Reducing overdose deaths

Dear President Trump,

I realize I’ve been very negative and likely coming across as quite whiny lately in my letters to you. Although I feel completely justified in calling out all the horrible things you’ve been doing, staying so focused on them is not good for me so I’m going to try (again) to write for the next little stretch about positive things that are happening.

The one I’ve nominated for today is from an in-service we had at the VA yesterday about an on-demand medication assisted therapy program for people who are addicted to opiates. The three people who spoke were terrific and did a wonderful job describing their program, how they got it started, and the challenges they’ve been meeting to keep it going. The program offers people same day access to buprenorphine and most of the patients get to the program through the adjacent needle exchange. The nurse supervisor described how they worked closely with their medical providers to figure out what they needed to have in place to feel comfortable prescribing the medication since a nurse case manager actually does most all of the work with the patients. The program had to get approvals from the DEA and the medical licensing board because it is an unusual arrangement involving a Schedule I medication. But they did it and have now served over 100 people in under a year. What was so very cool is that they are genuinely focused on the big target of reducing overdose deaths and are not caught up with things like whether their patients are free of other substances or are perfect in their attendance, which most such programs are sticklers about. They just want to keep people alive. The nurse case manager spoke movingly about her patients’ extensive childhood trauma exposures and how this left them vulnerable to developing substance abuse problems and to having difficulties interfacing effectively with care providers. She talked about how her colleagues have observed that she is essentially providing corrective parenting and it was clear to me she is providing corrective love and is teaching her patients they are valued and worthy. What a gift.

May we all know we deserve safety.
May we all know we deserve happiness.
May we all know we deserve health.
May we all know we deserve love and care.

Tracy Simpson

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