ANONYMOUS SCREENING (CAGE)

  • Have you ever thought you ought to Cut down on your blog entries or blurking?
  • Do you feel Annoyed at criticism of your blog writing or blurking?
  • Do you feel Guilty about your blog writing or blurking?
  • Do you ever take an Early-morning look (eye-opener) at your latest blog favorite or use blogging or blurking upon awakening  (“a little hair of the dog that bit you”) to start the day or to feel better?

IF YOU ANSWERED ONE OR MORE “YES” TO THE  ABOVE SCREENING TEST – CONTINUE TO THIS CONFIRMATORY EVALUATION . 

BLURKER ADDICTION CONFIRMATION SYSTEM ®

Eating meals alone while blurking or blogging

Rereading your blog or your latest entries

Rereading your favorite blogs

Trying to stop reading blogs

Considering group meetings for bloggers

Realizing your world is centered on your favorite blogs

Wondering repeatedly what writing an entry would be like

Time with family and friends are limited

Sneaking away to check your favorite blogs

Do you check your blog stats over once per day

Do you wonder in moments of calm who might be seeing your blog

Not owning up to the problem of the continuous blurker

Family members want to call a “confrontation” meeting

Limited showers and shaving while eating at the computer

Occasional outbursts of solo-laughter discussed by others in your life

Anxiety and panic arrive when you cannot blurk

Anxiety and panic arrive when you cannot hit “submit”

Anxiety and panic heightens when reading the submit “verify code” letters

Computer failure makes you go to the public library to “check out a book”

Computer server failure makes you just sit in disbelief

Now realizing you have blogger-buddies, you want a festive gathering to touch and appreciate them  

Your children ask your spouse or significant other who the stranger is while looking at you

Your complete social circle has changed

And your only means of conversation must be in blog format. 

GRADING SYSTEM 

0 – 2                             LOW RISK

3 – 5                             MOD RISK

6 – 10                           HIGH RISH

11 – 15                         EXTREME RISK

> 15                         COUNSEL/INPATIENT  
         

www.blurkeranonymous.com