Jan
29

Quotes – Pompous doctor stuff.

While cleaning my office, I came across some quotes I had written down while on clinical rotations in medical school. Here are a few of them.

“There are always ‘What else?’s’ in medicine. – It is really a pretty obnoxious specialty.”

-Gastroenterologist

“The longer they stay, the longer they stay.”

-Geritatrician, on hospital admissions

“Sometimes these things are erroneous and they get codified in the medical records, and further codified until they are legitimized.”

-Internist, on charting errors

Student in report: “The patient drinks two bottles of vodka a day.”

Reply from Critical Care Intensivist: “It’s nice to have a hobby.”

“A word to the wise, never tell a patient you will find an answer.”

-Medical Intern

“Did you see, that guy still has a dry-cleaning tag on his pants?”

-Medical student referring to lecturer from AstraZeneca.

“When the patient comes to your care they become your responsibility. Whatever someone did in the past is what THEY did.”

-Internist to residents

“We are pretty much overloaded with patients with no end in sight.”

-Internist, on inappropriate admissions

“Incarcerated persons get really good care in New Jersey – so get arrested and go to jail!”

-Internist, on primary care for homeless persons.

“If the river was an ocean, and I-uh was a duck, I’d swim down to the bottom, and never come up.”

-Patient with diagnosis of spinal cord compression

“When was the last time you saw a male flight attendant who shaves his body hair who was heterosexual?”

-Infectious Disease Specialist

“Most of the time you just sit and take it – whatever.”

Psychiatric Chief Resident, discussing getting hollered at by the past year’s chief resident for giving a mentally retarded boy a book on The Beatles. Since the child enjoyed the band so much, she felt it was a successful token economy reward for his good behavior and would allow him to leave the hospital and be transferred to a group home. The boy had schizoaffective disorder and was born to a schiophrenic woman who was raped while in Greystone hospital.

“She’s NBSB – No Boyfriend Since Birth”

-Psychiatrist on a patient.

“I wanted to kill myself but changed my mind at the last minute.”

-High school girl from broken household on her suicide attempt. She lay down on train tracks with intent to die, but as the train approached, let only her hands be amputated.

“The reason CEO’s aren’t diagnosed with antisocial personality disorder, is that they hadn’t met the requirement of being diagnosed with conduct disorder as children. Otherwise, they do violate the rights of others”.

-Medical Student

“There is so much new Psych bullshit: grief is now limited to two months, seasonal affective disorder is now treated with MAOI’s, ADHD for adults is suddenly a disease, atypical antipsychotics are now being given for depression.”

-Medical Student

“That lady was just operated on with a Walgreen’s receipt stuck to her ass!”

-Medical Student

“Aw c’mon! That is like getting an arrow through the neck and finding a gas bill attached!”

-Intensivist on a critical patient in ICU, suddenly found to have a pancreatic mass.

“If you’ve finished your CT surgery residency and people still like you, you’ve done something wrong.”

-Surgeon

“I don’t know why people who think they are the greatest bosses in the world want everyone to STOP working when they walk in the room.”

-Medical Student

“I have a patient who is 5′ 1”, 349 pounds, and she thinks her bad knees are from her hysterectomy.”

-RN, on patient

Apr
21

Piles – Remedies which literally “act like magic”. circa 1900

Current day product.

Hello again!

You know, an aunt once told me that it was believed that sitting on the cold ground would give one “the piles”, i.e.; hemorrhoids. Below is an excerpt from the Home Treatments section of a favorite turn of the century medical text, “Domestic Medical Practice”.

*DISCLAIMER: These are not modern treatments. If you really do have piles, see your doctor please.

PILES. Calomel and Lard Remedy

A half ounce of Lard beaten with a dram (teaspoonful) of Calomel applied as a salve on cotton has cured obstinate cases.

PILES. Witch Hazel Remedy

Extract of Witch Hazel on a wad of cotton, laid on the piles at night, will act like magic; use it until cured.

PILES. Cranberry Remedy

A free diet of cranberries is said to be a complete remedy.

ITCHING AND PAINFUL HEMORRHOIDS; ALSO PILES

Fluid extract Echinacea (Purple Cone Flower)

Directions: Apply the extract to the parts on aseptic cotton or boiled lint; or inject a teaspoonful in pint of water into the rectum.

ITCHING AND PAINFUL HEMORRHOIDS; ALSO PILES

The following wash is highly beneficial:

Fluid extract Lobelia………………..one ounce

Fluid extract Baptisia………………..one ounce

Zinc sulphate…………………………..one ounce

Water……………………………………..thirteen ounces

Mix. Dose: Shake well. Use frequently as a wash.

ITCHING PILES

A solution of a teaspoonful of powdered Alum to a glass of water applied frequently will relieve.

PILES

If inflammation and severe pain are present, a poultice made of Slippery Elm bark and sprinkled with a teaspoon of Laudanum, will give relief.

PILES

The following prescription will often cure:

Flowers of Sulphur………………..one teaspoonful

Vaseline………………………………one tablespoonful.

Mix. Apply two or three times a day. Note: The bowels should be kept soft with saline purgatives and diet looked after. No alcoholic drinks or foods that tend to constipate should be taken.

Feb
24

Landmines

History of the Landmine

Modern landmines are said to have first found their way into major use during World War II. Specialized explosives designed to destroy primarily tanks were laid underground, and these devices were termed anti-tank mines or AT’s. Approximately 300,000,000 mines were deployed during this war, and with the awareness that they could often be possibly removed or defused by the opponent, smaller anti-personnel mines, or AP’s were deployed amongst the AT devices to serve as an additional deterrent. (1)

The name “mine” likely originates from the earlier historical concept of using engineers and diggers to place explosives underground, setting them off as troops passed over. These underground killers serve a number of tactical purposes in combat operations. Among these include the basic idea of slowing, harassing or terrorizing land forces as well as directing an enemy to a particular direction or providing for defense across vast areas too large to station numerous troops. Today numerous and difficult to detect anti-personnel mines lay hidden on our planet waiting for an innocent person to unintentionally trigger them. (2)

Landmines and unexploded ordnance (UXO) are among what is known as ERW or the Explosive Remnants of War. They are considered particularly abhorrent in the indiscriminate destruction that they cause. As the author of this blog post I must report that I maintain a small but highly significant level of expertise in very specific aspects of ERW. However, ridding the world of landmines has become a major challenge in which many thousands of individuals from all over the world have been fighting to overcome. I will reference a variety of these actors in this brief article (which is by no means exhaustive) but meant to serve as an introduction to one of many major public health problems that threaten us today. Though diseases such as Diabetes are possibly more destructive in terms of numbers affected, most of us still enjoy the option of choosing water over sugary soft drinks – but the situation with landmines is different. I feel that they serve as a cruel message to mostly poor and powerless people. A message stating: “Welcome to your new world, a world of violence, where you can expect to be in constant fear in your own home from a threat you will be given little insight into – your resistance is futile.” This theme take many forms in our world and should cease. Landmine elimination is therefore no exception.

Ground Truths

Landmines and UXO remain active and viable threats for decades after the cessation of conflict. Every year about 800 people are killed and 1200 maimed by landmines – 90% are civilians, and at least 300,000,000 mines remain unexploded today – a number close to the original amount deployed in the 1930′s and 40′s. (3,4) In Iran for example a specific 10,000 acre area has been identified as containing 16,000,000 landmines.(5) Though they are all designed to maim or kill the passer-by who triggers them, they can all be designed somewhat differently and hence divided into four major categories: Blast, Fragmentation, Directional Fragmentation and Bounding varieties. An example of a few models is assembled in the image below.

They are often scattered in dense minefields and can be triggered by various predetermined levels of heat, pressure, time or tripwire. AP mines can range in weight from three ounces to perhaps five pounds. They may be composed of plastic, ceramics and/or specialized metallic materials which make them virtually undetectable by conventional means. (6,7,8) They come in many shapes, sizes and colors and can have an inconsistent appearance due to weathering and rust. (9)

Medical Issues

Many hundreds of injured people receive below the knee (BTK) amputations as a result of traumatic injuries inflicted while working in their own communities. People most often have instant amputations, limb penetrating injuries, frequently involving fracture or destruction to the tibia, calcaneus or femur and often accompanied by torso-penetrating injuries and pneumothorax. Patterns of Injury have been proposed and divided into three categories.(10)

In Pattern One Injury there is traumatic amputation of a limb or limbs, often from Blast-type mines which destroy all of the foot (or feet) and part of the leg. The resulting damage also tends to impregnate soil, clothing and vegetation into the wound which often requires further amputation or debridement.

Pattern Two Injury is characterized by a multiple laceration pattern, usually via explosive projectiles from UXO or Fragmentation-type mines. The nature of this ordnance often results in instant death based on proximity to explosion by default.

Pattern Three Injury relates to the upper body and results in amputation of hand or hands as well as damage to head, face and chest. This type is frequently associated with the inappropriate handling of ERW.

A large majority of victims are children, most of whom die before receiving emergency care. Children have small bodies that are close to the source of explosion and cannot withstand the impact. They are often far from home during the trauma and sometimes not found by others until considerable time has passed. The regions of the world afflicted tend not to have the acute care facilities necessary to handle the complicated injuries, and the long-term rehabilitation needs also often go unmet. It has been noted that the growth of childrens’ bones which outpaces that of soft tissue results in the need for numerous surgical interventions over a period of years and hence additional levels of vulnerability are added to the disastrous picture including: the need for blood, the prevention of infection, the application of prosthetic devices and support for the family. (11)

Personal Accounts

“A girl at the back of the bombed-out classroom was busy examining her newly-fitted artificial leg. One boy had lost his right hand and left eye and was showing a dummy landmine to his classmates….When I think of Afghanistan now there are no romantic visions of a fiercely proud nation, the mysterious Khyber Pass or the historic defeat of the British Empire or the Soviet Union. The images that remain are of children clearing mines an arm and a leg at a time, without limbs, without hope and without a future.” (12)

“After the explosion, I first remember seeing a foot lying on the floorboard of the car. I remember thinking: ‘Is it mine?’ It was. It was my right foot. I remember that I kept trying to put it back on, but it kept falling off. Then I looked at my left foot. The top part was ripped off and I could see bones going to my toes, one of which was missing. - Ken Rutherford (13)

We earn the living by collecting firewood with 20-40 bahts a day (less than $ 1). I stepped on a landmine at 9.30 AM on February 25, 2003. After collecting the firewood with my husband and four other villagers, I was 200 m away from my house. At that time I was three month pregnant. The blast destroyed my both legs, and tossed my body one meter high up before falling down on my bottoms. I was brought by motorbike to the district health center in Poipet for first aid. The health center charged me 300 bahts ($ 8), but we could not afford to pay it because we are so poor. Luckily an international NGO car passed by and brought me to the provincial hospital in Mongkul Borey, 57 km from Poipet. At 12.00 I arrived at the hospital, but the doctors did not treat me right away because we could not pay the charge of 5300 bahts ($ 123) for the amputation.

One and half hour later, they amputated my both legs below knees after my husband promised them to pay the bill. He tried to borrow money from the neighbors, and was able to collect 3300 bahts only ($ 80). I stay in the hospital for 17 days. Even though my wound had not been healed completely, I went home because I was not happy with the treatment. On August 7, 2003, I delivered a healthy boy baby, which my husband gave him a name Nhim Meun. – Yan Lay (14)

Action Against Mines

One of the obviously necessary actions includes mine clearance or “de-mining”.(15) Though sometimes performed by the military, this slow, expensive and not entirely comprehensive process is often performed by humanitarian agencies for the purpose of protecting civilians. It can take 100 times longer to remove a mine than to place one, and though the cost of manufacturing one mine might be as low as $3, the final removal cost of perhaps $1000 per unit is not uncommon. (16)

The president of Mozambique stated, ” In view of the three generations of landmines implanted in our territory. . . my people live in uncertainty and permanent fear, which prevent them from effectively using vast areas of arable land. . . .Demining and destruction currently take place at the pace of only 11,000 per year, thus requiring approximately 160 years to clear all of them.” (17)

Whether performed by military de-miners or engineers operating in a civilian capacity, UXO and landmines are discreet entities and are indeed treated differently in terms of clearance. Different burial scenarios, ordnance configurations and safety precautions as well as detecting technologies and environmental remediation considerations exist between these two categories of ERW. (18) Though there is a benefit to separating these two strategies for the purposes of clearance methods, my personal concern is that while the military may take a more active role in remediating UXO, the problem of landmines may become the sole “responsibility” of the humanitarian agencies. Thankfully, these organizations are aware of not only the mortality and morbidity caused by landmines, but also the loss of usable land, access to infrastructure and decreased productivity that is associated with landmine infested regions. They have been so far willing to provide support accordingly. (19)

The Work Process

The tedious mission of removing landmines begins with education of the public and training of specialized personnel. The Cambodia Landmine Museum has become an interesting point of focus in terms of public education. They not only provide information for rural inhabitants and tourists but also aid de-miners, victims and their families by providing a home and school. Their goal is total landmine and UXO removal in Cambodia.

The steps involved in clearing land require a great deal of time as well. Surveying must be performed, a process which then designates areas of highest risk to be dealt with first. Ground vegetation must be carefully cleared and de-miners must use specialized sensing equipment, sometimes employing dogs or rats as aids in the detection process. Eventually the items are deactivated, removed and destroyed.

It has been stated by The World Bank that operations in Afghanistan had to the year 2002 been rewarding – One U.S. dollar provided for $4.60 in economic returns. In addition, a cleared square kilometer provided for $2000 of grazing land while 50 straight kilometers of roads cleared allowed for $250,000 in economic benefit. The mine clearance activities until that time allowed for 1,500,000 refugees to return to previously abandoned regions. The international anti-mine community continues to work in order to not only clear mines but to support survivors and prevent the manufacturing of new anti-personnel weapons.

The Antipersonnel Mine Ban Convention

In 1999 an international movement led to what is known as The Ottawa Convention, an international ban on landmines with a goal of providing for worldwide clearance and a cessation to production and destruction of current stockpiles.

While over 100 countries agreed to the treaty, many including The United States, China, India, Iran, Israel, North & South Koreas, Nepal, Saudi Arabia and United Arab Emirates have not. It has been suggested that defensive barriers between the Koreas are a major sticking point for some of the aforementioned, non-signatory states. Other sources of information may be found at:

-ADOPT-A-MINEFIELD at: www.landmines.org

-INTERNATIONAL CAMPAIGN TO BAN LANDMINES at: www.icbl.org

-CLEAR LANDMINES FOR FREE at: www.clearlandmines.com

-E-MINE: ELECTRONIC MINE INFORMATION NETWORK at: www.mineaction.org

See the Film clips under the “Environment” Tab.

CITATIONS

(1) Cluster Bombs, Landmines, Nuclear Weapons and Depleted Uranium Weapons. A report on the financial links between banks and the producers of controversial weapon systems. April 2004 This report is part of the campaign ‘My Money. Clear Conscience?’ A campaign of Netwerk Vlaanderen vzw, in cooperation with Forum voor Vredesactie, For Mother Earth and Vrede vzw

(2) Landmines Policy. ADOPTED 1993, REVISED AND RE-ENDORSED IN 1997, 2001, 2004, 2005 AND 2008. Annual General Meeting (AGM) of the Public Health Association of Australia.

(3) Operations. Hidden killers: the global landmine crisis. Washington, DC: US Department of State, Bureau of Political-Military Affairs; 1994.

(4) International Committee of the Red Cross. Antipersonnel mines: an overview 1996. Geneva, Switzerland: International Committee of the Red Cross; 1996.

(5) Amputations Due to Landmine and Unexploded Ordnances in Post-war Iran. A. Soroush et al. Arch Iranian Med 2008; 11 (6): 595 – 597

(6) INCLUSIVE SECURITY, SUSTAINABLE PEACE: A TOOLKIT FOR ADVOCACY AND ACTION © Hunt Alternatives Fund and International Alert 2004.

(7) Landmine Monitor Report 2003: Toward a Mine-Free World. Washington, DC: International Campaign to Ban Landmines, 2003. 4 September 2004

(8) Landmines and Human Security: International Politics and War’s Hidden Legacy. Edited by Richard A. Matthew, Bryan L. McDonald and Kenneth R. Rutherford. State University of New York Press.

(9) Cleanup of Chemical and Explosive Munitions: Locating, Identifying the contaminants, and Planning for Environmental Cleanup of Land and Sea Military Ranges and Dumpsites. Richard Albright. William Andrew Publisher 2008.

(10) Understanding Landmines and Mine Action. September 2003 Prepared by Robert Keeley. minesactioncanada.org

(11) Green Teacher, #69, Fall 2002.

(12) Posted in: Free the Children International/Youth Ambassadors for Peace Project. United Nations Office of the Special Representative for Children and Armed Conflict. Jonathan White.

(13) Story of Ken Rutherford, co-founder of LSN Landmine Survivors Network

(14) Story of Yan Lay, posted in: Jesuit Service Cambodia, http://www.jrscambodia.org/index.html

(15) UN International Guidelines for Landmine and Unexploded Ordnance Awareness Education

(16) Machel, Graca. Impact of Armed Conflict on Children. New York: UN, 1996. 4 August 2004

(17) Statement by the President of the Republic at the Opening of the First Meeting of States Parties to the Ottawa Convention, May 3, 1999, Maputo, Mozambique.

(18) The Leading Edge, 16 (10), p. 1460.

(19) UN MINE ACTION SERVICE at www.mineactionstandards.org

Feb
11

Plumpy’nut – A discussion on ready-to-use therapeutic foods. (coming up)

RUTF — Must it taste good?

Research is being done on the subject.

Public Health Nutr. 2011 Feb 4:1-8. [Epub ahead of print]

A qualitative investigation of adherence to nutritional therapy in malnourished adult AIDS patients in Kenya.

Dibari F, Bahwere P, Le Gall I, Guerrero S, Mwaniki D, Seal A.

1Valid International, 35 Leopold Street, Oxford OX4 1TW, UK.

Abstract

OBJECTIVE: To understand factors affecting the compliance of malnourished, HIV-positive adults with a nutritional protocol using ready-to-use therapeutic food (RUTF; Plumpy’nut®).

DESIGN: Qualitative study using key informant interviews, focus group discussions and direct observations.

SETTING: Ministry of Health HIV/programme supported by Médecins Sans Frontièrs (MSF) in Nyanza Province, Kenya.

SUBJECTS: Adult patients (n 46) currently or previously affected by HIV-associated wasting and receiving anti-retroviral therapy, their caregivers (n 2) and MoH/MSF medical employees (n 8).

RESULTS: Thirty-four out of forty-six patients were receiving RUTF (8360 kJ/d) at the time of the study and nineteen of them were wasted (BMI < 17 kg/m2). Six of the thirteen wasted out-patients came to the clinic without a caregiver and were unable to carry their monthly provision (12 kg) of RUTF home because of physical frailty. Despite the patients’ enthusiasm about their weight gain and rapid resumption of labour activities, the taste of the product, diet monotony and clinical conditions associated with HIV made it impossible for half of them to consume the daily prescription. Sharing the RUTF with other household members and mixing with other foods were common. Staff training did not include therapeutic dietetic counselling.

CONCLUSIONS: The level of reported compliance with the prescribed dose of RUTF was low. An improved approach to treating malnourished HIV-positive adults in limited resource contexts is needed and must consider strategies to support patients without a caregiver, development of therapeutic foods more suited to adult taste, specific dietetic training for health staff and the provision of liquid therapeutic foods for severely ill patients.

PMID: 21294939 [PubMed - as supplied by publisher]

Feb
11

“The psychosis is impressive” – Bath salts follow-up

More news as our “Not Up To Snuff” article continues.
Reprinted from Business Week .com — Executive Health February 04, 2011, 09:00

Hallucinogens Legally Sold as ‘Bath Salts’ a New Threat

These products can spur self-destructive ‘highs’ but are legal in most states, experts warn

By Amanda Gardner
HealthDay Reporter

FRIDAY, Feb. 4 (HealthDay News) — An influx of highly hallucinogenic, potentially lethal but — in most states — fully legal drugs sold as “bath salts” has law enforcement and drug abuse experts very concerned.

According to Mark Ryan, director of the Louisiana Poison Center, in the first month of 2011, there have already been 248 bath salts-linked calls nationwide from at least 25 states, compared to 234 calls during the whole of 2010.

The $20 packets are available in corner stores, truck stops and on the Internet, and marketed as bath salts or sometimes plant food and come with the (often-ignored) disclaimer, “not for human consumption.” They’re not subject to regulation even though they contain various potent chemicals, including mephedrone, which is a stimulant.

“It’s a derivative that’s very similar to amphetamines, and its side effects are largely the same side effects we see with amphetamines in large dose,” said Jeffrey Baldwin, professor of pharmacy practice and pediatrics at the University of Nebraska Medical Center in Omaha, which seems not to have experienced this scourge — at least not yet. “[Those side effects] would be increased heart rate and blood pressure, not sleeping, not eating and eventually becoming paranoid.”

The “salts” come with gentle-sounding names like Ivory Wave and Vanilla Sky and are typically snorted, smoked, injected and even mixed with water as a beverage.

“If you take the very worst of some of the other drugs — LSD and Ecstasy with their hallucinogenic-delusional type properties, PCP with extreme agitation, superhuman strength and combativeness, as well as the stimulant properties of cocaine and meth — if you take all the worst of those and put them all together this is what you get. It’s ugly,” added Ryan, who recounted some harrowing stories.

“The psychosis is impressive,” he said.

One man barricaded himself in an attic with a rifle, Ryan said, vowing to “kill the monsters before they kill me,” while another user vowed to remove their own liver with a mechanical pencil.

The products have also been linked to suicides, not to mention hospitalizations, and on Tuesday investigators confirmed the presence of bath salt drugs in the blood of a man who killed a sheriff’s deputy in Tippah County, Miss., ABC News reported.

Once an addled user gets to the emergency room, they’re not controllable with normal sedatives such as valium, even in high doses, Ryan noted.

And when doctors try to wean patients off stronger sedatives or even antipsychotic medications, they just become uncontrollable again. “The longest I heard was someone who was sedated for 12 days and the psychosis came right back,” Ryan said. “The huge concern is the possibility that some of these effects could be permanent. We don’t know because we’ve never tested it on humans.”

At least with older drugs, sedation works and the patient returns to “normal,” at least until they hit the streets again.

Also worrisome is the fact that while all of the products “have the same basic chemical structure,” small changes in the chemical composition give you different side effects, which clinicians then have to learn how to deal with.

Despite these trips — which users readily admit are horrible — the cravings are so intense they often go back to the drug.

Louisiana has already banned the products, via a decree from the governor’s office that recently made them a Schedule 1 substance, putting them in the same class as heroin. Now law enforcement officials in that state — and Florida, which enacted a similar decree — can do more than just charge people with a misdemeanor for using or selling the fake bath salts.

Federal regulation of the products could take much longer. “We are actively studying and researching the abuse data to see if [the compounds in 'bath salts'] warrant scheduling. We evaluate the addictive potential and the harm to the user,” explained Rusty Payne, a spokesman for the Drug Enforcement Administration (DEA). “But we are not the only agency involved — the Department of Health and Human Services is also involved. It can take years, though it may not.”

The agency is also looking into whether it should try to get a 12-month emergency rule to control the substances, he said.

In the meantime, lawmakers in Mississippi are close to enacting a ban on the bath salt drugs there, and this week a measure to outlaw the products neared passage in Kentucky, according to the AP.

New York Senator Charles Schumer has also called for a ban on the products and White House Drug Czar Gil Kerlikowske spoke out against the products earlier this week.

But officials and doctors may still be facing an uphill battle.

When the ban in Louisiana went into effect, “calls dropped off the cliff but in the last four days we’ve had one each day, so it’s starting again,” Ryan said. In part, people are getting around the ban by ordering the products off the Internet and having them shipped to neighboring Mississippi, which has not yet outlawed them.

More information

There’s more on dangerous drugs at the U.S. National Institute on Drug Abuse.

SOURCES: Jeffrey Baldwin, Pharm.D., professor, pharmacy practice and pediatrics, University of Nebraska Medical Center, Omaha; Mark Ryan, Pharm.D., director, Louisiana Poison Center; Rusty Payne, spokesman, Drug Enforcement Agency, Washington, DC; Jan. 23, 2011, Associated Press; ABC News

Copyright © 2011 HealthDay. All rights reserved.

Jan
26

Not Up To Snuff.

How many of you knew that “bath salts” were being snorted by some for recreational highs?


Well these products, some of which are pictured above, are nothing less than substituted cathinones which act as norepinephrine-dopamine reuptake inhibitors, and yes, they have killed people via insufflation and inhalation. Some users have openly reported that home tests for amphetamines have not been sensitive in the detection of these products. With the added understanding that the chemicals are not presently controlled substances in most of The United States, the potential for illicit use therefore is presently quite high — and a general assumption would be to expect adverse effects similar to those found in other drugs of the NDRI class: Survector, Bupropion, Wellbutrin, Ritalin and Concerta. — Reactions could therefore include a sympathomimetic toxidrome of tachycardia, hypertension, drowsiness, lethargy, agitation, nausea, vomiting, delrium and seizures.

The Washington Post recently printed an AP article on this matter and I have re-posted it here.

Officials fear bath salts becoming the next big drug menace

By Sheila Byrd
Sunday, January 23, 2011; A07

FULTON, MISS. – When Neil Brown got high on bath salts, he took his skinning knife and slit his face and stomach repeatedly. Brown survived, but authorities say others haven’t been so lucky after snorting, injecting or smoking powders with such innocuous-sounding names as Ivory Snow, Red Dove and Vanilla Sky.

Law enforcement agents and poison control centers say the bath salts, with their complex chemical names, are an emerging menace in several U.S. states where authorities talk of banning their sale. Some say their effects can be as powerful as those of methamphetamine.

From the Deep South to California, emergency calls are being reported over exposure to the stimulants the powders often contain: mephedrone and methylenedioxypyrovalerone, also known as MDPV.

Sold under such names as Ivory Wave, Bliss, White Lightning and Hurricane Charlie, the chemicals can cause hallucinations, paranoia, a rapid heart rate and suicidal thoughts, authorities say. In addition to bath salts, the chemicals can be found in plant foods that are sold legally at convenience stores and on the Internet. However, they aren’t necessarily being used for the purposes on the label.

Mississippi lawmakers this week began considering a proposal to ban the sale of the powders, and a similar measure is being sought in Kentucky. In Louisiana, the bath salts were outlawed by an emergency order after the state’s poison center received more than 125 calls in the last three months of 2010 involving exposure to the chemicals.

In Brown’s case, he said he had tried every drug from heroin to crack and was so shaken by terrifying hallucinations that he wrote to one Mississippi paper urging people to stay away from the bath salts.

“I couldn’t tell you why I did it,” Brown said, pointing to his scars. “The psychological effects are still there.”

While Brown survived, sheriff’s authorities in one Mississippi county say they believe one woman overdosed on bath salts there. In southern Louisiana, the family of a 21-year-old man says he cut his throat and ended his life with a gunshot. Authorities are investigating whether a man charged with capital murder in the December death of a Tippah County, Miss., sheriff’s deputy was under the influence of the bath salts.

The stimulants are not regulated by the Drug Enforcement Administration, but are facing federal scrutiny. Law officers say some of the substances are being shipped from Europe, but origins are still unclear.

Gary Boggs, an executive assistant at the DEA, said there is a lengthy process to restrict these types of designer chemicals, including reviewing the abuse data. But it’s a process that can take years.

Mark Ryan, director of Louisiana’s poison control center, said he thinks state bans on the chemicals can be effective. He said calls about the salts have dropped sharply since Louisiana banned their sale in January.

Ryan said cathinone, the parent substance of the drugs, comes from a plant grown in Africa and is regulated. He said that MDPV and mephedrone are made in a lab and that they are not regulated because they are not marketed for human consumption. The stimulants affect neurotransmitters in the brain, he said.

The drugs cause “intense cravings,” he said. “They’ll binge on it three or four days before they show up in an ER. Even though it’s a horrible trip, they want to do it again and again.”

Ryan said at least 25 states have received calls about exposure, including Nevada and California. He said Louisiana leads with the greatest number of cases at 165, or 48 percent of the U.S. total, followed by Florida with at least 38 calls to its poison center.

Rick Gellar, medical director for the California Poison Control System, said the first call about the substances came in Oct. 5, and a handful of calls have followed since. But he warned: “The only way this won’t become a problem in California is if federal regulatory agencies get ahead of the curve. This is a brand-new thing.”

In the Midwest, the Missouri Poison Center at Cardinal Glennon Children’s Medical Center in St. Louis received at least 12 calls in the first two weeks of January about teenagers and young adults abusing such chemicals, said Julie Weber, the center’s director. The center received eight calls about the powders all of last year.

Richard Sanders, a general practitioner working in Covington, La., said his son, Dickie, snorted some of the bath salts and endured three days of intermittent delirium. Dickie Sanders cut his throat but missed major arteries. As he continued to have visions, his physician father tried to calm him. But the elder Sanders said that as he slept, his son went into another room and shot himself.

“If you could see the contortions on his face. It just made him crazy,” Sanders said. He added that the coroner’s office confirmed that the chemicals were detected in his son’s blood and urine.

Sanders warns that the bath salts are far more dangerous than some of their names imply.

“I think everybody is taking this extremely lightly. As much as we outlawed it in Louisiana, all these kids cross over to Mississippi and buy whatever they want,” he said.

A small packet of the chemicals typically costs as little as $20.

In northern Mississippi’s Itawamba County, Sheriff Chris Dickinson said his office has handled about 30 encounters with bath-salts users in the past two months alone. He said the problem grew last year in his rural area after a Mississippi law began restricting the sale of pseudoephedrine, a key ingredient in making methamphetamine.

Dickinson said most of the bath-salts users there have been meth addicts and can be dangerous when using them.

“We had a deputy injured a week ago. They were fighting with a guy who thought they were two devils. That’s what makes this drug so dangerous,” he said.

But Dickinson said the chemicals are legal, leaving him no choice but to slap users just with a charge of disorderly conduct, a misdemeanor.

Kentucky state lawmaker John Tilley said he’s moving to block the drug’s sale there, preparing a bill for consideration when his legislature convenes shortly. Angry that the powders can be bought legally, he said: “If my 12-year-old can go in a store and buy it, that concerns me.”

- Associated Press

Officials fear bath salts becoming the next big drug menace

Jan
02

What is “Colorspace”?

Traditionally the term colorspace refers to how people describe parts of the visible color spectrum.

Like on a map, one can determine where specific frequencies of light exist among a varied terrain — and perhaps like roads that connect cities, describe features which they share in common.

Here, we seek to describe the interconnectedness of many things.

In great ages such as The Enlightenment, before Art and Science were made to be separate entities, a new excitement for the possible began to glow.

The world was found to be, not a continuum of simplicity, but a realm of relatedness.

In celebrating these ideas, I have created a place to share my color photography as well as some of my interests and experiences.

Dec
28

Welcome!

Behold the new Colorspace site for 2011!

It has been a while since we’ve had regular postings, but prepare yourself for some great fun.

This year, we will be publishing:

  • Humorous passages from the turn of the century tome “Domestic Medical Practice”
  • Never before seen photos from The Spring Valley, FUDS site.
  • A primer on Poisonous Mushrooms.
  • Many new photos, oddities, funny stuff.