Why is it important for an emergency medicine to understand drug use?

  • Many emergency medicine residents feel that their medical schools and residency does not provide adequate training in addiction medicine.
  • While many want to discuss these topics with their patients, most admit that their limited knowledge and understanding of how people use the drugs prevents them from engaging on this topic with their patients.
  • Avoiding conversations on drug use with patients whom drugs play a significant role in their life can interfere with the bond between provider and patient.
  • Failure to develop this bond can lead to missed opportunities to engage with, and connect to the medical system, some of the most marginalized and chronically ill populations that we serve.
  • Stigma is often cited as a major barrier to seeking care for patients who use drugs and avoiding talking openly about drug use can further feelings of shame and stigma.

Do we really have time to deliver harm reduction in the emergency department?

  • It is true that we do not have time to deliver 10-minute-long harm reduction counseling sessions to our patients.
  • But we regularly deliver mini harm reduction interventions with other patient populations without even realizing it. Examples include:
  • Encouraging patients with poorly controlled diabetes to switch to diet soda.
  • Reminding patients with consistent hypertension to decrease salt intake and take their medications every day.
  • Telling a patient with newly diagnosed STI to not have sex until they complete their treatment and to have their sex partners get tested.
  • Encouraging helmet use and safer drinking in our bicycle trauma patients.
  • With a sufficient knowledge base, we can deliver bite-sized harm reduction tips with patients who use drugs without disrupting our workflow.