I love genuine questions and people putting in the effort to love and understand each other better. If you come at me just wanting to argue I’m going to troll you back. FAFO.

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Joined 3 years ago
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Cake day: June 12th, 2023

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  • Honestly the research on exactly why this happens is sparse enough as it is. It’s basically impossible to do truly conclusive studies with tobacco because of how dangerous it is. We can’t even technically conclusively say that tobacco causes cancer because to truly scientifically assert that you’d have to do a randomized controlled trial.

    To have a truly randomized controlled trial you would have to randomly select people from the overall sample and tell them to start smoking for the purposes of the study (otherwise you can’t technically rule out there being some third thing that both causes the cancer and causes people to want to smoke). And because we know tobacco is insanely addictive and are all but that one millimeter short of proving that it causes cancer, no medical ethics oversight body would ever allow a study that requires participants to start smoking.






  • It also paralyzes your cilia so it’s not improbable (cilia are the little hairs that line your breathey tubes and rhythmically beat to push gunk up and out). It’s actually why the smokers cough usually gets worse a few days after quitting then stays worse until you’re finished hacking up all the built up tar. Your cilia wake up to your respiratory tract fucking trashed like WHAT THE FUCK IS THIS.







  • Just because it would be a significant change to the comment you upvoted:

    We had a patient who was consistently verbally abusive and otherwise unpleasant during a long stay and completed after discharge and the most emotion I could summon was a melancholic relief that their pain had ended. We did not have the resources they truly needed and neither did anyone else. They were so deep in that despite being cognitively intact they were unable to meaningfully interact with anyone socially.

    They would have needed extensive social support and interpersonal skill building to be properly rehabilitated and nobody does that. Most of what we do for that type of patient is to get them sober and give them a second chance to seek help. Even that takes a lot of resources so we don’t really have the resources to do more than point them in the right direction if we can even find a decent place for them to go. Many get sobered up and discharged to the bus stop with a month of pills and directions to a shelter that’s probably at capacity.

    That was this person’s only way out and I honestly respect their decision. At this point I’ve contented myself with caring for homeless people who are faking or exaggerating suicidal ideation of psychosis for 3 hots and a cot. Some of them are obvious but ultimately I don’t want to be responsible for deciding who is and who isn’t, and the deeper truth is that I’d probably do it too. And 3 hots and a cot is more and better care than I could give them pretty much anywhere else in this current system.




  • It’s the fent fold / bent / drop / lean. Most likely fentanyl or carfentanyl, but almost definitely some kind of opiate (of which they’re the most potent). Some of it might be neuromuscular / specifically opiate related but there’s also just the practicality of it. The drug might be cut / mixed with another sedative for potency such as a benzo or barbiturate, but it also might be mixed with with a stimulant such as methamphetamine or cocaine to counteract the sedation.

    You’d want to counteract the sedation either to increase enjoyment (similarly to the relaxed buzz of a caffeinated alcoholic beverage) or because they feel too much distress from being sober / unsedated but also know that they’re in an unsafe area to be sedated. Even if it’s not cut with a stimulant they may still be forcing themselves to stay awake either because they know they’ve taken enough that they might stop breathing, or because, as I said, they know they’ll get mugged or otherwise attacked if they relax into the high.

    Being homeless / generally in poverty is often too emotionally stressful to tolerate sober, but too unsafe to be navigated zonked, so they just put themselves into a never sleeping but never really awake haze until they either intentionally or unintentionally die or almost die or experience psychosis, in which case they either go to a morgue or to meet up with me on the psych unit.