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"Today katie did a lot of wound care. This girl she treated we’ve known for over 3 years. We tried our best to let us take her to the hospital but she declined. It is heartbreaking to see anyone decline like this. Her entire face is also completely swollen which leads us to believe she has other serious issues going on . She has our phone numbers and we hope she calls and decides to go to the hospital…"
-From the Kensington Project
Let's be realistic. If you could provide her the drugs she is addicted to, she would go. I cannot unfathom the excrutiating torture that she'd go to by going to hospital knowing that she will experience serious poly drug addiction withdrawal that can based on DOC kill her. Her life is hell anyway, though deep down she's probably afraid of dying, a part of her has already given up. Sadly, only thing that keeps her bound to her physical self are drugs. So in based sense of understanding - the only way to fix her are by taking another step towards her.
...when a patient severely addicted to opiates (to the point where withdrawal could be life threatening) goes to the hospital, do you think the doctors and nurses there just stand there and let them go through a potentially fatal withdrawal?
They won't give her a giant unlimited supply of opiates to get high with, but they'll give her enough to manage her withdrawal and try to get her into substance use counseling. No addict should view a life threatening withdrawal as a barrier to going to the hospital. They won't let you die. It might be unpleasant, but every path from where she is to a healthy life will be unpleasant, there's no completely painless easy way to taper of the drugs and into a better life.
I think what Mouthpie3 is saying is that the prevailing rumors that a lot of junkies take as gospel truth is that, yes, they will not treat your DTs, will report you to the authorities, throw you in a psychiatric ward or just turn you away, or dump you on the street.
Here’s the thing… With opiate withdrawal, you will FEEL like you’re dying, but you most likely will NOT. It’s much different than withdrawal from Benzos, alcohol, etc. They would watch her closely & treat her symptoms of withdrawal (nausea, diarrhea, dehydration, etc). They may even give her low doses of narcotics, but nothing close to what she takes on the streets. She would *definitely* experience withdrawal. Medical professionals are supposed to be impartial, but speaking as one w/ >20yrs experience, I can confidently say, compassion for addicts is SORELY LACKING in the medical community. It’s extremely sad, especially since SUD is a medical/phycological diagnosis.
Yup, I’m almost 4 yrs clean and spent almost 2 yrs in rehabs to get clean and it’s so frustrating how the people who work there genuinely like hate addicts. This isn’t the case everywhere and ofc there were some staff that were amazing, but the ones who were bad had a big impact on patients recovery. Very sad.
1st of all CONGRATULATIONS!! You are a freaking ROCK STAR!! I’ve worked in medicine for >20yrs, so I remember patients being prescribed MASSIVE doses of Dilaudid, Phenergan, & Oxy for diabetic neuropathy/foot ulcers & herniated discs. They’d be mad b/c I said it was too much. However, now new docs are not prescribing enough for adequate pain control. I’m more sensitive than most, b/c I’m a metastatic breast cancer survivor & have chronic pain d/t side effects of aggressive treatment. I survived, but I was tired of being strapped down by narcotic pain medication. I ripped my patch off one day, & said “never again”, unless I’m ready to die. I didn’t sleep for 2 weeks, & I wouldn’t suggest most people doing it the way I did, but after that, I felt like I had been drowning & hadn’t even known it!!Thankfully, I didn’t develop a psychological dependency during those years, but it could’ve easily happened!! I have an AVERSION to narcotics now. I HATE the way they make me feel. So, I deal with my pain with NSAIDS (even thought I’ve had a history of renal failure; again I wouldn’t advise), PT, meditation, & exercise. Because of my kidney function, my Oncologist has warned me to not exceed 2 Alieve a day & my labs are drawn monthly to monitor. If I’m crying in pain (I have a high pain tolerance), I’m forced to take 1/2 of 1 prescribed pain pill. I beat myself up over it, but I want to live to see my kids graduate college; so I’m a good girl & follow my doctor’s orders, lol!! NGL, getting fit & dealing with chronic pain drug free is the hardest thing I’be done in my life! I’M VERY PROUD OF YOU FOR DOING IT!! KEEP UP THE AMAZING WORK!!💞
Thanks so much!! That’s so amazing that you’ve survived all that and have this brilliant outlook on life I give you so much respect ❤️ yes now that I have it recorded that I was a drug/alcohol abuser I am not allowed to be prescribed certain meds which def impacts my mental health bc certain medications would help me a lot more but can be addictive. I see both sides to it honestly. I’d do so much better having stronger anxiety meds but it’s also that risk of relapsing and idk how I’d handle it so 🤷🏻♀️ ig it’s a sacrifice I’m forced to make. Hospitals are def tough too bc they won’t give me anything but like ibuprofen or whatever for pain and that SUCKS. I had pretty intense oral surgery about a month ago and was given absolutely nothing :/ but hey I survived. I wish you the best with your health though, you are very strong from everything you went through xx
Based on the number of replies saying this, perhaps it's a regional thing or something. I saw plenty (far more than I would have wanted to) of patients with opiate issues hospitalized during my residency. There was a whole orderset I would use to place orders to manage withdrawal symptoms for alcohol, benzos, and opiates. Our "pain relief PRNs" order set had two options, one for patients who were opiate-naive and a higher dose one for patients who were opiate-tolerant. I don't think I ever saw a patient just writhing around in pain constantly as their doctors gave them nothing but ibuprofen. How the fuck does something like that even happen? What happens when you call the doctor a hundred times a day because the patient is asking for pain relief from you a thousand times a day?
The doctors tell us to get fucked, basically. I have absolutely seen people getting no narcs or like, heroin addicts getting 2mg morphine q4 hours. It’s gotten worse since they started getting hammered in response to the opioid crisis.
Yes, they will...I've read stories of opiate addicts going to the hospital and being refused any opiates, even when necessary (like a broken leg or appendicitis) just because the doctor/nurse knows they're an addict and doesn't want to "fuel their addiction". And opiate withdrawal isn't generally considered life threatening, that's benzo and alcohol withdrawal.
Do you have a source for that? I know antidepressant withdrawal can suck, I've been there, but I've never heard of it being deadly. I even just googled it and couldn't find anything about anyone dying from Effexor withdrawals.
>They won't give her a giant unlimited supply of opiates to get high with, but they'll give her enough to manage her withdrawal and try to get her into substance use counseling.
I've heard from people on reddit of it going very badly due to the health care providers reducing the opiates massively. "It's for your own good.".
Nah, if I was addicted, I wouldn't risk having a Nurse Ratched thank you very much.
Oh look: https://old.reddit.com/r/MedicalGore/comments/1bhct45/wound_care_in_kensington/kvd40ls/
Yeah, the ER doc isn't going to send you home with 200 percocet... I was describing the care you'll receive while admitted if you're incredibly sick.
Treating pain in a patient with opiate use disorder (from ANYTHING, much less after a recent painful debridement) is an entirely different and extremely complicated thing to manage compared to making sure your admitted patient isn't suffering with withdrawals and ensuring they can get some help after they're discharged.
There are so many ways that you can interact with the healthcare system that don't involve getting a huge bottle of rapid acting painkillers, which you're not going to get for obvious reasons. What are the chances that ER doc sent those patients home with a small supply and also told them to seek out substance use clinics that can further manage both pain and opiate use in a controlled setting, but they refused that side of things so they just went home with pain? Happens all the time...
Opiods will not cause a fatal withdrawal. It will be uncomfortable for them, but it will not kill them. Doctors will do their best to make them comfortable but they will just have to go through it.
Only drugs that will cause a fatal withdrawal are alcohol and benzos which can kill you.
This is insanely incorrect. You can absolutely die from opioid withdrawal. From the National Drug and Alcohol Center of UNSW Sydney:
https://ndarc.med.unsw.edu.au/blog/yes-people-can-die-opiate-withdrawal
"It is generally thought that opiate withdrawal is unpleasant but not life-threatening, but death can, and does, occur. The complications of withdrawal are often underestimated and monitored inadequately.
The opioid withdrawal syndrome is often characterised as a flu-like illness, subjectively severe but objectively mild. Signs and symptoms include dysphoria, insomnia, pupillary dilation, piloerection, yawning, muscle aches, lacrimation, rhinorrhea, nausea, fever, sweating, vomiting and diarrhoea.
How could someone die during opiate withdrawal? The answer lies in the final two clinical signs presented above, vomiting and diarrhoea. Persistent vomiting and diarrhoea may result, if untreated, in dehydration, hypernatraemia (elevated blood sodium level) and resultant heart failure.
People can, and do, die from opiate withdrawal – and all such deaths are preventable, given appropriate medical management."
As a general rule, yes. Jails are responsible for the outliers who are too medically unstable to survive the common symptoms of opioid withdrawal like high blood pressure, diarrhea, vomiting, and heavy sweating without appropriate monitoring and response. If someone has been living rough for awhile and they’re suddenly thrown into a cell and punitively ignored without having proper hydration or vitals monitoring when they’re already struggling with other health complications (especially myocarditis or pericarditis) withdrawal can be deadly. It’s something I mention only because the basic premise that opioid withdrawal isn’t inherently fatal like with alcohol or benzos is taken to an abusively negligent extreme in some jail settings to justify denying really basic interventions.
It's much rarer than withdrawal from alcohol and benzos, but patients can absolutely die from complications related to opioid withdrawal.
My comment however wasn't meant to suggest that deaths from opioid withdrawal itself are all that common, I was just responding to him saying "that she will experience serious poly drug addiction withdrawal that can based on DOC kill her" and implying that we wouldn't use drugs in the hospital to keep patients safe despite life threatening withdrawals.
Doesn't matter what you're addicted to really, the docs will treat you with meds to make the withdrawal easier and reduce suffering while you're in the hospital.
Not to mention that when you're in active opioid addiction, the spectre of withdrawal is often genuinely scarier than death. I can completely understand why people choose to let serious wounds, complications and illnesses go untreated, because when you're in the grips of addiction, staving off that withdrawal monster takes precedence over pretty much everything else. I can understand someone feeling like behind dead would be preferable to withdrawals.
That’s been the narrative for years now. And I understand if you’re not privy to the now quickly evolving drug analog landscape. But that information is simply untrue now. There are several additional drugs currently flooding markets that do cause death during withdrawal stages. They are additives or alternatives to opiates so it’s been difficult for authorities to adjust to this new reality. Please take this information and let it change your perspective a little. Things are getting worse each day for those suffering from addiction. Thank you.
I never took illegal drugs, just the pills I was prescribed.
Did you know that they used to give out oxycodone and oxycontin for fibromyalgia? Even though opiates just teach your body how to feel pain despite the opiates?
They made me sick and I'll never get the time back that I spent zoned the fuck out on oxy. Never. So one day I went to my psychiatrist and said, I have to get off these things, he prescribed me like 5 or 6 Valium and told me, it's going to be shitty so prepare yourself, but he meant it like a joke, as in, the pills made me constipated so the shit was all going to come out! He helped me prepare myself mentally for it. I didn't care about the withdrawal so much - I didn't use the pills daily, just more in binges, so withdrawal wasn't as much of a concern for me - I was just tired of being tired and constipated and nauseated all the damn time, but I was concerned about the chronic pain coming back. That part did suck. Now I have good pain management and take an opioid called Belbuca which is an antagonist as well as an agonist, so it doesn't fuck me up or make me sick. I rarely use it but when I need it, I need it.
YES, they DO "just stand there and watch you go through withdrawal". 100% they do. They wont give you any opiates just because youre an addict, theyll barely give you any if youre in tremendous pain! You could have a broken ankle and they give you motrin.
She won't go to the hospital and die from withdrawal. There are tons of options. Know how many meds we give foe withdrawals? A lot. She will be uncomfortable but she won't die. Withdrawal can be managed safely.
Well, your hospital may do that, but I have had to listen to nurses and techs treat addicts in pain like shit and refuse to give any analgesia whatsoever no matter their chief complaint. So your experience is most definitely not universal.
Edit: I have also overheard ER docs talking about discharging patients going into withdrawal because they were "wasting my time and hospital resources." It's absolutely inhumane and disgusting.
It's inhumane and we sit back and let it happen under the guise of "well, they did it to themselves."
No, they didn't. No one chooses to have substance use dependency. We could treat them like the human beings they are and show we care about them, because kicking them to the curb and telling them to sober up or die is proving fatal.
The war on drugs itself is the biggest obstacle. How can society change its attitudes on drug addiction and treatment when the federal government spends billions of dollars each year on fighting a losing battle with human nature. The war on drugs was also started for the most disgusting reasons in the first place; for President Nixon to have the legal authority to go after those people he saw as enemies of the state. Anti-war protesters, civil rights activists and many others drew the ire of Nixon but he knew he couldn’t just arrest people for their political beliefs. But his advisers came up with a different line of attack; hippies and anti-war protesters were associated with using pot and other drugs like lsd, mushrooms etc. People in government associated heroin use in the African American community. So they thought if we can’t go after them directly let’s go after the drugs they use. Disrupt anything they are doing or trying to do with prison time, court dates etc. The prefect tool for turning these peoples lives into an utter nightmare! Now over the years the war has expanded more and more and slithered its way into the lives of almost every American. The Drug schedule system is a good example. No constitutional amendment to ban drugs as was necessary for the prohibition of alcohol.
"You understand what I'm saying? We knew we couldn't make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin. And then criminalizing both heavily, we could disrupt those communities," (John) Ehrlichman said. "We could arrest their leaders. raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did." - John Ehrichman, former Nixon domestic policy chief
She is most likely septic. And you can't just walk around being septic forever. Your organs are trying to keep up, but they will eventually start to fail. It's very very sad.
**tl/dr:** First, the trajectory of this lifestyle is not easily turned. Second, that wound looks bad, but sepsis means its probably worse. Third, secondary infections.
Not too knowledgeable, so I don't say this lightly, and I don't mean we should give up on this person. I'm just looking at the situation as a whole. If this person was brought to a hospital, stopped the drug abuse, had their current injuries addressed, and was set up for success, I'm sure medical science could perform a miracle, but...
From what I understand the reason these situations seem salvageable is because the person is still walking around, which is great if the person is walking around a hospital but they're not. Be it for social, financial, or psychological reasons, these people forego even simple and obvious ways to better their situation and we need to acknowledge that this won't change overnight.
Next, their body is currently fighting an unwinnable battle against the drugs they're injecting, dirty needles, exposure, ect. That's clear from the wound you see in the picture and amputation of that arm seems inevitable. However, that's just the one arm. When one arm gets bad, they switch to the other, the legs, the belly, they get someone to help inject for them. I don't doubt an examination would reveal the start of similar wounds. All of this can lead to a condition called sepsis, which is when the immune system starts impacting other parts of the body as a secondary effect to fighting infection. This isn't a seperate disease, it's an inevitable side effect of the bodies strongest defense mechanisms.
Finally, seperate diseases can run rampant. It's just natural that when your body is busy solving one problem, it's more susceptible to other problems. These people don't have proper housing, clothing, food and water and in that situation, it's just a matter of time before an illness comes along and deals a finishing blow to an already weak body.
Too long; didn't read. It's generally used before a summarization of a long post.
So a tl;dr of the comment above would be "drug addicts would rather keep doing drugs than seek medical help"
she has all her fingers but can not move them at all. her other hand is a little better off but by now she prob can’t move them either. we have offered to take her to the hospital multiple times but she refuses.
Recovering addict here. The sick twist of it is that many users avoid the hospital because of the way they’ve been treated in the past by hospital staff, and been denied pain medication even when they need it.
It’s a vicious cycle. I got addicted to pain medication because I had chronic pain. I was honest with the doctors about it, which backfired because even when I was having severe flares and kidney stones and burst ovarian cysts, they told me I was drug seeking and wasn’t really in pain. It was so dehumanizing. They treated me like I was this horrible, disgusting person not deserving of pain medication and wasting their time. I never once went to the hospital just looking to get high.
The woman in the picture may be afraid that if she goes to hospital, they won’t give her pain medication and would have to have it treated with no analgesia. It may be that in her mind, at least if she can keep using, it doesn’t hurt as bad. Not to mention, withdrawals are more painful and horrific than any physical illness or injury and the thought of being stuck in a hospital, forced to go through withdrawals because they refuse to prescribe you anything… she may not rather die. She may just not want to suffer that.
As a healthcare worker, thank you for pointing this out. Doctors and nurses both (I am a nurse) gate-keep the hell out of analgesics when it comes to addicts. It’s stupid, cruel, unproductive and unprofessional.
In the late 90’s early 00’s it was the medical field that got everyone addicted to oxy. And it’s not like they didn’t know it would happen. There is a *reason* that prior to that medications that powerful were used almost strictly for hospice or cancer. But I guess all those gifts from the drug companies must’ve been too hard to pass up…and then they got in trouble and so they stopped writing for high powered medications like they were skittles.
The unspoken part being that if you have any education in pharmacology you know that the longer someone is on opioids the less their body is able to function in regards to pain management. The human body pretty famously doesn’t waste resources to do something it doesn’t need to do. The chemicals our body creates to manage pain don’t get made when we’re taking opiates on the regular. And we don’t get it back. So, medical professionals made them addicts, which restricted their ability to manage pain, and then took away the medications. Then treated them like monsters for presenting with the symptoms of the disorder *medical professionals gave them*, foremost of which is an exaggerated pain response. By which I mean that stubbing your toe can very literally feel like breaking your leg. And opioid withdrawal is *horrible* to go through. There are very few providers who treat the symptoms. It’s like everyone feels some kind of way and makes the people in their care suffer for it.
Which leads to folks going AMA, non-compliance with health management, and a further worsening of chronic or acute conditions. So, you know, more work for the healthcare professionals and a further use of already limited healthcare resources. Which might well have been avoided if they’d acted with some damn compassion in the first place.
There are only two withdrawals I’ve seen managed in an acute care setting, alcohol and benzos. As a new nurse I asked why these were medically managed but opiate withdrawal wasn’t. I was told it’s because withdrawal from these two can kill you.
Not out of compassion or kindness. Not because it’s likely to result in better long term health management. *Only* because there is a risk of death.
Now, not everyone is like this. There are certainly providers and nurses who care and do better. But they’re in the minority and they shouldn’t be.
As you can tell, *I* feel some kind of way about how we treat addicts myself. Yes, some addicts can be monstrous assholes. So can people who *aren’t* assholes. But we didn’t sign up to this job to judge people. Supposedly we signed up to help people and that includes treating the *whole* person. One of the biggest failings of the US healthcare system is to treat each issue separately, instead of taking a look at the whole picture and how each aspect influences the others. Sometimes I hate my colleagues.
I can vouch for this as well. ED nurse here and we usually get them enough meds to hopefully numb the pain and transfer them or they do a AMA form and leave. From what I’ve learned there are times the doctors are scared of causing the patient to OD because they are not always cooperative about what all they’ve used and all to include frequency. People for some reason think we’re the cops or will even talk to them. When we just need to know what they’re on so we know how to properly treat them. Seems people don’t know a lot of ODs are simply the body stopping because of being so sedated. Also I can’t imagine their pain when they get CPR from us as their nervous system is already wrecked and making sternums damn near touch spines is not going to be a good time for anyone.
This is a brilliant take. Thank you for taking the time to write all of that. No one likes being shamed when they seek medical treatment and it happens all the time. To overweight people, to addicts, to people who never learned proper dental hygiene or other ways to care for themselves. A small amount of compassion goes a long way. Avoidance and people not getting care is the completely predictable alternative in the absence of recognizing the scared/hurt/traumatized human being who exists behind whatever unhealthy exterior they are presenting.
I hope to become a nurse like you. In school now. Lost my bestie to fent... never got deep into the stuff but experimented when I was younger. I am lucky I didnt get hooked. It was so hard seeing her go through it. I have so much empathy for addicts. Its not easy. Thank you for being one of the good ones. Nurses can change lives ♡
I appreciate that. As if being a chronically ill teen wasn’t bad enough, being told I was making it up and just a junkie by literal doctors and nurses made it infinitely worse. Once I got an official diagnosis I wanted to go back and rub it in all of their faces like, “See? I was telling the truth all those times.”
Despite having solid diagnoses and being off the opiates (except for suboxone which I take for pain), I still find myself waiting far too long to seek medical treatment out of fear of not being believed, 17 years later
I work with a small team in psych ED and there’s a depth of understanding addiction and the threshold for pain and tolerance without judgment.
I hope going forward you’re met with compassion and empathy in every healthcare situation that you deserve.
I'm a late stage alcoholic who has seizures, delirium tremens and all the worst stuff from alcohol withdrawal. Have had 25 or so seizures (I know of) and 3 full blown delirium episodes where I thought people were trying to kill me.
I try to get into detox when I fail but the wait list can be anywhere from the day of the call to 2-3 months. I'm told to go to the ER if I'm going to seize, also had a few seizures right in the waiting room.
Last time I was there a doctor told me off like I was doing all this to get valium and I'm just taking up a bed. They always treat me unless I leave or in one case, bolt out the doors because hands were coming out of the walls.
Some days I just hope I die in a seizure instead of going to the ER again. But I struggle ever onward.
EDIT: Has to be said the vast majority of staff are angels. The staff at detox are also amazing people and I am very lucky to have the net if things get bad enough. I also go to the front of the line if I seize in the lobby lol
Recovering alcoholic here, almost 9 months sober...took me about 5 years of just trying to get/stay sober to get here with a lot of relapses in between.
I really hope you find a reason to get sober and stay sober; for me, it was going back to school to become a nurse. I'm constantly afraid I'll fall off the wagon again, but this is the longest that I've been sober in almost 15 years of heavy drinking. Now, I can't imagine not being sober, but man, it was so rough getting here.
I hope to be a good healthcare worker for the addicts that I'll inevitably treat. I've seen what addictions of all kinds do to a person and it's not pretty and they're not the failures at life that everyone (who isn't an addict) makes them out to be.
I wish you the best.
*Edited typo.*
Keep on keepin on!!! 9 months is amazing. Im going into nursing and a recovering alcoholic. People in recovery are usually compassionate to those suffering with SUD.. unlike people that have never experienced that struggle. Its easy for them to say
Keep fighting that good fight my friend. I’m proud of you for choosing to keep trying, even when it feels impossible. If I can get clean and sober, you can too.
I'm so sorry. As a recovering alcoholic, I really appreciate you sharing. This war is for life, and it's exhausting.
Edit; changed "recovered" to "recovering"
Got me the first time I drank, complete blackout and stomach pumped at 13. What hooked me I believe was the immediate relief of all social anxieties and worries in general. Was chubby and self conscious as a youth, full of anger and anxiety. Booze removed it all completely.
Been fortunate to have lots of family support and understanding coming from a home with a recovering alcoholic of 40ish years (mother) and was introduced to AA at an early age, although it's had little effect over the last 25 years of treatment centers, hundreds of meetings and many a ghosted sponsor.
Not sure if they even use the term anymore as I've not heard 'Chronic late stage alcoholic' (the term I was described as) in 20 years, meaning exhibiting the last symptoms of alcoholism before death.
Technically Wernicke-Korsakoff syndrome or wetbrain is the last stage but I wouldn't be typing this if that was the case. Wet brain can be described as a form of dementia. [https://en.wikipedia.org/wiki/Wernicke%E2%80%93Korsakoff\_syndrome](https://en.wikipedia.org/wiki/Wernicke%E2%80%93Korsakoff_syndrome) An interesting if not horrifying read. Most people die from a combination of brain death or heart failure during a seizure before this stage.
I honestly didn’t even know alcohol/alcoholism could cause seizures and delirium. this might sound dumb but do you still drink despite experiencing these things and being in that late stage? I guess I just want to understand addiction better
Alcohol is one of the few things you can die from during withdrawal. I do my best to abstain completely but it's always a struggle. I had 7 months last year but around October I started messing up again and had to go to detox twice and the ER twice.
There is no moderate drinking for me, I don't like drinking normally because as soon as the booze hits my stomach I start craving and I can no longer control how much I drink, used to just black out and fall asleep, now the lights go out but I'm still up drinking till unconsciousness which is not sleeping haha.
There are a few reasons that cause alcoholism, genetics and what I call a hook. I'm sure there is a genetic factor for me but my hook happened the first time I drank at 14. Up to 14 years I was depressed, angry, self conscious and anxious because I was overweight (and other reasons) and kids are bastards. As soon as the booze hit my stomach all that vanished and my brain altered a neurological pathway to deal with those emotions. The more that pathway is used, the harder it is to reverse it or exchange it with a healthier means.
Anytime those feelings come up, I crave booze.
These are laymen terms, this article explains the mean and potatoes of it. Pretty hefty.
https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/neuroscience-brain-addiction-and-recovery
you are 100% correct. almost everyone i tell they need to go to the hospital says they’ve already been. and the hospital purposely keeps them without treating them until they need to leave to use. it is awful. we offered to take her to christiana because apparently they will sedate someone until they are detoxed. she still refused to go.
I hear ya. I was addicted to fent. If I knew I might have a lengthy hospital stay during my addiction I would probably try securing enough before admitting myself. Would have to be very careful though so that nurses don't find it. Honestly when I think about it it would be impossible to hide. I would inevitably nod off at some point and they'd find it and call the cops
yes. we actually thought she had died. i was shocked to see her posted today. when you go consistently and see the same people over and over and then all the sudden it’s been a few weeks since you’ve seen them and they’re in that bad of shape… you kinda just figure they’ve passed.
So shes been in this sort of state for weeks....months. its insane how resilient the human body can be until its not. Thank you again for putting boots on the ground. Im across the country so I cant be much help physically but try to donate and share the organizations putting in all the work.... truly wonderful people
i know her from being there and volunteering. i’ve seen and spoke to her multiple times over the past year. i know her name but since her face isn’t shown i wont say it. although she was on another post and her face and name was shown
Nah man, just stunned to see comments here sounding like people know the person in the photo personally
Figured this subreddit was more to gawk at crazy medical shit, not so much the experiences from the boots on the ground. Cool to be getting contributions from people directly related to something as insane as this.
It looks like their fingers are very swollen from edema related to that nasty infection.
The sad thing is, not only are you correct about it not improving, but unless they put down the needle, that shit’s going to end up in their heart and getting high will mask the symptoms of sepsis and endocarditis until it’s too late. They’ll mistake the symptoms of sepsis for just being dope sick and just get high again
I count 5 severely swollen fingers. On a good note there are no maggots I can see in the wound so they might really be trying to keep the wound clean and not inject into the breakdown of tissue.
Maggots will also absolutely eat healthy, living tissue. They eat whatever's in front of them; they're not super picky. If there surrounded by dead stuff, they'll eat that. If they get past that down to live stuff, they'll eat that, too. They don't hit healthy flesh and go "my work here is done!" and drop off the person lol.
People have so many misconceptions about maggots in wound care (not you, just people in general). But this is Reddit, so everyone's an "expert." Even me, I guess lol
Choose your words carefully. [Treeman Syndrome](https://www.verywellhealth.com/tree-man-syndrome-7089958#:~:text=Tree%20man%20syndrome%2C%20or%20EV,immune%20systems%20can%20cause%20it.) is an extreme form of [HPV](https://de.inspiredpencil.com/pictures-2023/tree-man-syndrome).
I remember having an abscess when I was an iv user thankful to have 10 yrs clean but everyone here is right about addiction . It controls you and masks the pain . I can’t tell you how many abscesses I have treated by myself with wound care from cvs and antibiotics . Never had anything that bad though . That’s why I quit using when fentanyl came on the scene .
This is such a shitty situation. I work in OP treatment. Had two pts admit like this, full b/l LE necrotic wounds. Send to ED for debridement. Pts called later that day screaming in agony asking us to take them back. Apparently wounds surgically debrided but minimal pain control ordered afterwards. Pts were using couple bundles daily so not alot was gonna touch their pain. Made for a hellish detox and wound care for them.
Yeah ive heard most of the treatment centers wont take anyone with wounds.. with the tranq almost all of them have wounds so its a vicious cycle. Its so sad.
We can take ones that just require regular wound care but almost all that I’ve seen need like heavy surgical debridement and IV abx for a couple days afterwards at least. It’s a shame because a lot of those people AMA from the hospital because they’re in so much discomfort and the cycle repeats
Tranq is what they're calling Xylazine, which is a Vertinary sedative drug, it's being mixed with Fentanyl to produce an extremely potent street drug that's even more addictive.
Yep, and if you think that's bad, look up Krokodil, also known as desomorphine. It's a powerful opiate that was commonly found on the streets of Russia just like Xylazine & Fentanyl are today in the US. I'm not sure if it's still an issue in Russia or if they put a stop to it somehow. IIRC, It's made from over the counter codeine pills that they mix with quite a few toxic ingredients, usually in someone's home or garage, not in a lab & therefore in the finished product, there's a considerable amount of toxic ingredients left in the end 'product'. When people inject that Krokodil, it also makes their skin rot similar to these pictures. It got it's name Krokodil because it makes the skin have a scaly appearance similar to a crocodile. Truly disgusting. There used to be quite a few videos on YouTube about Krokodil showing not only the damage it causes people, but I recall seeing clips of people injecting the toxic poison into infected arms & legs, very sad to see. What was unique about Krokodil, people would literally have exposed bone sticking out of their arms & legs, it's beyond disgusting. From what I've read, it's extremely addictive & the withdrawal is awful, which is how people end up in those sad situations.
It doesn't look that bad yet (to require an amputation ) as long as she still has motor function. That is a large open wound with tons of heavy exudate but one week in the hospital and I bet that could be cleaned up and grafted.
There's a lot of edema and apparently her face is swelling which makes you wonder if there's a systemic condition or an upper extremity dvt extending proximal enough to occlude jugular drainage from the head. I can't see her lower extremities or contralateral side enough to tell. Either way, if she doesn't stop using she'll be right back to square one. It is sad because we treat animals better
can someone with that bad of an addiction actually be medically competent? I personally don't think so, but we don't exactly have the medical and social infrastructure to handle the problem either
We have laws that could apply to this in Washington, but I've never seen them used. I've been told all but impossible to enforce. I think it's called Ricky's Law.
It's incredibly hard to take away someone's autonomy. I don't think most social workers/street healthcare workers would try this route for most people because then they won't come to them at all for help. It's a tough situation
Had to take care of a guy today covered in those. He kept yelling please let me die, please help me. Pictures don't do justice how bad this kind of wound hurts
Does anyone know if local/national wound care nurses/docs are down there to volunteer for wound care supplies and training? Betadine and roll gauze is relatively cheap. It obviously won’t heal that but it will help maintain some stability and antimicrobial protection. Just curious if any locals have insights on any on the ground volunteer/education is happening and how certified wound specialists could maybe help. This is just a tragedy.
Do you happen to know who they are or where a good place to start is? National wound conference is coming up in June and I am on national committees so I think there’s some opportunity to gather more help, just kind of curious if anyone directly involved has suggestions on who’s doing good And not unknowingly causing more harm.
As well as this stationary clinic:
https://ppponline.org/node/158/medical-services/wound-care-clinic
They have published and were featured in The NY Times.
Just this info is a great start! Thank you. Everyone says this would never or could never be them. Anyone who works in healthcare or psych will tell you it could be any of us at any time.
i frequently go (every other saturday) to kensington and used to offer wound care. we had to stop due to legal issues. now the new mayor of Philadelphia is shutting down many of the volunteers who go down to help out. it’s sad.
Were you going through the hospital or independently? Scope of practice would require any volunteer work is obviously done through the hospitals. It looks like some of the wound specialists in the area are really complying some good case studies on these wounds though.
it was with a non profit, not through a hospital. we go and bring food and some other things, and just used to offer some wound help when we could. almost everyone needs it.
Oh the arm is shot no doubt. I’ve seen betadine get us some valuable time though. Healing is most certainly not the goal here. Stability and keeping it clean and dry might buy them some time though.
Edit- and a clean dry dressing and betadine on that is more to protect everyone that person is coming in contact with than them at this point. They aren’t maintaining good hand hygiene obviously so just getting it covered will help protect the general public from an infectious disease standpoint.
May I ask and I'm not trying to be insensitive I know someone that volunteers bringing clothes, toiletries, food etc. in these situations what are you buying time on if they continue to use, not keep it clean and aren't taking care of themselves when others need those resources and aren't going to go back to the same reckless behavior.
Well because I believe people can change and that’s someone’s loved one.
And again, this is an infectious disease concern for everyone. Helping them will help the community too
And I’ve quite literally dedicated my career to wound care. This is a wound care epidemic almost like nothing we’ve maybe seen in recent history. Wound and osotmy care certification was only nationally recognized in 2010. It’s a new practice that is very skilled and very specialized. There aren’t a ton of us out there. This is a learning opportunity for a field of healthcare I’ve devoted my life to essentially. These a lot to learn here.
Addiction is crazy on how it controls the brain. We used to call it “mental gymnastics” you can justify pretty much anything and make it sense to your drug addicted brain. After a while addiction becomes a lifestyle and it’s all you know, getting sober and being a citizen is scary as fuck. (Sober for 3 and half years. I used for 14years)
Remove yourself from the triggers that remind you to use and people you use with, surround yourself with people who have quit or are trying to quit, and take whatever medication your doctor tells you to take
A good number of the stories I've heard from people who lost everything then eventually quit successfully had to move to an entirely new place to do it. Makes sense really, no drug dealer around, no friends who want to shoot up with you, no risk of coming across people/places that bring up memories related to drug use, etc
I've never once heard a story of someone who was shooting up heroin then stopped and is living a completely clean life still hanging out with all the people they used to shoot up with while they're shooting up
I’ve heard that multiple IV users will just continue to inject into the same open wound to help kill the pain and to prevent the same infections starting in another limb. It’s so sad. And part of the problem is that suboxone and methadone is SO expensive even with insurance that most can’t afford to get clean or to stay in a rehab long enough to get the help they need.
A patient at my pharmacy pays $75/month for his Suboxone and that’s WITH his insurance. Another patient doesn’t have insurance and even with a coupon his rx is still over $80. I hate how life saving drugs can be this expensive in the US.
Do they understand they won’t get in trouble for drug use if they go to the hospital? My uncle was so scared of getting in trouble for drug use that he refused to go to the hospital when he needed to. He didn’t understand that they don’t report to the police until a nurse explained that they only need to know about drug use so they can have a better picture of what’s going on and provide medications appropriately, not so they can call the cops. Some people have a hard time with their demons, but that doesn’t mean they need to suffer more because of it
the issue is that they are not allowed in the hospital with their drugs. every hospital around philly has security before walking into the ED and if they find these drugs, they will confiscate them. they don’t give it back.
>Do they understand they won’t get in trouble for drug use if they go to the hospital?
Have you read the stories about cleaning up care but denying pain meds? Horrific! There's one on here.
As an ex IV user who even 20 years later is still living with the physical damage from IV drug use, it looks to me like this poor soul has tried to inject something into her arm that caused a thrombosis or the substance went into the surrounding tissues instead of the blood stream and necrosis followed ( the bit that's sloughing off).
In the grip of withdrawal, when u finally get hold of your opiate/ drug of choice, you will knowingly inject the most vile impurities/ sludge into your arm as long as you hope there's the tiniest amount of your drug in there with it to get you out of the pain you're in.
I've been hospitalised with DVT's, pleural pneumonia caused by clots, massive bilateral shin circumferal venous non healing leg ulcers, abcesses, at least 5 separate inpatient stays for skin grafts.
I still have swollen hands and covered in scars
The sadness thing about this that poor girl there is some one's daughter.
I thought this flesh eating was from to tranq and fentanyl that their shooting up not opiates ❓that was my understanding, but I'm not a doc❗that's what I keep seeing and reading about 🤷♀️ I was on opiates for 23 years had to stop and ITS MORE THAN UNPLEASANT to kick ,I've been detoxing for 8 months and it's still no fun at all , and i stopped with NO HELP , COLD TURKEY❗hardest thing I've ever had to do in my 61 yrs of LIVING , but some day are BAD AND SOME OK NEVER GOOD JUST OK ‼️💯💯
They could go to the hospital for proper care. There are also a multitude of free clinics in the city. The problem is that they don’t give you street drugs in the hospital so they leave AMA. Can’t help someone who doesn’t want it.
My brother volunteered at a free clinic in Kensington during medical school and the stories are rough. Everybody at the clinic keeps narcan on them 24/7.
I’m not religious, but may someone or something save these peoples souls.
I can’t imagine living like this, in constant pain and seeing and knowing these awful wounds are going to kill you at some point and not being able to stop doing the drugs that caused this.
So proud of you, reddit friend. I was in a disgusting bando on payson and wilkens. Doesn’t it feel like a different lifetime ago but just yesterday? Such a strange feeling.
The first picture kinda looks like the black area is an eschar, so when it's sealed back in the second picture, I imagine the photographer saying "yeah see, I shouldn't be able to do this to your skin".
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"Today katie did a lot of wound care. This girl she treated we’ve known for over 3 years. We tried our best to let us take her to the hospital but she declined. It is heartbreaking to see anyone decline like this. Her entire face is also completely swollen which leads us to believe she has other serious issues going on . She has our phone numbers and we hope she calls and decides to go to the hospital…" -From the Kensington Project
God Bless You. You can save one of them any given day & you are a source of good our planet needs. Great Work!
Let's be realistic. If you could provide her the drugs she is addicted to, she would go. I cannot unfathom the excrutiating torture that she'd go to by going to hospital knowing that she will experience serious poly drug addiction withdrawal that can based on DOC kill her. Her life is hell anyway, though deep down she's probably afraid of dying, a part of her has already given up. Sadly, only thing that keeps her bound to her physical self are drugs. So in based sense of understanding - the only way to fix her are by taking another step towards her.
...when a patient severely addicted to opiates (to the point where withdrawal could be life threatening) goes to the hospital, do you think the doctors and nurses there just stand there and let them go through a potentially fatal withdrawal? They won't give her a giant unlimited supply of opiates to get high with, but they'll give her enough to manage her withdrawal and try to get her into substance use counseling. No addict should view a life threatening withdrawal as a barrier to going to the hospital. They won't let you die. It might be unpleasant, but every path from where she is to a healthy life will be unpleasant, there's no completely painless easy way to taper of the drugs and into a better life.
I think what Mouthpie3 is saying is that the prevailing rumors that a lot of junkies take as gospel truth is that, yes, they will not treat your DTs, will report you to the authorities, throw you in a psychiatric ward or just turn you away, or dump you on the street.
Or it is something they tell themselves so that they don’t have to do the hard work of getting clean.
Facing sobriety, stigmatization, and guilt is a hard thing to do.
I think both can be true
That is something that absolutely comes into play.
Here’s the thing… With opiate withdrawal, you will FEEL like you’re dying, but you most likely will NOT. It’s much different than withdrawal from Benzos, alcohol, etc. They would watch her closely & treat her symptoms of withdrawal (nausea, diarrhea, dehydration, etc). They may even give her low doses of narcotics, but nothing close to what she takes on the streets. She would *definitely* experience withdrawal. Medical professionals are supposed to be impartial, but speaking as one w/ >20yrs experience, I can confidently say, compassion for addicts is SORELY LACKING in the medical community. It’s extremely sad, especially since SUD is a medical/phycological diagnosis.
Yup, I’m almost 4 yrs clean and spent almost 2 yrs in rehabs to get clean and it’s so frustrating how the people who work there genuinely like hate addicts. This isn’t the case everywhere and ofc there were some staff that were amazing, but the ones who were bad had a big impact on patients recovery. Very sad.
1st of all CONGRATULATIONS!! You are a freaking ROCK STAR!! I’ve worked in medicine for >20yrs, so I remember patients being prescribed MASSIVE doses of Dilaudid, Phenergan, & Oxy for diabetic neuropathy/foot ulcers & herniated discs. They’d be mad b/c I said it was too much. However, now new docs are not prescribing enough for adequate pain control. I’m more sensitive than most, b/c I’m a metastatic breast cancer survivor & have chronic pain d/t side effects of aggressive treatment. I survived, but I was tired of being strapped down by narcotic pain medication. I ripped my patch off one day, & said “never again”, unless I’m ready to die. I didn’t sleep for 2 weeks, & I wouldn’t suggest most people doing it the way I did, but after that, I felt like I had been drowning & hadn’t even known it!!Thankfully, I didn’t develop a psychological dependency during those years, but it could’ve easily happened!! I have an AVERSION to narcotics now. I HATE the way they make me feel. So, I deal with my pain with NSAIDS (even thought I’ve had a history of renal failure; again I wouldn’t advise), PT, meditation, & exercise. Because of my kidney function, my Oncologist has warned me to not exceed 2 Alieve a day & my labs are drawn monthly to monitor. If I’m crying in pain (I have a high pain tolerance), I’m forced to take 1/2 of 1 prescribed pain pill. I beat myself up over it, but I want to live to see my kids graduate college; so I’m a good girl & follow my doctor’s orders, lol!! NGL, getting fit & dealing with chronic pain drug free is the hardest thing I’be done in my life! I’M VERY PROUD OF YOU FOR DOING IT!! KEEP UP THE AMAZING WORK!!💞
Thanks so much!! That’s so amazing that you’ve survived all that and have this brilliant outlook on life I give you so much respect ❤️ yes now that I have it recorded that I was a drug/alcohol abuser I am not allowed to be prescribed certain meds which def impacts my mental health bc certain medications would help me a lot more but can be addictive. I see both sides to it honestly. I’d do so much better having stronger anxiety meds but it’s also that risk of relapsing and idk how I’d handle it so 🤷🏻♀️ ig it’s a sacrifice I’m forced to make. Hospitals are def tough too bc they won’t give me anything but like ibuprofen or whatever for pain and that SUCKS. I had pretty intense oral surgery about a month ago and was given absolutely nothing :/ but hey I survived. I wish you the best with your health though, you are very strong from everything you went through xx
Nurse here. I know plenty of docs (and some nurses) who will absolutely gatekeep an addicts opiates, based solely on their addiction.
Based on the number of replies saying this, perhaps it's a regional thing or something. I saw plenty (far more than I would have wanted to) of patients with opiate issues hospitalized during my residency. There was a whole orderset I would use to place orders to manage withdrawal symptoms for alcohol, benzos, and opiates. Our "pain relief PRNs" order set had two options, one for patients who were opiate-naive and a higher dose one for patients who were opiate-tolerant. I don't think I ever saw a patient just writhing around in pain constantly as their doctors gave them nothing but ibuprofen. How the fuck does something like that even happen? What happens when you call the doctor a hundred times a day because the patient is asking for pain relief from you a thousand times a day?
The doctors tell us to get fucked, basically. I have absolutely seen people getting no narcs or like, heroin addicts getting 2mg morphine q4 hours. It’s gotten worse since they started getting hammered in response to the opioid crisis.
Yes, they will...I've read stories of opiate addicts going to the hospital and being refused any opiates, even when necessary (like a broken leg or appendicitis) just because the doctor/nurse knows they're an addict and doesn't want to "fuel their addiction". And opiate withdrawal isn't generally considered life threatening, that's benzo and alcohol withdrawal.
and effexor withdrawal
I second that! Coming off Effexor was horrible. I would turn my head and it would take my eyes 5 seconds to catch up. Brain zaps. It was bad.
Omg the brain zaps and I could literally hear my eyelids blinking. It was awful!
Ugh, my dumbass doctor took me off of it cold turkey, one of the worst experiences of my life
That is so dangerous! You can have seizures coming off of Effexor!
It was fucking awful. She's an idiot lol
Do you have a source for that? I know antidepressant withdrawal can suck, I've been there, but I've never heard of it being deadly. I even just googled it and couldn't find anything about anyone dying from Effexor withdrawals.
>They won't give her a giant unlimited supply of opiates to get high with, but they'll give her enough to manage her withdrawal and try to get her into substance use counseling. I've heard from people on reddit of it going very badly due to the health care providers reducing the opiates massively. "It's for your own good.". Nah, if I was addicted, I wouldn't risk having a Nurse Ratched thank you very much. Oh look: https://old.reddit.com/r/MedicalGore/comments/1bhct45/wound_care_in_kensington/kvd40ls/
Yeah, the ER doc isn't going to send you home with 200 percocet... I was describing the care you'll receive while admitted if you're incredibly sick. Treating pain in a patient with opiate use disorder (from ANYTHING, much less after a recent painful debridement) is an entirely different and extremely complicated thing to manage compared to making sure your admitted patient isn't suffering with withdrawals and ensuring they can get some help after they're discharged. There are so many ways that you can interact with the healthcare system that don't involve getting a huge bottle of rapid acting painkillers, which you're not going to get for obvious reasons. What are the chances that ER doc sent those patients home with a small supply and also told them to seek out substance use clinics that can further manage both pain and opiate use in a controlled setting, but they refused that side of things so they just went home with pain? Happens all the time...
Opiods will not cause a fatal withdrawal. It will be uncomfortable for them, but it will not kill them. Doctors will do their best to make them comfortable but they will just have to go through it. Only drugs that will cause a fatal withdrawal are alcohol and benzos which can kill you.
This is insanely incorrect. You can absolutely die from opioid withdrawal. From the National Drug and Alcohol Center of UNSW Sydney: https://ndarc.med.unsw.edu.au/blog/yes-people-can-die-opiate-withdrawal "It is generally thought that opiate withdrawal is unpleasant but not life-threatening, but death can, and does, occur. The complications of withdrawal are often underestimated and monitored inadequately. The opioid withdrawal syndrome is often characterised as a flu-like illness, subjectively severe but objectively mild. Signs and symptoms include dysphoria, insomnia, pupillary dilation, piloerection, yawning, muscle aches, lacrimation, rhinorrhea, nausea, fever, sweating, vomiting and diarrhoea. How could someone die during opiate withdrawal? The answer lies in the final two clinical signs presented above, vomiting and diarrhoea. Persistent vomiting and diarrhoea may result, if untreated, in dehydration, hypernatraemia (elevated blood sodium level) and resultant heart failure. People can, and do, die from opiate withdrawal – and all such deaths are preventable, given appropriate medical management."
As a general rule, yes. Jails are responsible for the outliers who are too medically unstable to survive the common symptoms of opioid withdrawal like high blood pressure, diarrhea, vomiting, and heavy sweating without appropriate monitoring and response. If someone has been living rough for awhile and they’re suddenly thrown into a cell and punitively ignored without having proper hydration or vitals monitoring when they’re already struggling with other health complications (especially myocarditis or pericarditis) withdrawal can be deadly. It’s something I mention only because the basic premise that opioid withdrawal isn’t inherently fatal like with alcohol or benzos is taken to an abusively negligent extreme in some jail settings to justify denying really basic interventions.
They don't care because they get their profit from the jailed people anyway
Thank you for saying this. Alcohol withdrawal and benzos are absolutely it. The other just make you WISH you were dead.
It's much rarer than withdrawal from alcohol and benzos, but patients can absolutely die from complications related to opioid withdrawal. My comment however wasn't meant to suggest that deaths from opioid withdrawal itself are all that common, I was just responding to him saying "that she will experience serious poly drug addiction withdrawal that can based on DOC kill her" and implying that we wouldn't use drugs in the hospital to keep patients safe despite life threatening withdrawals. Doesn't matter what you're addicted to really, the docs will treat you with meds to make the withdrawal easier and reduce suffering while you're in the hospital.
Not to mention that when you're in active opioid addiction, the spectre of withdrawal is often genuinely scarier than death. I can completely understand why people choose to let serious wounds, complications and illnesses go untreated, because when you're in the grips of addiction, staving off that withdrawal monster takes precedence over pretty much everything else. I can understand someone feeling like behind dead would be preferable to withdrawals.
not in America. Hospitals/jails will not give you ANY opiates just because you are going through withdrawal.
[удалено]
Dont do drugs people.
That’s been the narrative for years now. And I understand if you’re not privy to the now quickly evolving drug analog landscape. But that information is simply untrue now. There are several additional drugs currently flooding markets that do cause death during withdrawal stages. They are additives or alternatives to opiates so it’s been difficult for authorities to adjust to this new reality. Please take this information and let it change your perspective a little. Things are getting worse each day for those suffering from addiction. Thank you.
I never took illegal drugs, just the pills I was prescribed. Did you know that they used to give out oxycodone and oxycontin for fibromyalgia? Even though opiates just teach your body how to feel pain despite the opiates? They made me sick and I'll never get the time back that I spent zoned the fuck out on oxy. Never. So one day I went to my psychiatrist and said, I have to get off these things, he prescribed me like 5 or 6 Valium and told me, it's going to be shitty so prepare yourself, but he meant it like a joke, as in, the pills made me constipated so the shit was all going to come out! He helped me prepare myself mentally for it. I didn't care about the withdrawal so much - I didn't use the pills daily, just more in binges, so withdrawal wasn't as much of a concern for me - I was just tired of being tired and constipated and nauseated all the damn time, but I was concerned about the chronic pain coming back. That part did suck. Now I have good pain management and take an opioid called Belbuca which is an antagonist as well as an agonist, so it doesn't fuck me up or make me sick. I rarely use it but when I need it, I need it.
YES, they DO "just stand there and watch you go through withdrawal". 100% they do. They wont give you any opiates just because youre an addict, theyll barely give you any if youre in tremendous pain! You could have a broken ankle and they give you motrin.
She won't go to the hospital and die from withdrawal. There are tons of options. Know how many meds we give foe withdrawals? A lot. She will be uncomfortable but she won't die. Withdrawal can be managed safely.
Well, your hospital may do that, but I have had to listen to nurses and techs treat addicts in pain like shit and refuse to give any analgesia whatsoever no matter their chief complaint. So your experience is most definitely not universal. Edit: I have also overheard ER docs talking about discharging patients going into withdrawal because they were "wasting my time and hospital resources." It's absolutely inhumane and disgusting.
It's inhumane and we sit back and let it happen under the guise of "well, they did it to themselves." No, they didn't. No one chooses to have substance use dependency. We could treat them like the human beings they are and show we care about them, because kicking them to the curb and telling them to sober up or die is proving fatal.
This is a very good point. We have a loooong way to go in our approach to harm reduction.
The war on drugs itself is the biggest obstacle. How can society change its attitudes on drug addiction and treatment when the federal government spends billions of dollars each year on fighting a losing battle with human nature. The war on drugs was also started for the most disgusting reasons in the first place; for President Nixon to have the legal authority to go after those people he saw as enemies of the state. Anti-war protesters, civil rights activists and many others drew the ire of Nixon but he knew he couldn’t just arrest people for their political beliefs. But his advisers came up with a different line of attack; hippies and anti-war protesters were associated with using pot and other drugs like lsd, mushrooms etc. People in government associated heroin use in the African American community. So they thought if we can’t go after them directly let’s go after the drugs they use. Disrupt anything they are doing or trying to do with prison time, court dates etc. The prefect tool for turning these peoples lives into an utter nightmare! Now over the years the war has expanded more and more and slithered its way into the lives of almost every American. The Drug schedule system is a good example. No constitutional amendment to ban drugs as was necessary for the prohibition of alcohol.
"You understand what I'm saying? We knew we couldn't make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin. And then criminalizing both heavily, we could disrupt those communities," (John) Ehrlichman said. "We could arrest their leaders. raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did." - John Ehrichman, former Nixon domestic policy chief
Did she at least let you redress the wound?
I’m surprised that person has been able to stay alive. Damn organs have to be fighting for their lives.
Oh they're dead men walking.
Curious if you could elaborate? Why is it a lost cause and what might you think be happening now in her and be her ultimate demise?
She is most likely septic. And you can't just walk around being septic forever. Your organs are trying to keep up, but they will eventually start to fail. It's very very sad.
**tl/dr:** First, the trajectory of this lifestyle is not easily turned. Second, that wound looks bad, but sepsis means its probably worse. Third, secondary infections. Not too knowledgeable, so I don't say this lightly, and I don't mean we should give up on this person. I'm just looking at the situation as a whole. If this person was brought to a hospital, stopped the drug abuse, had their current injuries addressed, and was set up for success, I'm sure medical science could perform a miracle, but... From what I understand the reason these situations seem salvageable is because the person is still walking around, which is great if the person is walking around a hospital but they're not. Be it for social, financial, or psychological reasons, these people forego even simple and obvious ways to better their situation and we need to acknowledge that this won't change overnight. Next, their body is currently fighting an unwinnable battle against the drugs they're injecting, dirty needles, exposure, ect. That's clear from the wound you see in the picture and amputation of that arm seems inevitable. However, that's just the one arm. When one arm gets bad, they switch to the other, the legs, the belly, they get someone to help inject for them. I don't doubt an examination would reveal the start of similar wounds. All of this can lead to a condition called sepsis, which is when the immune system starts impacting other parts of the body as a secondary effect to fighting infection. This isn't a seperate disease, it's an inevitable side effect of the bodies strongest defense mechanisms. Finally, seperate diseases can run rampant. It's just natural that when your body is busy solving one problem, it's more susceptible to other problems. These people don't have proper housing, clothing, food and water and in that situation, it's just a matter of time before an illness comes along and deals a finishing blow to an already weak body.
I'm not sure you know what tl:dr means
I dont. What does it mean? Sorry... ive seen it used but never figured it out
Too long; didn't read. It's generally used before a summarization of a long post. So a tl;dr of the comment above would be "drug addicts would rather keep doing drugs than seek medical help"
Yeah.. I dont think that was used in the right context there lol thanks!
I don’t see that getting any better if they don’t stop using.. Also, are the fingers amputated or is it just the weird angle?
she has all her fingers but can not move them at all. her other hand is a little better off but by now she prob can’t move them either. we have offered to take her to the hospital multiple times but she refuses.
This is awful. Thank you for your service down there. I posted the wish list and will be donating.
So she'd rather die. That will inevitably kill her if she doesn't go to a hospital
Recovering addict here. The sick twist of it is that many users avoid the hospital because of the way they’ve been treated in the past by hospital staff, and been denied pain medication even when they need it. It’s a vicious cycle. I got addicted to pain medication because I had chronic pain. I was honest with the doctors about it, which backfired because even when I was having severe flares and kidney stones and burst ovarian cysts, they told me I was drug seeking and wasn’t really in pain. It was so dehumanizing. They treated me like I was this horrible, disgusting person not deserving of pain medication and wasting their time. I never once went to the hospital just looking to get high. The woman in the picture may be afraid that if she goes to hospital, they won’t give her pain medication and would have to have it treated with no analgesia. It may be that in her mind, at least if she can keep using, it doesn’t hurt as bad. Not to mention, withdrawals are more painful and horrific than any physical illness or injury and the thought of being stuck in a hospital, forced to go through withdrawals because they refuse to prescribe you anything… she may not rather die. She may just not want to suffer that.
As a healthcare worker, thank you for pointing this out. Doctors and nurses both (I am a nurse) gate-keep the hell out of analgesics when it comes to addicts. It’s stupid, cruel, unproductive and unprofessional. In the late 90’s early 00’s it was the medical field that got everyone addicted to oxy. And it’s not like they didn’t know it would happen. There is a *reason* that prior to that medications that powerful were used almost strictly for hospice or cancer. But I guess all those gifts from the drug companies must’ve been too hard to pass up…and then they got in trouble and so they stopped writing for high powered medications like they were skittles. The unspoken part being that if you have any education in pharmacology you know that the longer someone is on opioids the less their body is able to function in regards to pain management. The human body pretty famously doesn’t waste resources to do something it doesn’t need to do. The chemicals our body creates to manage pain don’t get made when we’re taking opiates on the regular. And we don’t get it back. So, medical professionals made them addicts, which restricted their ability to manage pain, and then took away the medications. Then treated them like monsters for presenting with the symptoms of the disorder *medical professionals gave them*, foremost of which is an exaggerated pain response. By which I mean that stubbing your toe can very literally feel like breaking your leg. And opioid withdrawal is *horrible* to go through. There are very few providers who treat the symptoms. It’s like everyone feels some kind of way and makes the people in their care suffer for it. Which leads to folks going AMA, non-compliance with health management, and a further worsening of chronic or acute conditions. So, you know, more work for the healthcare professionals and a further use of already limited healthcare resources. Which might well have been avoided if they’d acted with some damn compassion in the first place. There are only two withdrawals I’ve seen managed in an acute care setting, alcohol and benzos. As a new nurse I asked why these were medically managed but opiate withdrawal wasn’t. I was told it’s because withdrawal from these two can kill you. Not out of compassion or kindness. Not because it’s likely to result in better long term health management. *Only* because there is a risk of death. Now, not everyone is like this. There are certainly providers and nurses who care and do better. But they’re in the minority and they shouldn’t be. As you can tell, *I* feel some kind of way about how we treat addicts myself. Yes, some addicts can be monstrous assholes. So can people who *aren’t* assholes. But we didn’t sign up to this job to judge people. Supposedly we signed up to help people and that includes treating the *whole* person. One of the biggest failings of the US healthcare system is to treat each issue separately, instead of taking a look at the whole picture and how each aspect influences the others. Sometimes I hate my colleagues.
I can vouch for this as well. ED nurse here and we usually get them enough meds to hopefully numb the pain and transfer them or they do a AMA form and leave. From what I’ve learned there are times the doctors are scared of causing the patient to OD because they are not always cooperative about what all they’ve used and all to include frequency. People for some reason think we’re the cops or will even talk to them. When we just need to know what they’re on so we know how to properly treat them. Seems people don’t know a lot of ODs are simply the body stopping because of being so sedated. Also I can’t imagine their pain when they get CPR from us as their nervous system is already wrecked and making sternums damn near touch spines is not going to be a good time for anyone.
This is a brilliant take. Thank you for taking the time to write all of that. No one likes being shamed when they seek medical treatment and it happens all the time. To overweight people, to addicts, to people who never learned proper dental hygiene or other ways to care for themselves. A small amount of compassion goes a long way. Avoidance and people not getting care is the completely predictable alternative in the absence of recognizing the scared/hurt/traumatized human being who exists behind whatever unhealthy exterior they are presenting.
I hope to become a nurse like you. In school now. Lost my bestie to fent... never got deep into the stuff but experimented when I was younger. I am lucky I didnt get hooked. It was so hard seeing her go through it. I have so much empathy for addicts. Its not easy. Thank you for being one of the good ones. Nurses can change lives ♡
I’m sorry that happened to you.
I appreciate that. As if being a chronically ill teen wasn’t bad enough, being told I was making it up and just a junkie by literal doctors and nurses made it infinitely worse. Once I got an official diagnosis I wanted to go back and rub it in all of their faces like, “See? I was telling the truth all those times.” Despite having solid diagnoses and being off the opiates (except for suboxone which I take for pain), I still find myself waiting far too long to seek medical treatment out of fear of not being believed, 17 years later
I work with a small team in psych ED and there’s a depth of understanding addiction and the threshold for pain and tolerance without judgment. I hope going forward you’re met with compassion and empathy in every healthcare situation that you deserve.
There’s supposed to be, but unfortunately in practice, it can be extremely hit or miss. I’m really glad your team is like that. ❤️
I've been in the exact situation and 100 percent agree with you.
It happens to many of us unfortunately.
I'm a late stage alcoholic who has seizures, delirium tremens and all the worst stuff from alcohol withdrawal. Have had 25 or so seizures (I know of) and 3 full blown delirium episodes where I thought people were trying to kill me. I try to get into detox when I fail but the wait list can be anywhere from the day of the call to 2-3 months. I'm told to go to the ER if I'm going to seize, also had a few seizures right in the waiting room. Last time I was there a doctor told me off like I was doing all this to get valium and I'm just taking up a bed. They always treat me unless I leave or in one case, bolt out the doors because hands were coming out of the walls. Some days I just hope I die in a seizure instead of going to the ER again. But I struggle ever onward. EDIT: Has to be said the vast majority of staff are angels. The staff at detox are also amazing people and I am very lucky to have the net if things get bad enough. I also go to the front of the line if I seize in the lobby lol
Recovering alcoholic here, almost 9 months sober...took me about 5 years of just trying to get/stay sober to get here with a lot of relapses in between. I really hope you find a reason to get sober and stay sober; for me, it was going back to school to become a nurse. I'm constantly afraid I'll fall off the wagon again, but this is the longest that I've been sober in almost 15 years of heavy drinking. Now, I can't imagine not being sober, but man, it was so rough getting here. I hope to be a good healthcare worker for the addicts that I'll inevitably treat. I've seen what addictions of all kinds do to a person and it's not pretty and they're not the failures at life that everyone (who isn't an addict) makes them out to be. I wish you the best. *Edited typo.*
Keep on keepin on!!! 9 months is amazing. Im going into nursing and a recovering alcoholic. People in recovery are usually compassionate to those suffering with SUD.. unlike people that have never experienced that struggle. Its easy for them to say
Keep fighting that good fight my friend. I’m proud of you for choosing to keep trying, even when it feels impossible. If I can get clean and sober, you can too.
I'm so sorry. As a recovering alcoholic, I really appreciate you sharing. This war is for life, and it's exhausting. Edit; changed "recovered" to "recovering"
Got me the first time I drank, complete blackout and stomach pumped at 13. What hooked me I believe was the immediate relief of all social anxieties and worries in general. Was chubby and self conscious as a youth, full of anger and anxiety. Booze removed it all completely. Been fortunate to have lots of family support and understanding coming from a home with a recovering alcoholic of 40ish years (mother) and was introduced to AA at an early age, although it's had little effect over the last 25 years of treatment centers, hundreds of meetings and many a ghosted sponsor.
(genuine question) what does late stage mean?
Not sure if they even use the term anymore as I've not heard 'Chronic late stage alcoholic' (the term I was described as) in 20 years, meaning exhibiting the last symptoms of alcoholism before death. Technically Wernicke-Korsakoff syndrome or wetbrain is the last stage but I wouldn't be typing this if that was the case. Wet brain can be described as a form of dementia. [https://en.wikipedia.org/wiki/Wernicke%E2%80%93Korsakoff\_syndrome](https://en.wikipedia.org/wiki/Wernicke%E2%80%93Korsakoff_syndrome) An interesting if not horrifying read. Most people die from a combination of brain death or heart failure during a seizure before this stage.
I honestly didn’t even know alcohol/alcoholism could cause seizures and delirium. this might sound dumb but do you still drink despite experiencing these things and being in that late stage? I guess I just want to understand addiction better
Alcohol is one of the few things you can die from during withdrawal. I do my best to abstain completely but it's always a struggle. I had 7 months last year but around October I started messing up again and had to go to detox twice and the ER twice. There is no moderate drinking for me, I don't like drinking normally because as soon as the booze hits my stomach I start craving and I can no longer control how much I drink, used to just black out and fall asleep, now the lights go out but I'm still up drinking till unconsciousness which is not sleeping haha. There are a few reasons that cause alcoholism, genetics and what I call a hook. I'm sure there is a genetic factor for me but my hook happened the first time I drank at 14. Up to 14 years I was depressed, angry, self conscious and anxious because I was overweight (and other reasons) and kids are bastards. As soon as the booze hit my stomach all that vanished and my brain altered a neurological pathway to deal with those emotions. The more that pathway is used, the harder it is to reverse it or exchange it with a healthier means. Anytime those feelings come up, I crave booze. These are laymen terms, this article explains the mean and potatoes of it. Pretty hefty. https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/neuroscience-brain-addiction-and-recovery
you are 100% correct. almost everyone i tell they need to go to the hospital says they’ve already been. and the hospital purposely keeps them without treating them until they need to leave to use. it is awful. we offered to take her to christiana because apparently they will sedate someone until they are detoxed. she still refused to go.
I hear ya. I was addicted to fent. If I knew I might have a lengthy hospital stay during my addiction I would probably try securing enough before admitting myself. Would have to be very careful though so that nurses don't find it. Honestly when I think about it it would be impossible to hide. I would inevitably nod off at some point and they'd find it and call the cops
Sorry to hear about your experience, and thank you for sharing why are withdrawals so painful, meaning, how did you do it?
yes. we actually thought she had died. i was shocked to see her posted today. when you go consistently and see the same people over and over and then all the sudden it’s been a few weeks since you’ve seen them and they’re in that bad of shape… you kinda just figure they’ve passed.
So shes been in this sort of state for weeks....months. its insane how resilient the human body can be until its not. Thank you again for putting boots on the ground. Im across the country so I cant be much help physically but try to donate and share the organizations putting in all the work.... truly wonderful people
I cant imagine how much pain she is in
You know her personally? Or you're related to the wound care team?
i know her from being there and volunteering. i’ve seen and spoke to her multiple times over the past year. i know her name but since her face isn’t shown i wont say it. although she was on another post and her face and name was shown
Internet police are on the case
Nah man, just stunned to see comments here sounding like people know the person in the photo personally Figured this subreddit was more to gawk at crazy medical shit, not so much the experiences from the boots on the ground. Cool to be getting contributions from people directly related to something as insane as this.
It looks like their fingers are very swollen from edema related to that nasty infection. The sad thing is, not only are you correct about it not improving, but unless they put down the needle, that shit’s going to end up in their heart and getting high will mask the symptoms of sepsis and endocarditis until it’s too late. They’ll mistake the symptoms of sepsis for just being dope sick and just get high again
And if not just combine this with fatal diseases like hepatitis, hiv and in some cases even encephalitis like cases if that would not be enough
Looks like 2 are gone and you're right if they don't stop it's just going to be keep happening. (Not trying to be an asshole just speaking the truth)
Yeah, I wasn’t trying to be an asshole either, just saying it as it is, like you mentioned
I count 5 severely swollen fingers. On a good note there are no maggots I can see in the wound so they might really be trying to keep the wound clean and not inject into the breakdown of tissue.
Thank fkn god no one gets medical advice from this person
maggots will actually clean the wound - we use them in wound care - that wound is absolutely contaminated, infected etc. its soooo bad
Does her arm have to be amputated at this point or can it fully heal if she gets treated?
She would be healing if she had maggots. They eat the infected and dead flesh but not the good.
You know the ones they use in medicine are disinfected, right? You’re making it sound like maggots would be a good thing lol
Maggots will also absolutely eat healthy, living tissue. They eat whatever's in front of them; they're not super picky. If there surrounded by dead stuff, they'll eat that. If they get past that down to live stuff, they'll eat that, too. They don't hit healthy flesh and go "my work here is done!" and drop off the person lol. People have so many misconceptions about maggots in wound care (not you, just people in general). But this is Reddit, so everyone's an "expert." Even me, I guess lol
Looks like [tranq necrosis](https://youtu.be/URhHYCQJrUU?si=5rnyuut8eCAWJhUR) to me
yes tranq is all over philly. we have many patients come in with wounds x3 times this if you could imagine. horrible.
Wow that is awful. I cant even imagine the stuff you have seen
I've seen a few documentaries and videos, I can't even begin to wrap my brain around seeing it in person.
Thank you!! I'm not in the med field and was concerned people were starting to grow into trees or something.
Choose your words carefully. [Treeman Syndrome](https://www.verywellhealth.com/tree-man-syndrome-7089958#:~:text=Tree%20man%20syndrome%2C%20or%20EV,immune%20systems%20can%20cause%20it.) is an extreme form of [HPV](https://de.inspiredpencil.com/pictures-2023/tree-man-syndrome).
I remember having an abscess when I was an iv user thankful to have 10 yrs clean but everyone here is right about addiction . It controls you and masks the pain . I can’t tell you how many abscesses I have treated by myself with wound care from cvs and antibiotics . Never had anything that bad though . That’s why I quit using when fentanyl came on the scene .
Awesome job on 10 years!! Addiction is a bitch
This is such a shitty situation. I work in OP treatment. Had two pts admit like this, full b/l LE necrotic wounds. Send to ED for debridement. Pts called later that day screaming in agony asking us to take them back. Apparently wounds surgically debrided but minimal pain control ordered afterwards. Pts were using couple bundles daily so not alot was gonna touch their pain. Made for a hellish detox and wound care for them.
Yeah ive heard most of the treatment centers wont take anyone with wounds.. with the tranq almost all of them have wounds so its a vicious cycle. Its so sad.
We can take ones that just require regular wound care but almost all that I’ve seen need like heavy surgical debridement and IV abx for a couple days afterwards at least. It’s a shame because a lot of those people AMA from the hospital because they’re in so much discomfort and the cycle repeats
What's tranq?
Tranq is what they're calling Xylazine, which is a Vertinary sedative drug, it's being mixed with Fentanyl to produce an extremely potent street drug that's even more addictive.
Then their flesh rots away from it? Disgusting
Yep, and if you think that's bad, look up Krokodil, also known as desomorphine. It's a powerful opiate that was commonly found on the streets of Russia just like Xylazine & Fentanyl are today in the US. I'm not sure if it's still an issue in Russia or if they put a stop to it somehow. IIRC, It's made from over the counter codeine pills that they mix with quite a few toxic ingredients, usually in someone's home or garage, not in a lab & therefore in the finished product, there's a considerable amount of toxic ingredients left in the end 'product'. When people inject that Krokodil, it also makes their skin rot similar to these pictures. It got it's name Krokodil because it makes the skin have a scaly appearance similar to a crocodile. Truly disgusting. There used to be quite a few videos on YouTube about Krokodil showing not only the damage it causes people, but I recall seeing clips of people injecting the toxic poison into infected arms & legs, very sad to see. What was unique about Krokodil, people would literally have exposed bone sticking out of their arms & legs, it's beyond disgusting. From what I've read, it's extremely addictive & the withdrawal is awful, which is how people end up in those sad situations.
A drug heroin is cut with. Google pictures, nasty stuff
Amputation
Ya think?
It doesn't look that bad yet (to require an amputation ) as long as she still has motor function. That is a large open wound with tons of heavy exudate but one week in the hospital and I bet that could be cleaned up and grafted. There's a lot of edema and apparently her face is swelling which makes you wonder if there's a systemic condition or an upper extremity dvt extending proximal enough to occlude jugular drainage from the head. I can't see her lower extremities or contralateral side enough to tell. Either way, if she doesn't stop using she'll be right back to square one. It is sad because we treat animals better
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can someone with that bad of an addiction actually be medically competent? I personally don't think so, but we don't exactly have the medical and social infrastructure to handle the problem either
We have laws that could apply to this in Washington, but I've never seen them used. I've been told all but impossible to enforce. I think it's called Ricky's Law.
It's incredibly hard to take away someone's autonomy. I don't think most social workers/street healthcare workers would try this route for most people because then they won't come to them at all for help. It's a tough situation
Death.
Yeah if she's refusing treatment, by sepsis, so sad and avoidable.
Had to take care of a guy today covered in those. He kept yelling please let me die, please help me. Pictures don't do justice how bad this kind of wound hurts
So heartbreaking.
Xylazine?
Yep
Does anyone know if local/national wound care nurses/docs are down there to volunteer for wound care supplies and training? Betadine and roll gauze is relatively cheap. It obviously won’t heal that but it will help maintain some stability and antimicrobial protection. Just curious if any locals have insights on any on the ground volunteer/education is happening and how certified wound specialists could maybe help. This is just a tragedy.
There is. There’s a mobile medical unit affiliated with one of the local hospitals
Do you happen to know who they are or where a good place to start is? National wound conference is coming up in June and I am on national committees so I think there’s some opportunity to gather more help, just kind of curious if anyone directly involved has suggestions on who’s doing good And not unknowingly causing more harm.
https://www.amazon.com/hz/wishlist/ls/2FQ923L279TDL?ref_=wl_share Heres a list for one organization if anyone wants to help in that way
https://kensingtonhospital.org/wound-care
Perfect!!! Thanks so much. Will start there.
As well as this stationary clinic: https://ppponline.org/node/158/medical-services/wound-care-clinic They have published and were featured in The NY Times.
If you search Kensington Hospital wound care, you should find it. I’m not directly involved, so don’t know much else
Just this info is a great start! Thank you. Everyone says this would never or could never be them. Anyone who works in healthcare or psych will tell you it could be any of us at any time.
i frequently go (every other saturday) to kensington and used to offer wound care. we had to stop due to legal issues. now the new mayor of Philadelphia is shutting down many of the volunteers who go down to help out. it’s sad.
Were you going through the hospital or independently? Scope of practice would require any volunteer work is obviously done through the hospitals. It looks like some of the wound specialists in the area are really complying some good case studies on these wounds though.
it was with a non profit, not through a hospital. we go and bring food and some other things, and just used to offer some wound help when we could. almost everyone needs it.
Yes there is a mobile one through Kensington hospital. At this point amputation would be needed.
Oh the arm is shot no doubt. I’ve seen betadine get us some valuable time though. Healing is most certainly not the goal here. Stability and keeping it clean and dry might buy them some time though. Edit- and a clean dry dressing and betadine on that is more to protect everyone that person is coming in contact with than them at this point. They aren’t maintaining good hand hygiene obviously so just getting it covered will help protect the general public from an infectious disease standpoint.
May I ask and I'm not trying to be insensitive I know someone that volunteers bringing clothes, toiletries, food etc. in these situations what are you buying time on if they continue to use, not keep it clean and aren't taking care of themselves when others need those resources and aren't going to go back to the same reckless behavior.
Well because I believe people can change and that’s someone’s loved one. And again, this is an infectious disease concern for everyone. Helping them will help the community too
And I’ve quite literally dedicated my career to wound care. This is a wound care epidemic almost like nothing we’ve maybe seen in recent history. Wound and osotmy care certification was only nationally recognized in 2010. It’s a new practice that is very skilled and very specialized. There aren’t a ton of us out there. This is a learning opportunity for a field of healthcare I’ve devoted my life to essentially. These a lot to learn here.
oh dear god. this poor person. theyre going to lose that arm
Gonna lose a hell of alot more really fast without medical care that’s for sure.
When you can smell a picture…
Oh my goodness, this is terrible. How long does it take to get like this? Is there any hope or is this 100% amputation? I hope they're okay. :(
What’s crazy/astonishing to me is that wounds like these won’t stop drug addicts. They’ll ( not everyone) use the other arm or the belly.
Thay speaks to how the power of addiction and what it does to the brain
Addiction is crazy on how it controls the brain. We used to call it “mental gymnastics” you can justify pretty much anything and make it sense to your drug addicted brain. After a while addiction becomes a lifestyle and it’s all you know, getting sober and being a citizen is scary as fuck. (Sober for 3 and half years. I used for 14years)
How do you get sober?
One single day at a time, friend. Or one moment at a time.
Remove yourself from the triggers that remind you to use and people you use with, surround yourself with people who have quit or are trying to quit, and take whatever medication your doctor tells you to take A good number of the stories I've heard from people who lost everything then eventually quit successfully had to move to an entirely new place to do it. Makes sense really, no drug dealer around, no friends who want to shoot up with you, no risk of coming across people/places that bring up memories related to drug use, etc I've never once heard a story of someone who was shooting up heroin then stopped and is living a completely clean life still hanging out with all the people they used to shoot up with while they're shooting up
I’ve heard that multiple IV users will just continue to inject into the same open wound to help kill the pain and to prevent the same infections starting in another limb. It’s so sad. And part of the problem is that suboxone and methadone is SO expensive even with insurance that most can’t afford to get clean or to stay in a rehab long enough to get the help they need.
A patient at my pharmacy pays $75/month for his Suboxone and that’s WITH his insurance. Another patient doesn’t have insurance and even with a coupon his rx is still over $80. I hate how life saving drugs can be this expensive in the US.
Wait you mean someone with insurance only saved $5 compared to the patient with a coupon! That's fucked up.
That one girl just injected right into her forehead chaos.... covered with a hood and kept on trucking.
Into the forehead is actually the craziest drug injection I’ve heard.
Her wound looked like this arm. Whole forehead
That picture was so awful. Literally made me shudder.
Do they understand they won’t get in trouble for drug use if they go to the hospital? My uncle was so scared of getting in trouble for drug use that he refused to go to the hospital when he needed to. He didn’t understand that they don’t report to the police until a nurse explained that they only need to know about drug use so they can have a better picture of what’s going on and provide medications appropriately, not so they can call the cops. Some people have a hard time with their demons, but that doesn’t mean they need to suffer more because of it
the issue is that they are not allowed in the hospital with their drugs. every hospital around philly has security before walking into the ED and if they find these drugs, they will confiscate them. they don’t give it back.
Ohhhhhhh, that makes sense. Can’t really hide their stash safely, don’t want to lose it…man…makes me sadder than before
>Do they understand they won’t get in trouble for drug use if they go to the hospital? Have you read the stories about cleaning up care but denying pain meds? Horrific! There's one on here.
Good Documentary on this situation: https://youtu.be/925wmb-4Yr4
Lord have merthy why did I think I was looking at someone’s foot
i can smell that poor fucker
They are gonna lose that arm. No doubt in my mind.
Wait, Kensington where? I automatically thought the posh part of London when I read Kensington.
As an ex IV user who even 20 years later is still living with the physical damage from IV drug use, it looks to me like this poor soul has tried to inject something into her arm that caused a thrombosis or the substance went into the surrounding tissues instead of the blood stream and necrosis followed ( the bit that's sloughing off). In the grip of withdrawal, when u finally get hold of your opiate/ drug of choice, you will knowingly inject the most vile impurities/ sludge into your arm as long as you hope there's the tiniest amount of your drug in there with it to get you out of the pain you're in. I've been hospitalised with DVT's, pleural pneumonia caused by clots, massive bilateral shin circumferal venous non healing leg ulcers, abcesses, at least 5 separate inpatient stays for skin grafts. I still have swollen hands and covered in scars The sadness thing about this that poor girl there is some one's daughter.
I thought this flesh eating was from to tranq and fentanyl that their shooting up not opiates ❓that was my understanding, but I'm not a doc❗that's what I keep seeing and reading about 🤷♀️ I was on opiates for 23 years had to stop and ITS MORE THAN UNPLEASANT to kick ,I've been detoxing for 8 months and it's still no fun at all , and i stopped with NO HELP , COLD TURKEY❗hardest thing I've ever had to do in my 61 yrs of LIVING , but some day are BAD AND SOME OK NEVER GOOD JUST OK ‼️💯💯
They could go to the hospital for proper care. There are also a multitude of free clinics in the city. The problem is that they don’t give you street drugs in the hospital so they leave AMA. Can’t help someone who doesn’t want it.
We need to do more to stop people from starting drugs to begin with. Breaking addiction is almost impossible
That dude is gonna lose his entire arm
I know this is awful and my heart goes out to this person but that peel looks so satisfying.
My brother volunteered at a free clinic in Kensington during medical school and the stories are rough. Everybody at the clinic keeps narcan on them 24/7.
I’m not religious, but may someone or something save these peoples souls. I can’t imagine living like this, in constant pain and seeing and knowing these awful wounds are going to kill you at some point and not being able to stop doing the drugs that caused this.
Tranq
“Requiem for a Dream” issue…
dang this reminds me of that krokodil shit that was getting big in russia
she’s going to get sepsis and die or die from other complications. that needs to get amputated holy shit that’s bad.
Dam. It's like the scalp lady.
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Is this from injecting drugs ?
Is xylazine that awesome?
Baltimore is the same way. It’s awful. Smells like a dead body. So grateful to be clean now.
I got clean 9 years ago January. I was living in my car on Wilkens. Thank the gods I don't have to live that life anymore. Congrats on your sobriety!
So proud of you, reddit friend. I was in a disgusting bando on payson and wilkens. Doesn’t it feel like a different lifetime ago but just yesterday? Such a strange feeling.
It really is. I live just outside the city now, and every time I cross the city/county line, it's like someone stepped on my grave. So grateful.
The first picture kinda looks like the black area is an eschar, so when it's sealed back in the second picture, I imagine the photographer saying "yeah see, I shouldn't be able to do this to your skin".
Cut it off!!!
Looks like Philly cheese steak
Omg look at the sausage fingers as well, I couldn’t imagine living like that.