Harm reduction in hospital facilities

[nurse_K (OP)]

Found this article. Basically its common sense, and it gives some practical advise and suggestions on how to implement harm reduction in a hospital setting.

enjoy

http://healthydebate.ca/2016/07/topic/harm-reduction-hospitals-injection-opioids

[Chip]

i see many familiar situations in that article - i once landed in hospital after shooting humongous amounts of Methadone. only to be given 10 mg. of Morphine on top of my 80 mg dose of Methadone at the time.

i didn't sleep for a fortnight and was in a lot of pain.

i can't imagine what i would've felt like if i hadn't been on Methadone program ... hospitalisation when i was an IV opiate user was always my greatest fear.

great article.

... another looming issue is GHB/GBL/1,4-BD addicts who wind up in hospital - there are no formal, established protocols for that (yet).

[nurse_K (OP)]

The article emphasizes the importance of adequate ( spelling?) pain treatment for patients with addiction whilst in hospital. It simply makes no sense that you can be treated for this and that infection, but at the same time withdrawal symptoms are neglected. Part of the oath is to cause no harm and ease pain.

I find this article raises a very important question; why go to hospital if  you will not receive the necessary help. Not least; how come you from a medical view can accept that patients have to go to the streets to get adequate pain relief. Its embarrasing.

[Chip]

... and i have heard many stories of friends having to bring Heroin etc. in to stop the abject misery.

i, myself, have had to get (extra) Methadone in, otherwise it would've been horrid.

maybe the problem is that the hospital staff often think "if they walked themselves into a dependency then they can't be trusted with their own health so why should we bother, too ?"

[nurse_K (OP)]

maybe the problem is that the hospital staff often think "if they walked themselves into a dependency then they can't be trusted with their own health so why should we bother, too ?"

It is not acceptable. Nor does it justify.  Would you treat the diabetes patient or the patient with COPD in the same manner?  Would you be stingy with the insulin so the patient could learn his or her lesson?

I often argue that we would rather know what the patient is taking ( we give the methadone, morphine) than  a patient runs outside the hospital and takes whatever he or her can get her hands on.

Firstly because it means the patient relaxes once they know that their withdrawal symptoms will be addressed, ( no conflicts) secondly they dont leave prior to discharge ( finish their Iv treatment).

Actually this is not rocket science, but just plain common sense.

[Chip]

{snip}

Firstly because it means the patient relaxes once they know that their withdrawal symptoms will be addressed, ( no conflicts) secondly they dont leave prior to discharge ( finish their Iv treatment).

Actually this is not rocket science, but just plain common sense.

common sense isn't that common and it's going to take much time and energy to convince the majority of nurses (and doctors) ... i applaud you on your deeply human, empathetic and best-practice attitude, though.