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

published on July 21, 2016 by Wendy Glauser, Jeremy Petch, and Mike Tierney in Healthy Debate

In 2015, Shawn was in the hospital with an abscess on his spine and a life-threatening blood infection. After waiting more than a day in the emergency department, he was withdrawing from heroin – sweating profusely, extremely anxious and in excruciating pain. “It felt like someone was crushing my skull. Tears were running down my face.”

He told his doctor that he spent upwards of $250 on one gram of heroin per day. So his doctor put him on a much higher dose of morphine than he would give to the average patient. “It was enough to take the edge off so that I wasn’t lying there in tears, but I was still feeling the withdrawal.” But when the shift changed, the next doctor cut his dosage to less than a quarter of that. Shawn was about to leave when the first doctor returned. “He flipped out. He said, ‘What are you doing to my patient?'” Shawn was put back on the originaldose.

Still, the nurses were often hours late with Shawn’s next dose, which was already much lower than what he would take on the street. Against his doctors’ advice, Shawn decided to leave the hospital after two weeks. He should have stayed on IV antibiotics, but health providers switched him to antibiotics in pill form. He got better initially, but now he has a swollen lump on his spine again. It’s been agonizing for months, but, Shawn says, “I’m not going back to the hospital.” He uses heroin to reduce the pain.

Shawn’s experience isn’t the exception. According to addictions specialists, patients often wait until their infection is unbearable and life-threatening before seeking treatment, due to past negative experiences. They tend to leave the hospital before they’re fully healed, or even before they’re treated at all, because they’re forced to go into withdrawal or because they feel judged by health providers.

“Very vulnerable people aren’t getting effective treatment,” according to Jeff Turnbull, chief of staff at The Ottawa Hospital and medical director of the Inner City Health Project for the homeless in Ottawa. “That could lead to increased disability and even death.”