Framing an Overdose Death

Another overdose death in Broome County. A very young man at the age of 22 did not wake up yesterday (2/6/16).
 
I am getting multiple versions of what happened with this young man. Some are saying he was at ACC and left because he couldn’t take the detox. Another said he just completed short term inpatient treatment at New Horizons and was waiting for a bed at Fairview. Another said he got kicked out of treatment for testing positive for suboxone (which he was apparently not prescribed). Another is saying it was her son’s roommate at Fairview and he overdosed there.

 
In the end, I can say, I’ve been at meeting after meeting where professionals and treatment providers call this ‘failing treatment’ or paint a picture that puts the blame on the person for being ‘unsuccessful’ in maintaining sobriety. They’ll say ‘he wasn’t serious about sobriety’. They will allow his death to be his fault and his fault alone.
 
I am going to say, this young man, like so many people in this country, clearly wanted to stop using heroin, but was not given the medical attention and treatments known to be effective, the length of time in treatment known to be effective, was not provided with the level of care, transfer of care or follow-up necessary and proven to be effective. Our system and the lack of proper medical treatment failed him and he died because of it.
 
For those who don’t know, detoxing from opioids or heroin is extremely painful to the bones and muscles in your body. I heard one person describe it as feeling as if every bone in their body was breaking. Add to that nerve pain, violent shaking, chills, vomiting, diarrhea, sweats, fear, agitation, severe cravings and severe anxiety.
 
There is a method for a person to be medically detoxed. A person can be given a tapering dose of suboxone to relieve their symptoms and make them more comfortable. Suboxone also curbs the intense cravings they have. In the US, it has been determined for some insane reason, this is not a medically necessary treatment. This is based on a determination that opioid withdrawal is ‘in most cases’ non-life threatening. Somehow the medical and insurance industries have been able to take this and run with it so that people addicted to opioids going through withdrawal are not granted the medicines known to be successful in easing their pain and making them more likely to be successful in both detox and treatment.
 
Our only local detox option, the ACC (through no fault of its own) is a facility that cannot offer medically assisted detoxification. They can only offer over the counter medications and take the person to the hospital if their symptoms are severe to be given some medications to relieve some of their symptoms. Note, they are not given what is known to best relieve the symptoms of opioid withdrawal and the symptoms can still be severe.
 
Many people (we are told 4 out of 10) leave the ACC because they cannot endure the withdrawals. Again – the withdrawals they are enduring could be alleviated GREATLY if given a tapered dose of suboxone.
 
Other facilities locally won’t offer medically assisted detox because insurance won’t pay for it and they hold to the idea that it’s ‘not life threatening’.
 
For those who are struggling to not use while in treatment will get ‘kicked out’ of treatment for ‘failing’ by most facilities rather than being providing more treatment or changing the type of treatment.

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Here’s another fucked up thing about opioid withdrawals – long term use of opioids actually reduces your pain tolerance… so the pain that person is feeling is literally worse than what a non-opioid user would experience. And, opioids damage the regions of your brain that control judgement and motivation. So, you’ve got a person in withdrawals in severe pain, anxiety and experiencing severe cravings… they are NOT being given the medication known to be most successful in reducing these symptoms, they have a damaged sense of judgement and motivation and yet we are expecting them to have some sort of super human power, strength or ‘desire’ to outweigh all of that and stay to ‘muscle through’ a non-medically assisted gruesome detox.
 
We also know that 90 days of inpatient treatment is proven to be effective. We know there is a 90% relapse rate after short term (less than 14 days) of inpatient treatment.
 
So rather than having people say this young man at the age of 22 went AMA, was ‘unsuccessful’, ‘didn’t want it bad enough’, ‘wasn’t strong enough’ or ‘gave up’, let’s all do his family and him the honor of being honest and frank about what happened.
 
Here’s what happened – our system did not offer a young man with a substance use disorder, which is a medical condition, the medical treatment necessary and known to be effective so that he could be successful in recovery that he needed to overcome a disease which often leads to death.
 
We need to stop blaming people seeking treatment for being ‘unsuccessful’ ESPECIALLY when we are not providing them the treatment and medical assistance that is clinically proven to help them be.
 
We need to change the conversation.
 
Let’s commit to saying – this person died of an overdose because he was not provided the medical attention or treatments proven to be successful.
 
We don’t require diabetics to give up sugar before we’ll give them insulin. We don’t require smokers to quit smoking before we treat their cancer. We don’t require people with clogged arteries to stop eating unhealthy food before we’ll clean out their veins or put in stents. And if we try a treatment for any of these and it’s unsuccessful, we don’t paint the patient as not being strong enough or not wanting to be well – we try a different type of treatment or a more intensive level of treatment. 


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