Recognizing Withdrawal in the Waiting Room

Harm reduction is an evidence-based, practical approach to reducing the negative personal and public health consequences of drug use. However, staff in healthcare settings often struggle to openly discuss drug use with patients. The Introduction to Harm Reduction in Healthcare Video Series demonstrates practical strategies to support the health of people who use drugs. This video presents an approach to identifying and supporting people going through withdrawal with your waiting room.

Additional Takeaways:
-Prepare your staff to recognize the basic signs of withdrawal and provide them with basic techniques to support patients
-Remember that while a patient is actively experiencing opioid withdrawal symptoms they have limited ability to concentrate, follow directions, or modulate emotional reactions
- A successful interaction with the patient means attending to basic physical and relational needs such as offering a glass of water, and acknowledging that the person looks uncomfortable

[BrabbitHabit]

Lol it’s funny the way withdrawal is portrayed by people who have never actually survived it. If that guy was in full blown WD, he wouldn’t have been able to leave his house. When I went through it, I’d be soaked from head to toe in sweat, as though someone poured a bucket of water over me, but I’d also be simultaneously freezing. Beads of sweat would literally drip off my face, chest, etc. My nose would be runny, my eyes would be watery, I’d keep yawning, my stomach would be a mess, and all I’d want to do is lay down and sleep but I’d be too restless and unable to get comfortable, so I’d just thrash around in my bed. I’d be cold, so I’d pull a blanket over myself, but that would make me sweat more, so I’d take the blanket off, but then I’d be freezing again. I’d want to curl up, but I’d be too restless. Restless legs were horrible during WD. It’s why I actually hated being in bed during that time and could never stay there long. I couldn’t even have a light or the TV on. I’d go days without eating and be barely able to keep water down. The only thing that made me feel better was a hot shower or bath but as soon as I eventually got out, I’d be back to square one.

Withdrawal isn’t like a “bad flu.” I’ve had a bad flu before and was still able to sleep and hold down water. Withdrawal feels like you’re dying but you don’t actually die (unless you’re coming off benzos or alcohol and then you could seize out). I understand for the purpose of this video, they want to show someone whose withdrawal is just kicking off bc showing the later stages would probably be too messy, but WD doesn’t cause stuttering/stammering, itching, and grabbing at your neck. The guy looked more like a tweaker than someone in WD. I’ve literally wanted to go to the hospital before bc of WD. I’ve read things that suggest exercising, going for walks, eating your favorite meal, participating in your favorite hobby, etc. as ways to get through WD. Those are literally the last things you’re able to do. Sometimes I wish people could experience just 10 minutes of WD to know how bad it is so they’d stop downplaying it and giving stupid suggestions to get through it. Oh and those are just the physical symptoms, mentally you’re at war too. I’ve never been someone who’d ever consider taking my own life but during WD, you feel so hopeless that you actually have thoughts like that. And as soon as you make it through the WD, you can’t believe those were really thoughts that went through your mind.

I know this is long af but I wanted to make it very detailed to give people a better idea of what it’s really like. There’s a reason people are scared sh*tless of getting sick and do crazy things to avoid it. Not saying the things they do are excusable but they are explainable

[Say_No-_Animal-Abuse_]

I'm surprised, they don't have a sign that says: "If you die, while waiting, please, call & cancel your appointment."

[RadagonTheRed]

This isn’t withdrawal. This is the first 1% of withdrawal. Within a few more hours he’ll feel like his mind, body and soul is being torn apart.

[ameliamae]

The ER I worked for didn't give 2 craps if you were detoxing and treated those people like felt sorry for them because I knew what they were going through

[malazan]

In Australia I was turned away from over 10 doctors who were partly responsible for getting me heavily into oxy contin for a back injury. I had done my own research and none wanted to even give me 5 minutes to talk about getting on suboxone and fixing my life. I ended up spiraling further into addiction in the following year until every pole i drove past in my car I had the compulsion to swerve off the road and drive into. Eventually one day I was running at a cliff in the blue mountains NSW but kept chickening out so i went to get a bottle of vodka to finish it. Thankfully when driving to get it i had a severe mental breakdown and ended up at katoomba emergency beyond suicidal. I was put in a basically locked down mental health ward for almost 2 months but I was treated and got clean and this was 2015 so im grateful i found some solution. I never want to go through those horrors again and even if not religious i pray for those going through it to get clean.

[quedogpop]

It's called being a decent compassionate human being

[corvettedm]

Even the smallest action feels like a monumental task.

[eb]

The receptionist is qualified to work any medical office anywhere - the right mix of aloof, resent and disdain.

[honeybee]

All so he can get back there and then tell him there’s nothing they can do for him . And that is not what withdrawals look like

[MikeRuben]

Director: “act like you’re in withdrawal”
Actor: “IM TWEAKIN!!!!”

[Basstroutfishing]

He’s not going to like the part where the exam room nurse leaves you there for even longer after saying the doctor will be right in to judge hi, I mean see him and probably will order labs etc.

[runeplate]

While they didn’t get the guy to act like he was in withdrawals completely they still captured everything else that happens during opiate withdrawals especially when they call someone else and 1min feels like 10mins and you feel like you’ll die from anxiety and pain.

[bjornrockettansky]

Doctors should be held responsible when a patient gets denied the right level of care and they go home and end up killing themselves because of it.

[EmilyTurvey]

I was always in sweat pants & a t shirt aggravated & anxious, my skin crawled, I was clammy, & my bones hurt, I couldn’t sit still, but people never give this kind of help they just tell you you’ll have to wait

[lazybelphegore]

I have been that patient before. Believe me he was being as nice as possible under the circumstance. When you’re in withdrawal every second is a lifetime, you look at your clock and it’s like its stopped. Time becomes your enemy because you have borrowed so much time with opiates you now have to pay back in misery and pain. I have literally wanted to cut my arms and legs off. My body feels like its on backwards and my spine feels so weird that I try to lay with the top half of my body face down and the bottom half face up; its like you try to twist yourself like you are wringing out a wet washcloth, (which you are, because you are covered with a cold sweat). Your back, spine, and pelvis hurt so bad you can’t imagine, (to me it was way worse than passing a kidney stone). You have this kind of panic that swirls into such a fear and dread that you can’t imagine anything worse. My eyes watering, skin feeling like its being pricked all over with electrified hot needles, one goes in twists around to hit as many nerves as it can. Randomly, all over. The constant diarrhea, its like you took a colonoscopy prep laxative, you just poop your brains out until there is nothing left. Most all opiate addicts say they vomit alot; I never did, I dont know why. But they also sat they get the dry heaves once all the food is out. I get the other version, I have diarrhea until there’s nothing left, but then I keep feeling like my colon is coming out; like the pooping version of the dry heaves. (Now that I think about it; some of these symptoms may be related to being dehydrated from all that; the muscle twitching; etc. There are actually what they call “comfort meds” for people going through opiate withdrawals; like a whole list. One of the main ones is Clonidine. It is a blood pressure medicine. I remember scoffing at that, and thinking “how can a blood pressure pill help opiate withdrawals”. But the last time I went through it I decided to read up on it. The way it helps is through your autonomic nervous system. I remember an article that said when opiate addicts are in withdrawls; their bodily systems are basically deranged; all your hormones, all your neurotransmitters everything is out of whack. (Methadone maintenance allows for regulating all those systems, so does suboxone but you have to go through pretty bad withdrawals before you can even start that; and I could never go that long, so I did Methadone). But I read up on the clonidine. It has to be dosed based on your body weight. I’m big, so I had to take 5 pills. Because it works on your autonomic nervous system; it stops the cold sweats; which makes your skin feel better; it works on your digestive processes which slows down the nausea and vomiting; but the MOST IMPORTANT thing is it literally knocks you out. It was like going under anesthesia; you take it, you pass out and sleep, you wake several hours later. This helps you get through some more time; and lets you sleep through parts of your withdrawals.

[TheUnknownDungeon]

What's even worse is even when you get clean it can be 10 years later and they will still treat you like an addict the moment they see your chart.

[michaelthompson]

I hate that people look down on people with drug or alcohol problems, no one knows what has gone in there life, I hate the saying they choose to take it, 90% of the time it was prescribed for them and it got a hold of them either because it number stressful situations or relieved chronic pain and it all spirals, I have been there myself, horrible lonely place to be. We are human, I don’t agree with robbing and stealing to fund a habit I never did, however it is so easy to understand why, they did wrong, they regret everything they ever done, which in effect keeps them in addiction, please don’t judge unless you have walked a mile in their shoes, love and recovery to all addicts. Love to all people too. 😊

[brandoferg]

This is just sensitivity training, and proper customer control. Why would this not be the standard.

[spunkysparks]

All doctors should be required to have more empathy.

[annaelisavettavonnedozza]

Someone who has zero experience with opiate withdrawal directed this