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

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

This is bullshit, doctors nowadays do not take the Hippocratic Oath at all!

They may in Greece, but they don't any where else in the world! :\
 
^ hah! yeah certainly not in the USA when they're working at an innercity public charity hospital....yeah no way lol
 
trip to the er - lethal dose heroin + naltrexone

I know it's almost impossible to die from wd alone but I was tols It's possible I could have from accidentally taking naltrexone during mass heroin wd. The past few times before when I needed to kick I was able to get methadone off the street. This time around it was not available but I knew a junkie would just got out of a govt clinic with some pills. I asked him if they were helping his wds and he said they were. This guy was the shittiest kind of junkie and I never should have taken his word for anything but I was desperate. As it turns out naltrexone is very effective for various types of pain management and seems to often work well for junkies after they are 100% what I didnt know is that if taken in wd it flushes the junk out all at once and causes instant wd. So long story short within an hour I was in the worst pain of my life. pain that made having the distal tips of my fingers cut off seem like a cake walk. Uncontrollable vomiting and diareah, demon chills, and a pain in my abs that felt like a series of different knives tearing open my organs. If that wasn't enough I actually went blind from dehydration. Yes blind thats when I called an ambulence. I don't see any other reason why you would ever need to go to the er for wd. I kicked heavy habits before and the sickness was awful but nothing like this. AVOID THE ER! heres how I was treated in the worst possible condition: EMT and cop show up in my room. Cop looks around and finds a few bags in the trash and a used rig. EMT
asks if he's going to press charges. Cop says nah this is the 4th one today why bother with the paperwork. The Emt wheels me to the ambulence. I scream That Im freezing and need a blanket. The emt says its because the pill was someones blood pressure medication. They don't give me one. Inside the ambulence the pain is so servere that I scream again and the cop punches me in the face which cases me to throw up. Then the Emt asks my age. I tell him 30. He says yep thats about right, your going to die you know. I actually believed him. The only good thing the hospital did for me is get me on an iv fast which hadno effect on the pain but stabilized me enough to regain my vision. The nurses treated me like shit and literally left me in shit for 4 hrs at a time. When I first got there they had not yet done a test on the remaining pill that i didnt pop so they hadno idea why I was so much worst then normal. There was a clinic in the hospital so I knew they had access to everything. After barfing 5 - 6 times they gave me 2 methadone pills which i immediately threw up. They began injecting me with morphine and that only intensified the pain which baffeled the doctors. When the pill report came in they told me what was happening and that I was stable so they did not need to pump my stomach. They then gave me some naseau and diareah meds and left me in the hallway all night. The Next day when the pills wore off they seemed to know nothing about the mysterious methadone and refused to give me any pain meds of any kind. I was released later that day and took high doses of loperamide for the next week. There are 2 morals here A. know what you are taking for wd! and B. Avoid the ER if at all possible. There are plenty of legal solutions worth looking at. Kratom, tramadol, and loperamide have all shown some success and are worth researching for a home detox. Good luck
 
I noticed lots of people complaining about how the hospital won't give addicts benzos and suboxone/methadone in the emergency room, and how they think it's hypocritical. It really isn't. The truth is most addicts will abuse the drugs the hospital gives them for withdrawals. I know because I am an addict also. None of you are putting yourself in the shoes of the doctors. Emergency rooms aren't made to ease the withdrawals of drug addicts. They are for treating life threatening wounds/illnesses/etc. A broken bone IS life threatening. You can die from broken bones, wounds, the flu, etc. It is almost impossible to die from opiate withdrawal alone. It's not an emergency. If you want benzos go and buy them off the street like the opiates you had. You aren't entitled to narcotics. Start taking responsibility for yourself and be accountable. You won't ever get out of your hole until you do. This isn't aimed at the OP btw. It's just a general post to help motivate those entitled lazy addicts, which is what I once was...

Edit: this was only made after reading the first page. It's only directed towards those complaining about the ER/Doctors :p
 
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I was suprised they gave me IV Ativan , IV Dilaudid (yes DILAUDID) and clonidine as well as IV fluids, my doc was a young asian dude who was extremely compassionate. You should havre seen the nurses trying to find a place to stick me for IV, my veind were gone. So a big dude who was an ex army medic comes in and say ahh this is easy ill just stick ya in the neck, (at this point i ddnt care i just wanted some opiates in me and FAST) he said hold still man. He jabbed it in and had a line in on the first try. The nurse gave me the ativan first(which felt suprisingly good) then the zofran and then 3 mg Dilaudid. It actually gave me a nice rush since I had been in withdrawl for 2 days.
 
My friend got a 7 day methadone taper, along with clonidine and ativan. Must be the exception to the rule. And she's the biggest crook when i8t comes to doctors..
 
My girlfriend and I used to hit the ER pretending to be in w/d all the time just to get Rx's for Clonazepam,usually just 20 pils or so,no refills.and Zopiclone.We saved the zopiclone for when we were actually in w/d so we could knock ourselves out.

Also,I think it has to do with what type of addict you are.My friend who has several painful diseases/conditions,was in very bad w/d after losing his bottle of morphine,Rx'ed ofcourse.
He went in to the ER and was immediatley given sublingual ativan and an IV morphine drip.
I doubt they would have did it if he didn't have his medical conditions,didn't have a legit prescription,had track marks up and down his arms,and admitted his opiate of choice to be an illegal,frequently injected intravenously one.
 
I know it's almost impossible to die from wd alone but I was tols It's possible I could have from accidentally taking naltrexone during mass heroin wd. The past few times before when I needed to kick I was able to get methadone off the street. This time around it was not available but I knew a junkie would just got out of a govt clinic with some pills. I asked him if they were helping his wds and he said they were. This guy was the shittiest kind of junkie and I never should have taken his word for anything but I was desperate. As it turns out naltrexone is very effective for various types of pain management and seems to often work well for junkies after they are 100% what I didnt know is that if taken in wd it flushes the junk out all at once and causes instant wd. So long story short within an hour I was in the worst pain of my life. pain that made having the distal tips of my fingers cut off seem like a cake walk. Uncontrollable vomiting and diareah, demon chills, and a pain in my abs that felt like a series of different knives tearing open my organs. If that wasn't enough I actually went blind from dehydration. Yes blind thats when I called an ambulence. I don't see any other reason why you would ever need to go to the er for wd. I kicked heavy habits before and the sickness was awful but nothing like this. AVOID THE ER! heres how I was treated in the worst possible condition: EMT and cop show up in my room. Cop looks around and finds a few bags in the trash and a used rig. EMT
asks if he's going to press charges. Cop says nah this is the 4th one today why bother with the paperwork. The Emt wheels me to the ambulence. I scream That Im freezing and need a blanket. The emt says its because the pill was someones blood pressure medication. They don't give me one. Inside the ambulence the pain is so servere that I scream again and the cop punches me in the face which cases me to throw up. Then the Emt asks my age. I tell him 30. He says yep thats about right, your going to die you know. I actually believed him. The only good thing the hospital did for me is get me on an iv fast which hadno effect on the pain but stabilized me enough to regain my vision. The nurses treated me like shit and literally left me in shit for 4 hrs at a time. When I first got there they had not yet done a test on the remaining pill that i didnt pop so they hadno idea why I was so much worst then normal. There was a clinic in the hospital so I knew they had access to everything. After barfing 5 - 6 times they gave me 2 methadone pills which i immediately threw up. They began injecting me with morphine and that only intensified the pain which baffeled the doctors. When the pill report came in they told me what was happening and that I was stable so they did not need to pump my stomach. They then gave me some naseau and diareah meds and left me in the hallway all night. The Next day when the pills wore off they seemed to know nothing about the mysterious methadone and refused to give me any pain meds of any kind. I was released later that day and took high doses of loperamide for the next week. There are 2 morals here A. know what you are taking for wd! and B. Avoid the ER if at all possible. There are plenty of legal solutions worth looking at. Kratom, tramadol, and loperamide have all shown some success and are worth researching for a home detox. Good luck

You should have reported the cop who hit you.

As you pointed out, it's a good idea to know what you're taking.

I'm sorry about your horrific experience, thank you for adding it though. That was a very interesting read.


I was suprised they gave me IV Ativan , IV Dilaudid (yes DILAUDID) and clonidine as well as IV fluids, my doc was a young asian dude who was extremely compassionate. You should havre seen the nurses trying to find a place to stick me for IV, my veind were gone. So a big dude who was an ex army medic comes in and say ahh this is easy ill just stick ya in the neck, (at this point i ddnt care i just wanted some opiates in me and FAST) he said hold still man. He jabbed it in and had a line in on the first try. The nurse gave me the ativan first(which felt suprisingly good) then the zofran and then 3 mg Dilaudid. It actually gave me a nice rush since I had been in withdrawl for 2 days.

IV hydromorphone is a pretty euphoric opiate. You got lucky there. That's funny they used your neck, how are your veins doing? Hopefully they're coming back.

Zofran is great for nausea too.
 
I've never heard of anyone getting anything whatsoever if they walk into a hospital in the UK in acute opiate withdrawal - however severe it is. Maybe alcohol or benzos as they are physically dangerous to withdraw from but on opiates you'd have no chance, in my experience. And believe me I've tried it a few times and so have many others :|

For opiates in the UK you'll probably be referred to a drug counsellor but given no treatment until you'd been assessed by an addiction specialist, in my experience. Policy varies slightly around the country slightly but I doubt anyone in the UK in that situation would walk out of hospital having had any treatment or with a script for anything - although some GPs will prescribe a few days worth of diazepam and maybe some codeine or DHC to tide you over till you get to see the specialist. Even in rehab I was only allowed 2 paracetamol every four hours, a single 2mg dose of loperamide in the morning and an unknown sublingual dose of mirtazapine at night. They turned a blind eye to smoking cannabis but it actually made my w/d worse so I didn't smoke much. Other rehab facilities may be less strict but us UK addicts are just plain hardcore ;)
 
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my only experience of getting meds (oxycontin, pethidine(very unusual i thought), nsaids, morphine) in wd from hospitals in australia is when i've had a signed piece of paper of consent from my doctor that has all the medications im on listed and have been out of town or my doctor has been on holidays and i was unable to get another doctor in his surgery to write me out my normal script. some doctors don't feel like risking their license over prescribing another doctors patients meds, some may do it as a once or twice off thing in my experience.
 
Good point. Legit scripted stuff may well be different. Opiate addicts in the UK basically means heroin addicts as the only widely prescribed pharm opiates are codeine, DHC, tramadol and maybe morphine if you're in really bad shape - there really isn't much of a pharm pills scene here at all. Junkies selling their Subutex or methadone for smack is as exotic as it gets for the most part. Never seen pharm stims at all and we just don't get oxy, hydro, fent or anything like that. Maybe in inpatient treatment if you're actually dying but otherwise very rare, in my experience.
 
yeah i can't really see many cases where you would go into a hospital in wd's and they would give you a hit. that's putting them on par with going to see your drug dealer and scoring, which they'd have no part of for obvious reasons.

i've gone into the hospital here because i was in wd's and my doctor was away and i'd been refused a script from one of his colleagues. all i was after was a 2 day script and they wouldn't go along with it. all they gave me was some iv nsaids and anti-nausea meds and a poke up the arse with something? im sure they said it was endone, it may have been, but it never gave me any relief. likely it was only a 5mg ir endo and given my tolerance it would have done little to nothing
 
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.

You overdosed on the meds they were nice enough to give you, and you're using that as an example?

Fun story sure, but it's stuff like this that ruins it for everyone else. No wonder ER docs treat H users like loser junkies.
 
I am appalled. I worked as a paramedic for 6 years in Brooklyn and have brought back more junkies from respiratory arrest than I care to count. Maybe it was cause I have suffered through them myself from my past years of banging dope on the streets but I NEVER once treated someone in such a disgusting manner. The EMT should have been reported as well as the cop. F*ing animals is what they are. Naltrexone is a full opiate antagonist- we use it to bring someone back from respiratory arrest secondary to OD. That junkie that gave you those meds is a c*cksucker. I am so sorry to hear your story. Just know that not everyone out there working the street is a total douchebag.
 
You overdosed on the meds they were nice enough to give you, and you're using that as an example?

Fun story sure, but it's stuff like this that ruins it for everyone else. No wonder ER docs treat H users like loser junkies.

I guess you missed the sarcasm in my post. That story was supposed to illustrate exactly WHY you don't give more abusable drugs to a junkie to wd with.
 
Speaking as a counselor that works in several ER's most often someone in withdrawal will speak with a counselor regarding their issues.

If they have some type of insurance they may be admitted to the Behavioral health unit if the hospital has one, or they may be transferred to another hospital with an appropriate facility.

If you are uninsured you will most likely receive referrals to outpatient/residential treatment programs and sent on your way.

Usually if the counselor is at all compassionate (like myself) you will get a Clonidine patch applied, which will help somewhat for a few days.

I've never witnessed an addict receiving opiate drugs for withdrawals. Benzos are also very rare.
 
I went to the emergency room barely able to walk myself from dehydration. While checking in, I told them I suffered from dehydration due to diarrhea and puking for the past three days. Once I was in the emergency room, I notified my attending doctor about my withdrawals. I was hooked up to an IV saline solution and some potassium as well as being given an anti-nausea medication by the name of Zofran. The saline solution alone was enough to get me feeling much better. It's unfortunate there are no effective OTC anti-nausea medications.
 
It's unfortunate there are no effective OTC anti-nausea medications.

There are a few medications available over the counter which can treat nausea. Diphenhydramine, dimenhydrinate, promethazine (in the UK at least).

Ginger extract is also available OTC and is even more effective than the above medications. Ginger extract is actually a superb anti-emetic. The only reason it's not used more often is because pharmaceuticals companies cannot patent it.
 
i feel bad for you!!!!!!!!!!!!

Listen u need to find a program locally of u that will put you on suboxone the problem is they will only see you right away if u are withdrawling severly if i were you i would make an appointment and keep up my habit until then:)that way u wont ever get sick unless your circumstances make u go tomorow to stop
 
I guess you missed the sarcasm in my post. That story was supposed to illustrate exactly WHY you don't give more abusable drugs to a junkie to wd with.

I suppose, but I think it's a fact that recreational drug users get mis/under-treated because they've been profiled by the medical community.

By giving validity to this (sometimes false) claim, it simply ensures that this will continue to be the case.

My point is that we should discourage doctors from withholding effective pain and anxiety treatments, and we can't do that if we reaffirm their bias.

Maybe I did miss some sarcasm, and if I did, I apologize. I just see this as a very real and serious issue, and the example you gave was doing nobody any favors.
 
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