[Erin RN]

We will probably have to agree to disagree on the "disease" point athomas. I agree that many times people do develop a disease without engaging in any activity which puts them at risk for it but many times there was some sort of activity in which the pt willingly engaged in which we could say "caused" the disease. But that argument does not hold completely true since if it merely a matter of engaging in risk behavior, why don't all individuals develop the disease state.. I mean why don't all 2 pack a day smokers end up with lung CA. Why don't all overweight sedentary americans develop coronary artery disease? In my opinion it is because all of us have a different genetic makeup and just the fact that we have certain makeup predisposes us to the disease...all we need to do is "turn it on" in many cases. There has been much research in the area of both addiction and alcoholism and there have been genetic factors identified. While I agree that everyone makes a choice the first time..what if by taking that first narc or drinking that first drink you flip the switch??
http://www.sptimes.com/2002/03/20/Ta...enetic_t.shtml

This article is quite interesting..Erin

[harry Krishna]

While I may not agree with you on some points, I respect the way that you articulate your thoughts.
It's quite all right to disagree with people and actually engage in friendly debate. You are one of the few people who post here who can do that. Too often I have read others comments on my posts (or others holding similar views, mainly on drug seekers) and they either dismiss what I say, or do not comprehend what I am saying.
I actually find it humorous at times, however, your posts I read and think about.
Keep up the good work.

HK

I would work with you anytime!!!!

[Marie_LPN, RN]

Originally posted by athomas91
a disease is something that someone gets w/o asking for it - without doing anything purposeful to bring it on....
ex : ca,cad......

The arguement for that would be "but you could have controlled your diet and lifestyle to prevent this". I'm not saying i disagree with you, we just recently had a debate in class about whether drug or alcohol problems are considered dieases or addictions.

[LilgirlRN]

As with another thread, the AMA recognizes addiction to drugs and/or alcohol as a disease. I don't agree with everything the AMA says or does. If you look at addiction from the that stand point, relapse is very easy... "I didn't mean to pick up a crack pipe again, I have a disease, I just can't help myself." I don't think it'sa disease anymore than obsessive compulsive behavior is a disease, because that's what addicts do, obsess about their drug of choice and then act compulsively to get it even though they know what the consequences could be. I believe that these people (most of them) honestly believe they are in pain. Have you ever heard the expression "she's a pain in the neck?" Well some people are pains in the neck or the a$$ and the people seeking in your ER are responding like they think (subconsciously) they should. I am a firm believer in psychogenic pain, I think someone can work themselves into an emotional state the precipitates into a migraine or stomach pain etc etc. My friend who is a counselor says that people who are afraid to say they are angry often store the energy of this anger in their cheek muscles and in the neck and shoulders. People who are very sad often have low back pain (think the pain in the a$$.) Not all addicts are victims of psychological illness but many are, I believe that with psychological help many could give up needing to escape from their emotions. We are allowed to vent here, I do not disagree with anything said on this thread because I have felt like each of you at one time or another. The older I get, the more lenient I become. I am not sure about getting someone help for their drug problem in the ED, most of the addicts I have taken care of do not want to stop using. A few do, occasionally we have someone come in and ask for help and every once in a while someone will ask for help after we tell them they we can't do anything else for them. I believe we are patient advocates too, just not sure how to help someone who doesn't want to give up their lifestyle.

[Erin RN]

Originally posted by harry Krishna
While I may not agree with you on some points, I respect the way that you articulate your thoughts.
It's quite all right to disagree with people and actually engage in friendly debate. You are one of the few people who post here who can do that. Too often I have read others comments on my posts (or others holding similar views, mainly on drug seekers) and they either dismiss what I say, or do not comprehend what I am saying.
I actually find it humorous at times, however, your posts I read and think about.
Keep up the good work.

HK

I would work with you anytime!!!!

Well thank you HK..I have my point of view, which I am entitled to as does everyone on this BB. I would like to reiterate that I have worked ER and I KNOW how frustrating the seekers can be and how on a bad night you just want to kick their a** out the door but I have seen a couple of my friends go the drug route and I have dealt with alcoholism within my own family. As I have "grown up" (*hahha) I have become more willing to listen to others thoughts just since if we all felt, thought and looked the same it would be a pretty boring world and not only that...nothing would ever change. I also agree with Liligirl that the ER is not the place to fix the drug addicts behavior..not enough time..I just wonder if anything would be a feasable solution??? My mom worked ER about 25 yrs ago and the same thing went on then and in 25 yrs it will still be going on..just wish there was some solution? The main reason that I feel that addiction is partially genetic or predetermined is my husband...he was adopted by a very ethical family..think Ozzie and Harriet here..Dad was law enforcement, mom stayed home....My husband experiemented with Alcohol in HS and basically went downhill from there as far as drinking. We recently met his mother that gave him up as a newborn and guess what...yep..Dad was a horrible alcoholic and has since passed from liver ca... Is it a coincidence? Maybe! but maybe my husband was predestined to have a problem. I just find all of the research interesting..if they can ID a genetic factor maybe they will be able to develop more effective treatment since what we have now does not have the best outcomes..I sure hope so!! Alcoholism and Addiction tear apart so many lives..mainly those that are around the addicts like kids and other loved ones. That is one reason why the drug seekers made me so damn mad in the ER...I actually had to contribute to their problem rather than make them better....

Erin

PS I would work with you anytime also!! I could give the seekers sympathy and you could do suction??? I hate respiratory!! I also hate self mutilators so you could be in charge of them!! Sound good?

[MAGIK GIRL]

Originally posted by LilgirlRN
.... I believe we are patient advocates too, just not sure how to help someone who doesn't want to give up their lifestyle.

here then lyes the problem. what does society do with all of these people who don't want to help themselves? who is responsible for them? who should be the ones constantly having to tell them what is good for them and not good for them? are they not adults? (not counting the ones under 18 or mentally indigent). why have these responsibilities been dropped into the er's around the world? it seems like one big dump.

there is a man who is homeless and high. it is cold out, there is no warm place to sleep. he calls 911 and the police come. he tells them he thinks that there is a warrent out for his arrest. the police check, and there is not. they tell the homeless man this. so he says, ok, and picks up a rock and throws it thru the window of the police car. now he has a warm bed for the night.

that manipulation seems to be common among our drug seekers. for example, the patient who is seeing a pain management doc. he uses up his script and calls for a refill. it is not time. he calls 911 for what ever reasonable pain complaint he can. they bring him to the er. he gets his warm bed and script refil for the night.

these are the kinds of patients that make these threads possible. it is much harder to help themselves (addiction is a bi@#c) than all of the manipulation used to accomplish thier goal. imagine if all of that energy was harnessed and used for good!

just a thought.

[CCU NRS]

which part of the anatomy is that again I have heard of pain in arse and pain in the neck but where exactly is the fabled ED? LOL!!!

[LisaRN2B]

Originally posted by CCU NRS
which part of the anatomy is that again I have heard of pain in arse and pain in the neck but where exactly is the fabled ED? LOL!!!

[harry Krishna]

What ever happened to the great Existential Philosophy of being responsible for one's own actions? I truly believe that our society has become enablers for people's circumstances they end up in. It seems we no longer blame people for the disasters that {thru their own choices and actions} they get themselves in to.

HK

[MAGIK GIRL]

Originally posted by harry Krishna
What ever happened to the great Existential Philosophy of being responsible for one's own actions? I truly believe that our society has become enablers for people's circumstances they end up in. It seems we no longer blame people for the disasters that {thru their own choices and actions} they get themselves in to.

HK

i agree! we have become a sad society. unfortunately, there are too many closed minded people with bleeding hearts in the world. i have met many of them on this bb. maybe, some light heart philosophy instead of the bleeding heart philosophy would knock some of them down a knotch and they could see that life is what you make it. maybe they could even "enjoy" life.

to all of the "enlightened ones" (you know who you are):


-do not think you will necessarily be aware of your own enlightenment - buddha

-what is the sound of one hand clapping? - master hakuin

-THE FOOL WHO KNOWS HE IS A FOOL IS THAT MUCH WISER. THE FOOL WHO THINKS HE IS WISE IS A FOOL INDEED. - BUDDHA
(this is one of my favorites and speaks to many of the "mature folk")

-two mirrors reflect each other. - a zen forest

for the uptights; scratch first, itch later! zen saying