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Injection Sites

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Re: Injection Sites
Fri Jan 10, 2020 4:39 pm
  • JGfromtheNW wrote:
    pmedic920 wrote:
    JGfromtheNW wrote:
    pmedic920 wrote:
    Do you think this is a realistic argument?


    Did you think yours was? Both scenarios happen...



    Mine absolutely 100% was realistic, I’ve worked that exact scenario more than once.

    Yours on the other hand has never happened in this country that I’m aware of.

    If you have proof, I’ll eat the crow.


    I'll eat some crow. There was a city council in Ohio that was thinking about passing a "3 strikes" ban on EMS responding to drug overdoses. They received enough backlash for them to scrap it. I thought it had passed and was in effect.


    I follow the industry news very closely.

    If your scenario had ever actually played out, it would have been HUGE news.

    I felt safe in making my statement.

    Thanks for manning up.
    pmedic920
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Re: Injection Sites
Fri Jan 10, 2020 4:53 pm
  • JGfromtheNW wrote:What? You think addicts, especially nowadays with the opioid crisis (which has lead MANY to street drugs), purposefully put themselves into these situations? These people are sick.

    Sigh. I've been prescribed opioids twice in my life. It's an addictive feeling and it feels great. I didn't let myself become a junkie, though. Feeling buzzed is great, too. I don't let myself become an alcoholic.

    Addiction isn't a disease. I can't get it from a damn mosquito bite. You can't spread it to other people. Don't quote definitions of "disease" at me to try and prove your point, either; there's SIGNIFICANT profit to be had in "treating disease", so the definition is becoming looser and looser as time goes on.

    I feel sympathy for people who struggle with it that are in chronic long-term pain, but those who let themselves become addicts because they were prescribed it for a temporarily reason? Not so much.
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Re: Injection Sites
Fri Jan 10, 2020 5:03 pm
  • JGfromtheNW wrote:
    pmedic920 wrote:
    JGfromtheNW wrote:I assume Tical's post will likely be edited or deleted all together, but I feel the same way. Disgusting post pmedic. Shocking that a paramedic would say such a thing. Do you have no compassion for human life? Or is this just you getting frustrated with the situation and saying "not in my back yard?"

    You people saying the only folks we should help are ones who realize they have a problem and want to stop... you realize the vast majority of addicts know they have a problem right? You expect addicts to not act like addicts...?



    It has nothing to do with compassion for human life.

    It’s absolutely about being realistic about the topic at hand.

    You want to live in a fantasy bubble go ahead.

    I work around this stuff on a near daily basis and have for almost 30 years.
    I’ve done so specifically because I have compassion for humanity.

    I’m just willing to see it for the reality it is, my head is not in the sand on this issue.


    Ok, so what have you proposed other than "help those who want help?" No one here is claiming you don't see this on a regular basis. You see the reality of the situation, denounce specific things because you feel like they're a waste or they're just enabling, but I don't see any suggestions as to what would help.


    I don’t have “thee”answer, if I could solve problems like this I wouldn’t be working on an ambulance after 30 years.

    What I did suggest, and you’ve blasted me for, is that we use our resources with a focus on those that are seeking/wanting help.

    Maybe you don’t understand the scope of the problem.
    We are talking about millions of people nationwide. We can’t help them all, why should we waste the limited resources on someone that doesn’t want help?

    My stance isn’t cold hearted if you’re willing to look past the shock of the statement.
    Apply a little common sense and be realistic for a minute.


    Have you ever watched a person die from malnutrition because they had given up on the struggle of life, and quit eating?

    I’ve seen it, and I’ve filed APS (adult protection services) cases on them.
    I’ve seen these people taken from their home, moved to the hospital and had IVs and feeding tubes placed in them.
    I’ve seen them recover to be discharged to home, only to stop eating and start the process over again.

    A drug addict that hasn’t decided that they want help yet, is almost exactly the same.
    Send them to rehabilitate, get them clean and past the physical part of withdrawals, order them into therapy.
    Let them back on the street and before you know it, they are back on the dope.
    Why?
    Because they didn’t want the help in the first place.

    Take the addicts that want help, do the same thing, now they very well may relapse but if they truly want the help, they will get, and eventually stay clean.

    Could/would you please explain how spending limited resources on a person that doesn’t want help makes ANY sense?

    I don’t see it but my mind is open, change my mind.
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Re: Injection Sites
Fri Jan 10, 2020 5:15 pm
  • RolandDeschain wrote:
    JGfromtheNW wrote:What? You think addicts, especially nowadays with the opioid crisis (which has lead MANY to street drugs), purposefully put themselves into these situations? These people are sick.

    Sigh. I've been prescribed opioids twice in my life. It's an addictive feeling and it feels great. I didn't let myself become a junkie, though. Feeling buzzed is great, too. I don't let myself become an alcoholic.

    Addiction isn't a disease. I can't get it from a damn mosquito bite. You can't spread it to other people. Don't quote definitions of "disease" at me to try and prove your point, either; there's SIGNIFICANT profit to be had in "treating disease", so the definition is becoming looser and looser as time goes on.

    I feel sympathy for people who struggle with it that are in chronic long-term pain, but those who let themselves become addicts because they were prescribed it for a temporarily reason? Not so much.


    It's been an ongoing debate, disease or not and some have said that the American Medical Association only declared it so addicts/alcoholics could get insurance help. For me that argument is moot, it just doesn't matter.

    To me it all flies under the same umbrella of addiction and just because you or I don't become addicted may have something to do with willpower and it may not. We know through many studies that some people are predisposed to addiction and some are not.

    Addiction is very insidious and has many levels of counter-interdiction built into the sufferer's psyche. Denial and just the overwhelming cravings dictate how incredibly powerful addiction really is. People will live in incredible squalor that they couldn't even have imagined a couple years before arriving at that condition.

    I saw an acquaintance that I played football with many years ago couple of years ago and it was shocking. The only reason I even knew it was him was a fiend I was with pointed him out. He tried to avoid us but my friend engaged him and we spoke to each other for a bit. He came from a great family and was one of the most normal people I had ever known. He was so sick with addiction.

    I have seen very responsible well-adjusted people become addicted in my lifetime so I know that it isn't just a case of will power.
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Injection Sites
Fri Jan 10, 2020 5:17 pm
  • RolandDeschain wrote:
    JGfromtheNW wrote:What? You think addicts, especially nowadays with the opioid crisis (which has lead MANY to street drugs), purposefully put themselves into these situations? These people are sick.

    Sigh. I've been prescribed opioids twice in my life. It's an addictive feeling and it feels great. I didn't let myself become a junkie, though. Feeling buzzed is great, too. I don't let myself become an alcoholic.

    Addiction isn't a disease. I can't get it from a damn mosquito bite. You can't spread it to other people. Don't quote definitions of "disease" at me to try and prove your point, either; there's SIGNIFICANT profit to be had in "treating disease", so the definition is becoming looser and looser as time goes on.

    I feel sympathy for people who struggle with it that are in chronic long-term pain, but those who let themselves become addicts because they were prescribed it for a temporarily reason? Not so much.



    Well to be fair.....
    (Love me some Letterkenny)

    There is an aspect that you either overlooked or simply didn’t address.

    People that have been on opiates for long term chronic pain control become physically addicted regardless of their mental status and awareness of the situation.

    The physical addiction is only part of the whole thing, and it is a part of the problem that generally the person has no control over.

    I recently worked an overdose of a 72 y/o female.

    She had been wearing a Fentanyl patch and taking Oxy for break through pain for over 10 years.

    For some unknown and stupid reasons her pain doctor stopped her patch and OxyContin without notice.

    But he wrote her a script for 200 Norco (hydocodone/apap 3/325)

    Although this lady wasn’t a junkie, she was an addict with a strong physical addiction. Her dumb ass doctor should have known better.

    The lady took those Norco until she felt better.
    Her care giver found her unconscious and breathing about 4 times a minute.

    Addiction is more than a mental thing that people just need to get over, or can easily control.


    Edit:
    I see now that you kind of addressed the long term pain control.
    My bad
    Last edited by pmedic920 on Fri Jan 10, 2020 5:27 pm, edited 3 times in total.
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Re: Injection Sites
Fri Jan 10, 2020 5:18 pm
  • pmedic920 wrote:Could/would you please explain how spending limited resources on a person that doesn’t want help makes ANY sense?

    I don’t see it but my mind is open, change my mind.


    I doubt if I could change your mind but them not wanting help just shows you how really powerful addiction is. That is a symptom of their sickness not an expression of who they really are.
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Re: Injection Sites
Fri Jan 10, 2020 5:22 pm
  • DomeHawk wrote:
    pmedic920 wrote:Could/would you please explain how spending limited resources on a person that doesn’t want help makes ANY sense?

    I don’t see it but my mind is open, change my mind.


    I doubt if I could change your mind but them not wanting help just shows you how really powerful addiction is. That is a symptom of their sickness not an expression of who they really are.


    And I’m not, nor would I argue that point.

    I’m only saying that I think the limited resources should be used trying to help those that recognize they need and want help.
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Re: Injection Sites
Fri Jan 10, 2020 5:37 pm
  • Recognizing the problem is the prerequisite and necessary step toward a successful outcome.

    My view is that injection sites are but a mechanism for institutionalizing a problem. They are not a solution. Unfortunately, it's easy to excuse ourselves by passing problems off to empire building programs that take on a life of their own. To me that just insulates an individual problem from a viable solution and successful outcome.

    In the end, it's locals that actually address and solve problems.

    Thanks for your service "pmedic920"
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Re: Injection Sites
Fri Jan 10, 2020 5:49 pm
  • Tical21 wrote:
    pmedic920 wrote:As cold hearted as it may sound, I’m to the point of saying f***’em let them die.

    I say we should focus on those that recognize they have a problem and want help.

    The problem is too big to be wasting resources on those that don’t want help.

    Addiction (any kind) is a Monster that has so many facets, it can be beaten and people can go on to enjoy productive lives but not if they don’t want help.

    IMHO the question should be, how do we help those that want help.

    Injection sites don’t address that at all.
    I’m sure that some of the programs included a measure of counseling but face the facts, very few of those words are falling on ears that hear.

    Yeah, let them die. They're concentrated highest in places that have maintained higher poverty rates for decades, so f*** em. They're not even people.

    Big drug companies, government agencies and the wealth inequality that the rich have engineered are the leading causes behind this, so we good.

    You're a soulless, elitist bastard. Go f*** yourself.


    Yea ok.

    How bout you google rural and suburban heroin use.

    How but you do a little research on non heroin opiate addiction/use


    Heroin is not a poor people drug, it makes people poor.
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Re: Injection Sites
Fri Jan 10, 2020 6:10 pm
  • JGfromtheNW wrote:
    pmedic920 wrote:To those that don’t like my stance.


    That me put this another way.


    Your kid just got hit by a car, he/she is laying in the street unconscious and bleeding.

    Or

    Your Father/mother just fell out. They are on the floor in cardiac arrest.

    Or

    You just cut your own hand off while using a chainsaw in your back yard

    Or etc etc etc.


    The closest and next available ambulance is down the road reviving a heroin addict that overdosed for the 3 rd time this month.

    You’ll get your ambulance when they get finished.


    Circling back to this post.

    What I'd really like to see is a separate team of publicly funded EMTs/paramedics/LEOs that are specifically for emergency drug response. Let the regular emergency response teams deal with everything else.

    It would probably never fly because too many people (this thread being exhibit A) would think it's just "a waste of money."


    Again your not looking at the fact that the majority of these people don’t want your help.

    Sure they don’t want to die, but they go right back into the $h!t as soon as you save their life.

    You would be amazed at how many of them deny any opiate use after you have saved their life with a medication that only works on opiates.

    I’ve removed needles from them prior to administering Narcan and still had them deny using drugs.


    Your also overlooking that fact that many communities are short on staff and apparatus already.
    They are for the simple fact that funds aren’t available.
    If the funds were available for more staff and apparatus, they would need to be used just as the others are.
    This is assuming we are talking about public funds.

    Your idea may work if it were funded privately but again I don’t think you are aware of just how big this problem is.

    I don’t know the numbers on a national level but I’d bet that even I would be shocked to know just how many 911 calls involve overdose every day.

    In my little sub urban district alone (15-20k population) we average about 5 OD calls per week. Some weeks depending on the dope delivery situation, that number can be as high as 10 per week.

    Units dedicated to OD calls is a nice thought but very unrealistic.
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Re: Injection Sites
Fri Jan 10, 2020 6:40 pm
  • pmedic920 wrote:
    JGfromtheNW wrote:
    pmedic920 wrote:To those that don’t like my stance.


    That me put this another way.


    Your kid just got hit by a car, he/she is laying in the street unconscious and bleeding.

    Or

    Your Father/mother just fell out. They are on the floor in cardiac arrest.

    Or

    You just cut your own hand off while using a chainsaw in your back yard

    Or etc etc etc.


    The closest and next available ambulance is down the road reviving a heroin addict that overdosed for the 3 rd time this month.

    You’ll get your ambulance when they get finished.


    Circling back to this post.

    What I'd really like to see is a separate team of publicly funded EMTs/paramedics/LEOs that are specifically for emergency drug response. Let the regular emergency response teams deal with everything else.

    It would probably never fly because too many people (this thread being exhibit A) would think it's just "a waste of money."


    Again your not looking at the fact that the majority of these people don’t want your help.

    Sure they don’t want to die, but they go right back into the $h!t as soon as you save their life.

    You would be amazed at how many of them deny any opiate use after you have saved their life with a medication that only works on opiates.

    I’ve removed needles from them prior to administering Narcan and still had them deny using drugs.


    Your also overlooking that fact that many communities are short on staff and apparatus already.
    They are for the simple fact that funds aren’t available.
    If the funds were available for more staff and apparatus, they would need to be used just as the others are.
    This is assuming we are talking about public funds.

    Your idea may work if it were funded privately but again I don’t think you are aware of just how big this problem is.

    I don’t know the numbers on a national level but I’d bet that even I would be shocked to know just how many 911 calls involve overdose every day.

    In my little sub urban district alone (15-20k population) we average about 5 OD calls per week. Some weeks depending on the dope delivery situation, that number can be as high as 10 per week.

    Units dedicated to OD calls is a nice thought but very unrealistic.


    I'm not saying you don't have any relevant things to say here but you tend to view everything as a black and white issue. Unfortunately, many of these issues have many shades of gray and to advance that they are an easy fix is just not factual. It is going to require a national debate and and probably many attempts at trial and error.
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Re: Injection Sites
Fri Jan 10, 2020 6:44 pm
  • And I will add this without solicitation.

    I do understand the desire to help people. I fully understand it, it is the reason I do what I do.

    I also understand the desire to help people that we feel need our help, even if they themselves don’t know that they need help.

    My opinion is based almost solely on what I’ve seen with my own eyes on the front lines @ street level.

    Although I’ve never experienced drug/alcohol addiction, I have struggled with my own demons.
    I’ve been officially labeled as “addictive personality”

    My heart actually goes out to those that live in bondage to any addiction.

    The fact remains, and it shocks me to hear anyone argue the point, we/you can’t help someone that isn’t willing to admit they need it, or one that doesn’t want it, and as sad as it is, that even holds true for someone that needs help but fails to or refuses to admit they need help.

    This is truly a situation where the old adage holds true....

    You can lead a horse (no pun intended) to water but you can’t make him drink.

    I’d like to save everyone.
    I’d be ecstatic if no one ever died an untimely death. “Saving lives” is kinda what I’m about, in spite of what some think based on a few lines of text.

    My life has taught me to be realistic about stuff like this, I can’t help it.
    I think the realistic thing to do is, help those that want help

    It makes zero sense too me to spend one once of energy, or one dollar of funds to attempt helping a person that doesn’t want the help, when there is a guy/girl right over there asking for help.
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Re: Injection Sites
Fri Jan 10, 2020 6:52 pm
  • pmedic920 wrote:And I will add this without solicitation.

    I do understand the desire to help people. I fully understand it, it is the reason I do what I do.

    I also understand the desire to help people that we feel need our help, even if they themselves don’t know that they need help.

    My opinion is based almost solely on what I’ve seen with my own eyes on the front lines @ street level.

    Although I’ve never experienced drug/alcohol addiction, I have struggled with my own demons.
    I’ve been officially labeled as “addictive personality”

    My heart actually goes out to those that live in bondage to any addiction.

    The fact remains, and it shocks me to hear anyone argue the point, we/you can’t help someone that isn’t willing to admit they need it, or one that doesn’t want it, and as sad as it is, that even holds true for someone that needs help but fails to or refuses to admit they need help.

    This is truly a situation where the old adage holds true....

    You can lead a horse (no pun intended) to water but you can’t make him drink.

    I’d like to save everyone.
    I’d be ecstatic if no one ever died an untimely death. “Saving lives” is kinda what I’m about, in spite of what some think based on a few lines of text.

    My life has taught me to be realistic about stuff like this, I can’t help it.
    I think the realistic thing to do is, help those that want help

    It makes zero sense too me to spend one once of energy, or one dollar of funds to attempt helping a person that doesn’t want the help, when there is a guy/girl right over there asking for help.


    I guess I look at it a little differently and that probably relates to my field. I approach any problem based upon serving the needs of the various stakeholders. In this case that includes the public, and the public is sick and tired of these people defecating all over our public areas. So, whether they want help or not isn't necessarily the prime issue.
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Re: Injection Sites
Fri Jan 10, 2020 7:24 pm
  • I was on Vicodin twice daily for almost a year following a shoulder issue. It was the only way I could get through the extremely painful PT that ended with my having to strap my arm into this medieval board thing to stretch things out. When the PT worked, it happened very quickly, and that day I was off Vicodin and didn't want any more. I mean, why would I, problem solved.

    Years later, I went in for cancer surgery. Got the hydromorphone drip, the oxys afterward, all of that. By that time, marijuana was medicinal, and I found that combining marijuana with the meds made it easier to transition to MJ only. But as to whether it would have been adequate at the beginning, not even close.

    I never had an addiction issue.

    There's one non-addicting drug that is as effective for pain relief--Torodol. And that drug is so dangerous to the kidneys and digestive system that usually, supplies are five pills for a month. The other alternatives--gabapentin/lyrica, 1980s antidepressants are about as effective as Reiki massage or hypnosis. Which is to say, for most people, not that effective.

    But from my experience, I can say that you can take these drugs daily and keep functioning at work and your daily life without dramatically upping the amount of drugs required. There are patients with chronic pain that do, because that's the only thing that allows them to function. IMO, they should be left to do that. It's cruel to tell a patient who has had a regimen work for him for years or decades that it's being taken away for basically placebos, which we are now doing.

    As to why the opiate epidemic presently continues--I think it has a lot to do with culture. Remember meth? Coke? Crack? All these became epidemics when opiates were much more freely available than they now are. It used to be that people wouldn't touch H, not even once, not even when they were snorting daily.

    As to where this now stands, you now have a bunch of physically addicted people who because of the opiate crackdown are indulging in stronger ways (i.e. IV) and creating more problems for the public (i.e. leaving needles around). The physical part can be handled with MAT or with kratom/Ayuhausca, all of which are taken orally. This lessens the risk to the public and to themselves by having dirty needles around.
    Last edited by SantaClaraHawk on Fri Jan 10, 2020 7:25 pm, edited 1 time in total.
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Re: Injection Sites
Fri Jan 10, 2020 7:24 pm
  • DomeHawk wrote:
    pmedic920 wrote:
    JGfromtheNW wrote:
    pmedic920 wrote:To those that don’t like my stance.


    That me put this another way.


    Your kid just got hit by a car, he/she is laying in the street unconscious and bleeding.

    Or

    Your Father/mother just fell out. They are on the floor in cardiac arrest.

    Or

    You just cut your own hand off while using a chainsaw in your back yard

    Or etc etc etc.


    The closest and next available ambulance is down the road reviving a heroin addict that overdosed for the 3 rd time this month.

    You’ll get your ambulance when they get finished.


    Circling back to this post.

    What I'd really like to see is a separate team of publicly funded EMTs/paramedics/LEOs that are specifically for emergency drug response. Let the regular emergency response teams deal with everything else.

    It would probably never fly because too many people (this thread being exhibit A) would think it's just "a waste of money."


    Again your not looking at the fact that the majority of these people don’t want your help.

    Sure they don’t want to die, but they go right back into the $h!t as soon as you save their life.

    You would be amazed at how many of them deny any opiate use after you have saved their life with a medication that only works on opiates.

    I’ve removed needles from them prior to administering Narcan and still had them deny using drugs.


    Your also overlooking that fact that many communities are short on staff and apparatus already.
    They are for the simple fact that funds aren’t available.
    If the funds were available for more staff and apparatus, they would need to be used just as the others are.
    This is assuming we are talking about public funds.

    Your idea may work if it were funded privately but again I don’t think you are aware of just how big this problem is.

    I don’t know the numbers on a national level but I’d bet that even I would be shocked to know just how many 911 calls involve overdose every day.

    In my little sub urban district alone (15-20k population) we average about 5 OD calls per week. Some weeks depending on the dope delivery situation, that number can be as high as 10 per week.

    Units dedicated to OD calls is a nice thought but very unrealistic.


    I'm not saying you don't have any relevant things to say here but you tend to view everything as a black and white issue. Unfortunately, many of these issues have many shades of gray and to advance that they are an easy fix is just not factual. It is going to require a national debate and and probably many attempts at trial and error.


    To be fair, and state what should e obvious.

    I can only comment on, and offer opinions on things that I know.

    I don’t jump into discussions and start spouting off on topics that I have no knowledge of.

    My opinions are based off real life things that I’ve either experienced personally, or seen with my own eyes.

    I’m not a “I heard”, “I read”, or “my buddy says” kind of guy.

    I don’t jump on any social bandwagon without doing some research, I don’t trust what the internet or MSM has to say, I check facts from multiple sources before I believe any rhetoric.

    My opinion on this particular topic is simply that, my opinion.
    I offer my opinion as a perspective that others may not have. I’m not trying to change anyone’s mind.

    I may be a black or white type personality, in fact I probably am but when I know something is black nobody is going to convince me it’s green, even if that means I don’t get to sit at the cool kids table.


    It seems the biggest stumbling point here is, that I think we should focus on helping those that want help.

    How is that a stumbling point when not one person has given a reasonable argument stating that we should help every addict.
    They’ve eluded to it but offered nothing in terms of how it makes sense or how it could be done. It’s a black and white fact, our resources are limited. Care to argue that?

    It’s pretty freaking easy to say we should do this or that but you have to be realistic and apply common sense to these things.

    Maybe the best answer is to make Heroin and it’s use illegal. People will surely stop becoming addicted then, right?

    ^^^^
    See how silly some things are. There was zero common sense applied to that statement.
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Injection Sites
Fri Jan 10, 2020 7:28 pm
  • DomeHawk wrote:
    pmedic920 wrote:And I will add this without solicitation.

    I do understand the desire to help people. I fully understand it, it is the reason I do what I do.

    I also understand the desire to help people that we feel need our help, even if they themselves don’t know that they need help.

    My opinion is based almost solely on what I’ve seen with my own eyes on the front lines @ street level.

    Although I’ve never experienced drug/alcohol addiction, I have struggled with my own demons.
    I’ve been officially labeled as “addictive personality”

    My heart actually goes out to those that live in bondage to any addiction.

    The fact remains, and it shocks me to hear anyone argue the point, we/you can’t help someone that isn’t willing to admit they need it, or one that doesn’t want it, and as sad as it is, that even holds true for someone that needs help but fails to or refuses to admit they need help.

    This is truly a situation where the old adage holds true....

    You can lead a horse (no pun intended) to water but you can’t make him drink.

    I’d like to save everyone.
    I’d be ecstatic if no one ever died an untimely death. “Saving lives” is kinda what I’m about, in spite of what some think based on a few lines of text.

    My life has taught me to be realistic about stuff like this, I can’t help it.
    I think the realistic thing to do is, help those that want help

    It makes zero sense too me to spend one once of energy, or one dollar of funds to attempt helping a person that doesn’t want the help, when there is a guy/girl right over there asking for help.


    I guess I look at it a little differently and that probably relates to my field. I approach any problem based upon serving the needs of the various stakeholders. In this case that includes the public, and the public is sick and tired of these people defecating all over our public areas. So, whether they want help or not isn't necessarily the prime issue.



    Here’s the typical response I would get if I posted something like that.

    So, you don’t care about the addict, you just want them to S H I T someplace else.

    You sir are a POS you make me sick.
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Re: Injection Sites
Fri Jan 10, 2020 7:34 pm
  • There is such a limitation to what an office bound view or institutionalized view or group thought can actually see. It is common to encounter disconnects from what field workers see up front and so clearly.

    Working as a field volunteer has taught me that it is those who are receptive to help that actually benefit. With limited time and resources, it really is that black and white.

    The reality of free will mandates that the prime prerequisite for help is "they must really want it".
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Re: Injection Sites
Fri Jan 10, 2020 7:51 pm
  • I can't think of many issues that will inflame the NIMBY gene faster than injection sites.

    The fact is, the typical addict can't get to the "want to quit" aspect until they have been cleared of the drug of choice. When under the influence, virtually no addict will ask for help until they hit absolute rock bottom, and in the case of some of the modern drugs that gets them very close to death, if not through it.

    Many addicts will shrug and call a detox visit a spin dry and go right back to the drug. Actual recovery rates are often difficult to determine and the culture of the 12 Step programs reject the keeping of records (anonymous, you know) and the casual nature of the programs means there are no records anyway. That's not how they operate, even though they claim high recovery rates, nobody really knows.

    The recent moves toward treating addiction as a medical problem rather than a law enforcement problem is a hopeful move. Sending addicts to jail to spend time with fellow addicts is kind of a crazy way to address the problem, you know? Drug addiction is not the only thing going on with the homeless question, either. There literally millions of Americans only 1-2 paychecks from living on the streets.
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Re: Injection Sites
Fri Jan 10, 2020 7:58 pm
  • pehawk wrote:Even as an ex heroin addict and IV user I'm torn on the idea of the sites. It just seems a bit too supportive. I'm far more comfortable with lower cost clean exchange programs. Those are a must. Without it you'll cause an HIV/Hep outbreak like that creepy governor from Indiana did.

    I would like to see a more federal approach to treatment vs funding these sites.


    What is your opinion on MAT? From what I've read, it cuts down on the physical addiction, and wholly on the dirty needles threatening each other and the public. These programs are often tied in with rehab efforts, even NA.

    I mean, not everyone is going to be able to kick heroin swiftly. It's far more likely if they go down to something like methodone that has to be viewed and doesn't ever involve dirty needle issues. Even more so when you go to oral bupe/sub.

    A good number of our population is going to be addicts, and at a certain point, sometimes society has to acknowledge this. Not everyone kicks nicotine, so for them, there's gum, patches, Juuls, whatever that don't subject society to burning objects or smoke. It is seen as basically their biz.
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Re: Injection Sites
Fri Jan 10, 2020 9:27 pm
  • As to what PMedic said:

    While I am not a medic, I worked as a 911 dispatcher for the city of SF under the standard medical protocol (proQA) that I think everyone still uses.

    The top of this list is basically not conscious/not breathing--but then there was a lot of wiggle room here. Is the vagrant out on Market/6th Street REALLY not conscious/not breathing? There'd be an SFFD medic on the bridge to sort this out, and many of those calls would get downgraded.

    At the time I worked there, OD calls involving opiates weren't as big of a problem, but it's handled with a similar process now: If a guy is not conscious/not breathing, you do have to do an E response, but once there, the city's obligation is basically to shoot them up with narcan, check their vitals for stability, ask that guy if he wants hospital assistance, and if not let him go.

    What I've never seen is a lack of resources for whatever emergency as pmedic has theorized. When someone's down NC/not breathing, medics have to get them back to a conscious and breathing state no matter how you feel about them, and now with Narcan as prevalent, that can be done very quickly.
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Injection Sites
Fri Jan 10, 2020 10:14 pm
  • SantaClaraHawk wrote:As to what PMedic said:

    While I am not a medic, I worked as a 911 dispatcher for the city of SF under the standard medical protocol (proQA) that I think everyone still uses.

    The top of this list is basically not conscious/not breathing--but then there was a lot of wiggle room here. Is the vagrant out on Market/6th Street REALLY not conscious/not breathing? There'd be an SFFD medic on the bridge to sort this out, and many of those calls would get downgraded.

    At the time I worked there, OD calls involving opiates weren't as big of a problem, but it's handled with a similar process now: If a guy is not conscious/not breathing, you do have to do an E response, but once there, the city's obligation is basically to shoot them up with narcan, check their vitals for stability, ask that guy if he wants hospital assistance, and if not let him go.

    What I've never seen is a lack of resources for whatever emergency as pmedic has theorized. When someone's down NC/not breathing, medics have to get them back to a conscious and breathing state no matter how you feel about them, and now with Narcan as prevalent, that can be done very quickly.



    First off.
    We don’t have the option to not transport people that we have revived via Narcan. They all go, and if they refuse transport, Law enforcement will do an EDO, not by law but by our request based on them being a danger to self/others.
    It’s the protocol we work under.
    I’d like to be able to walk away after reviving them but our Medical Director doesn’t see it that way.

    Local protocols vary from area to area, even within the State of Texas. We have no choice but to operate within the guidelines that are set forth.


    2nd, it’s great that you NEVER experienced a resource load that created a “calls holding” scenario but that doesn’t mean it doesn’t happen where I work.

    We also have the ability to prioritize calls based on complaint but once a crew is on scene and made patient contact, they aren’t going to pull that crew to make another response. That would be considered patient abandonment here in Texas.


    The fact alone that I’ve seen opiate overdoses require multiple doses of Narcan, makes me really question the quality of care in an area that allowed medics to walk away after the initial revival via Narcan.

    There are many things that get looked at when an ambulance call ends up in litigation, “standard of care” is one of the first.

    I could see the standard moving towards this practice someday but it most certainly is not at this time, and frankly I’m surprised that the city of SF is getting away with it.

    Hell, it’s possible that other big metropolitan areas are doing this as well, I don’t know it all, never have claimed I do.

    The other thing that I question regarding this practice is, how reliable is/was the 911 calling party?

    Probably a full 3rd of the OD calls we get are toned out as “unknown problem” or “man down”.
    We don’t know that it was an opiate overdose until we get there and evaluate the situation.
    Many times the caller states that they need an ambulance at the address, then hang up. It’s not uncommon to find the victim and nobody else, they all split to avoid answering questions.


    Edit:

    I’m talking about a scenario where the opiate out lives the initial dose of Narcan.

    It’s not uncommon for the person to require other doses 30, 60, or 90 minutes later.

    Image

    2nd edit:

    If I led anyone to believe that the scenario I mentioned is a common occurrence, or that it happens on a regular basis, that was not my intention.

    I does happen but not regularly.
    We like most places have mutual aide agreements with neighboring districts, they help us, we help them.

    A more common and almost regular occurrence is that my unit is already on an assignment, and then another emergency happens. This causes the need to dispatch the next closest available ambulance.
    That unit could have a 20 minute or longer response time.
    That’s still a very long time to wait if you are having a real emergency and in need of help. Ie the type of things I mentioned up thread.
    Last edited by pmedic920 on Fri Jan 10, 2020 11:42 pm, edited 2 times in total.
    pmedic920
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Re: Injection Sites
Fri Jan 10, 2020 11:19 pm
  • The misinformation about resources is $h!t, there is a lot of money out there, it is just managed extremely badly, the cost of the medication, The Administrative aspect, the Board of Directors, then you have the Governments and their mismanagement of funds historically bad. The ability to sue Doctors for prescribing identified Chronic Pain Patients relief Opiates is stupid is hell, I see no difference between them and Terminal Cancer Patients that seem to get relief since they are dying it is looked upon as different. With the Medication many Chronic Pain patients can have a semblance of normality and some function and dignity in their lives.

    Many without it become bed ridden and depressed and turn to what's available, Alcohol that will destroy their liver along with Tylenol etc destroys the Kidneys.

    Hard Street drugs like Heroin, is the other option and then they lose everything, end up on the street and eventually dead in an alley or camp somewhere.

    We as a country hate dealing with the ugly part of life, we want it to be hidden or moved to someone else's neighborhood, deny it is there until it appears on the doorstep and then want eradication, not managed or a finding a way to fix what created it.

    Socialized Medicine and Mental Health facilities may be the only answer really, the Health and Pharmaceutical Companies and HMO's like this system, they extort money from all. Government, the public, the Stock Market etc.

    We divide everything and put one against the other and then divide them and pit them against each other internally so the money can flow up, not down.

    Again it's not about having the money, they waste more money then would be needed every day.
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Injection Sites
Fri Jan 10, 2020 11:32 pm
  • chris98251 wrote:The misinformation about resources is $h!t, there is a lot of money out there, it is just managed extremely badly, the cost of the medication, The Administrative aspect, the Board of Directors, then you have the Governments and their mismanagement of funds historically bad. The ability to sue Doctors for prescribing identified Chronic Pain Patients relief Opiates is stupid is hell, I see no difference between them and Terminal Cancer Patients that seem to get relief since they are dying it is looked upon as different. With the Medication many Chronic Pain patients can have a semblance of normality and some function and dignity in their lives.

    Many without it become bed ridden and depressed and turn to what's available, Alcohol that will destroy their liver along with Tylenol etc destroys the Kidneys.

    Hard Street drugs like Heroin, is the other option and then they lose everything, end up on the street and eventually dead in an alley or camp somewhere.

    We as a country hate dealing with the ugly part of life, we want it to be hidden or moved to someone else's neighborhood, deny it is there until it appears on the doorstep and then want eradication, not managed or a finding a way to fix what created it.

    Socialized Medicine and Mental Health facilities may be the only answer really, the Health and Pharmaceutical Companies and HMO's like this system, they extort money from all. Government, the public, the Stock Market etc.

    We divide everything and put one against the other and then divide them and pit them against each other internally so the money can flow up, not down.

    Again it's not about having the money, they waste more money then would be needed every day.



    Actually Tylenol (acetaminophen) is hard on mainly your liver.

    Ibuprofen hurts your kidneys
    All NSAIDs can cause organ damage at high and long term doses though.

    But I get your point.

    And I won’t disagree that there is probably more money that could be used if it were allocated differently/used properly.

    I’ve always taken the stance that government is full of waste.
    The argument then becomes what services and programs should get the funds.

    I don’t care what service or programs you want to discuss, if it’s run by any form of government there’s probably a substantial amount of waste and misappropriation.
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Re: Injection Sites
Sat Jan 11, 2020 12:49 am
  • My issue with these sites is that the people who suggest them are completely ignorant of how they are implemented in other countries. What these politicians are trying to do is follow the example of countries such as Portugal. For those of you that don't know, Portugal has completely decriminalized drugs and they have safe injection sites with medical staff on hand all around the country. This radical drug program came as a result of a ramped opioid crisis in the late 80s, and 90s. They tried multiple approaches and then they decided flip the script -- it was met with the biggest drop in addiction that the world has ever seen.

    Now, what is wrong with what our politicians and legislators are trying to accomplish? First of all this was a nation wide program. We're trying to implement it on a city/community level. This is important because of the next part I'm going to tell you. What comes with these programs is support systems. The police in Portugal were given training in sociology and were trained as middle men. They were used as evangelist in the drug communities to spread the word of programs afforded to those that are addicted. Within these injection center they also had social workers that were on hand to inform those that were addicted of treatment options and programs.

    What is more they had robust drug treatment programs that were well funded by the federal government. If you decided that you wanted a change you'd be housed and put in a drug treatment program. All you need to do is go into a police station and ask for drug treatment services and someone in the department will get you set up in a program. No criminal record, or record of treatment. The quantities of drugs that are allowed on ones person is also significantly less than in Seattle. Drug dealing, and intent to distribute is still a crime. In Seattle it is very hard to prosecute people for drug dealing and distribution due to the amounts that people are allowed to have leaving the supply side thriving.

    What I'm getting at is these programs work in other countries because they have the backing of the federal government, and a VERY strong support system. They've created an environment in which people feel comfortable seeking help, and people are informed whether or not they want to of treatment options at every turn. They also have a very effective rehab system that is well funded by the federal government and well staffed. Anyone can get in whenever they want, at any time.

    What I'm getting at here is what Seattle is doing is not compassionate. In this circumstance we're enablers, we're offering them the means and spaces to continue their habit without doing the necessary groundwork to get them clean. Our police are told just to look the other way, our outreach sucks, our rehabilitation programs are lacking. I don't want anymore feel good policies, I want concrete action. What we're doing here in Seattle does not work without the necessary steps, it does not work without the whole package. What we're doing here is the foreplay and then skipping out on the action. It's incompetence and negligence on the behalf of our politicians.
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Re: Injection Sites
Sat Jan 11, 2020 8:22 am
  • SantaClaraHawk wrote:
    pehawk wrote:Even as an ex heroin addict and IV user I'm torn on the idea of the sites. It just seems a bit too supportive. I'm far more comfortable with lower cost clean exchange programs. Those are a must. Without it you'll cause an HIV/Hep outbreak like that creepy governor from Indiana did.

    I would like to see a more federal approach to treatment vs funding these sites.


    What is your opinion on MAT? From what I've read, it cuts down on the physical addiction, and wholly on the dirty needles threatening each other and the public. These programs are often tied in with rehab efforts, even NA.

    I mean, not everyone is going to be able to kick heroin swiftly. It's far more likely if they go down to something like methodone that has to be viewed and doesn't ever involve dirty needle issues. Even more so when you go to oral bupe/sub.

    A good number of our population is going to be addicts, and at a certain point, sometimes society has to acknowledge this. Not everyone kicks nicotine, so for them, there's gum, patches, Juuls, whatever that don't subject society to burning objects or smoke. It is seen as basically their biz.


    Some sort of maintenance program is the best way to handle this crisis. I'm more partial to suboxone over methadone though. Suboxone doesn't get you high like methadone does, it just takes away the urge and brings clarity to your thinking.

    I've been on suboxone for 9+ years. And coincidentally this 9+ years is the longest I've ever gone without a self-destructive 'reboot' of my life. This time allowed this douchebag to achieve a very comfortable salary, buy a home, and even splurge on nicer things for myself. So, I'm a big believer in the maintenance approach.
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Re: Injection Sites
Sat Jan 11, 2020 9:48 am
  • pehawk wrote:
    SantaClaraHawk wrote:
    pehawk wrote:Even as an ex heroin addict and IV user I'm torn on the idea of the sites. It just seems a bit too supportive. I'm far more comfortable with lower cost clean exchange programs. Those are a must. Without it you'll cause an HIV/Hep outbreak like that creepy governor from Indiana did.

    I would like to see a more federal approach to treatment vs funding these sites.


    What is your opinion on MAT? From what I've read, it cuts down on the physical addiction, and wholly on the dirty needles threatening each other and the public. These programs are often tied in with rehab efforts, even NA.

    I mean, not everyone is going to be able to kick heroin swiftly. It's far more likely if they go down to something like methodone that has to be viewed and doesn't ever involve dirty needle issues. Even more so when you go to oral bupe/sub.

    A good number of our population is going to be addicts, and at a certain point, sometimes society has to acknowledge this. Not everyone kicks nicotine, so for them, there's gum, patches, Juuls, whatever that don't subject society to burning objects or smoke. It is seen as basically their biz.


    Some sort of maintenance program is the best way to handle this crisis. I'm more partial to suboxone over methadone though. Suboxone doesn't get you high like methadone does, it just takes away the urge and brings clarity to your thinking.

    I've been on suboxone for 9+ years. And coincidentally this 9+ years is the longest I've ever gone without a self-destructive 'reboot' of my life. This time allowed this douchebag to achieve a very comfortable salary, buy a home, and even splurge on nicer things for myself. So, I'm a big believer in the maintenance approach.

    Brings clarity to your thinking???. I've read your posts....not sure there is clarity there lol. Jk well done in getting your life on the right track!
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Re: Injection Sites
Sat Jan 11, 2020 10:26 am
  • Fair.

    *More* clarity as opposed to your drugged out haze.
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Re: Injection Sites
Sat Jan 11, 2020 11:10 am
  • pehawk wrote:Some sort of maintenance program is the best way to handle this crisis. I'm more partial to suboxone over methadone though. Suboxone doesn't get you high like methadone does, it just takes away the urge and brings clarity to your thinking.

    I've been on suboxone for 9+ years. And coincidentally this 9+ years is the longest I've ever gone without a self-destructive 'reboot' of my life. This time allowed this douchebag to achieve a very comfortable salary, buy a home, and even splurge on nicer things for myself. So, I'm a big believer in the maintenance approach.


    Exactly this pehawk.

    When it comes down to it, society's interest here is 1) moving people away from IV routes that leave dirty needles around; and 2) having people be functional in their daily lives.

    We have fully recognized this with tobacco addiction, with myriad affordable alternatives available to lower the risk to society of burning cigarettes. If someone's a Nicorette addict for life, society does not see it as a problem.

    Same goes with subs. The person is alert, he is getting on with his life, and he's doing so without posing undue risk to society.
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Re: Injection Sites
Sat Jan 11, 2020 11:45 am
  • PMedic,

    When I was in SF doing that job, part of the training involved "riding along" with the actual cops. During the ride-along, we came across a dude who was screaming and yelling along Third Street and even stumbling out into the street itself, with a softball sized abscess.

    Dude was a frequent flyer with these cops. The cops encouraged him to let them call him an ambulance to SF General, told dude he would not have to pay for any of it but he still refused. As he said he wasn't trying to kill himself and had cooled down his behavior when the cops came, he was let go.

    The main way anyone is held in California is with a 5150 72-hour hold. This has come to be applied pretty much only to people actively trying to commit suicide. A stomach full of antidepressants or even aspirin will usually get a sheriff out there to sign the 5150, but being high in itself usually doesn't. If you're so high you don't know enough to get out of the street, they'll book you on a disorderly and you'll go to a dryout overnight, then be released.

    There hasn't been a case publicized here, yet, of people dying because they needed an extra dose of Narcan. If it did, it'd probably get covered up by saying the guy went and scored again and that's why he died. The first time that's proven not to be the case--especially if this person's got family--the first time it appears in the Chronicle, and then the city will react by updating the internal protocol.
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Re: Injection Sites
Sat Jan 11, 2020 5:52 pm
  • SantaClaraHawk wrote:PMedic,

    When I was in SF doing that job, part of the training involved "riding along" with the actual cops. During the ride-along, we came across a dude who was screaming and yelling along Third Street and even stumbling out into the street itself, with a softball sized abscess.

    Dude was a frequent flyer with these cops. The cops encouraged him to let them call him an ambulance to SF General, told dude he would not have to pay for any of it but he still refused. As he said he wasn't trying to kill himself and had cooled down his behavior when the cops came, he was let go.

    The main way anyone is held in California is with a 5150 72-hour hold. This has come to be applied pretty much only to people actively trying to commit suicide. A stomach full of antidepressants or even aspirin will usually get a sheriff out there to sign the 5150, but being high in itself usually doesn't. If you're so high you don't know enough to get out of the street, they'll book you on a disorderly and you'll go to a dryout overnight, then be released.

    There hasn't been a case publicized here, yet, of people dying because they needed an extra dose of Narcan. If it did, it'd probably get covered up by saying the guy went and scored again and that's why he died. The first time that's proven not to be the case--especially if this person's got family--the first time it appears in the Chronicle, and then the city will react by updating the internal protocol.



    That in itself doesn’t sound unreasonable.

    I think the stance here is, that a person that is high or intoxicated doesn’t have reasonable thought processes to make legal decisions, or informed decisions concerning their health and welfare.

    Although we don’t force drunks into going to the hospital we don’t just let them wander around in traffic either.

    They either get someone sober to come get them, they go to jail for sobering, or they go to the hospital.

    It’s a pissing match generally, LEOs don’t want them, and neither do the hospitals. If we get called, and many times we do because the cops don’t want to deal with them, they aren’t going to be left to themselves.
    I don’t necessarily like, or agree with it but it’s our guidelines/protocol.

    In the case of an opiate overdose that has been revived with Narcan, they are going to the Hospital by their own choice, or by taken into temporary custody.
    They are considered a danger to themselves. It’s more of a CYA, liability thing probably more so than anything.

    Here in Texas, every EMS service has a medical director.
    We have private services, Hospital based services, and city, county, or state government services.
    We do not have a state wide medical director, or state wide protocols.

    Each service has their own medical director, and that Medical director sets his/her own protocols within the parameters that the State of Texas sets.
    The Dr. (medical director) that I work under, and most of the others here, don’t want to accept the responsibility and liability of treating and releasing opiate overdoses.
    Although a person ending up dead for the opiate I revived him from is unlikely, the chances of him re-dosing is very likely for obvious reasons.

    We do treat and release people all the time, but it’s stuff like unconscious from low blood sugar or something along those lines. Those people can reasonably be considered to be able to make and informed decisions on their own behalf.

    A person that is intoxicated enough to be wandering in traffic, or one that is obviously high on narcotics can’t reasonably be considered able to care for themselves, and there is absolutely no reasonable defense should the case end up in litigation.

    Here’s a hypothetical scenario.

    Someone you love, child, bother, best friend ODs, medics show up and revive them with Narcan, they don’t want to go to the hospital so the medics leave.
    Next morning he/she is found dead, ME report says they died from an opiate overdose.
    Probably no way to tell if the dope out lived the Narcan, or they re- dosed on more.
    What is almost impossible to defend is, that person was under the influence of Narcotics, and didn’t have the capacity to make an informed decision. Narcan doesn’t mean you aren’t under the influence, it only means you aren’t going to die right now.
    Those medics, the service they work for, the Medical Director they work under, and whatever government entity they are employed by all can, and most likely will be held liable in a court of law. Civil courts definitely, Criminal negligence is a possibility.

    “Standard of care” is a huge part of this, and treating and releasing opiate overdoses in not the National Standard of care, it most certainly is not the Standard of care here in Texas.

    I could see a shift in the “standard” happening as this epidemic becomes worse, and maybe that’s what’s happening in California/SanFran but it sounds like it’s been going on for a while, so I don’t know.

    Like I said earlier, I don’t know how they are getting away with it.

    I also stated that these people simply aren’t left to fend for themselves.

    Our “EDO” (emergency detention order) is probably very similar to your “5150”

    In the case of a Drunk or Overdose it basically protects everyone involved.
    Patient, LEO, Medics and all the services.

    The EDO if used is only a way to ensure that the party is going to be safe in the particular incident.
    Many times they are held and observed until they are no longer under the influence.

    Occasionally, based on circumstances they are ordered for further mental evaluation or rehab, sometimes jailed for associated charges(parole violation), many times they are simply released to go about their business.

    The big issue is, they were able to walk away and go on with whatever life they have, they weren’t found dead.

    I’d like to know, how San Francisco knows that people didn’t die after being revived, especially if they left the location or immediate area of the original call.
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Re: Injection Sites
Sat Jan 11, 2020 6:00 pm
  • pmedic920 wrote:
    DomeHawk wrote:
    pmedic920 wrote:And I will add this without solicitation.

    I do understand the desire to help people. I fully understand it, it is the reason I do what I do.

    I also understand the desire to help people that we feel need our help, even if they themselves don’t know that they need help.

    My opinion is based almost solely on what I’ve seen with my own eyes on the front lines @ street level.

    Although I’ve never experienced drug/alcohol addiction, I have struggled with my own demons.
    I’ve been officially labeled as “addictive personality”

    My heart actually goes out to those that live in bondage to any addiction.

    The fact remains, and it shocks me to hear anyone argue the point, we/you can’t help someone that isn’t willing to admit they need it, or one that doesn’t want it, and as sad as it is, that even holds true for someone that needs help but fails to or refuses to admit they need help.

    This is truly a situation where the old adage holds true....

    You can lead a horse (no pun intended) to water but you can’t make him drink.

    I’d like to save everyone.
    I’d be ecstatic if no one ever died an untimely death. “Saving lives” is kinda what I’m about, in spite of what some think based on a few lines of text.

    My life has taught me to be realistic about stuff like this, I can’t help it.
    I think the realistic thing to do is, help those that want help

    It makes zero sense too me to spend one once of energy, or one dollar of funds to attempt helping a person that doesn’t want the help, when there is a guy/girl right over there asking for help.


    I guess I look at it a little differently and that probably relates to my field. I approach any problem based upon serving the needs of the various stakeholders. In this case that includes the public, and the public is sick and tired of these people defecating all over our public areas. So, whether they want help or not isn't necessarily the prime issue.



    Here’s the typical response I would get if I posted something like that.

    So, you don’t care about the addict, you just want them to S H I T someplace else.

    You sir are a POS you make me sick.


    I care about everyone in my community INCLUDING the average citizen whose children can no longer play in their public parks.

    What I posted was just on aspect of the problem. You don't think the public has a right to have their public places (parks, libraries, etc.) that they paid for restored to them?

    Let me give you an example of my personal experience: A couple of years ago I did some consulting work for an organization in Eureka, CA. Hwy 101 runs right thru the middle of Eureka on 4th Ave.(?) Ave and the traffic slows to city speed limits as you drive thru. As you do drive thru you can't help but notice that there are vagrants on both sides of the street. Some are milling around and some are just shuffling up and down the street. As I sat eating in a restaurant w/a street view I noticed that they would sometimes stop in front of businesses only to have management shoo them away. They didn't complain or hesitate, they just kept lumbering up the street.

    Talking to people I found out that 99% of these people were heroin addicts and they were housed in a local homeless shelter. Their main occupation was to panhandle enough money to get their fix for the day. This is the endless cycle of their life. Remember that this is Eureka, not SF, with a population of only around 30,000. I had occasion to go to the library to study local history and many of these addicts congregated there because it would be unlawful to deny them. I had occasion to talk to a few of them and made friends with a young man who was very bright and social. I felt bad for him and wondered what could be done to help him.

    At one point I was getting a quick breakfast at the local McDonald's on 4th (101) and was talking to a gentleman about the addicts congregated there. I said I wanted to buy them some food. He just laughed, they feed them three times a day at the shelter, he said. They're here to get money, nothing else, he said. On another occasion I spoke to a law enforcement officer, he relayed some of his experience to me. You know, he said, it isn't against the law to be a heroin addict and most off these people know constitutional right's laws better that we do, there is almost nothing we can do to them. I found that to be true and in talking to these individuals I found them to be VERY savvy regarding these laws.

    At the library I also met another woman who headed up a local needle recovery group. There were just a few in her group but she informed me that each one of them picked up 50-60 needles a day. I was shocked at this 50-60? I thought she might be exaggerating but it was confirmed by others.

    So, is Eureka a magnet for heroin addicts with guaranteed housing, food, and money available to them? How could it be otherwise? When I talked about delivering for the various stakeholders in the community that includes all of them, the addicts themselves, the local citizens, govt., law enforcement, business, etc. I am convinced that the only solution to this problem must be an effort by all of these groups working together.
    Last edited by DomeHawk on Sat Jan 11, 2020 6:07 pm, edited 1 time in total.
    DomeHawk
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Re: Injection Sites
Sat Jan 11, 2020 6:06 pm
  • DomeHawk wrote:
    pmedic920 wrote:
    DomeHawk wrote:
    pmedic920 wrote:And I will add this without solicitation.

    I do understand the desire to help people. I fully understand it, it is the reason I do what I do.

    I also understand the desire to help people that we feel need our help, even if they themselves don’t know that they need help.

    My opinion is based almost solely on what I’ve seen with my own eyes on the front lines @ street level.

    Although I’ve never experienced drug/alcohol addiction, I have struggled with my own demons.
    I’ve been officially labeled as “addictive personality”

    My heart actually goes out to those that live in bondage to any addiction.

    The fact remains, and it shocks me to hear anyone argue the point, we/you can’t help someone that isn’t willing to admit they need it, or one that doesn’t want it, and as sad as it is, that even holds true for someone that needs help but fails to or refuses to admit they need help.

    This is truly a situation where the old adage holds true....

    You can lead a horse (no pun intended) to water but you can’t make him drink.

    I’d like to save everyone.
    I’d be ecstatic if no one ever died an untimely death. “Saving lives” is kinda what I’m about, in spite of what some think based on a few lines of text.

    My life has taught me to be realistic about stuff like this, I can’t help it.
    I think the realistic thing to do is, help those that want help

    It makes zero sense too me to spend one once of energy, or one dollar of funds to attempt helping a person that doesn’t want the help, when there is a guy/girl right over there asking for help.


    I guess I look at it a little differently and that probably relates to my field. I approach any problem based upon serving the needs of the various stakeholders. In this case that includes the public, and the public is sick and tired of these people defecating all over our public areas. So, whether they want help or not isn't necessarily the prime issue.



    Here’s the typical response I would get if I posted something like that.

    So, you don’t care about the addict, you just want them to S H I T someplace else.

    You sir are a POS you make me sick.


    I care about everyone in my community INCLUDING the average citizen whose children can no longer play in their public parks.

    What I posted was just on aspect of the problem. You don't think the public has a right to have their public places (parks, libraries, etc.) that they paid for restored to them?

    Let me give you an example of my personal experience: A couple of years ago I did some consulting work for an organization in Eureka, CA. Hwy 101 runs right thru the middle of Eureka on 4th Ave.(?) Ave and the traffic slows to city speed limits as you drive thru. As you do drive thru you can't help but notice that there are vagrants on both sides of the street. Some are milling around and some are just shuffling up and down the street. As I sat eating in a restaurant w/a street view I noticed that they would sometimes stop in front of businesses only to have management shoo them away. They didn't complain or hesitate, they just kept lumbering up the street.

    Talking to people I found out that 99% of these people were heroin addicts and they were housed in a local homeless shelter. Their main occupation was to panhandle enough money to get their fix for the day. This was the endless cycle of their life. Remember that this is Eureka, not SF, with a population of only around 30,000. I had occasion to go to the library to study local history and many of these addicts congregated there because it would be unlawful to deny the. I had occasion to talk to a few of them and made friends with a young man who was very bright and social. I felt bad for him and wondered what could be done to help him.

    At one point I was getting a quick breakfast at the local McDonald's on 4th (101) and was talking to a gentleman about the addicts congregated there. I said I wanted to buy them some food. He just laughed, they feed them three times a day at the shelter, he said. They're here to get money, nothing else, he said. On another occasion I spoke to a law enforcement officer, he relayed some of his experience to me. You know, he said, it isn't against the law to be a heroin addict and most off these people know constitutional right's laws better that we do, there is almost nothing we can do to them. I found that to be true and in talking to these individuals I found them to be VERY savvy regarding these laws.

    At the library I also me another woman who headed up a local needle recovery group. There were just a few in her group but she informed me that each one of them picked up 50-60 needles a day. I was shocked at this 50-60? I thought she might be exaggerating but it was confirmed by others.

    So, is Eureka a magnet for heroin addicts with guaranteed housing, food, and money available to them? How could it be otherwise? When I talked about delivering for the various stakeholders in the community that includes all of them, the addicts themselves, the local citizens, govt., law enforcement, business, etc. I am convinced that the only solution to this problem must be an effort by all of these groups working together.


    I don’t think you understood my post.

    Re-read the first line.
    pmedic920
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Re: Injection Sites
Sat Jan 11, 2020 6:09 pm
  • pmedic920 wrote:
    DomeHawk wrote:
    pmedic920 wrote:
    DomeHawk wrote:
    I guess I look at it a little differently and that probably relates to my field. I approach any problem based upon serving the needs of the various stakeholders. In this case that includes the public, and the public is sick and tired of these people defecating all over our public areas. So, whether they want help or not isn't necessarily the prime issue.



    Here’s the typical response I would get if I posted something like that.

    So, you don’t care about the addict, you just want them to S H I T someplace else.

    You sir are a POS you make me sick.


    I care about everyone in my community INCLUDING the average citizen whose children can no longer play in their public parks.

    What I posted was just on aspect of the problem. You don't think the public has a right to have their public places (parks, libraries, etc.) that they paid for restored to them?

    Let me give you an example of my personal experience: A couple of years ago I did some consulting work for an organization in Eureka, CA. Hwy 101 runs right thru the middle of Eureka on 4th Ave.(?) Ave and the traffic slows to city speed limits as you drive thru. As you do drive thru you can't help but notice that there are vagrants on both sides of the street. Some are milling around and some are just shuffling up and down the street. As I sat eating in a restaurant w/a street view I noticed that they would sometimes stop in front of businesses only to have management shoo them away. They didn't complain or hesitate, they just kept lumbering up the street.

    Talking to people I found out that 99% of these people were heroin addicts and they were housed in a local homeless shelter. Their main occupation was to panhandle enough money to get their fix for the day. This was the endless cycle of their life. Remember that this is Eureka, not SF, with a population of only around 30,000. I had occasion to go to the library to study local history and many of these addicts congregated there because it would be unlawful to deny the. I had occasion to talk to a few of them and made friends with a young man who was very bright and social. I felt bad for him and wondered what could be done to help him.

    At one point I was getting a quick breakfast at the local McDonald's on 4th (101) and was talking to a gentleman about the addicts congregated there. I said I wanted to buy them some food. He just laughed, they feed them three times a day at the shelter, he said. They're here to get money, nothing else, he said. On another occasion I spoke to a law enforcement officer, he relayed some of his experience to me. You know, he said, it isn't against the law to be a heroin addict and most off these people know constitutional right's laws better that we do, there is almost nothing we can do to them. I found that to be true and in talking to these individuals I found them to be VERY savvy regarding these laws.

    At the library I also me another woman who headed up a local needle recovery group. There were just a few in her group but she informed me that each one of them picked up 50-60 needles a day. I was shocked at this 50-60? I thought she might be exaggerating but it was confirmed by others.

    So, is Eureka a magnet for heroin addicts with guaranteed housing, food, and money available to them? How could it be otherwise? When I talked about delivering for the various stakeholders in the community that includes all of them, the addicts themselves, the local citizens, govt., law enforcement, business, etc. I am convinced that the only solution to this problem must be an effort by all of these groups working together.


    I don’t think you understood my post.

    Re-read the first line.


    You're correct, I did not.

    My apologies.
    DomeHawk
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Re: Injection Sites
Mon Jan 13, 2020 8:30 pm
  • In conclusion I am as split on the efficacy of these sites as I was when I started this thread. BUT, I have learned much and that is/should be the point of a discussion forum.

    My feeling is this and it pretty much follows my overall philosophy. If you want to be an addict that is your business so long as it it doesn't impact me or the local community. The problem remains, however, that addiction isn't a victimless crime, it impacts the community in many negative ways that are not acceptable.

    Whether we want to assign resources to this problem is a moot point. Any societal problem will require an assigning of resources, there is no way of getting around that. The question becomes, how are we going to assign resources?

    I gave an example of a small city that tried to address this issue only to make it worse, much worse. It is enabling on steroids. There are so many different ideas about how to address this problem:

    Somebody, was it SantaClara?, offered up some really intelligent responses to new, more effective, drugs that are being utilized in different places.

    Some suggest offering more resources for treatment, (something I am not in favor of as most treatment solutions are 30-day spin dries that rarely accomplish anything. I am told by someone in the know that it takes a year for a heroin addict to begin to recover.)

    Some suggest doing nothing and spending anything. (All this does is promote more crime, contagious disease outbreaks and ultimately death.)

    I have thought that you need to make it illegal to be an addict and force them to quit simply by throwing them into detox and forcing them to kick. Running them through the court system would be far too burdensome to the economy but a 72-hour lock-down and the associated pain of withdrawal might inspire them to seek an alternative lifestyle.

    It will take more brainstorming and trial and error but one thing is for sure, just picking up after these people will not solve anything.
    DomeHawk
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Re: Injection Sites
Wed Jan 15, 2020 7:24 pm
  • DomeHawk wrote:In conclusion I am as split on the efficacy of these sites as I was when I started this thread. BUT, I have learned much and that is/should be the point of a discussion forum.

    My feeling is this and it pretty much follows my overall philosophy. If you want to be an addict that is your business so long as it it doesn't impact me or the local community. The problem remains, however, that addiction isn't a victimless crime, it impacts the community in many negative ways that are not acceptable.

    Whether we want to assign resources to this problem is a moot point. Any societal problem will require an assigning of resources, there is no way of getting around that. The question becomes, how are we going to assign resources?

    I gave an example of a small city that tried to address this issue only to make it worse, much worse. It is enabling on steroids. There are so many different ideas about how to address this problem:

    Somebody, was it SantaClara?, offered up some really intelligent responses to new, more effective, drugs that are being utilized in different places.


    Like DomeHawk, I believe that society's foremost role is to protect itself.

    The biggest extant threat is IV use. You won't stop people from using in their car or public bathrooms or beaches by providing an official "safe" self-injection site. All you do is spread the idea that the government in some capacity thinks this is OK here, so it must be OK there.

    That doesn't mean, however, having to kowtow to that thinking that only hard-core abstinence with religious overtones (i.e. AA/NA) is the only way either. Just b/c someone's not into that form of recovery doesn't mean they're fine sliding down the slippery slope.

    We have someone who talked here about getting well due to MAT. I'm not sitting here and saying this person doesn't deserve his 10-year chip, any more than I'm going to rudely cough when I see someone unwrap a Nicorette.
    SantaClaraHawk
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Re: Injection Sites
Sun Feb 02, 2020 12:58 pm
  • I'm in favor for the clean needle availability reasons alone. Not gonna stop addicts, but you can at least help slow the spread of HIV and Hep C.

    The other idiotic thing we did was outlaw Ibogaine to appease the makers of Suboxone. We could REALLY use Ibogaine centers in this country. Most report IMMEDIATE cessation of withdrawal symptoms.
    SeAhAwKeR4life
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Re: Injection Sites
Mon Feb 03, 2020 2:13 am
  • Our son Chris (who is 34) is HIV positive, from shared needles (meth). I never thought it would come to that. My wife and I have shed many tears. He's currently doing OK, though. But we can't be carted through the jagged maze of all this for much longer. It d-r-a-g-s you down.
    Aussie Seahawk
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Re: Injection Sites
Tue Feb 04, 2020 3:00 pm
  • Aussie Seahawk wrote:Our son Chris (who is 34) is HIV positive, from shared needles (meth). I never thought it would come to that. My wife and I have shed many tears. He's currently doing OK, though. But we can't be carted through the jagged maze of all this for much longer. It d-r-a-g-s you down.


    Sincerely hope you can find some peace through the pain Aussie. Addiction doesn't discriminate.
    DomeHawk
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