IVDU :(
Hello colleagues! I work hospitalist in a small, rural town: 7000 people, 90 bed hospital, about 2.5 hours drive to our nearest referral centre. The opioid epidemic has not been kind to us.
More often than not we will have admitted a person with a history of IV drug use with some sort of infectious complication. Clearly a very shitty situation for this person, especially when they need like 6 weeks of IV antibiotics for their spinal epidural abscess/discitis/endocarditis/what have you.
Recently, we have had a few patients who have been unable to abstain from regular IV drug use while in hospital, either while on smoke breaks or day passes, or even while in their rooms. They have used their PICCs for access.
For a small town we have a solid addictions team that sees people as both in and outpatients for continuity, a good public health department, I do my best to optimize medical management of withdrawal symptoms, and we offer harm-reduction. But it's the addiction man, it's terrible, both opioids and stimulants.
I'm looking for any insight on how other people have navigated the situation of ongoing IV drug use in admitted patients. Many thanks!