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Thread: How do emergency rooms treat acute opiate w/d syndromes?

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    How do emergency rooms treat acute opiate w/d syndromes? 
    #1
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    Anyone have experience with this? I might have to go to the ER tomorrow for w/d syndrome from a hefty heroin habit, might not have another option. What should I expect?
     

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    #2
    where are you from ?
     

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    #3
    Bluelighter
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    Michigan, the hospital near me is one of the best and most advanced/financed in the world.
     

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    #4
    Im sure they give you something for nausea and they'll put you on IV fluids

    they may put you on methadone but thats a long shot , thats only happened for me once out of the countless times ive been in the ER for acute opiate withdrawl. Honestly your better off just kicking at your house in my opinion with some Lopermide and Marijuana.

    Even if you lie about your drug use and just tell them your just in pain they'll find out about the heroin when you have to do a Urine test. Most of the time when you go to the hospital and tell them your a drug addict they treat you like shit and put you to the back of line. The healthcare system in america treats people like us horribly IME

    I hope everything works out for you

    Good luck on your detox
     

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    #5
    BL Ambassador Captain.Heroin's Avatar
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    You typically don't need to go to the ER to come off of heroin, though I'm sure it feels like you need to.
     

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    #6
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    You don't think they would give some kind of sedative or benzo?

    For some reason my w/ds are worse than most peoples, I have had seizures and other horrible symptoms not usually seen.

    Last time I detoxed they gave me suboxone too early (even though it had been 14 hours) and I went into immediate horrible w/ds they had to give me shots of Ativan in the ass.

    Edit: that was at a detox facility tho
     

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    #7
    Bluelighter xxkcxx's Avatar
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    Probably clonodine, an IV shot for nausea (Tygan?), tylenol, maybe something for diarrhea.


    You are not going to be given subs because you have to be specially licensed to give them and I've never met an ER doctor who was.
     

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    #8
    Bluelighter Artificial Emotion's Avatar
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    When I went to the A&E with opiate withdrawal they sent me home.
     

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    #9
    Bluelighter xxkcxx's Avatar
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    ^ ha that sucks....most places would at least transfer you to a detox or Bx Health Hospital with chem depend program.
     

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    #10
    Quote Originally Posted by Artificial Emotion View Post
    When I went to the A&E with opiate withdrawal they sent me home.
    Thats our wonderful NHS for you...

    Funny innit; if you'd gone down there with alcohol withdrawal they'd have given you benzo's no probs.
     

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    #11
    Bluelighter xxkcxx's Avatar
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    ^ well, in their defense you are probably 1 million times more likely to die from alcohol wd than opiate...


    most of what is given in an ER for op wd is available OTC.
     

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    #12
    Quote Originally Posted by Sorce View Post
    Anyone have experience with this? I might have to go to the ER tomorrow for w/d syndrome from a hefty heroin habit, might not have another option. What should I expect?
    I dont really know what they would do as they are an emergency room. Since it isnt life threatening, they may just referring you to treatment. I really don't see them administrating a benzodiazipine, or any type of sedative.
     

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    #13
    Quote Originally Posted by xxkcxx View Post
    ^ well, in their defense you are probably 1 million times more likely to die from alcohol wd than opiate...
    True nuff. But you're hardly likely to die of acute pain from say, a broken bone, but they'll still dispense strong painkillers for that.

    There's less sympathy for addicts, a prejudiced attitude of 'well its your own fault'. Which IMO goes against the hippocratic oath..
     

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    #14
    Bluelighter xxkcxx's Avatar
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    Yeah, but there is something you can actually do to aid a broken bone--put on a cast and help the pain with medicine. You can't get those OTC like aids for opiate wd symptoms.
     

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    #15
    I have only heard of two cases of people dying because of opiate withdrawal as a factor. Extreme alcohol withdrawal can be very fatal, and thats why they are stabilized in the ER using (typically) ativan.

    Again, ERs exist to treat emergencies. Thats why I highly advise against going to one for opiate withdrawal, since its not an emergency.
     

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    #16
    And there's things you can do to ease the pain of opiate withdrawal, like prescribing benzodiazepines etc, but they won't do that. Because of the risks...the addict just can't be trusted with anything potentially addictive, oh no....

    Prejudice.

    Doctors take the Hippocratic Oath, which includes the pledge to ''Relieve suffering wherever possible''.
     

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    #17
    Bluelighter xxkcxx's Avatar
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    They can relieve the suffering just as well without prescribing addictive meds to someone with an addiction problem.

    Fun story--the first time I told my primary physician I was addicted to heroin and wanted to get off, she prescribed me 30 1mg Kpins and sent me on my way. That night I ODed on a jab and a half of H, 14 mg of Xanax and 30 mg of Kpins.

    Giving someone an Ativan in the ER will relieve the symptoms for, what? 4 hours AT BEST. So you almost have to give a take-home prescription for it to be effective over the 3-5 days the wds will last. That means they would either need a RX for 20 or so pills or have to keep coming to the ER every day.
     

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    #18
    Quote Originally Posted by Levvytation View Post
    And there's things you can do to ease the pain of opiate withdrawal, like prescribing benzodiazepines etc, but they won't do that. Because of the risks...the addict just can't be trusted with anything potentially addictive, oh no....

    Prejudice.

    Doctors take the Hippocratic Oath, which includes the pledge to ''Relieve suffering wherever possible''.
    In an ideal world doctors would do just that (ie RX benzos) but docs are bound by the DEA/FDA laws no matter what country they're in. It's not worth the risk losing your career over a patient who in all probability could take those benzos and then combine them with heroin then die and then the OD is basically pinned on the doc for giving the benzos to an addict. It sucks, sure, but opiate WD is only rarely fatal
     

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    #19
    Quote Originally Posted by Artificial Emotion View Post
    When I went to the A&E with opiate withdrawal they sent me home.
    They gave me co-codamol 30/500 x28 and metoclopramide 10mg x28. Better than nothing, guess I got lucky...
     

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    #20
    I'm not suggesting that A&E departments should just hand out lengthy scripts of benzo's out to heroin addicts willy-nilly or anything like that, don't get me wrong.

    But someone going to an emergency room with opiate withdrawals shouldn't be just turned away.

    If an alcoholic goes into an A&E with withdrawal, they are usually kept in for a while & given librium under supervision, then referred to their doctor for follow-up treatment when the immediate withdrawals have subsided. Why not have a similar policy for opiate addicts? The fact that the withdrawals from opiates aren't potentially life-threatening in the way that alcohol withdrawal is is irrelevant IMO....they have an obligation to ease the symptoms of what is a very unpleasant condition, end of.


    Giving someone an Ativan in the ER will relieve the symptoms for, what? 4 hours AT BEST. So you almost have to give a take-home prescription for it to be effective over the 3-5 days the wds will last. That means they would either need a RX for 20 or so pills or have to keep coming to the ER every day.
    Having to keep coming back every day would work, why not?
     

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    #21
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    Going to the ER for withdrawals is overkill in my opinion. Waste of money and time, going through withdrawals in the hospital fucking sucks. Things were much better once I got home.
     

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    #22
    ^^^
    The US, im sure, has a different protocol for withdrawal syndrome than other countries.
     

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    #23
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    True, he should try going to the ER once and see how many hours it takes to get seen. Saying to go every other day is just ridiculous, I'm sure you would always be at the bottom of the list to receive Ativan. I seriously doubt that they would give a drug addict Ativan even in withdrawals. The ER is a joke here.
     

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    #24
    Bluelighter xxkcxx's Avatar
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    Quote Originally Posted by Levvytation View Post

    Having to keep coming back every day would work, why not?
    Because it is an ER not a Benzo Clinic.

    Look, I was a junkie and I know what withdrawals feel like. It's uncomfortable, I get it. But IMO, you are acting like this idea of not treating someone in the ER for opiate wd has something to do with doctor's hating junkies when really it has to do with the medical definition of an emergency and the fact that ERs are already overcrowded and understaffed as it is.
     

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    #25
    Bluelight Crew Mora Fiend's Avatar
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    You have to look at it from the doctor's perspective. If a patient is prone to abusing drugs, the last thing they are going to do is give that patient abusable drugs. What we see as cruel and unusual punishment, they see as common sense.
     

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