Tim Lahey, MD, an associate professor at Dartmouth's Geisel School of Medicine in Hanover, N.H., recently advocated for hospitals to provide addicted patients with areas to safely inject opioids in an op-ed for The New York Times.
Dr. Lahey opens his piece by describing an interaction with a patient who was placed on 24-hour watch — without access to visitors — after she was found injecting heroin in the bathroom. The patient was hospitalized for a heart-valve infection resulting from her drug abuse.
As the rates of opioid abuse across the nation continue to soar, hospitals are faced with the difficult task of treating patients addicted to opioids. This dynamic, Dr. Lahey argues, places an undue burden on the provider-patient relationship.
"Addicted patients usually bond with their providers over the shared goal of healing. Yet these interactions, which often bridge divides of class, culture and personal psychology, can break down," writes Dr. Lahey. "When addicted patients inject drugs in the hospital, doctors and nurses can find themselves cast in the role of disciplinarians, even jailers ... The worst effect of confining addicted patients in the hospital may be the damage to the patient-provider bond."
Dr. Lahey argues that while safe injection sites are typically designed to keep patients out of the hospital, the same principal of safe injection could benefit patients in the hospital as well. Rooms where addicts have access to clean needles have been instituted in hospitals in Vancouver, Canada, Paris and Berlin. Similar initiatives are being considered for places like Ithaca and Manhattan in New York State, according to Dr. Lahey.
"The creation of these rooms for hospitalized addicts won't be easy. There will be legal liability concerns, and hospitals must safeguard against the risk of overdose or unseemly behavior. It will be worthwhile to tackle these issues if it enables the provision of compassionate care for at-risk patients whose treatment would otherwise be endangered by conflict with providers," he writes.
To read Dr. Lahey's op-ed in the Times, click here.
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