August 17, 2023
Speaker: Dr. Charles Denham
Dr. Botz, thank you so much for taking time with us today to address this critical issue of a rising freshman in high school or rising freshman in college.
Specifically, can you help us understand the threat of the materials that are put in these e-cigarettes, nicotine and THC and then the counterfeit pills and what our kids are really facing these days?
Speaker: Dr. Gregory Botz
Well, I think that’s a really important question. You know, as a father of recent college graduate, I’ve gone through this recently and I have a lot of concerns about the things that our kids are exposed to when they go to college.
College is a great experience, but they also have, you know, the opportunity to explore things and I think we all did that when we were in college. Just the consequences are more dire now than they were ever before.
With the advent of e-cigarettes or vape pens, there is the capability to get very high concentrations of either nicotine or THC or other agents into the lungs very rapidly, which can cause very high levels of those agents and cause consequences.
It’s not the same as, you know, smoking marijuana in a bong or in a joint. These can be extremely high concentrations of THC that get to the lung tissue and get into the bloodstream, go to the brain and have dire consequences.
At the same time, there’s a really very chilling effect going on in society now with these drugs that are added to a variety of different agents, particularly things like fentanyl and xylazine.
In 2022, the DEA seized more than 50 million counterfeit pills in their law enforcement activities. Their estimation is more than 60 percent of those had a lethal dose of fentanyl in them.
That means tragic events can occur. The idea that one pill can kill is a reality now and so our kids who are very vulnerable going to school who may go to a party and accept a pill from someone, because that’s what everyone’s doing, could end up dead that night from that action. There isn’t a second chance. Pgslot
Speaker: Dr. Charles Denham
Can you address this Tranq issue and you use the other name that it is used? Can you kind of tell us what tranq is and why they cut it with tranq and why it’s so dangerous?
Speaker: Dr. Gregory Botz
Sure. So, so tranq is the street name for xylazine, which is a drug that’s used in veterinary practice for sedation, particularly in large animals. Its drug type is an alpha-2 agonist.
We use many drugs like that in in our practice, especially in anesthesiology, but not in such concentrations. And this one was developed some time ago, but never found a use in humans because it was so unpredictable, because it was so dangerous.
It’s never been used in human that never got the approval from the FDA, but it was approved in large animal practice because it’s very effective in animals of that size. It causes a profound sedation. It can cause respiratory depression. Kakek merah slot
The respiratory depression is not reversed with Narcan, like opiates such as fentanyl or morphine might be reversed. And even more worrisome is it causes very significant skin injury.
One of the other very concerning side effects of xylazine is that it causes unpredictable but very serious skin lesions. People that use xylazine even very early in their exposure can develop these lesions on their skin. The tissue dies. It doesn’t get good blood supply and it can get infected and is very difficult to manage even with traditional wound management that we do for people with burns or other skin issues when they’re in the hospital.
These sorts of lesions aren’t very amenable to that kind of wound therapy.
Speaker: Dr. Charles Denham
So, Dr. Botz, you really were wonderful in teaching us the critical importance of the recovery position or the rescue position and why the airway is so important. Now when we talk about our freshmen that might over and by the alcohol and might be at a party and be left unattended either as a freshman in high school because drinking is really moved into the younger and younger age groups and then these freshmen in college that have no guardrails and are subjected to hazing and other things.
Can you address why the airway is so important and why it’s so important that every freshman should understand the airway?
Speaker: Dr. Gregory Botz
Well absolutely it’s very critical because alcohol in excess and other medications that can affect respiratory drive or breathing can reduce the reflexes that are usually in place to help protect the airway from aspirating gastric contents that are fluid from your stomach. If you happen to vomit material up into your stomach and you’re lying on your back it will tend to go down into your lungs through the trachea and cause a very significant lung injury.
By placing someone in the lateral position or the rescue position the fluid if regurgitated from the stomach into the mouth will actually come out the mouth onto the ground rather than down into the lung and that certainly can reduce the very significant injury that can occur with an aspiration of it.
Speaker: Dr. Charles Denham
Last question we know that as our young people are now experiencing THC depending on the state and the relax the laws are the rules but the delay in having an impact and the possibility that they might overdose waiting for some impact compared to alcohol.
Speaker: Dr. Gregory Botz
Well I think that’s really true I think the studies that looked at the toxicity of THC happened in the 70s and 80s when the concentration of THC in marijuana was relatively low but now with the advent of commercial growing of marijuana and other products the concentration of THC has gone up and especially now with high concentrations of THC and things like getable there may be a you know a variable response obviously smoking marijuana gets the THC into the lungs and into the bloodstream relatively quickly.
But by ingesting it taking an edible and having it go through the stomach and the GI system is dramatically slower but nonetheless that concentration gradient will catch up with you and we find that people who may take an edible and don’t find that they have any sort of psychological or high from that take more.
And then take a little bit more not realizing that the peak effect by taking it by ingestion is a lot slower than by taking it by inhalation when you’re smoking and that can catch up with you we see people in the hospital with very high levels of THC who have overdosed simply because they didn’t understand the concentration and the amount that they were taking and they have a very significant increase in their blood levels which can lead to very significant brain issues like psychosis and other effects that are really not desirable.
Speaker: Dr. Charles Denham
What’s your message to parents about their young people learning these med tech skills and being prepared for these emergencies anything you want to share with parents
Speaker: Dr. Gregory Botz
Well, I realized that sending your kids off to school is both a great opportunity it’s a great thing to celebrate but it’s also incredibly frightening that your kids are going to be exposed to things that you have no control over. And so, by teaching them the knowledge and skills about bystander rescue care so that they can save themselves or others if necessary are key to imparting as much safety as we can into these kids that are exploring new things and learning new ways to live and enjoying the freedom of being in college. But also have the very significant threat of agents like alcohol or THC or fentanyl or other things that they might be exposed to in that environment. So, it’s not only really a really fun and exciting opportunity but there’s a lot of fear for what might happen to your kids. And I hope that by using the knowledge and skills of med tac we can arm these kids with some tools that they could use to make good choices or to help their friends and acquaintances if they find that someone’s in that circumstance themselves.
Speaker: Dr. Charles Denham
Well, Dr. Botz thank you for being our clinical leader and imparting such great knowledge to us that we can put to work in those first few minutes of an emergency we really appreciate it.
Thank you.