Heroin Demands It
Anyone who has been in EMS for a long time can tell you that drugs are nothing new to our society. They have always been part of our hidden underbelly. Heroin is not new either, but there is something different about this current epidemic that is nothing like we have ever seen. In 2011, about 1.6% of Americans aged 12 and over had tried the drug. Overdoses from heroin increased almost 50% from 1999 to 2010, but doubled from 2010 until 2012.
Statistics are one thing, but how does it look up close? Want to see the true impact of heroin? Talk to the families who are personally affected through the addiction or loss of a loved one. You won’t have to go very far to find one. Take a ride in the streets with the police and EMS personnel who are battling it on the front lines. They all can tell you. All drugs are bad, but there is something particularly vile about heroin and its addiction. Use it once, and one in four people become a slave to the drug, unable to resist its demands. Demand is the only word for it. It doesn’t call, it doesn’t lure, it doesn’t tempt. It demands. Take a ride with me and my crew and see what what we see.
We’ll start the day with our morning chores. Maybe we’ll catch a television broadcast of newspaper article where our brothers in blue have made a big heroin bust. Great job guys. Good win. It might slow the heroin on the street, but it won’t stop it. The desire is too strong. Heroin demands it.
As if to prove a point, we get a call for a subject unconscious and unresponsive. It always comes in as unconscious and unresponsive. It never comes in as an overdose. Going en route to the scene, we know what it is. Six or seven years ago when we got these calls, we started going through the protocols for heart attacks in our heads. That’s what these calls were then. Not anymore. We roll out the door prepared for anything but confident its a heroin overdose. It always is anymore. Heroin demands it.
One thing we don’t know is where we will be going. We don’t work heroin overdoses in alleys, abandoned buildings, or run down homes. We work them in public bathrooms, office buildings, 6,000 square foot white collars homes and cars. All too often in cars. People can’t even wait to get to a private place to use. They need the fix now; it can’t wait. Heroin demands it.
The other thing we don’t know is who we will be treating. Think you know what a heroin addict looks like? You do and you don’t. Heroin addicts may look like your stereotypical addict. They also may look like the kid next door, your high school sweet-heart, your dad, your best friend or one of your grandparents. The drug doesn’t discriminate. It will enslave anyone willing to try it just that one time. So you do know what a heroin addict looks like. They look like anyone, because it gets everyone. Heroin demands it.
So we arrive. Sometimes, someone is attempting poorly executed CPR. Your friend is blue because heroin knocks out their natural need to breathe. This time is no different. Someone on scene yells, “give them that Narcan, that’s what saved me.” That’s what we’ve come to, even the people on scene know the treatment, and it’s this miracle drug that makes everything okay. The drug that enables another attempt. Heroin demands it.
They all know the risk. It doesn’t matter if they have overdosed before, or their friends have overdosed before. It certainly doesn’t make a difference if their favorite actor or musician has overdosed and died tragically, drawing attention to the fact that no-one is immune. Not only are they fighting the drug, but they are exposed to all the other risks of intravenous drug use. HIV/AIDS is a concern and the concurrent rise of new hepatitis cases will stay with some even if they are lucky enough to eventually escape the drug. They know the risk, but they can’t refuse. It doesn’t matter if they don’t want to do it. Heroin demands it.
So you look into the eyes of your partner, a seasoned paramedic that you respect immensely. His eyes used to burn with a passion for the job that said, “I’m saving a life. I’m making a difference.” Now the fire is gone, replaced by a dull stare. The stare that is just going through the motions we have been through so many times before. The stare that knows that all we are doing is giving the drug its slave back. We are now just a cog in the wheel that that will eventually rotate back to this same situation. Bring them back so they can use again. Heroin demands it.
You see the same blank stare in the police officers around you. They seize the remainder of the drugs. There isn’t enough for charges of drug dealing. Simple possession isn’t even worth the fight anymore. They will seize it and destroy it, but there are too many cases of possession. Heroin demands it.
You take a look around the room and pray there are no children there to see. You used to be appalled that someone would use with a child in the house. Unfortunately, now you have seen it too many times to be surprised. First you were surprised there were children there. Then you were surprised that the parents were using their children as a safety net, telling them to call 911 if mommy or daddy goes to sleep and they can’t wake them up. They didn’t want to use with their child around, but they couldn’t wait. Heroin demands it.
Now you are appalled that the epidemic has become so bad that Naloxone (Narcan) is now available over the counter or handed out free at clinics. So parents are teaching their children how to give mommy or daddy the nose spray to wake them up. Parents don’t want to teach their children this, but they can’t resist. Heroin demands it.
So you push the drug, breath for them with an artificial ventilator until their normal breathing returns and they wake up. Then begins the tears and the lies. “I don’t want to do this again. I can’t do this again. I promise I am going to stop.” It doesn’t matter if they mean it or not. The drug will make it into lies and bring them back to it. Heroin demands it.
Sometimes we lose. The call is too late, the drug was taken in too high a concentration or was cut with something more lethal than heroin. Our compassion is short lived. We can’t carry that burden anymore; we have seen it too many times. To move on, we must lose a part of our compassion, our humanity. Heroin demands it.
So you are wrapping up, making sure you re-stock that ever-vital Narcan on the ambulance. You check the dates on the unused vials out of habit, but its a wasted exercise. It doesn’t stay on the ambulance long enough to expire. Heroin demands it.
You see your friend on the police force. You haven’t seen him in a while since he got promoted and moved up to the drug task force. You mention the bust you saw on TV and congratulate him. He shrugs it off. The informant that helped them get the dealer will get a call tomorrow. A new dealer who already has the contacts, already has the lists, already there to fill the need without interruption. Heroin demands it.
You can’t escape it. Drugs have become so casual that Charlie Sheen’s character’s shameless drug use on “Two and a Half Men” earned him millions of dollars and endless laughs on screen while his real life antics off screen earned him the status of a party demigod. It’s mainstream. Heroin demands it.
It’s all about the demand. Once someone submits to the drug, it has them. It demands they return. It demands they use. Escaping its grasp is extremely hard and never fully complete. When you see the hold it has firsthand on someone, you understand the supply is secondary. The demand is so strong that somehow the supply will be met. The money and the power promised will always find someone willing to take the risks to feed the demand. We can cheer as much as we want when drug king-pins like El Chapo are taken down. We can blame, we can vilify, and we can be repulsed, but we can’t do so without understanding that our own demand for heroin and our own dollars have helped create these monsters. We have lost so many to the demand of this drug and we will lose many more. We are losing. The question we should be asking ourselves is how do we prevent that first time, that first use? How do we prevent that demand in the first place? Its time we take our future back. We should demand it.
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