Open Discussion A suggestion for harm reduction

[Rio Fantastic]

Hello,

I'm sad to say that tonight I had an experience on this forum that shocked & disappointed me. I've always loved Bluelight, I thought it was a fantastic forum and the best of its kind by far. I did (and still do to an extent) consider it a great place for knowledge, advice, support & entertainment, and it has become indispensable to me for learning, debate, sharing opinions and just to have some fun, and it's become one of the very small & exclusive list of websites that I visit daily.

I have always assumed that if I was in need or required help that there were so many caring, informative and intelligent users here that I'd always get some kind of help. I figured if I had a general question about drugs than the huge amount of intelligent & smart users would be an invaluable resource in either answering it outright (BDD/focus forums) or providing clues or some small amount of knowledge that would help put the pieces in the puzzle together (NPD). I figured that I ever needed a little support when it came to my mental health or addiction that I'd be able to get *some* here from one of the warm & kind people who spend time everyday to help people frequenting here (TDS, sober/healthy living). Bluelight also was my go-to place whenever I just wanted to shoot the shit with some strangers and toss an idea round or start a debate with like-minded people (DC, OD, EADD) and obviously there's no better place to find people who are really on the cutting edge when it comes to interpreting and discussing the results of new research in psychopharmacology and discussing brand new psychoactives that have just been made available for public consumption.

So I hope it's understood that I really do appreciate the value of this forum, and that I always will. However, when I needed this forum the most, I was completely let down. Today I was with two friends and one of them unintentionally took an overdose of heroin, and (somewhat bizarrely considering it was an intravenous injection) he was fine for about three minutes before he started nodding mid-sentence and then within a minute he had lost consciousness. We both started slapping him and poured cold water on him, and when he wasn't coming round we started to panic. Obviously, we called an ambulance, and then my friend remembered Dave mentioning he had naloxone vials. The problem was that neither of us knew how to administer an I.V correctly, and at this point with Dave still being unresponsive, we started really panicking. Whilst Andreas was looking for the naloxone, I frantically posted a thread here begging for help on how to IV. I ensured the title was capitalized as I wanted to get the attention of the people browsing. In my blind panic, I cross-posed it to every subforum I could, refreshing each in the interim. I figured, considering the subject matter and due to the fact that it was such a simple request for anyone who's injected drugs, I was sure to get a few replies.

I must have posted the same thread to like ten subforums. Whilst I was doing that my friend tried to do it, missed him and shot one of the vials into him anyway and nothing happened. I had a suggestion to IM it, which I tried. The ambulance did arrive eventually and they managed to revive him and then took him to hospital, which is where he is now. I was totally, totally shocked to find I still only have two replies. Nobody bothered to answer the original thread question, there was one guy be nice and kind enough to reply and check the thread and elaborate on what he said, and I am eternally grateful to the guy. Truly deserving, IMO, of his moderator title, a really genuinely nice dude. The other person who replied was basically just looking to show off how smart she was and didn't even bother to reply when I asked her to tell me what on earth she meant with her acronyms and specialist terms.

My point is that even with by the forums own count hundreds & hundreds of people looking at the subs, with THOUSANDS at least who must have seen the thread come up on their feed or when browsing (it was a thread in all caps cross posted to a bunch of forums) only TWO people out of THOUSANDS could be bothered to help someone in a literal LIFE OR DEATH situation. Most people were so apathetic that they couldn't be bothered to type out a reply that could save someone's life. I am 100% certain I would have gotten four times as many replies if I posted a thread like "What does MDMA effect in the brain?", I would have probably gotten twenty replies in that time period, because everyone on this forum knows MDMA effects serotonin, but a ridiculously high amount of people think that they are intelligent for knowing that, and just can't wait show everyone how fucking clever they are (I'm sure plenty of people have noticed this, thus why in every single thread like "how long do cocaine comedowns last?" instead of a simple timeframe every dumbass will answer "well u jus gotta wait for ur dopamines to come back up, so usually a couplke of hours" and feel like fucking Albert Einstein for it), but when I was asking a question that I'm certain plenty of people know the answer to, based on how many shooters we have here, only two could be bothered to answer, and out of the two only one actually really gave a fuck.

My suggestion is simple - a forum for truly urgent questions that is highlighted in some ways so that it stands out against the rest - for instance one that's at the top of the forum so it's seen straight away and where the thread titles stand out in some way (perhaps bold or italics) when looking at the feed of new post to demarcate it from the rest, and I'm sure there are other ways that can be figured out to make it more noticeable. The forum could be reserved for truly urgent questions for example obviously imminent ongoing overdoses, accidental drug ingestion, potentially dangerous combinations that have been combined, a friend exhibiting dangerous/suicidal/psychotic behavior on an LSD freak-out etc. I think questions like mine shouldn't be totally ignored by an entire forum centered around harm-reduction, and I just think that the apathy in the face of death, even of a stranger, is absolutely shocking for a message board who's entire ethos is the prevention of harm. It's really made me "wake up and smell the coffee", so to speak. Perhaps I was being naive in thinking that's what this forum was about, and maybe I was being a little childlike thinking that in the first place - perhaps lip-service is paid to the concept of "harm reduction" to justify a forum that's centered around the discussion of an illegal subject. But alas, I figure even if the so-called "focus on harm reduction" is a bit of a smokescreen, my suggestion would still be a positive thing for this forum.

In addition to, or if preferred maybe instead of, maybe a chat room could be added to Bluelight as well, where anyone who's knowledgeable can stay on in order to provide real-time harm-reduction based advice for urgent & ongoing situations, and perhaps anyone's who generally caring and so inclined could spend time there to help people, and could be notified in some way when people sign onto there. I know I for one would spend time on there whilst I'm browsing BL and help people any way I could. I'm a generally solution-oriented kinda guy, and I figure there's no point bitching and moaning about how horrified and disgusted I am with the uncaring apathy I received here tonight, and instead should at least try to make sure that in the future nobody has to go through the same infuriating & depressing ordeal.

 

[Burnt Offerings]

Didn't you try a simple google search? I typed "administer naloxone" into google right now and the first link tells you how to do an IM injection.

I would've helped if I could, but (as I'm sure is the case with others here) I've never even seen naloxone nor IV'd a drug in my life, nor have any real medical experience, so I'm not really of much help...

 

[Rio Fantastic]

Didn't you try a simple google search? I typed "administer naloxone" into google right now and the first link tells you how to do an IM injection.

I would've helped if I could, but (as I'm sure is the case with others here) I've never even seen naloxone nor IV'd a drug in my life, nor have any real medical experience, so I'm not really of much help...

One of my mistakes was not elaborating on this in the OP posts of the threads, but as I'm sure was apparent I was very frantic and rushed and just wanted to post them as fast as possible. That post, like this one, was made using a tablet using an unsecured wi-fi that we "borrow" from a primary school opposite our flat. It has the advantage of being fast, a surprisingly strong signal that we can connect to 24/7 outside of school holidays (its even available at weekends and evenings! we are very lucky that their IT guy is a bit of a moron) and of course, free, but unfortunately it means we have to abide by an internet filter. Bizarrely, this forum isn't caught by it, but 420chan (and indeed all of the chans) are (also bizarrely it catches most porn sites but not assoass.com or xnxx.com, I have no idea why) but any google search with the words "Inject", "naloxone" or "needle" were getting caught. Didn't really have time to figure out how to bypass the filter, so I posted here instead, thinking it was the next best thing. I've seen your name around here and you seem like a pretty nice & helpful guy, so I'm sure if you could've then you would've helped, but that's more than I can say for the 5000 people who ignored it.

 

[alasdairm]

at any time there are, maybe, 3000 or 4000 people browsing bluelight. of those, perhaps 5% are registered bluelighters (i.e. capable of responding immediately) and 95% are guests who need to go through registration before they can respond.

i understand you were in a panic but your post contains a number of erroneous assumptions about both people who did not respond and bluelight's mission and function.

there are no circumstances under which bluelight is, or should be considered, a suitable source of help in an emergency situation. you did the right thing by calling the emergency services and, with the best will in the world, i hope your friend dave recovers and you (both) learn a valuable lesson about drug use.

we're here to arm people with knowledge before emergencies arise: we "encourage open dialogue that empowers the individual to be the primary agent of her own physical, mental and emotional wellbeing".

i've been a bluelighter for over 13 years and i don't know whether injecting naloxone is appropriate in the circumstances you described, let alone how to administer it correctly. i wasn't apathetic when i saw your posts and failed to respond. i may have done more harm than good in responding.

maybe next time, you'll (plural) take some responsibility for your own harm-reduction and ensure that, not only do you have the necessary equipment and medication on hand, but that you also know how to use it in the event of an emergency. i hope that you stick around and share what you've learned tonight so that others who are planning to use heroin might be better prepared in the event that, god forbid, they have a similar experience.

alasdair

 

[Rio Fantastic]

at any time there are, maybe, 3000 or 4000 people browsing bluelight. of those, perhaps 5% are registered bluelighters (i.e. capable of responding immediately) and 95% are guests who need to go through registration before they can respond.

i understand you were in a panic but your post contains a number of erroneous assumptions about both people who did not respond and bluelight's mission and function.

I see what you're saying. My claim that 5000 people ignored my post isn't true in a practical sense. I did assume that the proportion of registered to non-registered browsers would be more highly skewed in favor of registered, so that was certainly my first mistake. Since my post was up for half an hour and on multiple forums, I don't think it's too much of a stretch to say 200 people who were logged in saw my post and were immediately aware of the situation I was in. Considering the nature of Bluelight, obviously this is just a total guesstimation, but I'd say at least 20 of those would have IV'd in the past, but to be conservative I'll say 10. That's still eight people who read my thread title and knew somebody was dying, they knew exactly what needed to be done to prevent it, but couldn't be bothered to type out a procedure that might save a life. Even that figure still totally shocks me. I, for one, even after only seeing it briefly in the ambulance, if I knew that there was a human being literally about to die, even someone I'm never going to meet, would attempt to help, considering it would only be five minutes of my time. Maybe the misplaced faith I had wasn't in the members of Bluelight itself - maybe I just underestimated the extent of the total apathy of strangers on the internet, and now I know that a lot more people than I first thought would literally not lift a finger (which is literally what they would of had to do to help - type) to save a stranger's life.

there are no circumstances under which bluelight is, or should be considered, a suitable source of help in an emergency situation. you did the right thing by calling the emergency services and, with the best will in the world, i hope your friend dave recovers and you (both) learn a valuable lesson about drug use.

we're here to arm people with knowledge before emergencies arise: we "encourage open dialogue that empowers the individual to be the primary agent of her own physical, mental and emotional wellbeing".

Thank you for the kind words. He has not been seen by a doctor yet, and according to my friend he is going through a bizarre cycle of coming around and then actually complaining about getting sick, then passing out again and being given more naloxone. I've got no idea if this is normal or not, but at least he isn't dead on the floor of my flat. I will certainly take from this experience a renewed sense of the importance of testing drugs first, especially opiates. When I used to use, and all the people I know who still do, have always "known" that the heroin we get in our neck of the woods isn't very good quality, and have taken this for granted for as long as I've known. Clearly this batch is different, and I have already texted everyone I know who uses to warn them that the dude Dave bought off has some gear that put him in hospital. I understand that here at Bluelight you don't advertise as being a replacement for emergency care and/or real medical attention, I just hope you can empathize with an extremely frightened man turning in desperation to one of the only places he thought he would get some help. I will not be making the same mistake again.

i've been a bluelighter for over 13 years and i don't know whether injecting naloxone is appropriate in the circumstances you described, let alone how to administer it correctly. i wasn't apathetic when i saw your posts and failed to respond. i may have done more harm than good in responding.

I find it really, really surprising that you've been on Bluelight for over half the time I've been alive and that you didn't know that Naloxone was intended for intravenous use. Admittedly, drugs are a bit of an obsession of mine, and I developed an obsessive interest in them when I was 14, and when I haven't been consuming them I've been consuming information about them, a trend that has continued till this day even whilst I'm trying to live a sober life, so I may not be the best yardstick for comparison. However, I thought that it was common knowledge that Naloxone reverses the effects of opiates and that in an overdose situation Naloxone should *always* be administered and that it is designed for intravenous use - I thought most users and non-users alike knew this, if not from just deduction since in an overdose situation time is obviously of the essence, than from the cultural references like the famous scene in trainspotting or pulp fiction (although that was incorrectly called adrenaline, but still) where they're given an injection and then suddenly sit up gasping. We're very lucky to live in an urban area - had I of lived further away, say if the response time was another 30 minutes, I imagine Dave very well could have died here in front of me. Given that this was the alternative, what harm could you have possibly done by taking five minutes to briefly tell me how to hit a vein?

maybe next time, you'll (plural) take some responsibility for your own harm-reduction and ensure that, not only do you have the necessary equipment and medication on hand, but that you also know how to use it in the event of an emergency. i hope that you stick around and share what you've learned tonight so that others who are planning to use heroin might be better prepared in the event that, god forbid, they have a similar experience.

alasdair

I am not blaming anyone else for what happened tonight. Dave should have taken a tester shot. I should have advised him to take a tester shot, especially when he commented on how dark the solution had cooked up. I feel very, very stupid for not doing this already, and will definitely make a point of doing it now whenever I'm around people about to use. I understand Bluelight was under no obligation to help me, I just find it very, very difficult to accept the notion that every single person who looked at the thread didn't know the answer to my question, and am just shocked and saddened by the likelihood that there were probably several people who had the knowledge to help save someone's life, but just didn't care enough to bother. You're right in that I shouldn't make this a reflection on Bluelight though - the vast majority of traffic, as you said, are just people browsing out of self-interest, who never plan on even making an account, let alone helping anyone else. I am not planning on going anywhere - all of the reasons I quoted in the OP still apply. Even with all of what's happened to me tonight out of the picture though, do you have any thoughts on either of the suggestions? Do you not think the sub/chat room would be a good addition to BL? Thanks for the reply.

 

[Jabberwocky]

Naloxone, intended for IM use in the kind of situation you described your friend was initially in with you Rio, not IV (primarily I would imagine due to the hassle of safely IVing something). Just wanted to point that out in this thread too :D

 

[Rio Fantastic]

Naloxone, intended for IM use in the kind of situation you described your friend was initially in with you Rio, not IV (primarily I would imagine due to the hassle of safely IVing something). Just wanted to point that out in this thread too :D

Where have you got this information? I saw actual paramedics administer it tonight via IV, and I'm pretty sure they knew what they were doing, and the same has happened in the hospital when the first shot wore off, so either you're wrong or both the paramedics and the hospital staff have both fucked up in the same way tonight, and no offence but which situation is more likely?

 

[Jabberwocky]

I would imagine me over them, but in this situation we were both right

Unless one is a doctor, hospital nurse, a paramedic or trained phlebotomist heroin junkie monkey, which you are obviously not because you weren't aware how to administer naloxone, it would be a huge PITA and take far to long to find a usable vein, let know how to find a vein or administer anything properly IV, for it to be reasonable to expect you to master it in the time it took for the ambulance to arrive to take your friend.

For those reasons and more, the standard training for non-medical professionals in administering naloxone to prevent an OD - which by the way are most often administered by fellow users, their friends and families, and not by trained medical professionals - is for it to be inject IM or administered intranasally. Cap't Heroin gave a very good overview of how naloxone is administered in such as situation in his post closing your thread in SL.

Ok. Now goodnight!

 

[Rio Fantastic]

I would imagine me over them, but in this situation we were both right

Unless one is a doctor, hospital nurse, a paramedic or trained phlebotomist heroin junkie monkey, which you are obviously not because you weren't aware how to administer naloxone, it would be a huge PITA and take far to long to find a usable vein, let know how to find a vein or administer anything properly IV, for it to be reasonable to expect you to master it in the time it took for the ambulance to arrive to take your friend.

For those reasons and more, the standard training for non-medical professionals in administering naloxone to prevent an OD - which by the way are most often administered by fellow users, their friends and families, and not by trained medical professionals - is for it to be inject IM or administered intranasally. Cap't Heroin gave a very good overview of how naloxone is administered in such as situation in his post closing your thread in SL.

Ok. Now goodnight!

If you say so. I don't know if you caught this, but my friend attempted an IV and I did give him an IM, but he still hadn't been bought around by the time the ambulance came. If you ask me I'd say waiting on a potentially unsuccessful IM shot is far, far more risky than the harm caused by an incorrect iV, which is frankly negligible compared to the potential consequences of no naloxone i.e. brain damage/death

 

[alasdairm]

My claim that 5000 people ignored my post isn't true in a practical sense.

i don't think it was true in any sense

...but couldn't be bothered to type out a procedure that might save a life.

that's just one possible characterization. there are others.

...but at least he isn't dead on the floor of my flat.

indeed. that's the most important thing.

Clearly this batch is different, and I have already texted everyone I know who uses to warn them that the dude Dave bought off has some gear that put him in hospital.

good.

I understand that here at Bluelight you don't advertise as being a replacement for emergency care and/or real medical attention, I just hope you can empathize with an extremely frightened man turning in desperation to one of the only places he thought he would get some help.

of ourse i can.

I find it really, really surprising that you've been on Bluelight for over half the time I've been alive and that you didn't know that Naloxone was intended for intravenous use.

my drugs of choice are pot, mdma and cocaine for the most part. i wouldn't have the firs clue about nalonxone, let alone how to safely and correctly administer it.

Given that this was the alternative, what harm could you have possibly done by taking five minutes to briefly tell me how to hit a vein?

i have no idea how to hit a vein.

...but just didn't care enough to bother.

again, that's just one possible characterization. there are others.

...do you have any thoughts on either of the suggestions? Do you not think the sub/chat room would be a good addition to BL?

we're not, and have never intended, nor do we for now intend to be a real-time source. there's simply no practical way we could monitor such a channel and be assured it was doing more good than harm.

thanks for the feedback.

alasdair

 

[Rio Fantastic]

Yes, there are other interpretations (...or "characterizations" :S - a bizarre choice of word, but hey, potato potarto). Maybe out of the thousands of people who glanced at the thread title, absolutely none of them knew how to IV a substance. Maybe none of them spoke English. It's a pretty large stretch of the imagination though, and I don't know why you're trying to assert that Bluelight is some special place where everyone is lovely and cares and nobody is just uncaring & apathetic. I've come to terms with the fact I was being naive and optimistic assuming that out of the 1500 people that saw the thread I'd get a decent number of replies, but I'm not going to make enormous leaps of logic to try to explain it away in a way that doesn't involve just some people not giving a fuck. And why should they? I'm a stranger on the internet. I understand what you're saying about the chatroom - I guess there are similar reasons why there couldn't be a subforum devoted to emergency questions? I mean, it's not like there wouldn't be a demand for it, I see threads like mine or with similar problems ("help ive took drug x and drug y, will i be okay" "help my friend has taken drug x and is freaking out" "help ive drank 6 beers and taken drug x will i be okay" etc).

 

[swilow]

Consider this. If someone (not you) had asked the same question, would you have responded? Given that you did not know the answer, I would hope not. If you would have performed the same action as the "thousands" of non-respondents can you really blame them?

As you've noticed, Bluelight is not that effective in an emergency- but it really is not trying to be, and expecting such will lead to disappointment and possibly VERY adverse outcomes. Injecting heroin users should make an effort to know how to administer naloxone, waaay before they come to need that knowledge. Hopefully, you will understand how best to do so now, and will be able to spread that knowledge among your peers. If not, keep reading and asking questions BEFORE a crisis begins.

Always- the best and only service in acute emergency is the paramedics. In this sort of crisis, subjective answers are not going to assist you. You don't really need opinions, you need actions. Its bullshit that the illegal nature of drugs has for some reason made drug education taboo in many societies, but we can only play the hands we are dealt.

I'm glad that this turned out okay for your friend. I'm sorry that you had to experience that situation, and I hope you've gained some knowledge in case there is a next time. And, if you have gained knowledge, step up and share it!

For now, take it easy. You did everything correct in that situation because you called paramedics. Your friend probably owes their life to your actions. That's something to be proud of...

 

[dopamimetic]

Naloxone works intranasally (but not sublingual), it's too late now but think this is important to know nevertheless ... but yes, the half life of naloxone is very short (1-2 hours if I'm right) so it needs to be applied repeatedly until the causing opioid gets metabolised out.

This is the reason why I don't do opioids any more. Yeah, nobody wants to read that, but they are just too dangerous. No one dies off dissociatives when they are used with common sense, but when doing opioids death is always just one step behind ... I've had respiratory depression once and hospital admission what was just hell on earth, pure ignorance and overpaid stupidity in white smocks, and the fucking lawsuit is still pending thanks to the fucking idiot who called the police and I'll probably have to go into fucking jail because I didn't want to die ... my life is ruined now for sure & forever (at the very least I'm seriously planning to leave the country in the very soon future, before they make my trial and have to leave everything I lived and loved behind to get a chance to avoid torture and terror for not having hurt anyone).

Fuck prohibition. Fuck war on drugs. Sorry. Glad for you that all are still alive.

 

[BigG]

Hi mate, I'm a paramedic and have administered naloxone hundreds of times. I didn't see your post yesterday but have taken the time to post a comprehensive guide to administering naloxone. As for iv. Apply a belt or something to the upper arm to make the vein visible then slide the needle horizontally into the vein then pull back on the plunger until you see dark red blood enter the syringe then release the belt and slowly inject the drug. I've included a guide to im use as well. You really should have learned this before hand a nd if you can't administer naloxone stick to CPR until the ambulance arrives.

 

[maxalfie]

@Rio Fantastic I imagine that what happened that a day was a very scarey incident for all involved. To prevent this happenig again if you are going to be mixing with IV heroin users then i suggest you can make an appointment at your local Drug Service Provider (DSP) and then can teach you all you need to know about administering Naloxone if the occasion should ever arise again.
My DSP does give out Naloxone to folk who ask for it and my keyworker informed me that its use has already saved lives in our small town. I no longer inject heroin but i do have friends and neighbours that do so she has asked me to consider keeping some in my home in case one day of my neighbours is in dire need of help so i think i will do just that as i don't want to see any mother lose her son/daughter to an overdose that could have been prevented.