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Thursday, September 10, 2020

It would be far better to initiate treatment of the Medicaid reliant patient of Substance Use Disorder in the Crisis Center rather than make them wait for full admission to the detox facility.

The following is a firsthand account of a person I've known for a few years now as he tried to seek detox services while being reliant on Medicaid.


I have personally been to several crisis[1] centers in Philadelphia.  A few months ago, I went to one and sat for about 13 hours in a waiting room so very sick shaking and sweating and vomiting everywhere and all for them to come out and tell me that there were no beds and said to come back the next day to try again.  


Mind you I was very very sick and when they told me that, I asked them what should I do as I was laying on their bathroom floor vomiting everywhere and it looked like someone had sprayed a hose on me because I was dripping wet.  My clothes were soaked and I was flopping on the floor like a fish out of water.  


The doctor said to me "I don't know what to do."  She said she cannot give me anything because I am not admitted and there are no beds.[2]  So they asked me where would I like to go to because they will call a cab for me.  As I was waiting for the cab, security and a nurse came outside to me and asked me what I was doing and I said "You told me you are calling a cab."  The nurse said, "We did not call one and you have to get off of the property!" 


Mind you I had no money and I was so sick so I ended up walking to the EL.  The SEPTA personnel told me I cannot go through without money and I told them that I just came from the hospital.  I showed them paperwork and they still said "No" so I ended up jumping the train and the SEPTA personnel hit the alarm! 


So thank God the train came before any cops got there so I was fine.  As I was on the train I dropped to the floor and had a seizure.  When I woke up people were standing around me and they were waiting for the ambulance but I jumped up and said no and got back on the next train and got off at Somerset station and had to find a way to get well...[3] 


My experience that day with the crisis center made me so sick to my stomach thinking that I really wanted to get clean and I really wanted help and nobody helped.


[1] Medicaid reliant patients of Substance Use Disorder are required to go to a crisis center - a place where mental disorders are diagnosed - for clearance and as the first step in finding a bed for further treatment somewhere within the city.


[2] She said she cannot give me anything because I am not admitted and there are no beds…  The crisis center is the equivalent of an emergency room in a medical hospital.  Would the nurses or doctors of an emergency room tell a patient with severe life-threatening injury or illness that "We cannot treat you because you're not yet admitted to the hospital."?  No. Of course not!  That patient with the medical injury or illness is a patient of that medical emergency room and would be provided whatever medical intervention is needed until being transferred to an inpatient setting.  Why do we treat patients of Substance Use Disorder differently and in such a substandard way - a way that dishonors the sworn intentions of the Hippocratic Oath?


[3] find a way to get well… Well…  From what?:  What does that really mean?  Here's an outline as provided in this linked article:


The Symptoms of Withdrawal

Symptoms of dope sickness – and their intensity – can vary by person, drug of choice, and the amount of drugs used on a regular basis. However, common signs of dope sickness include:

Nausea, vomiting, diarrhea and/or constipation

Loss of appetite/huge return of appetite

Hot and cold flashes

Muscle aches and spasms

Sensation of bugs crawling on or under skin


Dry mouth




These physical effects are often accompanied by mental and emotional symptoms. Those who are dope sick may also experience:







What does "Find a way…" really mean?  Imagine, not that you can actually fully understand but do your best to try…  Imagine being a woman in this situation.  You have no money for that five-dollar little blue paper-wrapped "cure" to your dope sickness.  You have no option but stand on a street corner doing all you can to hide the above symptoms when some random man pulls up next to you…


"One was an important lawyer who picked me up in his Cadillac, took me to a center city hotel, tied me to the bed, had his way with me, got dressed, untied me and left the room.  I had to use some of the money he gave me for public transit just to get back here to buy my medicine." 


It would be far better to initiate treatment of the Medicaid reliant patient of Substance Use Disorder 

in the Crisis Center 

rather than make them wait for full admission to the detox facility?

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