# 21

Let's examine PCP and its long range effects...which can include death.

Unlike Heroin, Cocaine, Caffeine and Nicotine - which each have a known LD (Lethal Dosage) level for a 200 lb. man - PCP rarely produces fatalities following initial use...even with varying levels of substance administration.  As indicated below, "High doses of PCP can cause seizures, coma, and death (though death more often results from accidental injury or suicide during PCP intoxication).", but this substance is unique in several ways:

1.  Only 10% is excreted through the kidneys and the other 90% is re-circulated through an abuser's brain-prolonging its effect.

2.  Damage and lesions in experimental rat brains was not immediate but cumulative...suggesting that a human abuser may continue to use because he enjoys the effects while believing that the substance will not kill him.

3.  Hiding the abuse from a family physician may prevent the physician from having a serious discussion with the abuser regarding the cumulative deterioration and potential lethality of the substance.

Physical effects:

At low to moderate doses, the physiological effects of PCP may include a slight increase in breathing rate and a more pronounced rise in blood pressure and pulse rate. Respiration becomes shallow, and flushing and profuse sweating may occur. Generalized numbness of the extremities and muscular incoordination are common. The pupils are neither constricted nor dilated. Nystagmus (involuntary movement of the eyes) is a characteristic effect, and may be vertical, rotary, or horizontal. Motor symptoms are common and may include ataxia (impaired coordination of movement), athetosis (slow writhing movements), myoclonic jerks, and bizarre posture.

At higher doses, there is a drop in blood pressure, pulse rate, and respiration. This may be accompanied by nausea, vomiting, blurred vision, extreme nystagmus, drooling, loss of balance, and dizziness. High doses of PCP can cause seizures, coma, and death (though death more often results from accidental injury or suicide during PCP intoxication).

Treatment of PCP overdose is largely symptomatic and centers around increasing elimination. PCP is eliminated in the GI tract and then quickly reabsorbed, resulting in very long lasting effects. Oral administration of activated charcoal can therefore be helpful to bind it after elimination and remove it from circulation. Increasing the urine acidity by administration of ammonium chloride (or by drinking cranberry juice) also speeds elimination. If vital signs are stable and the primary symptom is confusion or agitation, it is best to reduce all sensory stimulation (such as touching and sound) as such stimulation may lead to an increase in disorientation. Agitation may be treated with valium. Phenothiazines such as haloperidol have been shown to decrease recovery time, but they may carry the increased risk of siezures (ref. 18).

https://erowid.org/archive/rhodium/chemistry/pcp/effects.html

# 20

State Forensic Labs gearing up for quick analysis and confirmation of Carfentanil; quick action needed because responders can die from trans-dermal absorption of a single grain or inhalation of a single grain of this illicit substance.

To illustrate the chasm which separates adult, self-administrating, abusers from Police and Medical responders; the professional adults who want to finish their shifts and return to their families are deeply concerned in knowing exactly what substance they are handling/coming into contact with  while the abusers either do not care or are trusting strangers along a path which begins with manufacture, distribution, lacing/cutting, smuggling and sale.

http://www.cnn.com/2016/08/24/health/elephant-tranquilizer-carfentanil-heroin/index.html

# 19

New finding in Prince Fatal OD death confirms what has always been known; Adult Substance Abusers are absolutely unaware of the qualitative and quantitative analysis of the substances they self-administer and Medical Examiners will always report the Death as accidental!

http://www.cnn.com/2016/08/23/opinions/prince-mislabeled-pills-cevallos/index.html

In this recent report, we learn that fentanyl is manufactured in China and shipped illegally to distributers in the US.  Additionally, we learn that "pill stamps" are readily available online and that crooks can press pills of Fentanyl which are labelled as something else.  These pills may then be packaged into bottles which are also mislabeled...all to thwart Law Enforcement and others from discovery of the true substance; usually until the self-administering adult is dead.

# 18 Age ranges from 18-59

26 adults given 2nd chance in life due to Police and Medical administration of antidote

Another instance where Naloxone administration by adults having sense provides an opportunity for 26 adults to re-order their lives and stop making potentially Fatal Decisions.

As in previous posts, the article does not address an aggressive pursuit of the dealers as well as their chemists/suppliers.

http://www.herald-dispatch.com/news/cabell-huntington-responders-were-ready-for-ods/article_0503ffe4-f0be-5513-9417-3bc26750ce43.html

# 17  Dealer selling Fentanyl as Heroin is convicted and jailed in homicide case.

http://bigstory.ap.org/article/e0574cb5db73484fb5d569b66192d144/prosecution-trend-after-fatal-od-dealer-charged-death

After reading the above article this week, I wrote the below email to the AP reporter:

Dear Ms. Cohen,

I read the referenced article and, as a former Narcotics Investigator in Virginia, I welcomed a trend that has States Prosecuting Dealers when their products result in deaths due to substances which are far more potent that the advertised substance; Heroin.

From a Journalistic/Human Interest perspective, I can appreciate why you focused on a victim (Ed Martin III) and a perpetrator/dealer (Michael Millette).

As a former Narcotics Detective, after reading of Mr. Millette's remorse, I have to wonder why the article did not reference the person(s) who Millette relied upon to obtain his supply of Fentanyl.  I doubt that it was cooked-up in some shoddy lab and I suspect that the substance was pharmaceutical grade and that some serious players are involved in intercepting this poison (from the point of manufacture) to sell it to distributors like Millette...for profit.  Surely Maine and Federal Authorities would welcome these facts from Mr. Millette...it may be time for Millette to sing, if he's truly remorseful.

On the other hand, if he is actively protecting his source, the readers have every right to question the degree of his remorse for Martin's death.

Perhaps a Part II will address this aspect of the case not referenced in your article.  I hope so.

Thank you,

Phil Hannum

Fairfax, Va

# 16  Three Videos addressing the Fatal Decision Topic

https://youtu.be/XQFxMCzsdx0

https://youtu.be/57nItxkO5uc

https://youtu.be/BIhapPB9qtk

# 15 Some families stop keeping their secrets and tell the truth regarding self-administration of fatal substances by adult family members.

The Washington Post has placed the below account on the front page of their August 1, 2016 issue.

Consistent with the three topics Coach Crain reminded us of during the pre-game prayer (In life we can choose our faith, our friends and what we put into our bodies) and referenced in earlier posts, the mother of Ryan - in the excerpt below - examines how her son's choice of friends should have been a flag to her that something in the son's life was amiss.  Similarly, this blog's posts are validated when the mother reports that her son, she learned, was injecting Heroin between his toes.

Finally, loved ones are surfacing as ones who deliberately seek truth over denial and express a desire to use the death of their loved one and his/her story as a motivation to save even just one life!

In this sense, the truth can be a blessing to the living.

https://www.washingtonpost.com/national/health-science/after-their-children-died-of-overdoses-these-families-chose-to-tell-the-truth/2016/08/01/b4e7c55a-38af-11e6-8f7c-d4c723a2becb_story.html?hpid=hp_rhp-top-table-main_additionobits-1045am%3Ahomepage%2Fstory

He’d recently become friendly with older kids in the family’s Manassas, Va., neighborhood. “I should have said no to these boys, but I didn’t realize they were swarming down on Ryan because they knew his mom was sick and would have opioids in the house,” she says.

Soon Ryan was smoking cigarettes, and then drinking beer and using marijuana. “Before we knew it, he’d become addicted to drugs.”

Heroin eventually became Ryan’s substance of choice — and now 21, he begged for help to defeat his addiction. Hawe says that her son, always compliant, completed more than two years’ worth of treatment and seemed to be on the right track.

On a bitterly cold afternoon in February, Ryan came home — happy and loving as usual — after a day on a construction job mixing mortar. He showered, grabbed his keys and headed out for a few errands — first to the bank, and then to the mall to buy his fiancee a Valentine’s Day gift.

At 6 the next morning, the phone rang in the Hawe home. It was a friend of Ryan’s, telling Hawe that he couldn’t rouse Ryan. “But there was no waking Ryan,” she says, “because he had been dead for hours.”

His cause of death was accidental fentanyl poisoning. Hawe says her son had injected the narcotic between his toes.

Within days, Robert Hawe had modeled his son’s obituary after one he’d seen elsewhere. The couple agreed that was important to tell people how Ryan died, to maybe change some minds about drugs.

“I had many miscarriages before he was born,” Lorretta Hawe says. “I always thought God had a purpose for him. If we reach even one person with his story, then maybe that’s it.”

# 14 Topping Fentanyl for fatal potency

In previous posts, we published accounts of overdose deaths, in the Buffalo, NY area, in which Heroin was cut with a powerful anti-canter pain medicine...a synthetic opioid known as Fentanyl.  It was Fentanyl abuse, self-administered by the adult known as Prince, which killed him and it was Fentanyl which killed one of a mother/daughter self-administering pair in the Buffalo-area report in July 2016.  Fentanyl, we learned, is 30-80 times more potent than the equivalent in Natural, refined, Heroin.

In late July, 2016, we learn that the creative authors of death have been lacing the Heroin they sell with an even more powerful synthetic opioid known as Carfentanil.  Due to the vast size of an elephant, a very potent synthetic drug is used to sedate (slow the respiration to sleep while not reaching coma/death) elephants and the drug is Carfentanil.  Veterinarians are so aware of this drug's risk that they take special precautions when they prepare to administer it in an approved setting for large animals.  They know that a mere drop of this drug can be fatal to a human and they wear protective clothing and protect their orifices from coming into contact with the drug.

So now, people who believe they are purchasing the natural substance Heroin (which has its own lethal dosage level), need to be mindful that they could be purchasing the drug which took Prince to death and they could also be buying a potent drug which sedates elephants and has killed people in Cleveland, Ohio.

http://www.clevescene.com/scene-and-heard/archives/2016/07/14/akron-police-chief-heroin-being-cut-with-elephant-sedative-88-overdoses-since-july-5