ER Docs on front line of drug epidemic

On Thursday, President Donald Trump declared the opioid crisis in America a “health emergency.” Emergency room personnel locally are also seeing an increase in drug use. Pioneer staff photo

BLACK HILLS — With the recent declaration that the opioid crisis is a “health emergency” by President Donald Trump, it comes as no surprise to Northern Hills emergency room personnel see first-hand how drug use ravages the health of users and the lives of their loved ones.

Dr. Patrick Tibbles, an emergency medicine specialist at Rapid City Regional Hospital discussed, the unwelcome trend.

“Emergency rooms in the Black Hills have seen a dramatic rise in the toxic effects of illicit and illegal drugs over the past 12 months, in epidemic proportions,” Tibbles said. “We are seeing meth and heroin overdoses occurring, synthetic marijuana, and in rare cases, ketamine, which is normally a medical anesthetic agent, sometimes manufactured and used for illicit purposes.”

Dr. Lee Bailey, emergency medicine specialist at Spearfish Regional Hospital, said that the number of toxic drug-related visits in his emergency room haven’t decreased, of late.

“I don’t know if we’re seeing more, but we’re not seeing any less,” Bailey said. “The types of drugs have changed. Years ago, it was bath salts and other recreational drugs, but that’s changed. Now we’re seeing more heroin because they synthesize fentanyl and put it in the heroin, and you can’t measure what the fentanyl is. Now it’s a different product which produces a bigger hit, a bigger rush. We’ve also seen a little bit of a rise in cocaine.”

Fentanyl, many times more potent than morphine, is commonly used following surgeries to help alleviate pain.

“Meth was a big surge, and it’s still there; we still see meth, but now it’s more expensive. People are going back to using heroin because it’s cheaper. Prescription drug abuse is always there, but it’s not as bad as it had been in years past and you don’t see overdoses on that as much. We may have seen a small increase in the number of heroin laced with fentanyl overdoses.”

At least one overdose patient arriving in the Spearfish Emergency Room per week is not uncommon.

“Over the course of any given week, at least one of us has seen one overdose,” Bailey said. “Some are severe, some are life threatening and need immediate emergency treatment. Some are symptomatic, they’re panicky, breathing rapidly, blood pressure is high, and we can give them medicine to calm them down. During a heroin overdose, they are not breathing. We see that weekly, which is sad to say. We’ve been seeing a lot of that for a long time. Fatalities are pretty rare. I haven’t seen one in quite a while.

In speaking with the Spearfish Regional Labor and Delivery Department, Bailey said that far too often, unborn babies are affected by drug use in the area.

“Monthly, they’ll see a baby born addicted to meth or some other type of recreational drug,” Bailey said. “Weekly, marijuana.”

Dr. Thomas Groeger of Lead-Deadwood Regional Medical Clinic said that the number one overdose seen in their emergency room is from alcohol.

“Next is methamphetamine, and there has been an increase over the past year in cold medicine mixed with pot,” Groeger said.

He added that medical professionals are trying to rethink the way pain medicine is administered in an attempt to alleviate the addictive effects of narcotics.

“What we’ve found is that chronically lowering the pain threshold causes more pain,” Groeger said. “We’re trying to get people off those types of medicines … trying to make it more and more difficult for people to get their hands on narcotics. We’re rethinking how we manage chronic pain.”

Worse yet, is the impact rising drug use has on the youngest residents of Hills-wide communities.

“It’s an unfortunate trend that we see, and I will say that these patients are getting younger and younger, and that’s bothersome,” Bailey said. “We’re seeing teenagers and even those in their mid-teens. To me, that’s bothersome. Looking back, when I was 14 or 15, I was worried about riding my bike and playing baseball. Not doing drugs. It seems odd to me.”

Tibbles said the most important thing to remember is that this is a community problem.

“It starts with prevention at home, followed up with vigilance and advocacy,” Tibbles said. “Remember, illicit drug use, whether meth or heroin, is a community problem, and we all need to work together to keep this vicious criminal with no regard to age, gender, or race, out of our communities.”

Tibbles added that Regional Health systems have strict opioid dispensing and monitoring in their emergency departments to reduce this threat to the community.

“We have been leaders in reducing opioid prescription medications and other controlled substances over the last 10 years,” Tibbles said. “We monitor it very closely. We have many patients in our narcotic monitoring program, in order to help us provide the best possible care without producing an addict or drug overdose.”

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