This last week has been the absolute PITS at my workplace.......seems like they must be having a half-off admission sale for every practicing alcoholic and drug addict in the county. I've given more Lactulose and Ativan, cleaned up more vomit and diarrhea, used more restraints, and transferred more patients to the ICU in the past few days than I have in the past six months. As of last night, we had ten patients (out of 33 total) on my med/surg floor who are in various stages of withdrawal; our nine-bed ICU had four, and another one was on the way there as I was leaving for the night.
What's up with that??! We're all wondering if the holidays had some kind of mass depressive effect on the county's heroin and meth users, not to mention the ETOH'ers.........or maybe it was our unaccustomed snow and ice storms that kept everyone cooped inside for over a week and gave them a bizarre sort of cabin fever.
At any rate, most of us have never seen this many addicts at one time in our little hospital, and it seems no matter how many staff we have on the floor, it's not enough to deal with them. I can't even imagine working exclusively with this population; it's enough to make you spitting mad, and break your heart at the same time.
I've been caring for one 51-year-old heroin/ETOH addict who developed abscesses on both arms from skin-popping, bled out after her I & D, and is now on comfort care due to liver failure; I watched as the three daughters she walked out on some years ago came to her bedside yesterday to say good-bye and to tell her they forgave her for abandoning them. I felt awful for all of them, and yet angry with the patient for having put her children through hell and thrown away her own life with both hands, all because of the damned drugs. Then I thought, as I always do, of how there but for the grace of God go I......yes, my drug of choice was the legal kind, but no less devastating to body and soul.
At any rate, I think we all will be glad when our patient population returns to the usual: confused elderly, surgical patients, diabetics, and COPD'ers.
Have any of you who work in hospitals experienced a rise in the number of drug-addicted patients on your floors since the holidays? How are you coping with it, and is your administration staffing accordingly? We're fortunate in that ours has consistently OVERstaffed us when we have these high-acuity patients, but there are times you could put 20 people out there and it wouldn't be enough.......they are an enormous challenge, and they drain our energies faster than even the combative, confused, ambulatory dementia patients.
Behold, I stand at the door, and knock: if any man hear my voice, and open the door, I will come in to him, and will sup with him, and he with me. Rev 3:20
The answer is simply "God". He is just waiting to pick them up out of the mire. First, they must come to themselves, desire more than anything to be free from this bondage, and truly seek Him with diligence.
Addiction is a DISEASE, NOT a DECISION. If they had the CHOICE, they would not be hurting their family by their using. They don't want to do this, but they cannot stop themselves.
I disagree and I do not subscribe to the addiction as a disease theory. Some addictions (heroin, alcohol, etc) do have a physical component but they also have a component of choice. Addicts do have a choice and the do choose to hurt their families and themselves. It is the height of self-centeredness. Many addicts ultimately can and do stop themselves.
We make very few big decisions in our lives. By the time the big decisions come along, the choice has already been made by all the previous little decisions we have made. I have made some really bad decisions in my life (so I speak from much experience)and the trick to coming out on top is to 1. recognize when you have a decision to make and make it as wisely as possible and 2. when you have made a bad decision, admit it and correct it as soon as possible. Everyone has this ability and opportunity but, sadly, there are many who just won't take responsibility for themselves or their life.
But by calling their compulsion to get high (or drunk, or eat) a disease, we are in fact taking away their accountability for their "DECISION"s. I agree with KMSRN...each person makes a decision to stick in the needle, inhale, snort, swallow, etc; this isn't a point that can be argued unless you don't believe in free will. We can give genetics only so much credit for our problems.
Of course this is an age old debate so this is my opinion in that debate.
Just a bit of fact here, and I'm not wanting to start a fight about this.....but.....the "disease theory" of addiction in just that, A THEORY....It has NEVER been PROVEN......and that's a fact......I make a decision every day to NOT use drugs or alcohol, its that simple.....Now if I wanted to go back to my selfish ways of using I could make that decision too, a very SELFISH AND SELF-SERVING decision.....If I decide to call it a "disease" then I'm taking the weight and consequences of my DECISIONS away from ME, "Its not my fault!!...afterall I am DISEASED!!"..........and that is sooooo wrong!:stone
If I decide to call it a "disease" then I'm taking the weight and consequences of my DECISIONS away from ME, "Its not my fault!!...afterall I am DISEASED!!"..........and that is sooooo wrong
If I decide to call it a "disease" then I'm taking the weight and consequences of my DECISIONS away from ME, "Its not my fault!!...afterall I am DISEASED!!"..........and that is sooooo wrong!:stone
Thank you. That's exactly why i can't accept that addiction is disease.
Specializes in LTC, assisted living, med-surg, psych.
I see addiction as a disease, in the sense that there's a difference in both the addict's mental and physical response to a certain substance ("Hey, so what if I threw up and acted like a complete a$$, I LOVE the way it makes me feel"), as opposed to that of the non-addict, whose body goes "Yuck, that was no fun, I don't think I'll do that again".
However, the fact that our bodies and minds are drawn to these substances like moths to a flame, does not absolve us of the obligation to work at controlling the addictive behaviors, IMO. That's where I think people go wrong with the disease theory: just because one cannot help the way his or her body responds to a certain stimulus, it's assumed (usually by the addict him/herself) that one cannot control what happens as a result of the illness.
However, IMHO, that's a pile of crap. It's like having a bad case of flu and then going to a meeting in a cramped, closed room where everyone you come in contact with can't help but get infected themselves. You had a choice---in fact, you were obligated by social convention and medical wisdom---to stay home, in bed, drinking warm fluids and taking Tylenol for your fever, but no, you just HAD to go to that meeting.......and now, your selfishness and disregard for not only your own but other people's welfare have spread to many others, whom you may not even know.
That's the way it is with addiction. It IS a disease, but having such a condition doesn't give anyone the right to play victim and fail to take responsibility for themselves. It also affects many more people than the addict and his/her family and friends.......it affects public policy, as there must be laws dealing with illegal substances and the resulting behaviors (e.g. stealing money or possessions to pay for their habit). It affects the quality of life in the community, as money must be taken from other, more worthy causes such as education, parks, and recreation to pay for the additional police and crime prevention services necessary to protect others from the addicts and their lifestyles. And it affects health services, which are already under tremendous pressure to reduce costs, forcing providers to treat many addicts who don't really want to give up their habits, and who therefore waste limited and valuable resources.
Why? Because that's what a civilized society does. Yes, I'm like a lot of you---I feel bad for addicts, and being one myself makes me able to empathize. But while I do believe addiction IS a disease, I also believe one must take personal responsibility for fighting it......and it makes me angry to witness the self-destruction that goes on and the lives that are shattered in its wake, when it doesn't have to be that way!!!
Here is a link to one of the best articles regarding addiction that I have ever read. It looks at addiction holistically and takes into consideration research in fields of neurophysiology, psychology, sociology, etc. Furthermore, it does not advocate a one-size-fits-all treatment for those that are struggling with addiction.
I don't think anyone chooses to become an addict. Really, do you think people get up one day and say, "Gee, I think I will get adicted to heroin"?
Sorry work has been so difficult.
No but they choose to shoot up, they choose to sell everything they own for a fix, they choose to break laws, they choose to abandon their family and loved ones for their cravings, and they choose to become a leech upon society!!!!!
They can also CHOOSE to kick the habit and gain back their lives!!!!!
Congrats to those who posted on this board about their habits and their ability to beat that habit!!!!! It tkes alot of courage and fortitude to do what you have done and overcome.
I thought for sure that my opinion about addicts was a minority on this board.
If you do not hold addicts accountable for their actions then you are enabling them!!!
Doesn't mean that I am mean to them or give poor patient care.
Lastly, for those who argue that addiction is a disease (I can respect the arguement) and call out those (or critic those)who vent their frustrations about it on this board.. what about child molestors?? Isn't that an addiction??? Where is your sympathy for them???
Not a politically correct comparison but think about it when you say addiction is addiction.
"enabling them".....Harry, you nailed it!!.....We must be held accountable or we will never change our ways!!.....I CHOOSE to not use today and everyday after this one!!....I also CHOOSE to not use all my money on drugs or alcohol...I CHOOSE to be a good mother, wife, and nurse instead of falling back into my self-absorbed addiction!!!......These are the CHOICES that I have made, everbody is capable of making these CHOICES, some just CHOOSE not to!!
Specializes in LTC, assisted living, med-surg, psych.
Yup, that's where I come from too........every day I have a choice as to whether or not I'm going to drink that day, and every day that I choose NOT to drink is one more day that I stay safe from all of the bad things I know will happen if I make the wrong decision. No one can choose for me, continuing sobriety is up to me alone. I used to try to imagine scenarios which might make me go back to drinking.........like losing a child.........becoming totally disabled.........coming home from work at night and finding my entire family slaughtered. Horrible, horrible thoughts.......but in all honesty, I know now that I would still choose not to drink.
But it took me 12 long years to be able to say this, and I don't believe for an instant that I will EVER be completely invulnerable to temptation, or that I'll ever stop craving alcohol when I'm stressed or unhappy. That's the nature of addiction, and I can't help that.......the one thing I do have control over is how I respond to it!!
I have great respect for people who overcome addictions. I am not an alcoholic and I realize that is mostly due to my genetic make-up, not any great strength on my part. The most important thing to learn in life is that we are what we are as a result of our choices and decisions. If we could effectively teach that in school, wouldn't it make a difference in the future?
Yes people do decide to become heroin addicts (or alcoholics or cocaine addicts). They make that decision when they DECIDE to get the money together, then DECIDE to go find a dealer, then DECIDE to buy the heroin, then DECIDE to get a syringe and needles, then DECIDE to mix the heroin, then DECIDE to find a vein, and DECIDE to inject it into that vein. Then they DECIDE to do it all over again the next day. That's how they DECIDE to become addicts - one little decision at a time
Bambi
102 Posts
Behold, I stand at the door, and knock: if any man hear my voice, and open the door, I will come in to him, and will sup with him, and he with me. Rev 3:20
The answer is simply "God". He is just waiting to pick them up out of the mire. First, they must come to themselves, desire more than anything to be free from this bondage, and truly seek Him with diligence.