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There's a patient that we would see a couple of days per month. They'd OD on heroin, we hit them with narcan and an electrolyte IV to hydrate. He'd eat something and leave. We would give him resources to get some help. Each time I'd get more and more angry.
6 months of this and I finally asked why he'd OD almost like clockwork. He said the good stuff sold fast and he'd only get enough for like 2 maybe 3 hits(?highs, fixes?) The guy's life was just waiting on his dealer to get it. He would figure out how to make enough cash to keep his withdrawals at bay while saving up to buy up as much as he could when the good stuff arrived.
The last time I saw him, day shift told me he came in, got hit with narcan twice, this was after EMTs had given him narcan as well. when he was steady enough, he left AMA(against medical advice). He came back 3 hrs later for another OD. Doctor came in and told him he's killing himself. this organ is damaged, this one has this, blah, blah, blah. He responded that he'd be fine if we would stop killing his high. I did the usual and he left sometime the next day.
We haven't seen him in 4 months. I guess he finally got to enjoy his high.
I remember back when reddit was edgier there was an /r/opiates sub where users would share cheery thoughts like, "I'm sure we all have a part of us fantasising about dying when we hit the plunger on the syringe."
It was so bleak that it stuck with me.