It’s time for hospitalists to be engaged with opioid use disorders

Alvin is a 42-year-old man who was never really given a chance. His parents both had severe alcohol use disorder. At age 12, his parents encouraged him to skip school to sell marijuana in order to fund their drinking. As his parents began using various illicit drugs, Alvin started selling larger amounts of marijuana to foot their bill. Eventually, marijuana was not profitable enough. Alvin, then 16 years old, turned to crack cocaine. A year later, he was arrested with enough drugs in his possession to justify a criminal charge for dealing.

Alvin spent the next 20 years in and out of prison. He had never been in a physical altercation, but now he needed to learn how to fight for survival. He had never been an artist, but now he taught himself to draw to pass time in solitary confinement.

I met Alvin when he was admitted to complete six weeks of IV antibiotics for his third bout of endocarditis. His infection was being treated, but not the underlying disease. Perhaps addressing Alvin’s life-long struggle with drugs was a lost cause.

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