Health Professionals... Listen Up!  

When that addicted person is in front of you as your patient, you are their ONLY hope for healing...  

Here's one example of what happens when you fail in your care giving...

I've known Amy from almost day one of my visits to Kensington. Here's a picture of her from before drug use. 

On Wednesday, May 6, 2020, I wrote this blog about Amy under the blog name "Allison."

Allison at Episcopal: "Get Out of My Emergency Room!"

It would have been better for Amy if that nurse had encouraged her to stay in the E.R. and not tell her to leave.

Here is Amy now: Please take the time to listen and learn from her.

Please do pray that Amy finds the healing she longs for so very much.

On the surface of the issue, my dearest friend died of an overdose on February 21st, 2024.

On the surface of the issue, my dearest friend died of an overdose on February 21st, 2024. I start that sentence with “On the surface of the issue… ".

I do so because, yes, on the surface of the issue, it appears that her body succumbed to an excessive amount of illicit street drugs. But we must look deeper. And there are so many directions into which we must look. My next several writings will be separate writings looking at various aspects of what served as a jigsaw puzzle of pieces creating the puzzle that ended the Earthly life of my best friend. 

Several times throughout her seeking detox care, she would go to a medical clearance facility or a detox center itself and start to go through the process of entry into care. For reasons that perhaps don't make sense to us in our non-addicted brain circuitry but made perfect sense to her in her drug-addicted brain circuitry which had been rewired and hijacked by her officially recognized disease process of substance use disorder, she walked away from the process. She gave up on that day.

I'll spare you all the details of her reasoning to get to the point of this particular message. 

There was a consistent pattern of intake personnel whether on the streets of Kensington or an admissions department in a facility who looked at my dear friend after her multiple attempts at seeking care and walking away when they said to her 

“This is your last time. If you walk away now we will not attempt to help you again.”

(For any individual struggling to feel accepted by family, friends, or society as a whole,

the only thing this statement does in the mind of that individual

is to tell them very directly that they do not have a place in this world,

and bit by bit they are being shoved out of every opportunity that they have for healing.)

From their perspective, I completely understand why one would be tempted to say this. My dear friend had presented herself to you this time and then that time and another time after that and maybe a fourth time etc. You're getting tired of it. You're getting tired of seeing her show up and then show up and then show up and then show up only to walk away. 

She kept showing up and that's what you were supposed to celebrate. 

Just like the diabetic patient who keeps showing up in your emergency room or ambulance because their diabetes is out of control and they can't seem to stop eating the sweets, my dearest and best friend came to you seeking care because she wanted care and could not get beyond herself because of the rewired circuitry of her brain caused by the disease known as substance use disorder. 

You are a professional! 

It is your responsibility to look beyond the annoyance of her showing up and then showing up and then showing up and then showing up! It is your responsibility as the medical professional who you are to look at her and say 

“I thank God that you are here again and again and again and again doing everything you possibly can to get beyond the circuitry of your brain and find healing!”

 But no!

You told her to leave and to not come back or to go to some other facility or you ignored her while she sat in your waiting area until she left unnoticed because you were tired of dealing with her. It Is not your job nor is it your privilege to ignore her in any way shape or form. It is your job to sit there for your hourly wage and serve her, the patient in front of you at that moment. She's in front of you! Just do her paperwork again and again and again and again and again and maybe one of those days it would have stuck and she would have found healing. But you in your lack of professionalism did not do the paperwork and she in the terror of her rewired addicted brain did not stay.

She is dead. 

She will never live to have her family of four children. 

She will never live to complete her Bachelor of Science in Nursing degree and enter society professionally as a BSN RN specializing in her goal of neonatal Intensive Care Unit nursing. 

She will never have the joy of touring the world and seeing the sights.

She will never again make candles or jewelry as her favorite hobbies.

She will never again hug her Dad, Grandmother, me, her cats, or mine.

She will never again enjoy DiGiorno rising crust pizza with pepperoni or Deluxe or sausage/pepperoni Bagel Bites or the sweetness of one of her favorite candies: Skittles. 

She will never again drink half a gallon of apple juice in one day or her preferred Wawa whole milk.

She will never again have the opportunity to surprise her loved ones with a special homemade breakfast, lunch, or dinner on any holiday.

She will never ever again create a homemade card that celebrates the love she feels for her loved ones. 

The next time any patient with substance use disorder is in front of you and may have been in front of you before and before and before and before and before, look at that individual and say 

“Welcome back. Let's make this happen this time.”

And if you want to take the conversation a little bit further, delicately ask them what the issues are that have been causing them to walk away. If it's something that you can correct, please do so. This is someone's daughter, son, father, mother, aunt or uncle, wife or husband or lover. 

If it is not something that you can directly correct such as staggering PTSD that needs painkillers and the only painkillers that they can get are illicit street drugs then make note of that inpatient intake observation and make sure that your patient sitting in front of you is given a warm handoff to the professional who can provide that higher level of care.

That would have helped in my dear friend's case. 

but no. 

but no. 

She’s Dead.

To Contribute to her final expenses, please click here.

Mayor Cherelle Parker and the City Administration,

 Mayor Cherelle Parker and the City Administration,

As you are going about what you perceive to be the proper thing to do in "cleaning out Kensington" please remember to clean out any nursing or medical staff in local hospitals and other similar facilities who are not treating with dignity, honor, respect, and prompt professional care the patients in their care who you are trying to remove from the streets.

As one among many examples, I offer this blog to you...

Allison at Episcopal: "Get Out of My Emergency Room!" A Story of Medicaid Vs. Private Insurance

Any nurse who looks at a recently Narcaned patient who has arrived by ambulance to the emergency room in which they are employed and instructs that recently saved patient to

"Get out of my emergency room!"

is as much a part of the issue as is every other aspect more easily identified by you and your administration. Please look at how the medical community can do a better job at welcoming these patients with substance use disorder, a medical condition officially recognized in the DSM 5.

They are not criminals first. They are patients first. They are trying to deal with a god-awful situation in which they are not seen as patients first. In your role as mayor, you can make a tremendous difference for the good if you see these people as patients and not criminals.

Not long ago, one of my long-term loved ones formerly from the streets of Kensington was seeking detox care from a facility in which they had been previously multiple times.

Not long ago, one of my long-term loved ones formerly from the streets of Kensington was seeking detox care from a facility in which they had been previously multiple times. In those past visits to that facility, this individual had signed out AMA a couple of times and been Narcaned a couple of times due to a suspected overdose on campus. 

But I do want to add and regard to these supposed overdoses, when you look at the details and the circumstances, I highly suspect that these were not actual overdoses. But that topic goes beyond the point of this blog.

This individual was seeking care not long ago from this exact facility. This particular facility does offer a combination of services that are very much needed by this person and not found at other facilities. Again, the details of that go beyond the point of this blog.

Now let's get to the point of this blog.

This facility was trying to not allow this individual to be admitted there because of their AMAs and their supposed overdoses on site.

In the end, this facility did accept their admission and as of this writing things are going well. But here's the point, if this individual was dealing with years and years of diabetes for example, and they were having problems at the facility because of their diabetes, and if those problems were persisting outside of the facility, the facility would not look at them and try to reject their entrance into the facility.

The stigma of addiction otherwise known as ‘substance use disorder’ is discriminated against and treated very differently than a more traditional and yet equally devastating diagnosis of uncontrolled diabetes. 

Of course there are differences. But the issue is that people with substance use disorder are seen as different or inferior or some other sad interpretation of diagnosis. It is high time that we look at substance use disorder on equal terms as diabetes or any other disease of the mind and body.

When we begin to do so, substance use disorder patients will start receiving on equal terms the treatment and the dignity and the honor and the respect and the love that they deserve as human beings.

If you have ever considered going to an outpatient methadone clinic to transition from illicit street drugs to sobriety, let this message be a word of warning.

If you have ever considered going to an outpatient methadone clinic to transition from illicit street drugs to sobriety, let this message be a word of warning. 

It won't work the way you would like it to. 

Methadone is a medication-assisted treatment (MAT) that counteracts within your body the desire for opioid-type elicit drugs. Unfortunately, street drugs these days have as their two primary ‘ingredients’ an opioid, typically fentanyl, and xylazine, a non-opioid (actually a veterinary tranquilizer). The methadone will help with the opioid part of the ‘recipe’ of what you are consuming. It will do nothing, I repeat nothing, for the xylazine. 

From close second-hand experience, I have come to understand that the xylazine detox is ridiculously more painful than any opioid-based detox. You may very well wind up in need of a hospital-based and perhaps intensive care unit-based detox. But please do not let this stop you. There is an incredible life of health and reconnection with loved ones, career, and every other wonderful blessing on the other side of that painful process. 

The point of my message here is simply to make sure that you understand that a standard outpatient methadone clinic does not currently have the resources nor abilities to transition you from the current street drugs to a life of sobriety and health. If any methadone clinic suggests to you that they can transition you from current illicit street drugs to a life of sobriety and absence of drugs, I would ask them how and challenge them with this information to see what they have to say.

I saw first hand today the staggering agony of unintentional fentanyl/xylazine withdrawal and the instant relief from one injection of it.

It's no wonder that people sign out AMA when inpatient facilities don't provide adequate and prompt relief.

From the patient's perspective, the cure, as temporary as it may be, is one little $5 blue bag away.

Telling the patient to wait until morning when the doctor will be back in to write an appropriate prescription for withdrawal relief just doesn't meet the immediate need when that blue bag is such a tangible option.

The transition from street drugs to a therapeutic level of methadone in outpatient clinics is dangerously slow.

As I write this article, a woman is walking the streets of Kensington, fearfully hoping to be picked up by some random guy so as to ‘do a date.’  Her goal is to have money to buy the drugs she’s working on removing from her life by way of the outpatient methadone clinic she’s been faithfully attending daily for over two weeks.

If you’re thinking that something seems very wrong with that statement, you’re right.  This woman began attending a Methadone clinic 16 days ago (as of this writing).  By policy of the clinic, she started on a daily dose of 20 milligrams.  A therapeutic daily dose for her is about 150 milligrams.  20 milligrams has no therapeutic effect.  Every five days or so, after a required discussion with her counselor, that counselor will submit to the doctor at the clinic a request for an increase. Her dosage will probably (but not definitely) be raised by five milligrams.  At that rate, she will not reach her therapeutic level for 6 to 7 months.

That’s multiple months of simultaneous (intended) therapeutic and illicit drug use.  Methadone is one of several forms of M.A.T. (Medication Assisted Treatment) therapy.  By using it at a therapeutic level, patients can free themselves of ‘dope’ and move on to a healthier life.  If they are not permitted by clinic policy and/or state/federal regulations, to receive a therapeutic amount of Methadone promptly, that interval between starting at a very low level and reaching that therapeutic level will have within it the ongoing use of illicit drugs.  The patient doesn’t want to continue using the illicit drugs but they must so as to avoid the agony of dope sickness.

The fundraising process to buy those illicit drugs…

• A very few of these patients may have the money available without doing anything to earn it. 

• Some will rely on family or friends to provide the money. 

• Others will continue to engage in prostitution, retail theft, or other illegal activities to raise the money.

Of these three modes of money-making, this third one concerns me most. Prostitution (or ‘doing a date’) is dangerous. Assaults and rapes are increasingly common. As an illegal activity, this as well as buying illicit drugs, retail theft, etc. carries with them the potential for a new or lengthened criminal record, time in jail, appearances in court, probation, fines, and more.  

What an incredible miscarriage of justice and shame on the healthcare process for anyone to wind up dealing with these legal issues simply because they were not given a therapeutic dose of an accepted M.A.T. in a timely manner after finding their ‘ready moment’ and starting this as their chosen health recovery process.

While I can appreciate the need to regulate the flow of methadone, the policies of the clinics and the state/federal regulations that are blocking the patients from quickly reaching therapeutic levels of Methadone need to be in better balance with the reality of the patient’s desire to be illicit drug free.  

As it is now, the drug trade is the big winner here while these M.A.T. patients continue to buy that which they are seeking to remove from their lives.  Family and friends who don’t want to see their loved one prostituting are put in a terrible moral dilemma to be or not to be the funders of the drugs that their loved one is seeking to remove from their lives. And let’s not forget, with the use of illicit drugs, overdose lurks in the shadows.

There is something very wrong with this current system of Methadone distribution in outpatient clinics. Let's identify why the system is the way it is and how it can be improved upon so as to allow these patients to achieve their therapeutic level sooner and get on to a healthy life.

Is there more of a reason why SUD patients sign out AMA than "they're just not ready"?

 Lately, I have been pondering why patients with substance use disorder tend to leave treatment 'against medical advice' (AMA). Although I am not an authority on the matter, I would like to share my observation.

If a particular patient consistently decides to leave medical treatment, could there be underlying psychological, physical, or emotional issues at play? It is common to categorize the patient as "resistant to treatment" or "not ready," without acknowledging the possibility of deeper, unresolved issues. It is important to consider that there may be underlying factors that are being overlooked.

Is it possible that the person is scared or even terrified of the thought of being sober and facing the childhood trauma that led to their addiction in the first place? Instead of faulting the patient for consistently leaving before completing or starting treatment, let's investigate the underlying reasons for their actions. Instead of blaming them, let's try to understand their perspective and identify the underlying reasons behind their actions. 

By listening to their thoughts and feelings, we can promote healing and develop a deeper understanding of the situation, rather than relying on our assumptions and assigning sole responsibility to them.

Which side will you fight on when a civil war battle breaks out in your detox facility or intake office?

 Have you ever heard something like this when a patient with Substance Use Disorder leaves detox or fails to complete the admissions process:

“They just aren’t ready.”

“They just want to get high.”

If someone willingly came to your facility to start a detox program, you may have said to them:

“I’m so glad you’re ready.”

“I’m glad you're tired of getting high.”

Can you tell me what occurred between the time they entered your facility and when they departed?

A battle in their personal mental Civil War!

That is what has happened right in front of you and inside of them!

Instead of blaming the patient for deviating from their detox plan, focus on supporting the aspect of their mental struggle that brought their entire being - mind, body, and spirit - to your office.

The patient had to exert a great deal of mental effort to come to you, as their thought processes are not functioning as they should. Your mind, on the other hand, is functioning properly.

Choose to take the higher path and do all that you can to support the patient in their ongoing internal battle.

Stand by their side, on the side of the civil war that was prevailing when they arrived at your door.

There's no such thing as a holiday weekend for people trapped in addiction and homelessness.

One day is no different than the previous or the next...

...unless you are a person who is financially reliant on prostitution, more politely known as ‘doing a date’, to raise money for the addiction you would rather not have.

On holiday weekends, men who hire women for acts of prostitution are not here in Kensington nearly as much because they're out with their families at the beach and other locations.

It's a stunningly heartbreaking system we have going here. 

90% of all the women on the streets are 100% reliant on prostitution to raise money for the drug addiction that they would rather not have. 

70% of all the men on the streets are 100% reliant on that 90% of women. 

For the sake of discussion and easy-to-follow math let's assume that the number of men and women are equal...

That means that 80% of the money for drug purchases from the homeless population comes through prostitution.

If we started targeting for arrest the men with the money and not the women with the addiction, we might start seeing an improvement in this nightmare.

If we were to do so, the money source would dry up. The healthcare system would have to step up to the plate with prompt, dignified, and respect-filled professional care.

Let's hope these factors come together someday so that some of this sad nightmare can be resolved.

How many times?

How many times in our own life or the lives of our loved ones have we heard that a particular surgical procedure is being scheduled for a date several days or weeks into the future? Most of the time, the future-dated surgical procedure is future-dated because it simply cannot be done sooner than that date. There's a whole bunch of reasons as to why. 

When a person is waiting for a particular surgical procedure they continue to deal with the medical situation as best as they can. A person awaiting a knee replacement, for example, will continue to use their cane. Someone waiting for a bladder procedure might continue to use a catheter. The examples are pretty much endless. In all of these procedures that people engage in while waiting for their surgical procedure, nobody is engaged in a life-threatening or immoral, or illegal activity.

This is not the case for someone who is waiting for a bed in a detox unit so as to begin methadone maintenance or any other form of MAT treatment for their substance use disorder. The person may be 100% committed to the idea of getting off their drugs and starting a methadone or other program. They will be told that the wait for a bed to begin this procedure is in the range of 5 days. During those five days, that individual will be reliant on continuing their illegal drug use and risking overdose. If they live on the streets, they may need to continue their prostitution to raise money for their illegal drugs. They may need to shoplift to raise money for their illegal drug use while waiting for that bed to open.

There is something incredibly wrong with this system of medical care provision. I'm not saying that I have the answers as to how to solve this situation. But it does strike me as horrendous and immoral and illegal and inappropriate that our society requires patients who are seeking care for an officially DSM-5 recognized disease process known as substance use disorder to continue to engage in various aspects of illegal activity while they are waiting for a bed to open up so that they can begin the life-saving procedure 5 days after the fact of being ready for that procedure and getting them away from the drugs they despise.  (My mother would not be at all happy with that run-on sentence. :-))

So my point is this. How can we change this aspect of healthcare provision to the men and women on the streets of Kensington and other places who are 100% ready for detox care and must continue to prostitute themselves or shoplift to raise money for drugs they would rather not take while waiting for a bed to open?

I'm dying over here.

I'm dying over here.

Your male patient on our co-ed floor put me in a chokehold which triggered my trauma from years ago.

I'm dying over here.

I happened to glance into the room across the hall from my own only to see a male patient on this co-ed floor masturbating. That also triggered my trauma from years ago.

I'm dying over here.

I was given Suboxone far too early by your staff person. I was thrown into precipitated withdrawal. You said there was nothing that you could do about it. You told me that I got myself into this situation and now I just need to deal with it. I signed out to find my own relief. You called it signing out ama. I called it trying to relieve my agony since you could not and to survive.

I'm dying over here.

You wouldn't give me anything to eat while I sat in your emergency room waiting 8 hours to be evaluated for admission into your detox. You told me that I could not be cleared for something to eat until the doctor saw me. I was so hungry. I finally left just to find something to eat. I had no money and so I had to do a date. That date exposed me to my first ever sexually transmitted disease that I will have for the remainder of my days on this earth. With no hope of receiving detox care, I immediately went back to the drugs from which I was trying to escape by trusting you for care.

I'm dying over here.

I trusted you to provide a drug-free environment. The patients on my unit all had drugs. Some of those drugs were brought in by one of your staff members. Others were brought in by an incoming patient who buried them under a bush in the smoking area which is easily accessible from your public parking lot. I couldn't resist and so I got high (which, by the way, is the most basic definition of addiction). I knew that wasn't what I wanted and so I signed out. You considered me to be signing out ama. I considered myself to be signing out to run from the drugs that you did nothing to keep out of your building and to try to survive.

I'm dying over here.

I trusted your facility a second time. I went through the admissions process. Another incoming patient saw that I was not feeling well. They offered me one bag of dope imprinted with a label I did not recognize that they had on them. You never discovered this because you didn't search any of us. I went into the bathroom unaccompanied and consumed that one little bag. I left the ladies' room, continued the paperwork to enter your facility, and overdosed. You gave me three Narcans. The medics who arrived informed you that that was far too much for such a situation. You explained to the medics that I would need Narcan once every 25 minutes for the foreseeable future. The medics tried to correct your lack of knowledge. You sent me to the emergency room and, with that, my battle to survive was over for this day because I couldn't see myself returning to your facility. 

I'm dying over here.

Knowing what the reward would be if I could survive your facility, I gave you one more round of trust. I acknowledge that I did a get well about 3 hours before this incident happened. Again, I was going through all the paperwork and answering all your questions. I was dipping out a bit from my get-well. I acknowledge that. But I also tell you, I was very aware that you stuck Narcan up my nose. I tried to stop you from doing it and you squirted that Narcan up my nose twice. You said "You're not alert enough for us." You then told me that now that I've received Narcan, I was a liability to your facility and that I had to go to the emergency room. I've never felt such heartbreak in my life because I knew that this day would be different. I would be putting my drug use behind me once and for all. I was truly heartbroken beyond my ability to explain when I realized that you had Narcaned me when Narcan was not necessary. You violated my trust. How could I return to any place that had done so?

I'm dying over here.

I don't need your derogatory comments about my situation. I don't need your inappropriate nicknames such as 'junkie' or 'whore' often applied to people in my situation. I don't need you to talk about how aspects of my body don't work the way they should. I have heard all these nicknames and I know all my bodily malfunctions. 

I need your encouragement to take the next healthy step. I need you to celebrate that I have volunteered to come into your care. I need you to be a professional caregiver in my world. I need you so very much to fulfill your training. I need you to know something. In the absence of that, you must understand…

I'm dying over here.

In the past 5 months, I've tried 10 times to seek medical care for my substance use issues. I want to heal more than I can possibly explain. I've tried and tried and tried and tried and tried and tried and tried and tried. I'm going to keep trying as much as I possibly can but I want you to know something. In the midst of my battle, I want a healthy life. My strength is waning and I don't know how much I can keep going but I'm going to try. In the absence of continuing to try,

I'm dying over here.

Finally, I want you to know this even though I struggle with this idea myself. I am an inspirational human being. I am made in the image of God. I am worthy of the highest dignity and honor and respect and love. I need you to know this. Through your words and actions and interactions with me, I need you to remind me of this. In so doing, I will be able to break from my current path and one day look at you and my family and all of my loved ones and proudly say… 

I'm living over here!

We have to get away from this misnomer: "All addicts lie all the time."

Substandard and often dangerous healthcare is the norm when the attitude of the healthcare
provider is 

"All addicts lie all the time." 

A bit over 4 years ago “Diane” sat in a jail cell for about 5 months. I would visit her every couple of weeks. During our conversations, she told me how she was completely done with drug use and the entire street lifestyle. 

The court system, under the direction of a very caring judge, was working on finding her placement in a rehab facility. She was placed in a Philadelphia-based Medicaid-level facility.  I learned after the fact that she signed herself out because there were so many drugs on the floor where she was residing that she could not focus on recovery. She was relying on a drug-free environment and this facility did not provide that so she left. 

She was making arrangements to go to a facility she was familiar with but could not get in for a couple of days. Kensington streets were her only option to stay in. She managed to find a room on the avenue. The temptations of the streets and the drugs called her louder than she could resist. She did a small amount of drugs and was dead by morning. 

Her two daughters will be her living legacy.

“Dakota” was an amazing naturally gifted counselor. Her dream was to one day become an attorney. In December 2021, she unintentionally injected an artery. Bleeding was profuse. After several days she was taken by ambulance to Jean's Hospital. 2 hours later one of the ER staff members came into her room and told her that she was being discharged because 

"We need your bed for real patients."  

Her bleeding continued and she died about 5 days later. 

Her two sons will be her living legacy.

Recently a loved one who I met on these streets was seeking care at a detox rehab facility. As is the case with almost everyone going into detox for opioid use detox, she used before going in. There's nothing unusual about that at all.

She had gone through almost all of the admissions process which was about 2 hours. She told me that she was high during the process and dipping but answered all questions and engaged in the entire process of admission.

She tells me that she was sitting in the admissions waiting area for the next step. She remembers being jolted awake when a staff member stuck Narcan up her nose and squirted it. She tried to stop them but they injected Narcan up her nose anyway. (It is medically unnecessary and completely inappropriate to provide Narcan to a conscious patient.)

They told her that she would have to go to the hospital since she was now a liability to the facility for having been narcaned. She was taken by ambulance to Cedar Avenue Hospital, a campus of the University of Pennsylvania. 

She begged and pleaded not to be taken away because she so much wanted the care of the detox. She wanted to be done with her addiction and all that comes with it. After several hours in the emergency room, as I sat with her, she told me how much trust she lost in the facility to which she had entrusted so much hope just a few hours before.

She is now trying to figure out what her next step is going to be. That next step might be returning to the streets and all that street life encompasses for a woman.

Each of these situations has been publicly discussed with professionals in positions of authority who could make a difference and correct some of these wrongs. But no one has and most likely, no one will. And you know why?

"All addicts lie all the time!" 

We have to get away from this misnomer. 

We must consider the statements of these people who have been made in the image of God and who are worthy of the highest dignity and honor and respect and love. They are suffering so tremendously in their own literal hell and their words of complaint and concern in the midst of seeking care must be taken seriously.

To that end, I have been gathering stories of first-hand accounts of mistreatment by professionals in medical facilities. The beginnings of this effort are found at this web link on my blog site. I invite you to read over these first-hand accounts to get a better understanding.

I am searching for accurate accounts of mistreatment. I'm not looking for exaggerated or false accounts of anything. I'm looking for patterns of mistreatment. 

All of this can be anonymously submitted through this survey. 

You can also submit true accounts by email which does not allow for total anonymity since there's an email address involved.  Here’s the email address: PlowDownMedicaidMountain@gmail.com

I invite you to pass along this blog and associated links as you see best for bringing resolve to this sad situation.

Could somebody please explain to me why this is acceptable?

I'm not there now but I was at Horsham Clinic helping a friend to get admitted voluntarily. 

I would love to know why this place allows coed floors. 

I would love to know why the staff did nothing when one of the men pinned my dear lady friend to the floor in a chokehold reminiscent of a rape years ago and therefore triggering her PTSD.

I would love to know why my lady friend was exposed to a male patient masturbating in his room with the door wide open.

I would love to know why the doctor completely negated her expressions of fear about being on that floor and simply told her that if she's that uncomfortable she should go to her room.

Could somebody please explain to me why this is acceptable?

Kirkbride failed and my dear friend is giving up on finding professional care.

I would love to know how, in two out of two times, my loved one was exposed to illicit drugs during her admissions process and once up on the floor. 

In her present condition at those moments, she was not able to resist the obvious temptation and consumed. 

The details that she shared with me were so detailed that I fully believe that other people brought the drugs into the facility and ultimately to her. No one was searched nor kept separated during the admissions process as they should have been.

Let us just assume that those stories were not accurate and she actually brought there's illicit drugs in which I fully believe she did not because I was with her in the hours leading up to both self-determined completely voluntary admissions.

Whether her account of what happened is accurate or not, Kirkbride failed her miserably! Any detox worth its weight or even a quarter of its weight has every moral and legal and ethical obligation to make sure that they are providing a drug-free environment. 

Kirkbride failed and my dear friend is giving up on finding professional care.

Go to your room if you're that uncomfortable.

Should a female patient be expected to stay as an inpatient on a coed floor where one of the men has reawakened her PTSD from a rape years ago by pinning her to the floor in a chokehold while the staff does nothing to stop the situation?

What appears as simply signing out AMA (against medical advice) because they don't want to be there often has deeper roots and needs to be considered as a possible violation of the trust the patient put into the care facility when that care facility did nothing to protect the patient.

The care facility only adds to the trauma when they simply tell this patient who trusted them to simply "Go to your room if you're that uncomfortable."

Imagine

Imagine being so desirous for detox and psychological services that you voluntarily commit yourself to a psychiatric hospital.

Imagine your surprise when after 36 hours, the doctor initiates your subutex when you know darn well that it has to be at least 48 hours. You mentioned that to the doctor but the doctor says… 

No. Trust me. 36 hours is fine. 

Imagine going into precipitated withdrawal almost immediately.

Imagine begging for comfort care as your unexpected precipitated withdrawal wreaks havoc on your mind and body. 

Imagine asking and being told there was nothing that can be done and furthermore being told by professionals on staff in your co-ed unit… 

You put yourself in this situation and now you just have to deal with it.

Imagine being in so much agony that you give 72 hours' notice that you will be leaving since they can't help you with the precipitated withdrawal that they caused by giving you what you would have taken willingly at the appropriate time.

Imagine being stuck in this co-ed unit when a large muscular man, a patient, pins you to the ground in a chokehold reminiscent of a rape you experienced years before and immediately results in PTSD flashbacks.

Imagine walking down the hallway of your co-ed unit heading to your room when you randomly glance into the room across the hall from you and witness a man, a patient, masturbating.

Imagine the conversation with your doctor when you explain that all of this has left you very uncomfortable with being on this unit. 

Imagine your doctor saying… 

If you're that uncomfortable then just go to your room.

Imagine leaving that unit where you came for detox and psychological services further traumatized by these events and lack of caring on that floor and being back at Square One trying to figure out what next to do to remove yourself from your substance use when you know you need professional help to do so.

One person I know does not need to imagine any of this. This happened to one of my loved ones who I met in Kensington and who is desperately desiring to be relieved from their demon of addiction.