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    The Care of Hospitalized Intravenous Drug Users in 2019

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    Genre
    Thesis/Dissertation
    Date
    2019
    Author
    Spivack, Stephanie
    Advisor
    Jones, Nora L.
    Department
    Urban Bioethics
    Subject
    Medical Ethics
    Addiction Medicine
    Infective Endocarditis
    Intravenous Drug Use
    Opioid Use Disorder
    Opioid Withdrawal
    Staphylococcus Aureus Bacteremia
    Permanent link to this record
    http://hdl.handle.net/20.500.12613/3602
    
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    DOI
    http://dx.doi.org/10.34944/dspace/3584
    Abstract
    People who inject drugs, particularly opioids, are a growing population, especially in North Philadelphia. This population is at high risk for medical complications that require hospitalization. While hospitalized, this population poses unique challenges to the healthcare system, including high costs and readmission rates, as well as stress and burnout among providers and staff. These patients are at high risk of discharges against medical advice because of complicated social factors as well as inadequate recognition of pain and withdrawal. As the opioid epidemic evolves, previous strategies for managing these patients, which traditionally relied on referral to psychiatry or social work in addition to symptomatic treatment, need to be re-evaluated. Ethically, the decision-making capacity of these patients is frequently called into question, and there is a difficult-to-strike balance between respecting their autonomy and acting with beneficence to provide the best care. There are also public health concerns that come into play. Better acknowledgment of the issues that this population faces, and better management of pain and withdrawal, may improve their outcomes, as well as reduce provider stress and burnout.
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