Sun Jan 07, 2018 5:43 pm
I once worked in a county ER where we would see the same alcoholics each night, hold them until BAC was below 0.02, then discharge them to drink again. I wondered why we couldn't hold them against their will.
Now I know why. Yes, active addicts always have some degree of ambivalence. But 72 hours is not near long enough to tap into the ambivalence. If you held them for 2 months you might get half to buy into treatment. Of those, most would go back to using within days of being back in the using world again. That sounds pessimistic, I know, but you could put a positive spin on it and recognize the indefatigability of the human spirit-- even when directed toward self destruction.
People must be ready for treatment, at least from what I've seen. I've seen people who should be very desperate, who turn down gold-plated treatment. And I've met people who have no resources at all, yet found a way get straight.
I recognize that I'm becoming more cynical... unfortunately many people addicted to opioids are now coming in addicted to cocaine (crack or IV) and/or methamphetamine. MUCH harder to treat than the people who had pain pills run up.