Sunday, August 4, 2019


    Now a days we have significant talk about the drug use  and drug addiction. The problem is old  and there are are different shades  and what we used to see in New York in seventies  and eighties is not seen that often. WE ALL ARE RESPONSIBLE FOR THIS . We may not like this statement, but in my mind it is accurate. In hospitals there were surveys from patients about the satisfaction. So to get have higher'scores', the hospital pushed doctors -not directly but indirectly -to give -offer- pain medicines. When I had hernia surgery,after the surgery I took only Tylenol  and Advil. I had prescription for narcotics and i never filled it. I stooped the pain medicines in 3 days. But in the hospitals we offered much stronger medicines  and narcotics  and patients did take them  and some came in to get the medicines only . Taking them for short time is OK But over period of time patients got addicted . Some were addicted  and demanded pain medicines  and some came to hospital and would not give good reports unless got the pain medicines . This part is now corrected . But now we have pot being made 'legal'.So more people are doing it and that is step one. The pendulum has swung on the other side . The government has new regulations  and now I see some doctors doing pain management practice  as it is lucrative. But the problem is not solved . Some of these people that get medicines from these doctors sell it  add then the addicts buy them. This brings me to today/s story .
       I saw this young lady for diagnosis of pneumonia .I went to see her . She was a young lady and
did tell me that she did use drugs.She was a smoker and did not drink alcohol.But she was on pain medicines obtained on streets. But she was not taking them as pills even though they were suppose to be taken orally. She had some cough and fever and she had some right sided chest pain . She came to ER  and she had chest X- ray done  and that showed pneumonia. So she was admitted. When I saw her she was comfortable  and she she seems to be honest about the drug addiction. She was admitted few months ago with sepsis and MRSA infection. She denied using cocaine and did not drink alcohol,She did smoke sometimes , When I asked her on her drug addiction she stated that she used Dilaudil pills.SHE DID NOT HAVE THEM AS PRESCRIPTION but she bought them on streets. She would dissolve them in water and then inject them intravenously to get effect quickly.
      This form of abuse is very dangerous. The pills taken by mouth or drugs used by intravenously or smoking pot or use of cocaine are all risky behaviors. But the injecting pills is especially dangerous . The pills are meant to be taken orally  and so the pill contains talc or other substance that is particulate- has small particles of talc or chalk. This is not completely dissolved in water and when injected gets caught in lung blood vessels - causing pulmonary embolism -smilier to blood clots getting trapped in lungs . This in significant quantity can cause death . 

     I explained this to her  and she seemed to understand. She looked like honest drug addict  and looked like she will try to kick the habit . When I looked at the chart the drug testing was positive for number of other things that she had told me she did not use!

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