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U.S. - Doctors Who Hate Drug Users Are Fueling the Opioid Crisis

S.J.B.

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Doctors Who Hate Drug Users Are Fueling the Opioid Crisis
Maia Szalavitz
Vice
November 23rd, 2017

For decades, many people dealing with addiction have been branded with an obscene label by their own doctors: SPOS—an acronym for “subhuman piece of shit." It's hospital slang, handed down over time from attending physician to resident to intern to medical student. In a recent story for the New Yorker, Dr. Jerome Groopman described his own introduction to the label: As an intern at Harvard-affiliated Massachusetts General Hospital in the 1970s, he was proud that he had saved the life of a patient named Vinny, who had a dangerous infection spread by unclean needles. The young doctor believed it when his patient swore he’d never shoot drugs again. But the guy was back in the E.R. with another addiction-related problem in less than a month.

“My supervising resident told me that I had been naïve to have any faith in Vinny’s promises; he was, in the parlance of the resident, like all addicts, an SPOS—a subhuman piece of shit.”

The very existence of the label encapsulates the way America’s health care system has made physicians and people with addiction into natural enemies. While docs who have trained more recently suggest casual use of cruel medical vernacular has declined, many say the bias it reflects remains devastatingly common. And if we don’t change the structural features that create this problem, it will be almost impossible to end the overdose crisis, which is now the leading cause of death for Americans under 50.

This brutal stigma helps explain why people with addiction frequently avoid medical care—and why, as recently as 2015, only an estimated 3 percent of primary-care doctors had done the legally mandated training required to prescribe the lifesaving medication buprenorphine, a.k.a Suboxone. (And fewer than half of them were actually dishing it out.) Obviously, addiction is heavily stigmatized in society generally, in part because the whole point of criminalizing a behaviour is to shame and damage the reputation of those who engage in it in order to deter others. But why does the stigma seem to be even worse among those who we expect to compassionately care for it?

“I’m so sad that this is even a question,” said Dr. Esther Choo, associate professor of emergency medicine at Oregon Health and Science University, noting that it is difficult to quantify prejudice.

Read the full story here.
 
Yeah it sucks big time to be a drug addict in the United States of American if you require any type of medical treatment, even worse if you're drug addict without medical insurance!

But what really gets me is that if a drug user overdoses on heroin and is then brought back to life by paramedics there is a good chance the police will come and charge the overdose victim with drug possession. Talk about zero tolerance.
 
I recently had to find a new family physician due to the retirement of my previous (and only other) one. Admittedly, I was glad to be rid of the old coot, as he was always a greedy, indifferent, unsympathetic individual (I suspect he was a staunch conservative at the ballot box, but I could be wrong).

Anyway, eventually I found a very young replacement with remarkably-liberal views in general (e.g. totally pro-weed legalization and proud to admit it), and the difference in terms of my treatment with respect to Rx'd, controlled substances has been like night and day. And mind you, she's known full well that I'm on MMT.

One day, I mustered up the courage to flat-out inquire from my awesome GP as to why she has placed the prolonged trust in me with the aforementioned drugs on top of my MMT, when, in contrast, I could never attain such faith in punctuality from her predecessor. And, she contently-replied that the fact I've never tried to double-doctor her into prescribing me any narcotic analgesics whatsoever on any occasion convinced her that I wasn't an SPOS. And mind you, she only found out about the MMT over a year after she took over, yet regardless, I never betrayed her once.

I guess what I'm trying to say is as follows: It would appear to me that times are a changin' for the better with regards to the medical community's views on junkies - thank God if that is indeed true; if my anecdotal experience isn't some rarity. Because if my fellow SPOSs can't turn to doctors in hopes that they won't be looked down upon as trash, then I truly mourn for their chances of recovery. At the end of the day, they're still human beings, and they don't need to be kicked anymore while already down.
 
Good article. ER doctors tend to be the most cynical by far ime. I guess I get it I usually just kill them with kindness.
 
I HATE learning about the medical community referring to anyone as a subhuman piece of shit.
Shame on people, especially doctors who should know better!
Their arrogance will be punished.
Never judge anyone. You just don't know what is really going on or what someone has suffered or is suffering.
"Lean not to your own understanding"- Jesus

I never refer to anyone as an addict or junkie either! As if that is who and what they are!
Some of the nicest, most kind, wise, and impressive people that I have ever met have had drug problems.

Material wealth and society standing mean nothing. This society here in the U.S really sucks! I get more and more disgusted with it everyday.
 
This opiate epidemic is a direct cause of society today and the way love has been lost for one another.
People are longing to fill that spiritual gaping hole in their being that society has stolen away!
"Tough Love" and shame etc. is the worst thing you could do to someone with this kind of a problem!

Love One Another!
 
Yeah, its awful. The way some doctors are towards patients is abhorrent. I've been treated with as much welcome as a dog shit smoothie by medics in hospital just because I was on morphine&oxy (both scripted by my GP, due to a knee injury along with nerve damage and bilateral trochanteric bursitis, that would otherwise cripple me and leave me barely able to walk or lie down), and after an injury that left me with a leg swollen to several times its size, that could have killed me, and left me almost screaming in pain, I was given, after BEGGING doctor after doctor for some pain relief, I was, after near ten hours given, grudgingly, 10mg oral morphine (when at my tolerance level I could easily take 1g dipropionylmorphine via IV along with a handful of oxy pills in the shot and stay standing, not that I told them that, but my SCRIPTED dose was hundreds of milligrams morphine a day plus a couple hundred mg oxy)

And after another injury, that involved getting blasted in the face by a gout of scalding, searing hot concentrated base slops, including lithium amide, NaOH, KOH, KOtBu, ammonium salts, all dry, after filth raided and removed a label from something, tampered with a bottle of rubbish, that resulted in water being added, capped, shaken to clean it out thinking it solely hydroxides and carbonates due to that label being removed, the thing superheated and began to swell up like a rugby ball in the blink of an eye, before blasting the cap to shreds in moments, and sending a jet of blazing hot corrosive basic wastes pelting out with enough force to knock the goggles right up off my face, and much of it shot into one eye, I again had to beg, and beg and beg for hours, I think in that case it was their impatience with my shrieking in agony that got them to give in to my demand for pain relief. Even then they gave me a mere 20mg oramorph, which knowing the oral BA of morphine, and to their shock and horror I stuck up my arse and plugged right in front of their face. Didn't even stop me going into hardcore opiate WD, from my GP-scripted meds. Fucking stingy cunts wouldn't even allow me the chlormethiazole I need to take daily (its a fairly oldschool GABAa modulator, agonist at the barbiturate binding site, not licensed in the BNF for anticonvulsant use but for seizure prevention and emergency response is the reason I'm prescribed, and reason I use it, since its reliable, its incredibly fast acting, its potent as hell and yet I've taken it several times daily for at least 3-4-5 years or so without any physical dependence, although again, for all they knew i would have gone into seizure, and the opiate WD had me shaking and twitching like a cat on a barbeque grill. In that instance, the wound was bad, and something objectively provable which I could not fake, save by throwing corrosives in my own face, and even the most desparate and stupid addict would not do, they PH-tested the eyeball itself and it was at 14, and that even AFTER my spending all the time in between immediately irrigating my eye, dropping some local anaesthetic in there, packing away the labware somewhere nonvisible in case some paramedic turned out to be a pig loving grass and suspicious cunt in combination), then irrigating it again until the paramedics turned up. Turned out from later research that I was lucky in reacting within about ten seconds of being hit to make the difference between sight, and blindness. Was barely able to see for months, and in constant pain, supersensitive to light, on fuck knows how many kinds of eyedrops after having my cornea partially burnt off, along with base-burns all up over my forehead, top of my head and from half my face, down my neck and beginnings of my chest/shoulders, aside from that 20mg morphine I stuck up my arse in defiance of the nurses, the only pain relief I got for DAYS was the tank of nitrous I drained dry in the ambulance itself, and again in the ER waiting cubicle after one kind doctor, after telling me he wasn't ALLOWED to account for tolerance to opioids for chronic pain patients, at my request, he assented to let me have some more nitrous, brought me a tank and regulator and apologized for not being able to get me any IV morphine, and I could tell from the the way he was, even helping me attach the regulator to the tank and guiding my hands to bring it under the trenchcoat I'd wrapped round my face to keep out the light, and turning the lights off in the cubicle, and telling me not to worry, just help myself to as much of the tank of N2O as I wanted to (which I did, by the time I was transferred to a ward, I'd drained it completely)

Took several days before I got my proper meds, and even then they skimped on the full dose of opioids, yet when I left the hospital, after I'd threatened legal action (and quietly, to somebody I found going through my backpack some far more unpleasant consequences) they'd sent me off, after I told them I needed, it being late friday, too late to get a doctors appt with my surgery and get any help, needed a few days meds, I instead got sent off with transport home and a bag so full it was heavy to carry one-handed, replete with 10mg, 30mg, and 100mg morphine caps, of my preferred brand that don't gel up when prepped, along with various doses of oxy, plus a couple of big bottles, half liter I think, of liquid oxy, two pharmacy stock-bottles of chlormethiazole caps, benzos ( nitrazepam), zopiclone, tizanidine (zanaflex, its similar to clonidine, which they gave me also), enough tranqs, adrenergic autoreceptor agonists, morphine, oxy, gabapentin...christ, they gave me enough to shut me up, alright, enough that as far as THEY knew, if I'd have taken the meds given me as the scripts said to would have killed me with the first dose without a doubt. Hell I wouldn't have been surprised if it would have been enough, knowing how unforgiving chlormethiazole is in overdose, to have wiped out every patient in that ward with half the dose if it were split up into equal portions and given to each patient bar myself)

That was definitely them trying to keep me from suing. And enough that I could have sued for gross negligence too, with them advising me to take what, according to my KNOWN medical history WOULD have been a fatal dose quite a few times over and a bottle of tranqs and gear in change left over! Lucky for me, I know my limits, know my shit when it comes to pharmacy and at the time had what was the one of only two times in my life I ever have or will be thankful for a monstrous opioid tolerance, the pharmaceutical equivalent to a point-blank cannon shot from a tank, at the time. And knew thoroughly what I could get away with. Hell, the opiates alone they gave me, would have ODed me in one dose if I'd taken them as directed AND had the tolerance they thought I did and only that.

The worse thing almost, was the way that through the other eye, the one that avoided being broiled in corrosive alkalis, they actually looked disappointed when I grabbed one of those bottles of liquid oxy and took several deep long pulls straight from the bottle like it was a can of coke. And after capping it again, thought better of it and drank enough to quench my thirst, since I'd had no water either for a couple of days. The nurses and a dr that saw me do that had a look on their faces that was pure disappointment, as if to say 'fucking shite, this guy is going not only to survive this, he's actually going to enjoy himself the filthy cunt'

That was disgusting to see, and they didn't do anything to hide it, just shook their heads and looked like somebody just shit in their newborn baby's breakfasts. They looked like they were actively going out of their way to give that message. Shit, I'm fucking classically kanner's autie and I STILL picked up on that! Subtle they were not. Any less subtle and they'd have written an epitaph for me in blood and rammed it up my arse.

And they've done that same thing twice! the treatment I've always got at the hospital near me whenever I've had to go for any reason, I've never ONCE had a visit there I was not terrified of going because of the treatment I KNEW I was going to get. A mixture of outright, bald faced sadism and outright incompetence (such as asking me if I was allergic to anything, being told beta-lactam antibiotics, only for the stupid cunt to attach an IV bag of a penicillin to me and ignore my howls of protest and anger, telling me he'd come back in ten minutes or so and check up on me, despite my asking him if he knew what 'anaphylactic shock' means. I had to take my knife out and slash the IV line to prevent it getting into me, and then the incompetent moron tried to put me on one of metronidazole, after my telling him first, after this time demanding an exact explanation of what was going in that IV before it went anywhere near me, my telling him I had drunk a liter of southern comfort an hour or two earlier to dull the pain of a serious, potentially fatal, I was later told, injury, and my having to, whilst in hideous pain, and pissed as a fart, give him a lecture in enzyme kinetics and biochemical interactions, after he smarmily told me 'oh you'll be fine'. I think he got the message after I made it abundantly clear to even the thickest piece of shite, that he would end up the same way as the first IV line did, only in more pieces and a lot more liquid on the floor if he tried it.

I'm quite honestly, more afraid of going to hospital than I am of most injuries, and will go only if more or less forced there. Because if I go, I'll be treated like dirt, only with less of the consideration given to dirt. And there are too many doctors and nurses that are nearly so stupid as to need an assistant in order to both walk and breathe at the same time, and who could miss giving a bull cunting elephant an IM injection (seriously, I insist on doing injections myself in hospital now because the only ones who don't fuck it up and take half an hour to an hour to find a vein are anaesthetists, who I've find to be the very few kindly doctors in that shithole of a hospital. I actually get it right. I'd not trust them to hit a vein with a 40mm grenade launcher)
 
It's sad when someone in need of medical support is afraid (for good reason) of going to a hospital. What, is this Soviet Russia now? ;) But seriously, I know a lot about how shitty that is. Horrible way to organize a health care system - unless the point it to harm/injure/kill people who use opioids.
 
look americas opiate epidemic is hugely fuelled by its love of caffeine

one of the best combos ever- on their own opiates are nice but not mind blowing, drink 4 cups of coffee and fucking hell they are orgasmic

u try quitting skag while mass consuming caffeine- the anxiety would be unfathomable

first you must teach people to not drink caffeine all the fucking time then they wont have this tension that needs sorting with sedatives
 
It's sad when someone in need of medical support is afraid (for good reason) of going to a hospital. What, is this Soviet Russia now? ;) But seriously, I know a lot about how shitty that is. Horrible way to organize a health care system - unless the point it to harm/injure/kill people who use opioids.

Completely agree with you toothpastedog.
 
look americas opiate epidemic is hugely fuelled by its love of caffeine

one of the best combos ever- on their own opiates are nice but not mind blowing, drink 4 cups of coffee and fucking hell they are orgasmic

u try quitting skag while mass consuming caffeine- the anxiety would be unfathomable

first you must teach people to not drink caffeine all the fucking time then they wont have this tension that needs sorting with sedatives

Drug use is not so much the problem compared to policy issues, that's probably the most frustrating aspect of the whole "opioid issue."
 
There's going to be a big discrimination suit one day. I don't know when. But I hope one day legally scripted pain patients will have their civil rights movement.
 
Interesting read. I'd say the same stigma applies in the UK too, although I guess differences in healthcare system may be behind different outcomes.
 
Yeah it sucks big time to be a drug addict in the United States of American if you require any type of medical treatment, even worse if you're drug addict without medical insurance!

But what really gets me is that if a drug user overdoses on heroin and is then brought back to life by paramedics there is a good chance the police will come and charge the overdose victim with drug possession. Talk about zero tolerance.

I'm not sure if you live in the US, but this is not the case anymore at least where I live in the Northeast. They are just trying to get people into treatment centers or on a list to get into a treatment center.

I personally know paramedics and the ones I know have a lot of compassion for the users & families, but, there are no absolutes in life.

It is sad that anyone came up with that kind of an acronym for addicts... they say that what comes out of your mouth is a reflection of you not the person you are speaking ill of so really they SPOC is a reflection of the healthcare provider. I hope they fired them because they are very detached from the world if that is how they are labeling their patients. There is a higher authority that sees all of what they are doing whom they will answer to one day.
 
After reading this thread I find myself incredibly disappointed in the medical profession. I was actually on track many many years ago to become a doctor. After reading this, I wish I had followed through with the schooling. I think I could have made a difference, especially being I'm a chronic pain patient myself. All I can say is shame on any doctor displaying this attitude towards patients/"people"! Believe me when I say, KARMA is a cruel bitch!
 
I found this thread through PainfulOne. Thank you!
For some doctors it is just a job, and your body to them is no different than a car to a mechanic. And as long as you don't die, they did their job well.
There is a legitimate problem worldwide with opiate use and people using Dr's and hospitals to get their fix, but the real problem is that there is no way to force medical professionals to care and do their job well. I had a doctor recently who had only done about 30 seconds of examination on me. When I told him I had been prescribed oxy for pain he said "we don't prescribe narcotics in this office". That is a doctor who wants to get paid without having any of the paperwork that comes with writing prescriptions. Like a dentist who refuses to fill cavaties.
 
I'm not sure if you live in the US, but this is not the case anymore at least where I live in the Northeast. They are just trying to get people into treatment centers or on a list to get into a treatment center.

I personally know paramedics and the ones I know have a lot of compassion for the users & families, but, there are no absolutes in life.

It is sad that anyone came up with that kind of an acronym for addicts... they say that what comes out of your mouth is a reflection of you not the person you are speaking ill of so really they SPOC is a reflection of the healthcare provider. I hope they fired them because they are very detached from the world if that is how they are labeling their patients. There is a higher authority that sees all of what they are doing whom they will answer to one day.

I live in the south east US and the cops absolutely arrest everyone at the scene of the OD including the patient
 
I live in the south east US and the cops absolutely arrest everyone at the scene of the OD including the patient

What part of the South if you don't mind? I'm about 40 mins East of Bham. Never really heard of everyone being arrested, but then again I suppose the situation is usually a call and people dip out. Fornutely, I've never been around to make such a decision, although there has been some "just after you left" calls...
 
I live in the south east US and the cops absolutely arrest everyone at the scene of the OD including the patient

If that's true that's super fucked up. I live in the northeast like Unregi and I can attest that IMO paramedics/EMTs are very compassionate and it does seem that the primary focus is getting these people into treatment.

I don't understand what grounds they would have to arrest everyone at the scene of an OD. I DO understand that cops don't need to follow their own rules as much as we'd all like them to so I'm not saying I don't believe you. It's just so messed up.
 
I live in the south east US and the cops absolutely arrest everyone at the scene of the OD including the patient

Happened to my son in our self-congratulating "progressive" west coast community as well. The poor kid wakes up in the ER with two cops standing over him. Regardless of the fact that he almost died, regardless of the fact that he was a 17 year old scared and traumatized kid, regardless of the fact that his two traumatized parents were standing there sobbing, the cops just handed him his order to appear as if they were ticketing a motorist. The doctors and even the nurses were no better. Their biggest concern seemed to be getting him out of there as fast as possible.
 
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