Pubdate: Mon, 09 Jul 2001
Source: Elizabethton Star (TN)
Copyright: 2001, Elizabethton Newspapers, Inc.
Contact:  http://www.mapinc.org/media/1478
Website: http://www.starhq.com
Author: Kathy Helms-Hughes

DRUG OVERDOSES KEEP PATHOLOGISTS BUSY

In the year 2000, Quillen College of Medicine conducted 323 autopsies 
in a morgue designed for 30, according to Dr. Gretel Harlan, forensic 
pathologist. The caseload is prohibitive, Harlan said. "We can't do 
them two at a time or anything.

The morgue just isn't equipped for it. It's too small and it wouldn't 
even be safe," she said. Many autopsies are conducted on persons who 
are believed to have died from drug overdoses and who did not receive 
medical attention in time because those present at the time they took 
the drugs "will not get medical help if they see that they're 
unconscious or can't be roused." "That is a chargeable crime," she 
said. "Even if you're the one that supplied the drug, and you're 
trying to get them help, the consequences are much less than if 
(police) find out later you gave them the drug and did nothing about 
it when you thought they were overdosing." Dr. Harlan said her office 
is beginning to see deaths related to such drugs as the 
continuous-release OxyCodone (OxyContin). With an OxyContin overdose, 
she said, "You basically go to sleep and forget to breathe.

And (the victim) is very savable if somebody can get to them. 
"Another thing is that some of these people are trying to shoot up 
things like these pain-release formulas.

When they do that, they are putting an awful lot of filler material 
that's used to slow down the release of the drug ... into their blood 
streams and depositing it into their lungs. "They're going to wind up 
with no blood flowing through their lungs and they're going to be 
either respiratory crippled or cardiac crippled if they just don't go 
ahead and die," she said. "Of course if anyone wants to overdose, 
they can just take more than their dosage.

But what they don't realize is that it's slow release.

You don't get a peak effect immediately. And because the onset is 
delayed, people will take more and more of them, and by the time they 
reach the peak effect, they may have taken an overdose and may die." 
Dr. Harlan said there are also problems associated with the drug 
Ecstasy. "We've not seen a whole lot of problem in the area yet, but 
it's beginning to show up. It seems like our youth are a little 
behind the rest of the country, but they eventually get to the same 
place. "Ecstasy doesn't kill in and of itself.

But because people forget to rest and forget to drink fluids and 
forget they overexercise, they basically work themselves to death," 
she said. "With cocaine, sometimes they can get very feverish, very 
hot, and the heart just overworks itself.

The bad thing about cocaine, even if it's somebody that's used to 
taking cocaine, they can take a normal amount for them, and all of 
the sudden, their heart will just respond wrong, and they will die," 
she said. The opiates morphine and methadone produce the same type 
reaction as OxyContin, according to Dr. Harlan. Methadone, which is 
used to treat opiate addicts, "has the same type of effect on the 
respiratory system.

You go to sleep and forget to breathe.

People who are used to taking it will require it in larger amounts 
than somebody that hasn't tried it or that hasn't had it in a 
prolonged period of time. "What happens in those cases, is that if 
somebody that's used to taking it gives it to someone else, and he 
says, 'I get my peak effect at however many tablets over whatever 
length of time,' the other person thinks, 'OK,' and takes that number 
of tablets and dies," Harlan said. Alcohol combined with opiates also 
causes respiratory suppression, she said.
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