Save blame for later, it’s time to work together to solve the opioid crisis

Every day I entered her hospital room it felt as though I was entering her actual bedroom. Any empty space I could see was covered with personal memorabilia: cards from friends and loved ones, flowers, schoolbooks and packs of her favorite candy livened an otherwise dull and unwelcoming hospital room. She had made this space her home and I didn't blame her. After a diagnosis of endocarditis that had affected one of her major heart valves, she was going to receive six weeks of antibiotics through a peripherally inserted central catheter, and she would spend those six weeks in this exact room.

Every few days I would check in, making sure she wasn't having any fevers and that the site of the catheter was clean. Beginning my exam, I would auscultate her chest to listen for irregular heart sounds. Going through the same routine each time, she had come to anticipate my next move. "I never thought I would be in this position," she told me one day. I loosened my stethoscope from my ears instead of beginning my exam.  

 

Further reading: What should physiciand do about the opioid crisis?

 

She told me she was 22 when it started. She began drinking more heavily on weekends with friends to relieve some of the stress she was feeling in her job as a teacher. Then one weekend, one of those friends asked her if she wanted to try a line of cocaine, and she did. Surprised and euphoric from the high, she quickly dabbled in other substances and eventually advanced to intravenous drugs.

After several weeks, she found herself injecting heroin every other day, except this time it was not just on weekends when she was drunk. She was shooting up in her office between teaching classes during the day and in her bedroom when her parents were outside watching the nightly news. Each attempt to satisfy her need for a high grew more risky. She was taking trips to surrounding cities where she had heard heroin was cheaper but not telling anyone where she was. She admitted she was ashamed, but felt she couldn't stop. 

 

Even more opioid coverage: Physicians don't want hands tied by opioid reform

 

I listened as she talked, partly empathizing but not fully understanding how a seemingly well-educated and highly-functioning young person with a meaningful job and a supportive family could so quickly take a turn toward a much darker path. She explained to me that because heroin was so accessible, she easily began to seek it out through different buyers on her own, despite being a novice. Her own hunger for the drug scared her.

I thought to myself that maybe her diagnosis was the jolt she needed. Instead of falling deeper into the abyss of addiction, she was now sitting in a hospital bed, in a controlled setting, and forced to deal with her mental demons every day for the next six weeks. Of course, her story was one of many I had heard since starting to work at this rural community hospital, and with each patient encounter I was becoming less and less surprised by the details.

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