health

continued from page 50

not advertise their problems.
Maybe a friend knows. When
people die from drugs, their
families and friends do not
want to talk. No one contacted
for this story who works with
addicts or their families could
convince anyone to be inter-
viewed.
David Techner of Ira
Kaufman Chapel in Southfield
became a licensed funeral
director several decades
ago. Back then, he occasion-
ally dealt with a drug death.
Techner estimates he does
funerals for about six persons
a year whose cause of death is
listed as opioid drugs.
“And one per year is too

Staying Safe

Local medical experts offer
these suggestions:
• Get your medicine from a
reliable source.
• Make sure your doctor knows
all the medicines you are
taking to avoid potentially
dangerous interactions.
• When you are done with the
narcotic, get rid of the old
medicine. Keeping it in your
medicine chest could put a
child in your home at risk.
Taking it later for some other
condition, under changed
circumstances, could have
bad results.
• Proper disposal of expired or
unused prescriptions protects
human health (once it is
out of your hands) and the
environment. Drugs should
be taken to a collection for
incineration to destroy the
chemicals within and prevent

52

October 26 • 2017

them from entering our
drinking water. Visit Michigan.
gov to find resources for drug
disposal.
• If you suspect a family
member might have
overdosed, consider it a
medical emergency; call 911
immediately. This could be
a life-and-death situation.
Seconds or minutes could
make the difference.
• Watch for behavior changes
in your children. Watch
for disappearing cash or
objects from the house, or
trouble at school or work. If a
family member seems to be
misusing drugs, get in touch
with an addiction physician
(Google lists this specialty)
or visit the Substance Abuse
and Mental Health Services
website’s (samhsa.gov) detailed
instructions for how to proceed.

jn

many,” he says. “I see way more
than I am comfortable with. I
did not become a funeral direc-
tor for this. It scares the hell
out of me.”
Some people enforce silence
about this epidemic. Techner
recalls, “I got invited to speak
at a local high school after
a student died by suicide.
Some other parents started to
worry, so I got disinvited. I feel
comfortable talking to young
people about death, bereave-
ment and grief. I am a funeral
director.”
Instead he passed along a
message. “So, I said, ‘Any stu-
dent who wants to talk with me
should give me a call.’ But I did
not go.”

and also a danger to the public.
Synthetic opioids compound
the danger.
In the past decade, John
W. Huffman, a researcher at
Clemson University, devel-
oped hundreds of synthetic
chemicals similar to opium and
marijuana, hoping to find a safe
drug that would have medical
benefits without causing addic-
tion or altered states of con-
sciousness. His work produced
drugs useful to physicians and
veterinarians.
Manufacturers of illegal
drugs have copied Huffman’s
recipes to make synthetic
opioids available by retail in
America. Some of these syn-
thetic drugs are thousands of
times more powerful — and
deadlier — than heroin, an
opioid two to three times
more powerful than morphine.
Fentanyl, for example, serves
as an effective tranquilizer for
horses and elephants, and as a
dangerous drug for humans.
First responders — emer-
gency medical technicians,
public safety officers and even
family members of addicts
— carry a supply of Naloxone
(trade name Narcan) that
reverses the effects of poten-
tially fatal doses and revives
dying patients. But reversing
doses of the new drugs may
take more than one application
of Narcan. Meanwhile, the first
responder needs to stay alert:
A snowflake-sized bit of the
original drug may endanger his
or her life.

[prescriptions] and/or refills
fraudulent? Is the physician
writing an exorbitant number
of prescriptions for control
drugs or combinations of the
drugs that appear suspicious?
Should we avoid stocking some
drugs because they increase
our risk of hold-up or break-in?
“The quandary is yours,”
he says. “You don’t want to
be sued by a doctor for mak-
ing false accusations and you
don’t want your State Board
of Pharmacy to say to you,
‘Proper judgment should have
prevented you from filling pre-
scriptions from Dr. X.’”
The whole medical com-
munity faces a dilemma.
Posner notes, “There’s been a
lot of discussion lately about
DANGERS OF OPIOIDS
pain patients who have their
pain inadequately controlled
Why are these drugs so danger-
because of under-dosing nar-
ous?
cotic meds.”
“Opium suppresses breath-
But Dr. Anna Lembke, assis-
ing. An overdose, or a dose in
tant professor at Stanford
combination with other factors,
University and chief of the
can result in death,” says Dr.
Stanford Addiction Medicine
Ira Winer, assistant professor
Dual Diagnosis Center, stresses
of gynecological oncology at
the danger of using opioids to
the Karmanos Center at Wayne
treat chronic pain. In her book
State University.
Drug Dealer, MD, she asserts
Patients’ tolerance for the
that, in trying to make sure
drug can vary greatly, depend-
that every patient gets perfect
ing on whether the patient has
pain control, physicians have
a full or empty stomach, on
contributed to making their
what other drugs the patient
patients into addicts.”
has taken and on the patient’s
Dr. Carl Christensen, profes-
general health. One more fac-
sor of addiction medicine at
tor: People who take opioids
the WSU School of Medicine,
often come to need higher and
observes: “Drug abuse is a
higher doses to get the same
leading cause of death in this
results. Doctors call this tachy-
country, especially in young
phylaxis. A patient can become
people, and it is getting worse
addicted by taking just
year by year. The number of
the drugs the doctor
PROFESSIONAL
prescriptions for pain-killing
ordered.
DILEMMA
drugs is also increasing year by
The CDC reports
Pharmacists also need
year. The two graphs map each
that in 2015, more than
to stay alert. Erwin
other.”
15,000 persons in the
Posner of Southfield,
EMT Shaina Shevin Warshay
U.S. died from prescrip-
a veteran pharmacist
adds, “For parents, I think the
tion opioids, and about
who now recruits for
twice that number from
the pharmaceutical
hardest part of the job is to
Erwin Posner
street drugs. Street
industry, writes in a
recognize there is a problem
drugs, of course, come
professional journal
with your child. Don’t be blind
in unregulated strength.
about the conundrums and say, ‘Not my child.’ I am not
If the dealer usually dilutes the
facing his fellow pharmacists.
saying that parents should be
drug, and this time does not, or
“We are often caught
paranoid and untrust-
this time contaminates it with
ing of their children;
in a dilemma when we
a different drug, or replaces
I am saying know the
choose to either fill or
one drug with another, the
warning signs and do
not fill a prescription.
buyer may wind up dead.
We have to ask our-
not deny them if you
For mysterious reasons, the
selves: Has the patient
start to see them.”
poppy plant produces chemi-
been compliant with
Dr. Talia Ziv, a
cals that somehow alter the
labeled usage? Has
clinical psychologist
way our brains perceive pain.
the physician over-
whose practice in West
Naturally occurring opioids
or under-dosed the
Bloomfield often pro-
Dr. Talia Ziv
provide vital help to patients
patient? Are the Rxs
vides service to clients