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Gabriel Suarez
09-02-2018, 09:13 AM
Lets talk about crazy guys and druggies. I dealt with them back in the previous life as have many of the guys here. What I want to do is discuss the characteristics of a crazy dude or a druggie, as well as their nature as adversaries to those without the experience. If we have any drug experts, please contribute. I was DRE and DARE (LAPD's version), but that was a lifetime ago.

What I will start with is this - craziness or drugs doesn't make anyone any stronger or immune from injury or blood loss. In my experience and in layman's terms, it desensitizes to pain and the recognition of injury. So that at the point where most normal people would begin shifting to self-preservation mode, these guys do not. But a meth-golum will still stop moving if he is knocked out and a giant nutball will stop chasing you if his leg is broken.

And of course...nothing is more neutralized than a man with a bullet in the brain. But...lets discuss the nature and visual clues of the Druggie Adversary.l

EDELWEISS
09-02-2018, 10:23 AM
Gabe thanks for bring this topic to discussion. First theres crazy and then theres crazy off HIS Rx meds and on street drugs. Mental Health providers will tell you that mental patients are fine when properly medicated, they will even say that most even when not properly medicated are still no danger to anyone but maybe themselves. Those of us in the real world (delete most Mental Health providers who never leave their air conditioned office or the ER) almost never see the mental patients that are "fine" BUT we DO see the ones that are BATSHITE crazy and acting out. To us those are the real face of CRAZY (unless we have family members who are depressed or otherwise mentally ill).

So YES broken bones do stop/slow down attacks and YES sometimes its a clearly necessary use of force BUT just like in the KWTL discussions articulation is everything. As for visual clues, well that is often more than just a single viewing. Most of us who were ever on the job got to know both the addicts and the crazies (again there is some blurring). We knew Crazy Ed and we knew Heroin Susan. How we dealt with them often depended how we found them. Was Crazy Ed pissing on a fire hydrant and barking because he thought he was a dog or was Heroin Susan on the nod in some one's backyard treehouse?

Once we know what we're dealing with we need to act accordingly. Knowing is the issue. When Mom calls and says her son with Schizophrenia (or for that matter Bi-Polar) is off his meds and acting weird than he needs medical attention. No that doesn't mean he wont require some force to get him to the ER. Conversely When Heroin Susan's father calls and says that shes breaking into his garage to steal stuff to sell for drugs, that's another issue.

As for specific visual clues, without any prior knowledge well that's harder, not impossible but harder. More importantly, NO differentiating is needed when they attack at hands on distance, standard Use of Force escalation should apply. Just as going straight to guns for a cop with a Batman Utility Belt of options may not ALWAYS be the best option.

Papa
09-02-2018, 02:36 PM
K.
Hope this part isn't too incoherent. You're right about the mechanism, but the effect is the same. If I felt no pain, I might not be able to lift a Buick but I could pitch the average cop over a fence, if he didn't wriggle around too much. As with any ICE, if you cut off my air supply or my fuel, I stop running. But if you break my leg, and I can't feel it, better stay out of my reach, because I may still be sufficiently mobile to engage you and hurt you some. Stuff that has worked in the past, like a throat strike, may not work on a meth monkey or an EDP. Same with a hickory shampoo (thank you, Choirboy, for resurrecting that one).

As far as recognizing the signs, the one that tells me the bell is gonna ring is the instantaneous mood swing, usually from almost passive, motionless calm to agitated movement, verbal and physical posturing and belligerence. And back again.
This one is gonna end up in LVNR or dirt on my uniform. This is different from but not necessarily independent of the usual offender fight cues.

LawDog
09-02-2018, 06:16 PM
To my eye, the biggest difference between crazies/druggies and other criminal elements is the deescalation tactics. I wouldn't use different techniques in a fist fight just because my opponent was on meth. But I would talk to them differently.

My area is pleasantly free of real criminals, but we have plenty of junkies and lunatics. Real thugs are not always stupid. And there is often a logical risk-versus-reward calculation going on in their head. If you want to deter a real thug, you want to present a sufficiently hard exterior to make them think twice. But that same posturing will invite trouble from a meth freak, and could destabilize a schizo.

I've had minimal experience with druggies at the peak of their high. I usually encounter them the day after, at their initial arraignment. I've got plenty of experience dealing with them while they are going through withdrawals. On the few occasions that I've encountered potentially violent junkies who were flying high, I just met them head-on and went with an honest approach to why I was there: "Hey, is Fred around?" Who the F are you? "I'm Fred's lawyer. I'm trying to keep him out of jail. Is he around?" No, man, he's out. "Okay. I'll just leave my card. Here's one for you, too." Then I scoot along. I'm not a cop. I don't care how much more dope he has in his pockets.

With crazies, the best general approach is a sympathetic one. Ask questions. Listen and nod. Don't argue. The mental health professionals will tell you to not engage in the delusion. I sometimes disregard that advice. My greater priority is personal safety, not their long-term mental health. So if going along with their craziness helps to keep them calm, I'll do so.

Once it turns violent, I treat them all the same.

Gabriel Suarez
09-02-2018, 06:22 PM
I have three bulged discs and a fracture. It was why I tried to leave the job. I got a big black wrestler in a choke after he threw three officers off him. He went out, but not without cost. Not something I will do again. Crazy or druggie, you have no idea how little I care about what his problem may be. Leave me alone or I will empty your crazy skull. Transmission ends.

Justification - Based on my prior training and experience...

Papa
09-02-2018, 07:23 PM
I have three bulged discs and a fracture. It was why I tried to leave the job. I got a big black wrestler in a choke after he threw three officers off him. He went out, but not without cost. Not something I will do again. Crazy or druggie, you have no idea how little I care about what his problem may be. Leave me alone or I will empty your crazy skull. Transmission ends.

Justification - Based on my prior training and experience...

...including permanent injuries sustained during the performance of my duties as a law enforcement officer..."

As far as engaging in the delusion, I once exorcised the ghost of Mel Blanc from the mobile home of a nice vague old lady who was otherwise functional.

toothie
09-02-2018, 08:04 PM
And seems like, when they want to fight, often as not the clothes start coming off. Wrestling a naked junkie or drunk ain't my idea of fun. Also, NICE only goes so far with them; all the rational discussion in the world is useless when they're already irrational. Be ready to use FORCE.

GorillaMedic
09-03-2018, 06:32 PM
This is something I'm unfortunately pretty familiar with—treated a bunch of these as patients, but also have worked on several research projects related to this and watched hundreds of hours of bodycam footage. The medical term is "Excited Delirium"—although it is often also referred to as Agitated Delirium. This whitepaper from the American College of Emergency Physicians is a good introduction to this condition. (https://www.acep.org/globalassets/uploads/uploaded-files/acep/clinical-and-practice-management/ems-and-disaster-preparedness/ems-resources/acep-excited-delirium-white-paper-final-form.pdf) So I can speak to this both from the medical/biological knowledge side, as well as personal experience.

Triggers/Risk Factors
Fundamentally, this is about a huge imbalance of chemicals in the brain that leads to imbalances in the body. It does not happen without prior risk factors, but there may not be an immediate connection between drug use and this syndrome happening. Screwed up brain chemistry builds up until something is the "straw that broke the camel's back" and they tip over into this syndrome. At that point, they are likely to go down hill and die (either from tactical intervention or from their own body burning up and destroying itself). The only thing that keeps them from dying is sedating them heavily to allow the brain to "reset".

The risk factors that set up a person to have this condition are either a) Drug use (particularly PCP), b) Psych history (particularly schizophrenia/bipolar), or c) Psych med use. A prominent risk factor to "flip the switch" and go into Excited Delirium mode is going off of psych meds (they need to be weaned off carefully) or using drugs like PCP. It could also be a strongly emotional event, lack of sleep, or something similar.

Presentation/Identification
The behaviors and presentation that most prominently seperate these individuals from a regular behavioral incident are:

"Superhuman" strength and imperviousness to pain
Partial or complete nakedness (the body is literally cooking itself, so they take off clothes unconsciously to cool down)
Grunting or guttural sounds, generally mostly out of touch with reality
Not following commands—usually not even tracking
Violence towards objects or people, often running or walking into traffic
Apperance is usually completely psychotic—they are clearly disturbed, with a 1,000-yard-stare, vacant eyes/facial expression, "lights on but nobody's home"
Often, a weird attraction to mirrors, windows, glass, or shiny objects
Usually very sweaty and skin is hot—core temps can be high as 107 degrees. They are literally burning up.


Handling These Subjects
Three factors significantly impact how these subjects can be approached and handled:

They feel no pain, so pain compliance will not work. Period.
They are irrational and cannot understand, let alone follow, commands, so deescalation will not work.
They do have superhuman strength, as a result of their body dumping adrenaline. The stories of moms lifting a car off their toddler have validity; given a sufficient amount of adrenaline and motivation our bodies can accomplish far more than we know (look up the "Central Governor" theory for some insight on why). These individuals won't last forever in a sustained fight, but they are very challenging to control with fewer than 4–6 grown men. I've seen an 110-lb meth head that was giving 8 burly Texas LE officers a run for their money.


When they stop fighting/being aggressive and become "calm" (but still completely irrational, detached, and often still clenched) they are usually minutes away from death.

From a public safety/LE perspective, the best, most-proven approach is to "sedate under power", which means to utilize a Taser to accomplish muscular incapitance (its not pain compliance, but rather keeping them from being able to move that is the goal) and then administer a massive dose of Ketamine intramuscularly. Ketamine is a powerful sedative that quickly (within a few minutes) puts them to sleep without harming their ability to breathe. Then, aggressive medical treatment is necessary to treat the acidosis and hyperthermia this condition caused.

Simply using a taser and then restraining them has led to a high incidence of in-custody deaths (erroneously attributed to the taser in many cases) because the underlying medical condition is never treated.

From a civilian standpoint, the best bet is to avoid them if possible. The good news is that these are not superhuman predators with some kind of enhanced intelligence or rational planning that are looking to hunt prey. The bad news is that they can still inflict a tremendous amount of damage to innocents. Typical rules of force would apply here—if they are a direct threat to you or to innocent bystanders, and escape/avoidance is not possible, then lethal force will be necessary. The stories of drugged-up Moro soldiers resistant to multiple .38 shots leading to the development of the .45ACP come to mind. As Gabe and others have pointed out, either catastrophic damage to the heart and great vessels or a direct shot to the command/control areas of the brain will be necessary to stop them.

ShopMonkey
09-04-2018, 08:59 AM
we also have to take into context current narcotic situations. meth while still very prevalent is not largest threat anymore with things like flakka and bath salts. these aren't your typical psycho-hallucinogenics and from all reports of contact with a suspect on the drug, create quite a problematic adversary. I can't find the article anymore, but i recall a police chief or sheriff down in florida telling his officers that if they encounter a suspect showing signs of use of one of those two drugs, to just shoot them because it wasn't worth the personal risk to the officers to attempt to detain them.
is that the proper response to the situation? not if you're PR, but based on the videos and articles out there on contact with users, i wouldn't do any different. if someone comes at me and its obvious they're on something, they're going to take a few to the face
GorillaMedic brings up the Moro soldiers, and their induced resistance to .38 and .45, but we dealt with the same overseas with the jihadis. they had already intended to be martyrs anyway so why not make themselves a bit more lead resistant in hopes to take out more of us

LawDog
09-04-2018, 09:53 AM
As far as engaging in the delusion, I once exorcised the ghost of Mel Blanc from the mobile home of a nice vague old lady who was otherwise functional.Now that is old school public service. I've stopped to change a lady's tire, but performing an exorcism is going above and beyond the call of duty.

NM_Dude
09-11-2018, 10:35 AM
From my experience, it isn't too hard to spot a crazy or meth head. You can usually spot them by their paranoid behavior and general lack of personal upkeep. When I spot someone that's acting twitchy or just generally out of place behavior, my radar pings.

barnetmill
09-11-2018, 01:10 PM
This is something I'm unfortunately pretty familiar with—treated a bunch of these as patients, but also have worked on several research projects related to this and watched hundreds of hours of bodycam footage. The medical term is "Excited Delirium"—although it is often also referred to as Agitated Delirium. This whitepaper from the American College of Emergency Physicians is a good introduction to this condition. (https://www.acep.org/globalassets/uploads/uploaded-files/acep/clinical-and-practice-management/ems-and-disaster-preparedness/ems-resources/acep-excited-delirium-white-paper-final-form.pdf) So I can speak to this both from the medical/biological knowledge side, as well as personal experience.

Triggers/Risk Factors
Fundamentally, this is about a huge imbalance of chemicals in the brain that leads to imbalances in the body. It does not happen without prior risk factors, but there may not be an immediate connection between drug use and this syndrome happening. Screwed up brain chemistry builds up until something is the "straw that broke the camel's back" and they tip over into this syndrome. At that point, they are likely to go down hill and die (either from tactical intervention or from their own body burning up and destroying itself). The only thing that keeps them from dying is sedating them heavily to allow the brain to "reset".

The risk factors that set up a person to have this condition are either a) Drug use (particularly PCP), b) Psych history (particularly schizophrenia/bipolar), or c) Psych med use. A prominent risk factor to "flip the switch" and go into Excited Delirium mode is going off of psych meds (they need to be weaned off carefully) or using drugs like PCP. It could also be a strongly emotional event, lack of sleep, or something similar.

Presentation/Identification
The behaviors and presentation that most prominently seperate these individuals from a regular behavioral incident are:

"Superhuman" strength and imperviousness to pain
Partial or complete nakedness (the body is literally cooking itself, so they take off clothes unconsciously to cool down)
Grunting or guttural sounds, generally mostly out of touch with reality
Not following commands—usually not even tracking
Violence towards objects or people, often running or walking into traffic
Apperance is usually completely psychotic—they are clearly disturbed, with a 1,000-yard-stare, vacant eyes/facial expression, "lights on but nobody's home"
Often, a weird attraction to mirrors, windows, glass, or shiny objects
Usually very sweaty and skin is hot—core temps can be high as 107 degrees. They are literally burning up.


Handling These Subjects
Three factors significantly impact how these subjects can be approached and handled:

They feel no pain, so pain compliance will not work. Period.
They are irrational and cannot understand, let alone follow, commands, so deescalation will not work.
They do have superhuman strength, as a result of their body dumping adrenaline. The stories of moms lifting a car off their toddler have validity; given a sufficient amount of adrenaline and motivation our bodies can accomplish far more than we know (look up the "Central Governor" theory for some insight on why). These individuals won't last forever in a sustained fight, but they are very challenging to control with fewer than 4–6 grown men. I've seen an 110-lb meth head that was giving 8 burly Texas LE officers a run for their money.


When they stop fighting/being aggressive and become "calm" (but still completely irrational, detached, and often still clenched) they are usually minutes away from death.

From a public safety/LE perspective, the best, most-proven approach is to "sedate under power", which means to utilize a Taser to accomplish muscular incapitance (its not pain compliance, but rather keeping them from being able to move that is the goal) and then administer a massive dose of Ketamine intramuscularly. Ketamine is a powerful sedative that quickly (within a few minutes) puts them to sleep without harming their ability to breathe. Then, aggressive medical treatment is necessary to treat the acidosis and hyperthermia this condition caused.

Simply using a taser and then restraining them has led to a high incidence of in-custody deaths (erroneously attributed to the taser in many cases) because the underlying medical condition is never treated.

From a civilian standpoint, the best bet is to avoid them if possible. The good news is that these are not superhuman predators with some kind of enhanced intelligence or rational planning that are looking to hunt prey. The bad news is that they can still inflict a tremendous amount of damage to innocents. Typical rules of force would apply here—if they are a direct threat to you or to innocent bystanders, and escape/avoidance is not possible, then lethal force will be necessary. The stories of drugged-up Moro soldiers resistant to multiple .38 shots leading to the development of the .45ACP come to mind. As Gabe and others have pointed out, either catastrophic damage to the heart and great vessels or a direct shot to the command/control areas of the brain will be necessary to stop them.
In the agitated state that you describe, are these people capable of using a firearm with any precision? Overall is their coordination still good? I understand that they are super resistant to pain and will continue to put out until something catastrophic happens to them like a bullet to the brain or a taser.

GorillaMedic
09-13-2018, 05:03 PM
In the agitated state that you describe, are these people capable of using a firearm with any precision? Overall is their coordination still good? I understand that they are super resistant to pain and will continue to put out until something catastrophic happens to them like a bullet to the brain or a taser.

No, this state is not compatible with precision, coordination, fine motor control, or much planning.

Essentially, these are all the result of what’s called “executive function”, which happens in the prefrontal cortex at the front of the brain. This high-level brain function, and is lost in delirium.


Sent from my iPhone using Tapatalk

barnetmill
09-13-2018, 05:31 PM
No, this state is not compatible with precision, coordination, fine motor control, or much planning.

Essentially, these are all the result of what’s called “executive function”, which happens in the prefrontal cortex at the front of the brain. This high-level brain function, and is lost in delirium.


Sent from my iPhone using Tapatalk
They sound much like a berserker.

Berserkers (or "berserks") were champion Norse warriors who are primarily reported in Icelandic sagas to have fought in a trance-like fury, a characteristic which later gave rise to the English word "berserk." These champions would often go into battle without mail coats.

choirboy
09-14-2018, 05:57 PM
Papa,

I never did an exorcism but I ran into a couple of candidates in need. I did two Baptisms of guys who were still alive but not going to make it - MVAs. Sister Mary Charles would have been proud.

Choirboy

Papa
09-14-2018, 06:22 PM
Papa,

I never did an exorcism but I ran into a couple of candidates in need. I did two Baptisms of guys who were still alive but not going to make it - MVAs. Sister Mary Charles would have been proud.

Choirboy

Now that is cool, and far better than chest compressions on an unrepentant hophead.