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How and when to save a heroin addict

A door slams shut every time an addict overdoses, is revived with naloxone, taken to an emergency room and then discharged to confront her demons on her own.Open door and green meadow with blue sky

This door is open for only a very few, precious minutes. Once the naloxone wears off, the craving immediately – fiercely – returns. If that addict doesn’t get another fix, withdrawal sets in. Any addict who has been revived with naloxone will tell you they must get high…quickly.

To a non-addict, this makes no sense. Why would anyone who has just been brought back from the dead immediately go out and do the same thing that stopped her heart an hour before? Who does that?

A heroin addict.

It is during those few minutes between the naloxone wearing off and withdrawal setting in that we need to do an intervention. During those few minutes when reality, guilt, fear and remorse hit an addict and withdrawal sets in, we need to give an addict a choice: continue living the life you hate or let us give you what you need: detox.

We need to let that addict know, in those few minutes, that we will not let them suffer the horror of withdrawal. We will begin the detox process immediately. We will take care of them. We will care for them with compassion – not revulsion. We will even pay for it if they cannot.

Exactly how should this be done? Hospitals that see a high volume of overdose cases in their ERs should have a full-time social worker or interventionist on staff at all times. When the ER receives notice that an overdose victim is on the way, that interventionist or social worker must be waiting.

Here is the tricky part: Those social workers or interventionists – preferably a recovered addict themselves – must be trained in how to speak to an addict in this state. Semantics is crucial. They must be non-judgmental and compassionate.

Most importantly, we must follow through on the promises made by an interventionist or social worker. The hospital, with the community’s support, must have an empty detox bed waiting for that addict. There can be no waiting around in the ER for a few hours because as soon as that addict starts feeling sick, she will walk out – AMA (against medical advice) – and get high.

If we screw up and don’t make good on our promise to offer immediate care for that sick addict, the door slams shut and won’t open again until the addict ends up back in the ER after another overdose.

Policy makers, politicians and do-gooders who are not addicts need to understand that in an addict’s world, word of mouth is everything. How do you think drug addicts find their drugs? Word of mouth.

You can put out all the public service announcements and hold all the community forums you want, but if just one addict is promised immediate relief via detox and then doesn’t get it – word will get out on the street that the promise of detox is bullshit. Don’t do it.

We – as a society – are capable of doing this. The question is – do we want to do it? Yes, it will cost money. But there are ways we can contain the costs. We – taxpayers or non-profits – can underwrite the costs for hospitals to hire full-time interventionists and social workers. We can underwrite the cost of sending addicts to private detox facilities – far cheaper than building public detox centers and staffing with public employees.

But the biggest challenge is not financial. It’s challenging our own beliefs and attitudes about addiction and how we treat addicts. Look, I understand that active heroin addicts can be mean – very, very mean. They can say horrible, vile things. Believe me, I know this first hand.

It’s not easy to be nice to an active drug addict – especially one that is desperate and going through withdrawal. It will push the limits of our compassion and patience. It will force us to confront our own bigotry and ignorance and admit that we are and have been wrong in our own beliefs about addiction.

Are we willing to do this? We cannot try. This approach is all or nothing. We are either in or out. We cannot make promises to addicts and not keep them. We cannot promise and addict a detox bed and then say, “Sorry, we don’t have any beds until next week.”

If we do, the door will slam shut.

 

 

 

 

 

How and when to save a heroin addict

Christine Stapleton

Christine Stapleton has been a journalist for 35 years. She is now an investigative reporter for The Palm Beach Post. In 2006, began writing a blog for PsychCentral called Depression on My Mind. Her latest blog, Addiction Matters, draws on her 19 years of sobriety and her coverage of the drug treatment industry in South Florida.


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APA Reference
Stapleton, C. (2016). How and when to save a heroin addict. Psych Central. Retrieved on March 19, 2019, from https://blogs.psychcentral.com/addiction-matters/2016/06/how-and-when-to-save-a-heroin-addict/

 

Last updated: 20 Jun 2016
Last reviewed: By John M. Grohol, Psy.D. on 20 Jun 2016
Published on PsychCentral.com. All rights reserved.