Hospital policies put the lives of people who inject drugs at risk, say experts


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22 comments

  1. Wip Lamba

    Thank you for bringing this topic to the forefront. When a patient leaves AMA due to withdrawal it is a sign that the system failed. We need the attitude shift that Dr. Selby was talking about and access to supplies, harm reduction principles and access to active addiction treatment within the hospital setting. I look forward to see how this attitude shift occurs and the addiction team at St. Mikes would be happy to help in any way possible.

    Offering Buprenorphine, methadone, alcohol withdrawal treatment, anti craving Meds, harm reduction tools/kits and psychosocial interventions would be a great place to start and anyone is welcome to contact us if they want to build capacity in those areas – Wip Lamba, addiction physician St. Mikes , toronto.

    • Jennifer Torres

      Hi i’m from San Antonio, Tx. I am writing in regards to your article about illicit drug use in hospital. My boyfriend was admitted Sunday morning. When i left the hospital, he was a free man sick in a hospital bed with a sever case of cellulitis, agonizing pain, and suffering from opiate withdrawal. When I arrived back
      at the hospital afew hours later.they had him handcuffed in a hospital bed no clothes on . incoherent and helluccinating. A SAPD officer at his door telling me that he’s been arrested for possession. I wasn’t able to talk to him,and still have no idea what kind of mind frame is he in. What’s going on with his legs. Before this visit I had took him twice before to the hospital and both times the severity of his legs got him admitted. Both times he left the hospital against doctors orders, cause of withdrawal symptoms. This all in a 3 week period. Now he’s going to jail and I’m never going to get him to trust or go to a hospital again. I’m just upset with myself. I made him go back to the hospital and now he’s suffering alone. I’m left wondering about him while raising our 8month old daughter.

      • Jen Ball

        Jesus I am so sorry to hear this. I am going through a similar situation minus the legal charges thus far. I’ve bounced in and out of in patient at different hospitals and no doctor will address my withdrawals so I just keep leaving ama after a few days. The stigma and attitude that addicts aren’t worthy of medical care is just so sad and disgusting. I hope your boyfriend is now free and getting the care he needs.

      • Jennifer

        Hey, I read your story and was wondering why he was arrested? Did he have drugs on him?

  2. Kenneth Lam

    This is a great topic that doesn’t get enough attention in the hospital.

    The bad relations between health care providers and drug users stem from a lot of assumptions made by both parties. As the article suggests, drug users are likely to have bad experiences with health care providers, and sometimes just one experience is all it takes for them to lose faith in the system and start seeing doctors and nurses as uncaring and stingy. For health care providers, we are scared of being held responsible for over-prescribing opiates, but I think we are made even more hesitant from experiences with shrewd and misleading requests for drugs in hospital: I believe we are more averse to the idea of being taken advantage of than of the risk of over-prescribing.

    For health care providers to become less judgmental, there needs to be a change in attitudes about drug use and the long road to recovery as the articles suggests, perhaps made explicit through some re-assurance from regulatory bodies about what actually constitutes egregious prescribing practices in hospital. But we also need a strategy to deal with that feeling we get when we find out someone has lied to us – that mixture of anger, betrayal and humiliation – which colours so many of our encounters with this marginalized population.

  3. Lisa Bromley

    In addition to offering harm reduction services, hospitals should be prepared to offer pharmacologic treatment for people with substance use disorders (SUD). Specifically, contrary to popular perception, Opioid Use Disorder (OUD) is a highly treatable illness. It often responds spectacularly well to pharmacologic treatment with methadone or buprenorphine-naloxone. Methadone and bup-nx are gold standard treatments with incontrovertible scientific evidence behind them. Methadone treatment for OUD is over fifty years old: talk about a gap between evidence and practice. Not offering treatment for OUD in hospital is akin to not starting treatment for a newly diagnosed diabetic in hospital. It is a combination of attitude gap and knowledge gap. Hospitalization with a serious illness can be a major motivation for change for someone who is injecting, a window of opportunity. If a hospital is to offer harm reduction services, it makes the most sense to offer the full spectrum of harm reduction, namely, offer proven medication treatment for Opioid Use Disorder *in addition to* safer injection support. Without it, patients who are interested in treatment and who would benefit from methadone or bup-nx would miss a precious opportunity. The gains in health and cost savings would be massive if even a small proportion of injection drug using patients were captured into methadone or bup-nx treatment during a hospitalization. -Lisa Bromley, family physician with focused practice in addiction, Ottawa

    • Wip Lamba

      Lisa’s comment on in-hospital treatment is so true. Many hospitals do not have a regular prescriber who can initiate and continue buprenorphine-naloxone or methadone. Harm reduction works best when we are in environments where there is a saturation of treatment options.

      Hopefully there will be a shift in hospital policy so all patients have access to these treatments when indicated.

  4. Kimberly Wintemute

    Thanks for bringing this issue to light. One of the hardest things to do in life – and as a care provider – is to put yourself in someone else’s shoes. This piece helps me do that.

  5. Elliott Coronado

    I had pleaded with the hospital not to take any decisions without first speaking to me, but they ignored me, as they had done since she was admitted as an emergency six days earlier.

  6. Richard Gould

    I understand that Health Canada has recently classified heroin in such a way that physicians can legally prescribe it. So perhaps this is another option available to hospitals. A hospital could possibly try methadone or suboxzone first but if that doesn’t work then injectable options could be available for the patient.

  7. Carrie H

    Heroin has been legal for a very long time. Many patients in Hospital (especially cardiac patients) are give it for pain on a routine basis. It is safer for the hear than the alternative, Morphine.

    It is labeled as “Diamorphine” it is, esentially, more refined heroin. I bet at least 1/3 or more of elderly patients in hospital have recieved it on a routine basis. (Not available in many countries but luckily Canada allows it).

    If you havent already and have an interest in the subject, please check out Johann Hari and listen to his Ted talk. If you want to explore further, he as a superb book out about everything anyone should know about it and many of its Opiate/oid relatives.

    Being informed and knowledgable, especially in the Healtcare field, about something that affect a huge percentage of patients can only make you a better provider. Knowledge is power.

    One cannot truly have an opinion on a subject that he/she know little about. Who know, it just might change perceptions, opinions, and help you save someone who would otherwise be lost to the tradgedy of addiction.

  8. Quintina

    I’m waiting to my have blood checked for poisoning, after using.
    They took a pee example .. I’m never heard here as before a few one year ago , I was turned down twice and than with my CMHA worker was admitted. Now I feel they are not taking me for coming here real. I should be drinking water while waiting for the doctor to take my blood ?

  9. Cbass

    Ive been in the hospital now for two weeks. I was admitted for septic shock and due to my heroin IV use I can’t leave the floor because I have a picc line or mid line i get IV antibiotics. My doctor was giving me oxy 5 mg and narco 5 mg seriouly i use a half to a gram of heroin a day. Im put in the “drug seeker” category. One day my doctor was not their so another physician came to do his round he was so insensative to my pain and situation and he to me off all narcotics and put me on torodal even the nurses were glad out of my best interest. Guys all am saying is the patient is less likely to stay a 4-6 weeks antibiotic treatment if you take his 5mg pain control pills because even after withdrawals and addict for 7 years like me still have mental neuro like desire for opiods. Which effect the ill patient treatment. He may leave the hospital to go shuve dope into his picc line because hell he can’t find a vain get reinfected and die. Give the patient the perk 10 because its not like his friends can’t bring him heroin into his hospital room.

  10. Rob

    I’m in the hospital right now for the second time dealing with an infection they say my two infections were not tied together because they had just treated one infection in my spine in August and it is now December and they say they are not tied together but I believe they are and they’re covering their ass but besides that they have a PICC line in and they are giving me only options to either go home with no antibiotics nothing and tell me my chances of dying or very good or I have to stay here for four to six weeks or go to a nursing home for four to six weeks I’m sorry 4 to 8 weeks and it’s b******* because I don’t have the time to go to a nursing home or stay here for another 6 weeks I already did it once this year and I cannot do it again and they don’t really give me any options I have the PICC line I am an addict but a PICC line isn’t even set up for the person to inject into it if you injected into it things well just leaked out of it it’s not set up for a Sharp needle and set up for a syringe that doesn’t have any dough it hopes up and screws onto the tip of its unless you have that you are not injecting anything into it not only that as an addict I don’t need a PICC line to shoot up I’ve never had a PICC line in my life and I’ve never had an issue with shooting up not only that I have been clean it’s now December and I’ve been clean since April well I’ve had four uses since April so it doesn’t exactly matter if I have a PICC line or not I just do not want to be in the hospital at long as they do not let me outside and I basically stay or not forward I can walk down a month 60 to 70 feet and I can turn around and come back and go in my room and that’s really all I can do because I went outside and have a cigarette they’ve harassed me five times already by searching my room drug tested me and yet they’ve never found anything in one of the times but yet they keep doing it and doing it and doing it they’ve now said that my girlfriend is not allowed to come here anymore and I’ve been with her for 6 years they are not allowing her in here anymore because they are mad because I went outside to smoke a cigarette but yet they say they’re only worried about my safety when I came back in and all they did was have 15 nurses sitting there staring at me and came back and yelled in my face that I need to get to my f****** room and told my girlfriend to leave sorry to f****** leave but yet then they called security and had the actual police here and were telling me that they were just doing what was best for me and they were worried for my health if you were worried for my health you wouldn’t have screamed at me and told me to get the f*** to my room you have been asking me are you okay are you okay can I check this out can I check you out telling someone to get the f*** to their room isn’t something that is a worry or something that somebody does when they’re worrying about you or they’re scared for your life that’s something someone does when they are mad because you did something that they didn’t want you to do and anytime I bring up wanting to not be here or I cannot stay they avoid the question tell me that’s why I really only option until a nursing home takes me I don’t want either of those I want to go home but they told me if I go home I will die and they make sure to tell my family that too so now my family thinks if I leave here I will die they need to stop this ignorance

  11. Marilyn Mance

    Currently hospitalized in Phoenix, AZ and also an active opiod addict, this topic truly hits home.
    From what was reported here, as well as other articles I’ve read lately, it seems like our Canadian neighbors seem to have truly began embracing the challenge as well as the individual addicts with a realistic amount of support, encouragement, and equal common decency that has been 100 years over due.
    I believe with Canada’s budding new ideals on the proper way to address and treat this overwhelming crisis, and that if this trend will spread to the point of becoming the standard in hospitals and health care as a whole, perhaps finally this century long scourge can become a declining social enemy of the past.
    As with so many intolerable crisis of the past, after society addresses the illness logically, sympathetically, and respectfully we usually seem to find a way to overcome it, find treatments and medications, and lastly, exonerate the individuals from the life long stigmatism.

  12. Connie Wolford

    I too have had a rough way to go with er drs its like once you tell them the truth you are then judged and belittled and labeled as just another needle junkie seeking a fix! I am one of the addicts that waited until i was almost septic bc i had a spinal abscess in my thoracic spine and didn’t know that i had it .The infection was so bad that it had compressed my spinal cord. On Feb 4th 2019 I went to get up from my bed in my home and when i swung my legs Aarons to the edge of the bed, I tried to stand and i fell flat on my face in the worst pain that i had ever imagined it felt like my back and stomach was on fire not like a normal fire more like an inferno iwas rushed to the nearest er and life flighted to a trauma hospital i went straight to surgery when i woke up in recovery i didn’t remember how i got to a trauma hospital 80 miles from my home town until the nurse told me .I woke up in so much pain. As i said above the infection was so bad it had compressed my spinal cord and there was a large puss pocket on my spine as well drs also took out tissue from T7 and T9 I am currently to date (Mar 20TH) in a skilled nursing facility who has inhouse pt and ot therapists ,i also get iv antibiotics vanc as they call it here twice a day. I still can’t walk but i have came a long way since Feb 4th. i just wish had hadn’t waited so long to go to er but it only takes one illiterate uneducated dr who don’t see past the “needle junkie” stereotype that he or she created in their mind to ruin it for all drs bc we the addicts have absolutely no trust in any er drs. Thank you

  13. Ryeki

    What is you are not an iv drug user and are discriminated because you are positive for a drug you only smoke?

  14. Ryeki

    What if you are not an iv drug user and are discriminated because you are positive for a drug you only smoke?

    They are refusing a picc line for my husband who doesn’t do opiates and has never done drugs intravenously. This hospital in so many words do not believe addicts, or a former addicts, deserve the same treatment and pain management as non-addicts. How is that legal?

  15. Audrey

    Wow I thought I was the only one this happened to. I was an iv user in 2004 and was admitted to hospital with endrocardis and was told I need 6 weeks antibiotic treatment and could not leave with a pic line, Because I admitted being addicted to diladid, every week I had a new Dr, who would have different views on if I should detox or not. I went from being comfortable, to complete withdraws. I checked myself out 2 or 3 times, I “hospital hopped” trying to find somewhere I could go that would let me stay yet not let me go through withdraws, I was dying from my infection. And I ended up bouncing around and stayed almost 6 months before finally being rushed to have heart surgery, even the day after heart surgery, without asking how my pain was my dr tried to take me off of pain meds and I almost left until Dr changed her mind and left me Alone, I was not there to get high, I was there to get better and they were so worried about not giving me pain meds that they didn’t care to correctly treat the infection that I was dying from. Once the drs know your an addict you are treated very differently to the point to where its affecting the decision there making and basically forcing very sick people to check them selves out where many have died, I was lucky and stuck with it, and went through alot of ups and downs. But I this article couldn’t be more true. Drs and nurses are supposed to help people, but these days many feel that addicts are not people worthy of there help, and are forced to leave, then die. When had the Dr not judged and put all his energy in trying to treat addiction they would have been able to save the patient treating the correct infection that needed treated at that time.

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