Ice, Ice, Baby, or How Not to Treat an Opiate Overdose

Kenaz

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From opiatedshamanism.blogspot.com​

James Mann's friend became unresponsive after consuming approximately 120mg of Oxycontin along with alcohol and marijuana. Mann, a 20-year old Norcross, Georgia man, decided he would awaken him. Alas, while his heart was in the right place his judgment was fogged by 160 mg of oxycodone. Thankfully, he was coherent enough to realize that he was in over his head after his efforts to rouse his friend failed.

When paramedics arrived on the scene, they discovered Mann's friend was indeed unconscious. He was also bleeding profusely as the result of injuries sustained when Mann had forced ice cubes into his rectum. The victim was transported to Gwinnet Medical Center: Mann was charged with misdemeanor reckless conduct after police determined that his actions constituted "a gross deviation of standard care."

Mann's efforts to awaken his friend with Frosty the Enema may elicit some chuckles. But many other opiate users labor under similar mistaken ideas. It is quite common for users to throw ice water on an unresponsive friend, put them under a cold shower or throw them in an icewater bath. But these methods will not bring a comatose user out of an overdose. While the initial jolt of ice may cause gasping, it will not dislodge the opiates from their receptors. Should the "treatment" persist it may cause hypothermia and shock, further complicating the situation. Perhaps most important is the time which is wasted: when someone stops breathing a few minutes may be the difference between recovery and permanent brain injury or death.

If you are in the vicinity of an overdose, the best thing you can do is seek medical attention. Unfortunately, many users do not receive aid - or receive it too late - because of heavy-handed law enforcement attacks on overdose victims and their companions. One answer to this problem is "Good Samaritan" laws which protect those who seek medical treatment for themselves or their friends. Another would be ready availability of Naloxone, a powerful opiate antagonist which can reverse an opiate OD within seconds. But while these ideas have gained traction in a few areas, they still face resistance from those who equate harm reduction with encouraging drug abuse.
 
Goodness gracious. Like it says, his heart was in the right place I suppose, but man... Ice in the anus? That's just hanus.

Kenaz- Congratulations on your writing success. I've noticed that when you post articles such as this one, you don't usually get a ton of responses. But I always enjoy reading things you put up, and I'm quite sure I'm not the only one. So please, keep it coming!
 
Stories like these are why I'm a huge proponent of more widely available intranasal naloxone sprays as a stop-gap until emergency services arrive.
 
Stories like these are why I'm a huge proponent of more widely available intranasal naloxone sprays as a stop-gap until emergency services arrive.

Wouldn't an intranasal spray require them to inhale? Tricky when you're unconscious.

I've always thought they should use a device similar to an epipen, except with naloxone in it. If somebody OD's you just have to pull the cap off the pen and jab it into their leg, will revive them until you can get them to hospital.
 
Wouldn't an intranasal spray require them to inhale? Tricky when you're unconscious.

I've always thought they should use a device similar to an epipen, except with naloxone in it. If somebody OD's you just have to pull the cap off the pen and jab it into their leg, will revive them until you can get them to hospital.

you are right sir
 
Its not required they inhale, you can spray it into the nostrils and it will absorb. These are already out and have saved many lives in some areas (Boston I want to say?) this isn't a theory. This works.
 
Excellent article.

The current state of things in which we are so far away from legalization (or even decriminalization) that something so simple and so potentially beneficial as a ready-to-use naloxone preparation is not available to junkies, and not even widely known of, outside of the medical community really bothers me. Just another reason why this has to change.

Also, OP, I like your writing style. Kudos.
 
^yeah I got intranasal dose of naloxone when I OD'ed. It wasn't bad either, I didn't notice precipitated withdrawal or anything. Might have just been the combo of a low dose of nal. and the hefty dose of benzos I took before OD'ing.

They really need to catch up on harm reduction. Naloxone is not going to get abused and it could save thousands of lives. I don't see the problem with giving addicts access to it.

And jesus fuck, I've heard about odd OD remedies before...but an ice cube in the ass??? Wtf! I mean really?
 
What is the argument that providing nalaxone to dope fiends will encourage drug use?

Like, do they even back that up with anything or did i just sum up the argument in one sentence?

Sickening.
 
@Morphonorconic: thanks for the kind words! It's always great to receive positive feedback for one's writing. Given the sad, sorry state of most contemporary "drug journalism," I'm hoping to put some solid information out there for posterity.

@Melange: while cold water may cause vasoconstriction and may get a reaction from someone who is nodding off, it will do nothing but harm in a genuine overdose situation.

@Allalong & caseface99: according to Illinois state representative Dennis Reboletti, who was instrumental in blocking an Illinois Good Samaritan bill: “You’re granting immunity to drug dealers. This won’t be protecting the people it’s meant to protect.”

And when I did more research on rectally applied ice (research I never expected to pursue, may I note?), I found this article, which suggests the "icewater enema cure" started with raver kiddies as a response to GHB overdoses.
 
Its not required they inhale, you can spray it into the nostrils and it will absorb. These are already out and have saved many lives in some areas (Boston I want to say?) this isn't a theory. This works.

Just wanted to reiterate this.

Also, depending on what opiate the person is OD'ing on and its half-life, repeated administrations of naloxone may be necessary. So continue to keep an eye out and make sure you have enough of the antagonist.
 
I agree that more access to Naloxone could save many lives. People should be aware though that there are risks with administering naloxone outside of a hospital without proper education. Rapid reversal of opioid effects can lead to an acute withdrawal syndrome (and also a risk of seizures and arrhythmias) so it's important that the dose be carefully titrated, which involves knowing how much to give at a time and then how long to wait before giving more. Given the short half-life, it's also usually necessary to keep giving naloxone (ideally IV infusion in hospital) until the opioid they overdosed on is sufficiently cleared, esp something like methadone with a long hl. Pretty simple advice that could easily be distributed.

I read that it also shouldn't be used in pregnant women due to risk of withdrawal in the foetus but if the alternative is the mother OD'ing...
 
I stuck ice in this girls vagina and rectum one time and she survived, I didn't even need to involve those exuberant medical workers
 
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