A drug user holds her syringe as she prepares to use heroin at OnPoint NYC, a supervised drug injection site in New York City. Gabrielle Lurie, Staff / The Chronicle
By William Andereck, David Smith, and Steve Heilig, San Francisco Chronicle, July 25, 2023
Sadly, they are called “frequent flyers” — severely ill patients with serious medical conditions who routinely cycle in and out of hospital emergency departments. On any given day, their affliction could be an overwhelming infection, festering wounds or even a coma. Sometimes they require a ventilator and ICU care.
These patients may not come to the hospital voluntarily, and if they do, they usually want to leave quickly. They are helped as much as possible but, despite ongoing medical needs, they leave the hospital against medical advice as soon as they begin to feel better — only to return soon after in even worse shape. The pattern continues while their suffering endures, health care staff get frustrated, and costs pile up. This sad dynamic has continued for decades in hospital emergency departments, but fentanyl and methamphetamine are making the suffering increasingly worse.
That’s because the disease underlying many of the problems these patients face is substance use disorder (SUD), more widely known as addiction. SUD is a chronic, relapsing and potentially fatal condition characterized by compulsion, loss of control, and continued use despite adverse consequences. The disease gradually overcomes our ability to control it — those of us who suffer from it cannot stop using drugs even though we know it is harming our health, work, family, social life and even our freedom.
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