Many people who experience opiate addiction in Fresno, CA, utilize the emergency departments at their local hospitals for simple illnesses that a family doctor could address. Those who lack private insurance plans—including people on Medi-Cal who abuse drugs in general—often fail to establish themselves with primary care physicians. When they need general or emergency medical care, they simply go to emergency departments, where they find themselves treated like second-class citizens.
Ask yourself this question: The last time you developed a persistent sore throat, did you go to your family doctor, or did you go to an emergency department? The last time you tried to detox from heroin or pain pills and got sick, did you go to a methadone clinic or did you go to an emergency department? Here’s why it’s better to establish yourself with a regular doctor: According to Dr. Robert James in Emergency Medicine News, people with opiate addiction in Fresno, CA — or anywhere, really—don’t always receive the most appropriate treatment at urgent cares or hospital emergency rooms.
Doctors Don’t Understand Addiction
Dr. James writes about the fact that doctors in emergency departments simply don’t understand opiate addiction very well. Dr. David Sack, writing for PsychCentral.com, states the same thing: He tells us that most doctors don’t like treating addicts because they fail to see the disease that causes the negative behaviors. They blame addicts for being “immoral, unmotivated or weak…as criminals rather than sick patients.”
Is that how you feel sometimes, as a person receiving treatment for opiate addiction in Fresno, CA? Do you feel that the medical establishment treats you as a lesser person, someone not worth their time and attention? Keep telling yourself these words, also from Dr. Sack: “Addiction is a chronic brain disease for which there is no cure or quick fix.” Doctors like him respect the disease and feel compassion for the people who are addicted.
Dr. Sack tells us that despite all the years of training required of doctors, most of them receive no experience with addiction medicine unless they purposely seek it out. Even those who want to gain some experience in a methadone treatment program can find little time to do so in their busy training or work schedules.
Dr. Sack also cited a study done at Columbia University demonstrating that emergency room doctors simply don’t recognize the symptoms of opiate addiction very well. Fresno, CA physicians are no different than the physicians who participated in those studies: While 80 percent of them stated that they could diagnose drug abuse and addiction, only one percent of them came up with the correct diagnosis when given a set of symptoms for a hypothetical patient. And 55 percent of them admitted that they had not been trained in prescribing pain medications during their medical school training.
But requiring additional training is not the answer. Additional research proved that internists asked to undergo 10 hours of training in addiction medicine exhibited attitudes that were only marginally improved. It takes a genuine interest in addiction medicine in order to make a difference.
Emergency Treatment for Opiate Addiction in Fresno, CA
No matter what prejudice that doctors may bear against people with addiction, including those with opiate addiction in Fresno, CA, there are medical consequences the doctor has when seeing such a patient in the emergency department.
- Suppose the patient comes to the emergency department because they missed their methadone dose and they don’t want to relapse. The doctor has no way of knowing if the patient is telling the truth. They have no documentation for the medical chart of the patient’s regular dose—other than the word of the patient. And doctors feel pretty universally that if they are not registered to dispense methadone, then doing so would amount to fraud.
- The doctor also has little patience with the excuses from people who missed their regular doses, because most people, in order to make their cases sound compelling, say that their medication was stolen—but no, they didn’t report it to the police—or they couldn’t get their dose at the methadone clinic because the receptionist hated them and shut the door in their face.
- There is also little help for the patient who comes to the emergency department because of a condition involving pain. Many patients present complaining of ongoing chronic pain, and the doctor has to wonder why the patient doesn’t coordinate treatment for pain with the doctor at the methadone treatment program. The California Society of Addiction Medicine’s guidelines for opiate addiction in Fresno, CA, or throughout the state, allow for the treatment of emergency pain. However, how does the doctor know when the patient last received methadone? What was the dose? Methadone takes a while to leave the body, and giving a patient an analgesic for pain could result in respiratory depression if the wrong decision is made.
- Federal guidelines for buprenorphine allow physicians to write emergency prescriptions for a limited amount of this medication if they can document that the patient is regularly under the care of another doctor.
- What happens in times of disaster? In the wake of Hurricane Katrina, the Substance Abuse and Mental Health Services Administration wrote a letter authorizing physicians to prescribe methadone or buprenorphine even if the patient could not provide identification or documentation of treatment for opiate addiction. Fresno, CA, clinics could follow similar guidelines under similar disaster conditions if there were some kind of disaster. But these precautions are recommended: (a) Contacting the clinic, since most methadone clinics are open seven days per week; (b) accessing the California drug monitoring program to look for evidence of abuse or opiate addiction in Fresno, CA, no matter where the person fills their prescriptions; and (c) utilizing quick dip urine screen tests, since a person participating in addiction treatment should in fact test positive for buprenorphine or methadone.
Getting Help With Opiate Addiction in Fresno, CA
Remember that doctors have a reason for their hesitation in prescribing methadone or buprenorphine in the emergency department. The Medical Board of California tells us that in the first decade of this century, fatalities from overdoses in the emergency room skyrocketed from 4,000 to almost 15,000.
In the Journal of the American Medical Association (JAMA), a journal read universally by physicians, a study demonstrated that of 329 patients who were addicted to opiates and sought help in the local emergency department:
- 104 were referred to treatment.
- 111 underwent brief interventions.
- 114 received buprenorphine in the emergency department with a referral to primary care for 10-week follow-up.
At the end of 30 days, 78 percent of those treated with buprenorphine were still in treatment, compared with 37 percent referred to treatment and 45 percent of those who received brief intervention.
If you are seeking treatment for opiate addiction in Fresno, CA, your best bet is to follow the guidelines of your methadone program. Ask the doctor ahead of time what you should do in the case of a missed dose or if you end up in the emergency department for a true emergency that puts you in pain. Get a referral to a primary care physician that you can see instead of going to the emergency room if you have some kind of medical issue. It’s all part of your decision, as a person getting help with heroin or pain pill addiction, to take back control of your life.
