Friday, November 30, 2018

If You Can't Nar-Can

I worked for a manufacturer of pharmaceuticals for 30 years of my working career. Looking back on my personal experience in that venue is a dizzying and surreal experience. I promoted several products. Some of the list are Percodan, Percocet, Hycodan, Nubain, Narcan. The first four on that list are narcotics. Two of them are Oxycodone products and the last is the polar opposite of a narcotic. It is a narcotic antagonist and reverses the illicit effects of the first four.

Against the canvas of history those narcotics were once considered the good guys. If you were in moderate to severe pain your physician could use his pen to almost instantly relieve your pain. Nowadays in the new light of some grassroots campaigning we are in the midst of the Opiate Crisis. Percodan, Percocet, OxyContin, etc. are all bad guys now with this new perspective. The Opiate Crisis drum is being beaten all across America. Who created this crisis? Physicians who prescribed opiates irresponsibly? Pharmacists who dispensed opiates irresponsibly? The manufacturers who created these products and promoted them irresponsibly? Rarely does the end user bear any responsibility for the abuse feeding this crisis! In my opinion the only thing that has been creating this crisis are those down and out individuals that choose to start down the path of opiate abuse through their irresponsible search to take them out of the main stream. I really don't want to get a job nor to go to school. I would really rather inject heroin into myself, get high and sit around and beat on my drum all day. I am the poor, poor victim here. Society, commercialism and the free enterprise system have driven us all to this crisis. I am a victim of all that. Let's institute a government centered in Socialism and all this will go away. You want to talk about some jacked up thinking.

So we have our protagonist to our story now we have to introduce an antagonist. In most stories the antagonist is a bad guy. However this one is a good guy. The brilliant scientists who worked for the same company as I did created a unique analog to the opiate molecule. Up on the carbon chain they substituted an allyl chain for the carbon. What they got was a molecule that did the polar opposite of the opiate. Whereas the opiate killed people by occupying the nerve centers along the diaphragm thus inducing respiratory depression this product competed with the opiate at the receptor site and via competitive antagonism always won the fight to occupy the receptor. You could have a patient stop breathing during balanced anesthesia. The anesthesiologist might have gotten a little heavy handed with the fentanyl. At that point the physician ordered the administration of  Narcan ( naloxone HCl). The patient would miraculously start breathing again. Thus the phrase arose in medical circles, " If You Can't Then Nar-Can" 

This morning I read an article in our local muckraker about a policeman who encountered a heroin overdose patient who had stopped breathing. His local agency had just authorized all law enforcement people to carry Narcan in their emergency kits. So he gets his name in the paper for reversing the overdose caused by an addict exercising their right to imbibe the illicit drug of their choosing, in this case a narcotic of choice.

All the while, dear reader, a new sophistry has arisen. Another psychoactive substance the use of which could send you to prison 10 or more years ago has arisen to save us all. It is Tetrahydrocannibinol (THC) the psychoactive component of marijauna. As we learn from other states first comes medical use and then recreational use. All the while those who have aided and abetted its legalization get incredibly rich. We have just elected a new Ag Commissioner who is heavily engaged in the marijuana issue and will surely add to its burgeoning adoption by a beer drinking, weed smoking, opiate consuming public.

At the bottom line as always is the almighty $$$$. The prophet Isaiah, who lived roughly 3000 years ago said it pretty well in the 5th Chapter of his book "Woe unto them that call evil good and good evil; that put darkness for light and light for darkness; that put bitter for sweet, and sweet for bitter!"