This year, I had the privilege of rotating through an addiction clinic, Addiction Allies. During the rotation, I heard many stories similar to this one. It surprised me just how many of the accounts contained a medical professional joking about opioid use or presenting a drug as the solution to pain.
On the first day of my summer fellowship, I almost stepped on a used needle. The road was littered with needles and syringes, a byproduct of widespread intravenous drug usage and a physical embodiment of a much larger problem. The United States is in the midst of an epidemic that takes over 115 lives per day.
There are patients who leave lasting impressions on us in one way or another throughout our training. I had never expected an angry, alcoholic patient who left against medical advice to be one of those patients for me.
“We have a drug seeker in two,” the nurse declared. My preceptors responded with a long sigh, and they rolled their eyes in unison. My pulse quickened.
Dr. Alison Holmes, pediatric hospitalist at Dartmouth-Hitchcock, did not expect to work in perinatal addiction. “I had no interest in addiction,” Dr. Holmes admits.
In 2006, Daisy Goodman first experienced a patient disclosing a narcotics addiction. A certified nurse midwife working in obstetrics, Goodman had had years of experience working with pregnant mothers to cultivate a healthy pregnancy and birth.
On the first day of my neonatology elective I met Aaron, a one-day-old infant born to a mother with a history of intravenous drug abuse. The mother was reportedly attending a methadone clinic during her pregnancy to address her opioid addiction, but her urine drug screen was positive for fentanyl.
As a medical student, I always carry naloxone in my backpack. Naloxone is the antidote for opioid overdoses, and is readily available at most pharmacies in Boston. My medical school, Boston University School of Medicine, is located near the epicenter of the opioid epidemic in Massachusetts.
An addict in detox, again. / Chief complaint of “at his wits’ end” / Manipulation, his malicious game.