I’ve treated thousands of patients over my 20-year career as a doctor on the front lines of substance abuse and psychiatric illness. Recently, however, I had a heartrending experience that I feel must be shared; one that brings home the true nature of compassionate and genuine treatment in this fearful and uncertain time when millions of Americans suffer from life-threatening opioid addiction and struggle to access treatment.
It is all too easy to become detached in my world as I encounter hundreds of people suffering from the scourge of opiate addiction. In fact, so many insurance companies see the growth of the industry of addiction treatment in South Florida as a manifestation of fraud and “unnecessary” care, and are working to limit or deny treatment. That boundary, for me, was broken some months ago when an earnest 26-year-old woman who had worked very hard to achieve several months of recovery at the treatment center for which I serve as Medical Director succumbed to despair and compulsion and perished in a lethal overdose of opiates. This happened just two weeks after staff tried so desperately to reach out and re-engage her.
We have served more than 300 clients since opening our doors and this woman was one of over a dozen to meet this tragic end. The staff and clinicians had witnessed this tragedy too many times and, within days, met to try to address it. We decided that regardless of costs and time (thus far approximately $8000 out of pocket) we had a responsibility and a mission to educate and provide every discharged client with a potentially life-saving double dose of nasally-inhaled naloxone medication to use in the event of an overdose. This is not a measure that’s required in any treatment plan or by any particular insurance provider, nor am I aware of other treatment programs that take it. Several dozen discharged clients have now left the program with the life-saving naloxone nasal inhaler ($136 for the two-dose inhaler) in their pockets.
I happened to be a medical director at another intensive outpatient program where one of our clients eventually transitioned. Literally a month after starting the naloxone inhaler program, I learned that our former patient had utilized his inhaler, and another client’s, to administer four doses of naloxone within two minutes of a very lucky young female patient becoming non-responsive due to respiratory arrest caused by opiate overdose at her halfway house. The education on how to administer naloxone, and having it available immediately, literally saved this young woman’s life according to the later-arriving emergency medical services.
This epidemic is real and it’s killing tens of thousands of young Americans every year. Treatment can be complex, difficult and lengthy. It also can be cost-effective, sensible and life-saving. These are very real people: daughters and sons, sisters and brothers, friends and neighbors. Compassion, will and common sense can save so many of them and guide them toward the help they need.
David R. Kramer, M.D.
Medical Director and Treating Psychiatrist – Recovery Unplugged Treatment Center