By Maureen Ann Milligan
While living in Houston during the cocaine epidemic of the late ’80s and early ’90s, it was proposed in an article that the multiple deaths related to cocaine were part of survival of the fittest, and that they be allowed – no intervention on the part of first responders. As a medical professional working in the addiction field at the time, I thought this an interesting perspective.
Now, Buffalo is trapped in a heroin epidemic and the “finger in the dike” is first responders administering Narcan. Then what?
Addiction is a disease of body, mind and spirit, a physiological compulsion pushed by a bankrupt mind and hopeless spirit for the next hit.
Anyone who has dealt with addiction will tell you that it takes the addict admitting that she/he has a problem before any recovery can commence.
Once the Narcan works, the addict is admitted into the local emergency department. She/he will meet a variety of attitudes from total disgust (maybe even hear comments from staff to first responders like “why did you bother?”) to uninterested staff avoiding any conversation about the overdose. Once stable, the addict is discharged home. There is a lack of detox beds, especially at 1 a.m., and inpatient drug rehab beds are usually unavailable. A case manager will supply paperwork, even pamphlets, and maybe a list of 12-step meetings and referral telephone numbers, as the addict walks out the door.
What has changed?
Dealing with addiction is in no way being cured of a disease. It is an insidious element that may even be spun into the DNA fabric of an individual. Diabetes is a good comparison: ignore the fact you suffer from diabetes, eat what you want, ignore taking insulin injections or pills, and in time you are dead.
Narcan alone is no answer. Once that addict is brought around, breathing again, nothing in her/his life has changed. The next need is detox followed by an inpatient 30- to 60-day addiction rehab unit. Upon discharge, follow-up is intensive outpatient group and individual therapy, 12-step meetings, employment and/or education and family/community support.
I’ve yet to read anything about increasing the number of detox beds at Erie County Medical Center. In all the refurbishing of old architecture in the city by millionaire entrepreneurs, none have been designated for inpatient drug rehabilitation or halfway houses for addicts.
And, I have heard nothing about community centers, churches or civil organizations asking for Al-Anon-type information about drug addiction that teaches families and friends how one supports an addicted loved one, and no longer enables them.
Without these infrastructures, we’re chasing our tail.
Maureen Ann Milligan, of Getzville, is a registered nurse and a retired art therapist and addiction mentor.