The Land of Addictia

Nurses have ambivalent relationships with narcotics and benzodiazepines.  Those drugs have an important role in health care.  Pain and anxiety are formidable opponents.


Drugs can be good; drugs can be our friend!  


But, there is a DARKER side to drugs

 DUM-DUM-DUM!!  



Drugs can take your humanity and make you into a self-centered husk.


Here are some of my favorite addicts with their scepters:

Cocaine

   

Patients with cocaine troubles are usually upper class.  They arrive in a Porsche wearing an Armani suit or clutching a Coco Chanel purse.  Their hair is professionally styled.  They have chest pain and tachycardia; their blood pressure is stroke-high.  

When you explain that you need a urine sample, they glare at you and say, "Do you know who I am?"

Doctors frequently come up in conversation.  "Dr. HeadHoncho golfs at my country club.   My pool boy used to work for Dr. BigCheese.  Dr. NumeroUno is my next-door neighbor."

Nurse's Note:  The doctor is not my boss.  He's just another  coworker.  Stop threatening me.

Meth

Meth is bad.  Meth lab explosions cause children to be brought in to the emergency room with third degree burns and carbon monoxide poisoning.   Meth addicts have broken black teeth and jittery, manipulative behaviour.  They don't sleep, they are tachycardic and it is difficult to bring them down with anxiolytics.  Their skin is covered with sores they've dug to get those burrowing bugs out.

Meth is bad. 

Heroin

Heroin addicts come in with endocarditis and hepatitis C.  Their high tolerance to opiods makes it nearly impossible to treat them for pain.  If they need surgery, ordinary dosing does not touch them.  And since they almost always deny their addiction,  you usually don't discover it until they are withdrawing and you have had to tie them down with four-point restraints.

Marijuana

Marijuana just doesn't seem that bad to me.  In all my years as a nurse, I have never seen a patient come in with a marijuana overdose, marijuana poisoning, marijuana seizures or any other issue specifically related to marijuana.  

But, I have seen a lot--and I do mean A LOT--of alcohol overdoses and alcoholic liver failure.  And a lot of respiratory failure, small cell lung cancer and COPD from cigarette smoking.

Why have we demonized marijuana and legalized cigarettes and alcohol?  Are the pot smokers holding up the local grocery store for chips and pizza to ward off the munchies?

America has a schizophrenic attitude about drugs.   I've heard the argument that marijuana is a "gateway drug" to harder substances.  That folks using meth, heroin and cocaine started with marijuana.

Bullshit.

The folks using meth, heroin and cocaine started with cigarettes and alcohol.

 What causes the most damage to humans, illegal drug use or cigarettes?  It's cigarettes.  Cigarettes are worse than all the illegal drugs COMBINED. 

 

 Let's stop throwing flower children into prison and start growing and taxing pot.  Our national deficit would vanish in five years.   It would create jobs, employ farmers and get the criminal element out of it. 

Haven't you seen, Breaking Bad?


Nurse's Note:  I have actually GIVEN marijuana to patients, including pediatric patients.  It comes right up from pharmacy in a neat little capsule labeled, "marinol".   It is prescribed to increase appetite and prevent nausea. 



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