I love working with drug addicts....but sometimes I really hate working with drug addicts.

A lady came in to dose at the methadone clinic where I work this morning and the nurse at the dispensary window thought she looked like she was possibly loaded on something. She didn't blow numbers on the breathalyser, so she wasn't drunk, but she was quite clearly...not herself. So the nurse told her to go and sit in the waiting room while she dosed the other people who were waiting, and would deal with her in 10 or so minutes. Because it's a weekend, the clinic works with a skeleton staff: a front desk nurse, a dosing nurse, and yours truly. There's no doctor, no manager, no counsellors, etc. Just the bare minimum to get people in and out as quickly as possible. Because there's no doctor and no manager, all the liability if someone crashes out (overdoses) in the clinic falls to the dosing nurse, so this nurse wasn't just trying to ruin this woman's day, she was just erring on the side of caution.

But this woman just threw an absolute fit, crying and screaming, even though the dosing nurse made it very clear that she wasn't going to refuse to dose her, she was just going to call the weekend on-call doctor to get a second opinion. She even said that it wasn't personal, it was a liability issue, and that if this woman was in fact just sleep-deprived as she claimed, then she had nothing to worry about.

Still, she cried and wailed to the nurse at the front desk, and then she came up to me and was asking me if I would dose her. I told her that I wasn't a nurse, chemist, doctor, or med tech, and as such was not qualified to dispense medication. And even if I was qualified to dispense medication, there was no way I could just go over the head of the dosing nurse, who was in charge of the clinic on weekends. I did offer her some water and told her that I'd wait with her, or that we could go outside and smoke a cigarette if she smoked, and by the time we re-entered the building, the situation would probably be sorted out. She told me I was totally useless, but she did accept the cigarette I offered her, so...not really sure what to make of that.

Anyway, after about 15 minutes of her crying and screaming, and her going back and forth between being determined to wait and get her dose or just give the finger to all of us and go out and score, our on-call doctor came by and looked her over, took a urine sample, and determined that she did have opioids in her system, but that she was showing early signs of withdrawal, so they gave her 70% of her usual dose and sent her on her way. Which she was still pissed about, but...well, you can't please everyone.



I realise that a lot of our patients treat getting their dose of methadone the same way they would treat getting their fix from a drug dealer, and woe to the person who stands in the way of a junkie getting their fix. What many of them don't understand is that this clinic is not made up of drug dealers. Most of the staff are either therapists and/or medical health professionals, and the clinic is responsible for the well-being of every patient. If they show up looking like they're loaded, that's a problem, not just because we're an addiction rehab clinic, but also because you don't give a loaded person more drugs. It's just common sense. And if something goes wrong, the clinic is liable. If someone were to die or be hospitalised as a result of the drug we gave them, the clinic would be shut down. But, of course, if we won't dose them right away for any reason, most patients treat it as if we have some sort of personal vendetta against them and we all got together and decided to just ruin their day because we're mean people. It's classic addict psychology, which I do understand to some degree having been an addict myself, but it still gets very tiresome being treated like a villain when, in fact, all you're doing is trying to look out for the patient's best interests.

/rant


Anyone else have any good stories about the people you have to deal with at work? What sort of job do you have, and what sort of outrageous characters does it seem to attract?