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Published on Sep 30, 2019

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PRESENTATION OUTLINE

1.

Poisoning,
Overdoses
And Regulation

Ian Mitchell, MD, CM

Photo by Leo Reynolds
2.

Ian Mitchell

  • Emergency Physician, RIH
  • Site Scholar, Family Medicine Residency Program
  • Associate Professor, UBC
3.

Disclosures

  • Speaking Fees: Tilray, Maricann
  • Consulting: Shoppers Drug Mart, MD Briefcase
  • Cannsolve Clinic, Kamloops
  • Research: Tilray
Photo by Esteban Lopez
4.

Mitigation of bias

  • Avoid therapeutics
  • No licensed producers
Photo by mikecogh
5.

Poisoning
Or
Overdose?

Photo by rvacapinta
6.

20 G ACETAMINOPHEN

Poisoning or overdose?
Photo by Thư Anh
7.

SOMEONE PUT GHB IN HER DRINK

Poisoning or Overdose?
Photo by Thư Anh
8.

PARTYING, SHE TOOK TOO MUCH GHB

Poisoning or Overdose?
Photo by Thư Anh
9.

PARTYING, SHE DRANK 15 TEQUILA SLAMMERS

Poisoning or Overdose?
Photo by Thư Anh
10.

POISONING VS OVERDOSE

Exposed to white powder, gave self naloxone
Photo by Gabry$
11.

Cost of Stigma

12.

Summary

  • A Little History
  • The Fentanyl Crisis
  • Vaping Respiratory Disease Illness
Photo by c@rljones
13.

Poisoning
& Regulation

Photo by Juá
14.

DRUG REGULATION

1888
15.

MASSENGILL MASSACRE

Diethylene glycol, 1937 >100 DEAD
16.

CHICAGO, 1982

A City In a Panic over Poison.
Photo by Miradortigre
17.

CYANIDE

7 deaths
Photo by mynameisharsha
18.

Opiate Crisis

>3000/YEAR
Photo by peabodyproductions
19.

ISN’T FENTANYL SAFE?

Photo by nilswommelsdorf
20.

Untitled Slide

Photo by simonetomirotti
21.

WHY FENTANYL?

Photo by didkovskaya
22.

Why Fentanyl

23.

Poisoning
Or
Overdose?

Photo by DES Daughter
24.

Response to Opiate Crisis

Photo by Travelin' Librarian
25.

TAKE HOME NALOXONE

26.

SUPERVISED CONSUMPTION SITE

Zero deaths, ever.
27.

PRESCRIPTION HEROIN

28.

HYDROMORPHONE

Safe supply
Photo by apalapala
29.

SYNTHETIC CANNABINOIDS

K2 & Spice
Photo by raymondclarkeimages
30.

WHY SYNTHETIC CANNABINOIDS?

31.

SYNTHETIC CANNABINOIDS

Brodifacoum, 2018 8 dead >300 Ill
32.

THE IRON LAW OF PROHIBITION

Increased Potency, Increased Danger.
Photo by j3net
33.

Vaping Related Lung Injury

34.

VAPING VS SMOKING

Photo by Vaping360
35.

E-CIGARETTES

Photo by Ecigclick.co.uk
36.

Untitled Slide

  • Cartridges: Lead
  • Oil: Mycobutanil, synthetic cannabinoids
  • Filler: Vitamin E
Photo by Ecigclick.co.uk
37.

VITAMIN E Acetate?

Photo by theogeo
38.

Response to Vaping Crisis

18 deaths, >1000 sickened
Photo by Vaping360
39.

the Future?

Summary and
Photo by obviously_c
40.

Questions?

@travels2little
Photo by Camylla Battani

Ian Mitchell