- Apnea (not breathing)
- Pinpoint pupils
- Ice in the crotch
The first two make pharmaceutical sense. Opiates make you stop breathing and squeeze your pupils into tiny black dots. It's the third sign that has baffled paramedics for decades.
Ice down the pants.
Imagine: junkie shoots up with friends. Friends notice (after an unknown duration) that junkie isn't breathing. Friends attempt to wake junkie to no avail. Friends run to the ice machine in the motel hallway and dump the whole bucket down junkie's Wranglers. Junkie is still heading for the light. Friends call 911, gather up all the drugs and cash -- including junkie's wallet -- and skedaddle before the fuzz gets there.
We show up to find junkie lying on the bed, sweating profusely, blue lips, arms outstretched like Ted Neeley, cubes in his drawers and wallet lying open on the nightstand entirely devoid of any founding fathers. In no way, shape or form will we find any illegal substances on the premises. The fuzz, by the way, couldn't care less.
This presentation results in almost every paramedic I know shaking his or her noggin wondering how professional heroin users like this guy and his acquaintances haven't figured out by now that the only thing that's gonna wake him up is Narcan, a magic little concoction we paramedics carry to wake up junkies. It's like the heroin antidote and it's only available by special delivery.
Don't these guys get that the ice trick doesn't wake the dead?
The concept is solid, I mean a Big Gulp on the twig and berries should really give you enough of a jolt to come back from the edge of the abyss. It's like a convenience store defibrillator.
CLEAR! Jamba Juice all over your Fruit of the Looms -- ZAP!
So we, the self-righteous paramedics who obviously know how futile ice in the pants is, continue to shake our collective heads as we prepare our Elixir of Life and mainline it directly into our junkie's last remaining vein, smugly grinning as he rolls over and tosses lunch all over the motel room floor from his instant heroin withdrawals. The only problem with this line of thinking is that the junkies are still using ice. You'd think by now they'd have noticed they were still calling 911 and leaving Bubba for the cops to find even after dumping their smoothies down his tighty-whities.
Unless they're not. Maybe -- just maybe -- this ice trick works better than we sheltered, non-IV-drug-using paramedics realize. Maybe this is the ultimate junkie home remedy, and only when a deep freeze to the nether regions doesn't bring Bubba back from the brink do his junkie friends decide to jump ship and call out the troops.
Maybe. It. Works.
Maybe there are junkies overdosing three or four times as often as we think they are. Maybe overdosing is like the choking game, a way to play with fire and only when you get burned do your best friends make off with all your money and drugs and leave you to wonder how you got in this motel room with a rubber tube in your nose, puking your guts up, surrounded by firefighters and a paramedic with a Cheshire Cat grin.
The next time I find a heroin overdose patient with ice down his pants, I'll know that indeed his friends did everything they could before they called an ambulance -- and made off with his unemployment check.
