Pitfalls in the Treatment of PWIDs (People Who Inject Drugs)
- It is not uncommon for clinicians to assume that drug users don’t care about their health; such misperceptions are noticed by patients. Fearing this negativity and condescension, many drug users avoid the emergency department by trying to “doctor” themselves.
- Some providers automatically under-treat or minimize pain when they suspect drug-seeking behavior, or perform procedures (e.g., abscess drainage) with inadequate anesthesia in order to “teach the patient a lesson.”
- Health care providers occasionally bring in other colleagues to gawk at patients without their permission.
- However, these insensitive “Look at the crazy thing this junkie did to herself/himself!” conversations are inappropriate.
- Nurses and doctors should not contact law enforcement without the patient’s knowledge.
- Vague or unrealistic aftercare plans are futile.
- Long speeches and shaming life lectures about drug use can and should be replaced by educational information about risk reduction.
- Patients often overhear health care providers talking about them negatively outside of the room or behind a curtain. Assuming the patient can’t hear them, clinicians can be heard warning other providers about the “druggie” or “drug seeker.”
Counseling Patients with Substance Abuse/Misuse Disorders
Remember the harm principles: