Food for thought

This post started life as a response to ernurse and her post, The Usual Suspects, about prevention and health promotion reducing numbers in the ER. It's a great post and you should read it.

Hey there ernurse,

ERnurse journal is a great blog. I haven't been by in a while, but I really liked this post [The Usual Suspects] I agree that prevention and health promotion could go a long way to reducing numbers in the ER. I wish there was a quick fix way to turn the system on it's head and make public health and primary care the driving force rather than the secondary & tertiary care in the hospitals.

Anyways, re: your quote "For the drunks and drug users that we have to cater to every night, I really don't know what to say" I just wanted to offer a couple of suggestions to help you formulate what you might want to say (knowing full well you may come down against, which, of course, is fine too). Below are some prevention & promotion ideas & resources for this segment of the population.

Harm reduction is a big, scary idea for a lot of people, which is [kinda] understandable given how addiction in our society is seen as an issue of criminality rather than of mental health/ illness.

It's funny though, when I've talked to the average Joe/Jane and asked well, what do you think about seat belt programs, bike helmet programs, smoking/drinking cessation programs that don't require you to go cold turkey, condom & safer sex programs, even needle exchange programs, people are all for those.

Change from those programs though to a program for drug addicts to use their drugs safely and people are dead set against it. Even after you explain that a harm reduction program such as Insite doesn't exist in a vacuum but with programs for prevention of addiction, treatment, and enforcement. Even after you explain that it treats & prevents disease spread & abscesses & sepsis and thereby prevents long hospital stays and ultimately saves the system money. Even after you explain that at Insite there have been nearly 1000 overdoses prevented. Even after you explain that despite those overdoses there has not been one single fatality. Even in the face of all of these arguments, some people just see the addicted as the disease, not the addiction.

My own blog is all about a harm reduction approach in Vancouver, Canada, the Insite Safe Injection Site. Here's an intro.

Here's a link to a similar program for street living alcohol users in Ottawa. The Shepherds of Good Hope is a church run ministry that makes it's own wine and gives it out in a controlled manner to prevent binge drinking, drinking of unsafe substances, etc.

Lastly though, if you only do one thing, I would recommend reading the book "In the Realm of Hungary Ghosts" by Dr. Gabor Mate. Mate looks at legal addictions of affluence (shopping, gambling, work) and contrasts them to addictions of poverty (drinking, smoking, illegal drugs) in a unique way. He asks many excellent questions for reflection of your own beliefs (which I am working on as a future post).

Cheers, Jen