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People often misuse Suboxone by crushing it and injecting or snorting it to get high. Prescription opiate drugs are commonly abused and can lead to addiction. In the past, doctors would give long prescriptions for opiates, but now they are more restricted due to the risk of abuse. Pain doctors offer alternative treatments for pain that don't involve opiates. Fentanyl pills are being illegally sold and causing overdoses, especially among young people. Narcan is used to reverse opiate overdoses, but it is important to administer the correct dose and not give too much too quickly. Barbiturates and benzodiazepines are also central nervous system depressants and can be abused. They can be taken in various forms and can cause altered consciousness. Inhalants like paint and gasoline can be abused, especially by teenagers, and can cause serious health problems, including cardiac arrest. is that people will take the Suboxone and they'll cheat it. They'll put it in their cheek or under their tongue and open their mouth and it'll look like they swallowed it and then they take it out and they crush it up and they inject it or snort it. If you inject it or snort it, you're gonna get high because it's a very rapid intake of the opiate versus the Narcan. And sometimes they'll take, they'll go get the Suboxone and they'll get high before or after. So it's a very poorly administered program. Prescription opiate drugs are among the most commonly abused drugs in the United States. Some people become physically addicted and we talked about that. Now when you go to the, it used to be when you go to ED, you could get a prescription for 10 days, 20 days of opiates, right? You go in, you break your leg, here's a 20 days prescription for opiates. Now you go in, you'll be lucky if you get three days. They might even give you a dose and say, okay, take Tylenol when you get home, right? Because of the fact they don't want people, Massachusetts got really strict with that. So what'll happen is the hospital, like you come out of surgery, you come out of the ED, the doctor will give you a prescription, maybe three days of opiates. When I had my tooth pulled, they gave me like two days worth of opiates. And then they'll prescribe you or they'll refer you to a pain doctor. A pain doctor is somebody who specializes in pain treatments and they do alternative pain treatments, non-opioid treatments. Things like you might get, what is it, Toradol. Toradol is non-opiate. Or they might do certain types of neuro-blockers or things like things that do not involve opiates. Opioids, these agents, opiates or opioids, whatever, they lead to central nervous system depression, respiratory depression, and then cardiac arrest. Goes in that, and that's where you find your overdose patients. And that's the problem with the shit coming over the border now is because these pills are coming over the border and these pills are fentanyl. And they're made to look like Dilaudid or Percocets. And so somebody comes up and says, here, take one of these Percocets. And you're thinking, ah, it's a Percocet. Yeah, I'll have a nice little high. And instead, they're taking 20 milligrams of fentanyl. And they fall asleep and they die. And that's where these overdoses are coming from, these young kid overdoses. They're not shooting up heroin. They're taking what they thought was a legitimate pill. That's why you never take a pill unless it's given to you by a doctor. And make sure you tell all of the young people that you know and warn them. People are dying. 100,000 people a year are dying from fentanyl overdoses. More people than died in the entire Vietnam War are dying. Double the number of people who died in the entire Vietnam War are dying every year from opiate overdoses. And most of those are kids who are taking pills that they don't even know what's in them. So tolerance has developed quickly for opioids. Some users require massive doses to experience the same high. It can often cause nausea and vomiting and can lead to hypotension. Although seizures are uncommon, it can happen. Most seizures in opioids occur to the hypoxia and it results in hypotension. Patients typically appear sedated and unconscious with cyanotic skin and pinpoint pupils. They'll be blue with pinpoint pupils. And you'll be like, oh yeah, that's opiates all day. Start ventilating and then hit them with Narcan. Naloxone, which is Narcan, is a opiate antagonist. It knocks opiates off of opiates and substance type 3's, they're reversing the high. Now, your dose is 0.4 to technically four milligrams. Now you can give up the point. They have auto nasal injectors now that you put in the nose and you shoot it and it's four milligrams. So you can give anyone from 0.4 to four milligrams. We carry two milligram, I showed you the two milligram kits. What I like to do is shoot up, it used to be that I used to tell people, I used to train people, do one milligram in one nostril, give it a minute or two and see if they come around. And if not, give the other milligram. I don't do that anymore. Now you start bagging them, set up the Narcan and deliver all the Narcan. One dose, two milligrams. Half in one nostril, half in the other. And then wait three to five minutes. If they don't respond, while you're bagging them, give them another dose. Just don't worry about one milligram. They're not gonna respond to one milligram. They're probably not gonna respond to two. They're probably gonna need four or more, especially with the drugs that are out here today. You guys give it nasally, intranasally, right? If you happen to have, for some reason, a Narcan kit that only has IM needle, you can give it IM, because you can give IM injections. But you want to give it intranasally because it's much more rapidly absorbed. Narcan is given to patients in severe respiratory depression, right? Those that are breathing two or three times a minute, unresponsive, pinpoint painful cyanosis. We don't give it to patients just because they're altered. Even if they're severely altered, if they're breathing, leave them alone. Many people can be permitted to administer Narcan. That's why it's important to know if somebody's administered Narcan. In Vermont, and for me personally, I think if everybody in the state carries Narcan, you're just perpetuating a problem. And I'm not saying that we should weed out people who are, not by any means, but if somebody knows that everybody around them has Narcan, they're more likely to take risky behavior. So I'm not one for that. I think that first responders and ambulances and things and hospitals should have it. I don't think everybody should carry it. But this is the problem. You're overdosed. I walk up, oh, that's an overdose. I hit you with Narcan. Jeez, I gotta get going. Somebody will be over here in a minute. And then the police come up and say, oh, Jesus, I hit him with Narcan. And then the police forget to tell me and I hit him with Narcan. Six milligrams of Narcan in short succession can cause what they call acute pulmonary edema, flash pulmonary edema. And the patient can drown in their own fluids. So that's why it's very important, before you give Narcan, find out if anybody gave it, right? If they did, when? If it was more than two minutes ago, give them another dose. But if it was right away, wait. Ventilate and wait. And the most important thing to do is to ventilate right away, immediately. First thing you do. Barbiturates and benzodiazepines are central nervous system depressants. Benzodiazepines actually have, I talked about that flumazenil. That is actually an antidote to benzodiazepines. And they can be given quickly in the hospital. We don't carry it. Altered level of consciousness, they'll appear drowsy, peaceful, or intoxicated. They'll seem like they're drunk. But there'll be no smell of alcohol, no history of alcohol. Benzodiazepines and barbiturates can be taken by pill form. They can be crushed up and snorted. Or they can be smoked. They can be injected. I will tell you that smoking or snorting a chemical gives you a far more quick and powerful high than orally eating it, right? That's one of the reasons why people smoke cocaine. It's called crack. That's why people smoke crack rocks. Because you get a much more rapid high, much more powerful high. It's faster, and it's a much stronger high. Set of hypnotics, usually these are taken by mouth. Most of these are prescribed medications that are either sold on the black market or stolen or bootleg made. And they're usually crushed up and snorted or injected. Some people, these set of hypnotics have amnesiatic effects like Versed or Rohypnol. Roofied, you ever heard of somebody being roofied, right? Rohypnol. And they have amnesiatic effects. There's a video that was on Facebook years ago. And it's just a girl, she's dancing, right? She's got a cup in her hand. And this guy walks by, he just drops a little pill in her drink, she doesn't even see it. So what do you think's gonna happen? You know what's gonna happen. He's gonna be watching her, and she's gonna start getting drowsy and altered. And he's gonna go up to her and say, look, you don't look well. Let me take you home. You look like you need to go home. And it's all over after that, right? I have gone to college calls where a girl, it was altered mental status, we go for the intoxicated female. And we walk in a room, and she's lying there, and she's saying, these aren't my pants, or my bra is missing, or this isn't my room. This is no longer an intoxicated female. This is a potential sexual assault. So a lot of these can turn out to be sexual assaults. So when you walk into these calls, be aware that something else may have happened. It may not just be an overdose, okay? Treatment is to make sure the patient has a clear paid airway, bag him if necessary, and provide transportation. Again, there is really no antidote to these. They need to go to the hospital, and unless the hospital has an antidote, it's just gonna go through the system. The body's gotta break it down and absorb it. Abused inhalants. These agents are inhaled. Acetone, toluene, xylene, and hexane. Especially halogenated hydrocarbons. Most of the time it's teenagers, but not always. Most common is paint, especially spray can paints. They spray it into a plastic bag, and put it over their face and breathe it in. Gold seems to be the most powerful one. It gives you the best high. So patients will have a ring around their mouth, gold or red or whatever, and that's the color that they inhaled. Sometimes it can be gasoline. Anything that's halogenated hydrocarbon based actually produces a sensitivity to adrenaline. So if you inhale halogenated hydrocarbons, even once, getting up and walking can cause an increase in adrenaline released in your body that can cause cardiac arrest. You can get up and walk, drop of a cardiac arrest. The first time you huff. And I say, they call it huffing. And I tell kids that all the time when I go to huffing calls, when I used to go to huffing calls, I'm like, you know, you realize you could die right now. First time you've ever done this. How many times have you done this? The first time you could die. You've done it how many times now? Usually that's gas. Commonly abused by teenagers. And it could be anything. Anything where you concentrate and inhale the fumes. Air dusters, whippets, cheese whiz, right? Or whipped cream, right? It's not the, or even air dusters, like when you dust off the keyboards. It's not the air that's in it, it's the propellant that knocks oxygen off the brain and it causes that high euphoric feeling. I went one time, I got a call for, I got a call, we got a call simultaneously from a company on Mill Street in Worcester and from a mother who we transported for dialysis so she knew us, she called us as well. She told us that she thinks her son is abusing drugs. The company called within a short period of time and said there's a person in the parking lot, an employee of ours, been in the car two hours and people have knocked on the door and he won't open it. So we arrive and I knock on the door and he's kind of drowsy, he opens it. I look in the back and there's 30 cans of air dusters. Now unless he dusted 100,000 keyboards, what's he doing with 30 cans of air duster? He's inhaling, he's huffing, right? So these patients, you want to pick them up very gingerly, put them on oxygen, very calmly take them to the hospital. Don't let them get agitated, don't let them get excited because again, that increase in adrenaline, especially if it's a halogenated hydrocarbon, can cause death and you don't want to be doing CPR on these people. There's this new thing called Galaxy Death, I see it all over TikTok. It's literally flavored air people are inhaling. Why is it your algorithm? It's the thing, right? I'm 18. I'm sorry to say that to you, but. I'm a kid. Weird. I see it everywhere. It's just flavored air. YouTube, TikTok. Oh, nitrous oxide. Yeah. It's the same thing, right? Nitrous oxide is laughing gas. I told you what nitrous oxide is, right? We talked about that in medication. So it's basically a disassociative agent. So it disassociates you from unhappiness. So the flavor will go high. Follows this big. Nitrous oxide is what they use in, you know where you get most nitrous oxide from? Race cars. Yeah, yeah. Race cars. It's superchargers. And that's where they get it. And that's not medical grade, but that's what they're breathing in. Non-medical grade nitrous oxide, which is very bad because it's particulate. And then they flavor it, just so you want an extra little boost. Crazy. Hydrogen sulfide. A highly toxic, colorless, flammable gas with a distinctive rotten egg smell. They call that smell brimstone, right? From hell. Brimstone, right? That's not brimstone. I know the smell of brimstone. That ain't brimstone. Anybody ever see Shrek? When they're going up the... Anyway. So you ever, when you turn on your gas stove and you get that rotten egg smell, that's what you're smelling. Natural gas is colorless, odorless, tasteless. If they add this to it because it burns, but it also gives that smell. If you didn't have that rotten egg smell, you turn on your gas stove and forget to turn it off, your house will go ba-boom when you wouldn't even know it. So that's the rotten egg smell that you smell. If you ever smell that, get the hell out of the area. But hydrogen sulfide can be produced and concentrated. Matter of fact, in ambulances, we plug our ambulances into AC and we keep them charged that way. Every now and then the battery will overload and you'll hear it crackling and you'll walk down through the garage and you can smell that rotten egg smell. That's hydrogen sulfide. That's the acids in the battery overheating and cooking. And you get that hydrogen sulfide exhaust. And it's actually, it's very dangerous because it causes pulmonary edema, but it also, and it burns the lungs, but it also causes central nervous system dysfunction. So it affects both the central nervous system and respiratory. It's used to commit suicide. You can make it. You can go online and make it. All you need is battery and you can make it. If you suspect the presence of this, wait for hazmat. Don't just walk into it. Because again, you could succumb very quickly to this. And an N95 respirator is not gonna protect you from it because it's not a particular, so to speak. So signs and symptoms, nausea and vomiting, confusion, dyspnea, loss of consciousness, seizure, coma, death. Actually, hydrogen sulfide will have a lot of the signs and symptoms of cyanide. Once the patient's been decontaminated, management is largely supportive. These patients aren't gonna off gas or breathe out hydrogen sulfide. So once they've decontaminated and the chemical's off of them, they're okay to transport. And you may end up just bagging this patient all the way to the hospital, or suctioning this patient all the way to the hospital. Sympathomimetics, sympathomimetics, catecholamines, adrenergenics, right? They're all the same thing, stimulants. So you'll see kind of a theme in this. Methyl diethylene oxymethamphetamines, that's MDMA. That's ADAM, MOLLY, Ecstasy, EVE. They're all the same, right? They're all stimulants. They give a euphoric high, they give energy, they give a heightened sexual arousal, and they can last for hours and hours. Very common in a rave. But you're gonna see other things on here. Things like phencyclidine, PCP, angel dust. This is one of the types of drugs that patients take and they put their fist through a windshield, break every bone in their hand and they still bite ya. Cops put eight or nine rounds in them and they keep biting, very dangerous. Cocaine, things like that. But you see, most of them are MDMA. Ice, which is crystal meth, right? It's crystallized methamphetamines. MDMA or methamphetamines is the most abused, widely abused drug on college campuses. Because again, Ritalin or Adderall, that patient, I take it, but you know what, you need to make a little money. You can, as much as 20 bucks a pill. I've got a really big exam, so I'm gonna go out and party this weekend and then Monday I'm really gonna cram for my exam. I'm gonna take a pill and I'm gonna stay up for 24 hours and study. Seen it. Very dangerous. So one of the things that this causes, apart from hypertension, tachycardia, it also causes hyperthermia. And these patients get very hot. And I've seen patients 104, 105, 106 degrees. And 108 is considered uniform or fatal. 106, pretty damn close. Very dangerous. It also dries you out, dries up your secretions. So what you do with a rave, I don't know if you've ever heard of what a rave is. Most of us have heard of a rave. They're parties that go on for hours and hours and sometimes days. What happens is they charge you 10 bucks to get in and then they just go around giving you, you want a pill, you want a pill, you want a pill, they just give out the pills. They don't even charge for them. But they charge 30 bucks for a bottle of water. And these kids just, they're so thirsty, they'll pay anything to get water. And that's what they do. A lot of times they have a need to suck on things. And you'll see a kid, these raves are pacifiers. Things in their mouth, they're sucking on things. It's a physical need to do that while you're high. What do you got on mine? Produces an excited euphoric state. Causes hypertension, tachycardia, dilated pupils. Again, constricted blood vessels, dilated pupils. Includes amphetamines, methamphetamines, fentamine, hydrochloride, and benzidrine. Some of these used to be used in weight loss medications. Designer drugs such as MDMA are also frequently abused. Patients taken by mouth are also injected by drug abusers. And sometimes they mix these drugs. You may get a patient that'll mix MDMA with heroin. So you get the high, yet you're wide awake. So you walk up to the patient, maybe they're in respiratory depression because of opiates. You give them Narcan, you wipe off the opiate, and then the MDMA takes over. And now they go from unresponsive, not sleeping, to off like a shot. Cocaine may be taken in a number of ways. We can snort it, we can inhale or smoke it, we can shoot it up. Usually it doesn't last for more than an hour or more. Crack cocaine or smoking cocaine is the most potent, gives you the strongest high, but it also usually runs out within about 45 minutes to an hour. That's why people smoke crack multiple times a day. If you ever wanna know what it's like to be an addict, Mike Lindell, the pillow guy, he's got a book. And he was a 30-year crack addict. Read his book. It tells you all about it, and sometimes you need three or four times a day, and you just disappear and smoke crack all day. And it's very, very strong addiction. One of the strongest addictions you could have. An acute overdose of a sympathomimetic is a general emergency. Patients will have seizures, cardiac dysrhythmias, which might be tachycardia, and stroke. They exhibit hallucinations and paranoia. They're gonna feel like feelings of persecution, or they're being followed, or the aliens are there. Never leave a patient unattended, especially a patient who has like a sympathomimetic overdose because they've been known to shoot up when they're alone, or to arm themselves and attack the first responders, or to run away, so don't do that. If you're gonna go somewhere, I'm going with you. You go to the bathroom, I'm gonna be there with you. You wanna pack a bag, I'm gonna help you pack a bag. And prompt transport. Synthetic capinomes, called BAP salts, an emerging class of drugs similar to MDMA. It is not the BAP salts from BAP and Body Works, although that's the way it's advertised. And that's the way China, where it's manufactured from, was able to get it into the United States because they advertised it as BAP salts, so it didn't fall under the FDA's umbrella. So they were able to just ship it in. But they advertised it, well, you are BAP salt, but you could smoke it. And it produces a euphoric mental clarity and sexual arousal similar to that of MDMA, but it can last up to 48 hours. You guys ever, I don't know if you remember this, but there was an actually, in New York a few years ago, they had, the police responded to an apparent assault, and when they arrived there, they found one neighbor eating another neighbor's steak. That was synthetic capital, that's all. These guys do not, do not address them personally, like do not be one-on-one with them. You want to have a bunch of people with you. Now, I like to have the cops. You know, cops have anodized metal batons, they've got tasers, they've got mace, they've got the gun, they've got the, you know, the trauma vest and the trauma plates. What do I have, an O2 bag? I'll let you guys handle that, come back when you're done. O2 tanks can do some damage. It can do some damage, that's for sure. Adverse effects, teeth grinding, appetite loss. This is one of the things when you see crystal meth, you see patients with meth mouths, they have blackened teeth, and they get all these pot marks all over them. These people, these chronic users, they'll have, like they'll have these scabs, so they get these itchies, and they scratch them, and they get these scabs, and they pick these scabs, and their body's covered in these scabs. They're very skinny, very gaunt, bad teeth, pot marked all over their face and body. You can tell, a long-term user. Teeth grinding, appetite loss, muscle twitching, lip smacking, confusion, GI conditions, paranoia. Keep the patient calm and transport, call ALS. We'll come in, and we'll give them, you know, we'll give them sedatives. We'll sedate them, we'll give them Haldol, we'll give them Versed, but I'll be honest with you, I probably don't carry enough sedatives to sedate these people who are really on this, who are really hopped up on this. I've seen people in the hospital on bath salts get the B-52, and don't go to sleep. The B-52 will put a horse to sleep. I'll bring my mom here today. She put a horse to sleep? No, they put the B-52. She worked with CSO, had a guy come in, that was like going insane, like a heavy Russian accent. They hit him with a B-52, he didn't go down. Yeah, and then probably bath salts. Marijuana is abused, it says it's abused across the world, I don't know if it's necessarily abused, but it's used worldwide. THC is a chemical, tetrahydrocannabinol, there's two chemicals that come out of marijuana, there's THC and CBD. The cannabinoid, that's the medicinal one, that's got a lot of medicinal uses. CBD has been known worldwide to do fantastic medical things, whereas THC, the tetrahydrocannabinol, that's the high, that's the high you get from it. In order to sell something as a CBD medicinal medication, it has to have less than 0.2% THC. Anything more than that, then it's gonna produce a high and it has to be classified as that. CBD has a lot of usage. Matter of fact, if you're gonna use CBD oil, right, if you have a particular joint issue or something you wanna put on, put it directly, but the best place to put it is lie down before you go to bed and put two drops in your umbilicus. There is a complex of 30,000 blood vessels that meet at your umbilicus, because that used to be where you got fed as a baby. They're still there. So if you absorb nutrients through your umbilicus, it'll get spread out most quickly throughout your body. You'll wanna do that. Produces euphoria, relaxation, and drowsiness. It impairs short-term memory and the capacity to do complex thinking. Absolutely, the only thing I'm thinking about is where I'm getting my next bag of Doritos. And could progress to depression and confusion, which can't happen. You can get a bad high, so to speak. Although in my years growing up, I don't remember ever getting a bad high. What's your prostate? I smoke trees when I was a kid. What's that? What's your prostate? Prostate? That's when you're drunk. Yeah, when you get drunk and high at the same time. Oh, oh, oh, oh, yeah, that'll, yeah, that's interesting. Fuck you up. With very high doses, patients may experience hallucinations or become very anxious or paranoid. And what else can they develop? What's that condition? Cannabinoid hyperemesis. Very good, cannabinoid hyperemesis syndrome. That's that severe vomiting due to the overdose of cannabinoid hyperemesis syndrome. And the best treatment for that is a hot, hot shower, as hot as you can stand it, until the symptoms go away, and then go lie down. But you can't prescribe that, so you transfer. Marijuana is often used as a vehicle to get other drugs into the body. That's one of the reasons, there are two reasons, two main reasons that I felt that marijuana should be legalized now, should be federally legal. Number one is that instead of spending billions in interdicting it, we make billions in tax revenue. So it doubles the income. Number two, marijuana is a gateway. My ex-brother-in-law is deceased now, but he smoked a joint that was laced with PCP and went after my ex-in-laws with a steak knife. Ended up spending seven days in a psychiatric center. That's the problem, is you never know what you're getting when you buy, like I did, buying marijuana from your buddy on the corner where you got it from somebody else. Now you go to a place where it's regulated, people inspect it, and when you're buying it, you're buying a note. You might not know the dose you're getting, but at least you know you're getting clean marijuana. If you can buy alcohol, you smoke cigarettes, what's the difference? That's my view. But that's my own personal belief. Everybody has their own belief on if it should be legal or not. Several states have legalized it. We have it in Massachusetts. It is legal. You can get it the same way you get alcohol. As long as you're 21, you can buy it without restriction. Now the thing is, with edibles, when I was a kid and I bought a joint, I smoked a joint, I got a joint dose, right? Now with these edibles, we can remove the THC from the marijuana plant, concentrate it, and put it into different cooking things. So I might get, you're supposed to take one gummy. One gummy is equivalent to one joint. Or you might get a brownie this big and it's equivalent to five joints. You're only supposed to take a bite out of the brownie. Who the frig takes a bite out of a brownie, right? You're gonna eat the whole damn thing. I actually had one of my old partners, he doesn't work for us anymore, but he was like a connoisseur of marijuana. He could tell you everything about it. He grew it, he knew everything. He was gonna make his own growing cell site. But anyway, he made gummies and he put them in a vitamin bottle and he brought them on a cruise with him. And he got all the way through the cruise. They thought they were vitamins. Oh, they were vitamins already. Synthetic marijuana, also called spice, a variety of herbal incense or smoking blend that resembles THC. So it's a THC-like reaction to this. And it's not just, I call it potpourri, but it's not really potpourri. But there are certain chemicals that you can smoke and get from it. It has powerful and unpredicted effects. You might get a high like THC. You also might get a loss of consciousness, severe paranoia, respiratory injury. Remember, it's chemicals that you're smoking as opposed to a natural herb. Hallucinogens. Hallucinogens alter a person's sensory perception. Classic example is LSD, lysergic diethylamide. Anybody know who invented that? The FBI. Or US Army, US military. It was supposed to be a soldier enhancement tool. Oh, when they had soldiers, all right, they decided to kill themselves and each other. So they stopped making it, but the recipe or the manufacture of it got out in the general public and now everybody's taking it, people make it. LSD is acid. Did you ever hear the term, oh, he's tripping on acid? That's what they're talking about. And the thing with LSD is it takes a very small amount. You can get a small sticker and just lick it and you can get high from it. It takes just micrograms, very little amount. So what they would do is they would go to schools, dealers would go to schools and they'd give out tattoos. And you'd lick the tattoo and put it on and it'd get stuck and kids would get high from it and then they could sell the tattoos afterwards because the kids got high and liked it and then they would buy more tattoos. That's how they'd get kids hooked on it. Well, because it also, again, just like LSD, you're not controllable. It's not like an Apollo horse. So these are different things. Bufotinine, a toad skin, that's actually not frog skin, that's actually a plant, but they do have a frog that produces a hallucinogenic effect. There was a video years ago, it was on YouTube, I don't think it's on there anymore, of two guys that went to this tropical forest, this rainforest, and they found a frog and they licked the skin and they videotaped it and they were on the videotape and they died on the videotape because they overdosed on it. And you watched them going through the hallucinogenic effects and they died. There's that ginseng weed, that turia strontium that grows in your backyard. Dextromethorphan, where do we see that? Cough syrup. Cough syrup, Robitussin D. That's why you need a license, you're gonna be over 18, to buy it in CVS. And they only sell you so much. They call it RoboTrip, what is it, RoboTrip? And people will take that dextromethorphan, sometimes they mix it with, what do they call that? Kiss your wings, there. Red Bull.