Some of our political leaders have identified a new threat to our nation. It is not the explosion of school shootings that are turning kindergartens into armed camps. It is not the ever-widening gap between the haves and the have-nots. It is not even the climate changes increasingly affecting most Americans. No, my fellow Americans, it is the invasion of pet kidnappers alleged in one misconstrued Tik Tok post as already occurring in a small town in Ohio. We have been put on notice that our dogs, cats, and geese are at risk of being parboiled by illegal immigrants. Vladimir Putin may be threatening to launch nuclear missiles if his efforts to conquer the Ukraine are frustrated, but our political leaders are unconcerned. They are laser-focused on the canine, feline, and avian carnage they believe will ensue if we allow more people fleeing the devastated economies to our south to migrate north. Can this be real or is it just a Monty Python comedy skit disguised as political theater?
After ascertaining that our neighborhood pets and migratory birds were secure, I went to my computer to read about innovations in medicine in the hope this would slow my pulse and lower my blood pressure. Unfortunately, this refuge from controversy failed me. In addition to the numerous debates concerning abortion, birth control, in vitro fertilization [IVF], stem cells, sex change operations, etc., there were new issues with monitoring devices and ‘implants.’
For several decades, we have had several types of monitoring devices and medical implants. Some are diagnostic; some, therapeutic; and some, combined. The most familiar of the monitoring devices are the watches and rings that can check our pulse and count our steps. The most familiar diagnostic implant is the heart monitor. A small recording device can be left in or on a person suspected of having heart disease. The heart activity recorded by the device can be reviewed for anomalies after days or weeks of monitoring. Similarly, the most familiar therapeutic implant is the heart pacemaker. This device assures that the heart muscle is triggered to contract at a preset, minimum frequency. It delivers a tiny electrical impulse to the heart if the heart is beating too slowly. An excessively slow heart rate drops your blood pressure and makes you faint.
More recently, devices to check heart rate, blood pressure, blood oxygen levels, body temperature, breathing patterns, and blood sugar levels have been developed that do not require implantation in the body. There are also implantable devices that are life-saving. A device is available that monitors heart rhythm and delivers a rescue shock [defibrillation] if heart activity is dangerously abnormal. Devices to regulate breathing patterns in sleep have proven useful in eliminating “sleep apnea,” episodes of suspended breathing that are associated with an increased risk of stroke.
Implants just under the skin that release hormones over time have benefited millions of people. These include insulin pumps for people with diabetes mellitus and Norplant implants for women seeking a safe and reliable birth control device.
Given our experience with these monitors and delivery devices, we would not expect a new system to detect a potentially fatal condition and to rescue the affected individual would elicit much controversy. Our expectations are often wrong, and we can add another life-saving innovation to the list: an implantable opioid-overdose rescue device.
Tens of thousands of Americans die every year from self-administered narcotics, including heroin, oxycodone, fentanyl, etc. Our government dedicates billions of dollars annually to a ‘war on drugs’ that we lost decades ago and that continues to enrich criminals around the world. Support for programs that target the drug user and promote the health and welfare of the addict has been inconsistent and often opposed. Only recently has the distribution to the public of a nasally-administered drug, naloxone [Narcan], that reverses the more lethal effects of opioids been adopted. This drug is only effective if given within minutes of an overdose, and the dose available to the general public without a prescription may be insufficient to reverse the effects of a substantial overdose.
Device manufacturers have developed an implantable monitoring device that will automatically administer naloxone [Narcan] when an individual’s vital signs [breathing, heart activity, blood pressure, body temperature] indicate an opioid overdose has occurred. Within ten seconds of a perceived overdose, this device will automatically inject naloxone at a dose substantially greater than that available with the intranasal device. This will usually prevent the overdose from being lethal. The device currently developed is not designed to call first responders for further management of the patient, but that additional feature will certainly be available when or if this device is approved by the Food and Drug Administration [FDA].
Although the development and distribution of this device is a no-brainer for most medical professionals, its approval will inevitably face protracted resistance from politicians who will argue that saving drug addict lives encourages drug addiction. This type of device could have spared us the loss of incredibly talented and irreplaceable people, like Whitney Houston, and the loss of hundreds of thousands of other anonymous Americans, most of whom were loved and valued by family and friends. An overdose rescue device not only avoids a death but also provides an opportunity for remediation.
Our ‘morality police’ will inevitably shift their attention from the alleged pet slaughter being perpetrated by carnivorous migrants and focus their moral indignation on aid, such as this implantable device, being provided to Americans addicted to narcotics. Narcotic addiction is a life-threatening medical condition for which there are treatments. It is no more a moral failing than cigarette smoking, alcoholism, obesity, or sky-diving. Each of these poses a risk to our health and longevity. An implantable, self-triggering Narcan delivery device is nothing more than a parachute for the opioid addict.
Dr. Lechtenberg is an Easton resident who graduated from Tufts University and Tufts Medical School in Massachusetts and subsequently trained at The Mount Sinai Hospital and Columbia-Presbyterian Medical Center in Manhattan. He worked as a neurologist at several New York Hospitals, including Kings County and The Long Island College Hospital, while maintaining a private practice, teaching at SUNY Downstate Medical School, and publishing 15 books on a variety of medical topics. He worked in drug development in the U.S., as well as in England, Germany, and France.
