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Monday, March 25 , 2019, 1:17 am | Fair 50º


Emergency Room Doctor Talks Drugs, Alcohol with Dos Pueblos High School Students

Dr. Joseph Freeman shares the gory details of the potential harm from substance use and abuse

Dr. Joseph Freeman tells students at Dos Pueblos High School on Wednesday that, ‘I’m not telling you guys not to use drugs. I’m just telling you what’ll happen when you do.’
Dr. Joseph Freeman tells students at Dos Pueblos High School on Wednesday that, ‘I’m not telling you guys not to use drugs. I’m just telling you what’ll happen when you do.’ (Giana Magnoli / Noozhawk photo)

During his years practicing emergency medicine, Santa Barbara physician Joseph Freeman has seen countless people come into the hospital with alcohol- and drug-related problems.

Many would tell him that they were never told what could happen if they abused alcohol or drugs.

Those encounters prompted Freeman to start making presentations to high school students so they can make informed decisions about drinking and drug use.

“This is not a ‘say no to drugs’ presentation," Freeman told a crowd of students at Dos Pueblos High School on Wednesday. "I went to UC Santa Cruz, so I’m not the person to tell you not to use drugs.”

Freeman came as part of the Council on Alcoholism and Drug Abuse's COMMITTED campaign, and colloquially explained the brain chemistry and physical impacts of alcohol and drug use and abuse.

“I’m not telling you guys not to use drugs," he said. "I’m just telling you what’ll happen when you do.”

So now, if any Dos Pueblos students go to the ER for alcohol- or drug-related emergencies, “you can’t say no one ever told you,” he said.

Freeman has been working at the Santa Barbara and Goleta Valley Cottage Hospital emergency rooms for about a year and a half, coming from inner-city hospitals in San Francisco. He’s been in emergency medicine for six years, and never learned any of this stuff, even though he attended a top medical school, he told students.

He has never worked a shift in his career without a case in which drugs or alcohol were the direct or indirect cause of the ER visit.

Starting off with alcohol, which he called "yeast poo," he explained about complications from liver failure and alcohol poisoning.

Freeman had a slideshow of graphic photos to illustrate his points and a video of esophageal varices (expanded blood vessels in the esophagus), which can burst when blood backs up from liver failure. He described them as “basically geysers,” saying patients can die within minutes if they burst.

Doctors try to stabilize patients and operate to stop the bleeding, but anyone who has one of these has a 50 percent mortality rate within three months, Freeman said.

“Has anyone heard of these?” he asked. Hearing nothing, he added, “And this is like my job. I deal with it all the time.”

He sees patients with alcohol-related liver failure frequently in the ER. Some people come in when they can’t breathe because of the swollen liver and blood vessels in the belly, and he has to drain the fluid — just to see them again in a week or two for the same issue, he said.

Even though he said he purposefully chose the “calmest” and “non-graphic” examples he could find, he warned students to close their eyes and take deep breaths if they started to feel faint.

One student got up during the presentation, started to walk away from his seat and fainted on the auditorium floor.

Students asked about alcohol poisoning, which can cause people to pass out and stop breathing. If patients come into the ER who have passed out from drinking, doctors have to guess how close they are to not breathing, Freeman said.

If a patient is close to not breathing, or already not breathing, doctors have to shove a breathing tube into their windpipe, which is a painful and high-risk procedure, he told students.

Doctors first give patients drugs to knock them out, if they’re not already, paralyze them and then insert a breathing tube, called intubating. 

“If we miss (the windpipe), you die,” he said. “This is what I have to do as an emergency room doctor on Friday and Saturday nights.”

The youngest person he has intubated for alcohol poisoning was 12 years old and the youngest in Santa Barbara was 14, he said.

When asked if he drinks, Freeman said he does, adding that he knows the risks and is very aggressive about not drinking and driving since he’s seen sad cases in the ER from DUI accidents.

“What nobody tells you” is that alcohol use and abuse can cause female characteristics in men, since livers break down estrogen, he said. That means enlarged breasts and shrunken testicles.

Women’s bodies don’t break down alcohol as well as men’s, regardless of size, he noted.

Women get worse hangovers, also because of body chemistry, can experience hair loss and have a heightened risk of breast cancer with regular drinking, Freeman said. 

He didn’t plan to talk about marijuana, saying he’s only seen two cases in the emergency room of people with marijuana intoxication. Students clapped at that news, but Freeman warned that he’s seen plenty of cases where marijuana was laced with other drugs.

He showed pictures and explained some of the gruesome side effects of other drugs, including cocaine, meth and ecstasy.  

“I’m not here to tell you not to use drugs, but don’t use meth,” he said. “I don’t know any emergency department nurse or doctor who doesn’t think meth is just a horrible creation.”

Students asked about ecstasy, or MDMA, which can cause schizophrenia-like symptoms, hyperthermia and hyponatremia, which is low sodium levels that can cause seizures.

Normal seizures stop when the brain resets, but the MDMA sodium-caused seizures don’t stop, he said. Doctors can try to reverse the effects with a special type of saline, but only if they know ecstasy is causing the seizures.

Freeman lost a patient in San Francisco, a young girl, who came in with seizures but doctors didn’t know she had taken ecstasy.

She died by the time the test came back, 10 minutes later, to indicate the hyponotremia and the autopsy showed ecstasy use, he said. If a friend takes ecstasy and suffers seizures, tell the medics, he urged students.

“An ER doctor is not the person you want to lie to,” he said.

In closing, he told students that “none of these drugs give you anything that your brain does not already have.” There are natural ways to release the same chemicals, by doing something they enjoy, he said.

For more resources and help with substance abuse issues, he directed students and families to 211 and the California Youth Crisis Line

Noozhawk news editor Giana Magnoli can be reached at .(JavaScript must be enabled to view this email address). Follow Noozhawk on Twitter: @noozhawk, @NoozhawkNews and @NoozhawkBiz. Connect with Noozhawk on Facebook.

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