In the emergency room at North Shore Medical Center, Dr. Marisela Marerro says they will see at least one opiate addict every day.
She breaks them into three categories:
- A person not trying to harm themselves who overdoses, and a family member calls 911.
- A person who is trying to commit suicide with the drug and needs psychological help.
- A person who comes in seeking help when suffering withdrawals while detoxing.
In each case, the individual is stabilized. Suicidal addicts are kept until a bed at a psychological hospital can be found.
The rest are asked, “Do you want help?”
If the answer is no, the hospital can’t keep them, because in the medical and insurance worlds, addiction is not viewed as a disease. And if the answer is yes, Marerro said, there is no guarantee the hospital can get help for them right away.
First, physicians and nurses give the individual a medical work-up to see if they have any other medical issues like diabetes or kidney problems that a detox facility would not be able to handle. If there are no medical problems, a psychological social worker meets with the patient to see if he or she has any mental health problems that a detox facility would not be able to handle.
If the patient passes those tests and is need of acute detoxification services, the hospital searches for a bed, but due to the overloaded treatment system, that bed is often not available.
“Unfortunately, if there is no bed available and the patient is not deemed to be suicidal or homicidal or any risk of harm to themselves, we give them a list to call on their own,” Marerro said.