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The Age of Fentanyl: Ending the Opioid Epidemic
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About The Age Of Fentanyl: Ending The Opioid Epidemic
Product Description Is there a way to end North America’s opioid epidemic? In The Age of Fentanyl, Brodie Ramin tells the story of the opioid crisis, showing us the disease and cure from his perspective as an addiction doctor working on the front lines. We meet his patients, hear from other addiction experts, and learn about the science and medicine of opioid addiction and its treatments. He shows us how addiction can be prevented, how knowledge can reduce stigma, and how epidemics can be beaten. Dr. Ramin brings the hopeful message that just as patients and health care workers rallied together to fight HIV one generation ago, a coalition of patients, advocates, scientists, doctors, and nurses is once again finding solutions and making plans to stem the overdose deaths, block the spread of fentanyl, and end the epidemic. Review A first-hand clinician’s account of one of today’s greatest social crises…. There are lessons here for everyone. ― Jeff Turnbull, Medical Director of Ottawa Inner City Health A fascinating, wise, and humane analysis of one of the most pressing health challenges of the 21st century. ― Steven Pinker, Johnstone Professor of Psychology, Harvard University, and author of Enlightenment Now. About the Author Brodie Ramin is a primary care and addiction physician. He is an assistant professor at the University of Ottawa and a Diplomate of the American Board of Addiction Medicine. Dr. Ramin lives in Ottawa. Excerpt. © Reprinted by permission. All rights reserved. Introduction The nurse on the phone told me Amber had been eating breakfast an hour earlier, she had seemed well, but now she was hardly breathing. She wouldn’t wake up. When I entered the room, she was unconscious. She looked so peaceful, her long black hair spread across the pillow. I placed an oxygen meter on her right index finger and saw the blue sapphire glow under her nails, the sign of hypoxia I had seen in my textbooks. The oximeter beeped into life and confirmed what we could see with our own eyes: Amber was dying. The most accurate sign of an opioid overdose is a person taking fewer than twelve breaths a minute. Try breathing only once every five seconds. If you wait too long, your brain stem takes over and forces you to breathe. Amber was breathing once every ten seconds. She had been admitted two days earlier to the third floor of the Toronto hospital where I was a fourth-year medical student on the internal medicine ward. Amber had come to the emergency room with a fever on Sunday night. Every part of her body hurt, and her chest felt heavy; she thought she had the flu. Her doctor knew she was using needles. It was 2009, and more men and women like Amber were walking into emergency rooms across North America with track marks, abscesses, and infections deep in their bodies. More were coming in by ambulance after overdosing, as well. Amber was anxious, especially when she was told she had a murmur in her heart. She said no one had told her that before. Not that she’d been to the doctor in a while. Her mother drank and her father was long gone. Her teachers cared about her, but she had left school and home at sixteen. The first time Amber snorted heroin, she forgot, for a while, about her mother, her absent father, the men who had hurt her, and the small room where she lived with her latest boyfriend. The heroin travelled to the opioid receptors in her central and peripheral nervous system. The opioid flooded her brain with the pleasure molecule dopamine. She felt no pain. It was like floating in a pool of warm salt water. She had been injecting for only a month when her fevers started. The heart murmur and the red sores on her arms, quickly identified as track marks by her doctor, led to the diagnosis of endocarditis, an infection in her heart, which took her some time to understand. A mass of bacteria was coalescing on her heart’s tricuspid valve, sending waves of bacteria and debris ricocheting through he
