It was 6½ months ago that we published “Sometimes you just have to be an [insert slang term for the rectum here] to do things right,” noting Olivia Reingold‘s report that addiction activists say they’re ‘reducing harm’ in Philly, but Kensington locals say they’re causing it. It was an article noting that the oh-so-well-intended activists trying to help junkies — we’re not willing to use the less loaded term “addicts” any more than necessary — are actually harming the larger community around them. We also snarked that Miss Reongold’s article would never, ever, have been published by The Philadelphia Inquirer, the ever-soft-hearted liberal newspaper.
And here they go again:
Banning mobile care in Kensington could lead to amputations, hospitalizations, maybe even deaths
No shirt, no shoes, no wound care? A bill proposing a ban on mobile services runs counter to best health care practices, writes street wound care nurse and researcher Eleanor Turi.
by Eleanor Turi | Friday, December 6, 2024 | 6:00 AM EST
A patient was on the floor of the waiting room of our opioid use disorder clinic, his eyes closed tight from the pain pulsing from the wounds on his legs. When I asked if he’d like to me to change the dressings on his legs, he said no, because he couldn’t take off his pants. I suggested cutting them from the bottom up, but he said they were his only pair. We didn’t have any extras in the clinic. After much negotiation, I gave him supplies to do his own wound care, knowing that they were likely to get stolen and I might not see him again.
Through my work as a wound care nurse and as a nurse scientist studying wound care delivery, I have learned that patients like this one — for confidentiality reasons I’ll refer to him by the initial in his first name ‘J’ — are common, and that offering compassionate care is key to healing them.
There are thousands of our sons, daughters, brothers, and sisters like J. living with severe wounds due to injection drug use on the streets of Philadelphia and other cities across the U.S. Many patients come from traumatic backgrounds, which fuels their severe chronic condition of addiction. Wounds are common among people who use drugs because the street supply often includes unsafe chemicals that are mixed with heroin and fentanyl like xylazine, an animal tranquilizer known to cause severe wounds. These people face the amputation of their limbs and even death from infections if they go untreated.
Dr Turi is clearly a good and compassionate woman, highly educated, “passionate about the nursing workforce, health equity, and improving the quality of care for patients with behavioral health conditions, with specific focus on patients with substance use disorders.” Along with her post-doctoral research, she works at a “low barrier clinic” in Kensington, low barrier meaning “that people can easily receive care like medications for addiction, sexual health testing, and wound care despite ongoing drug use.”
But, it has to be asked, is Dr Turi actually doing anything good for the community?
She is a registered nurse, and any good nurse is going to want to render aid and caring for people who are hurting. She sees someone with an open wound, and she is going to want to treat that wound. My wife is a nurse; I understand the impulse and the situation.
Nevertheless, there is a hard truth that Dr Turi did not address in her OpEd: treating junkies without getting them off the streets is simply enabling continued “ongoing drug use.” Treating “J’s” wound — or, in this case, giving him supplies to dress his wound himself, “knowing that they were likely to get stolen,” simply means that “J” will be out on the streets longer, stealing from other people longer to support his drug habit, doing his part to keep the Kensington neighborhood a fetid and festering sewer even longer.
Across the board, I learned that compassionate harm reduction care — like offering clothing, housing, and clean needles — is key to keeping people like J. in care. However, it is hard to continually supply these services when funding is tight at small organizations and local policies are constantly changing.
I read through Dr Turi’s article twice, and the one glaring omission that I noted was that she never mentioned attempts to get junkies off the streets and into rehab. I suspect that she and the other people who provide care at these ‘street clinics’ do at least try to push junkies toward rehab, but if they do, it wasn’t deemed important enough to Dr Turi to mention it in her OpEd.
For example, on Dec. 2, Councilmember Quetcy Lozada introduced a bill that proposes to ban services or distributions from mobile vehicles in Kensington on residential streets or near schools/recreation centers. This is a direct action against people who use drugs who require mobile services to receive the care they need, as many are in wheelchairs, unable to walk to receive care.
Well, yes, it is a “direct action” against the junkies who line and lay in the streets of Kensington. The goal is to clean up the city, not to make things easier for drug users . . . and drug dealers.
Although this policy was brought forward to address the needs of local residents, the bill will not address the root problem of poverty, the criminalization of drug use, and systematic racism. In fact, without mobile care in Kensington, many people who use drugs will be unable to receive preventative wound care, leaving their wounds undressed and open for infection, leading to complications such as hospitalization, amputation, and even death.
What? Dr Turi is concerned about the “criminalization of drug use”? Has she looked at her patients? Drug addiction makes criminals out of the junkies, because, as recovering addict Theo Fountain wrote in another Inquirer OpEd:
I was arrested for participating in the typical hustles addicts support themselves through: shoplifting and dealing dope.
Dr Turi used the term “compassionate harm reduction care,” but what she and her fellows are not doing is reducing harm. Rather, they are transferring some of the harm from the drug dealers who cause it and the junkies who consume it, onto other people, people not using drugs, and people who are forced to pay more in taxes to clean up and treat the junkies. Dr Turi included a call for easier, more simplified Medicaid billing for the service they render, which just takes more money out of the pockets of the poor people in Kensington, and elsewhere, who are not causing the problems.
Dr Turi told us what the lack of these mobile clinics would be: “many people who use drugs will be unable to receive preventative wound care, leaving their wounds undressed and open for infection, leading to complications such as hospitalization, amputation, and even death.” As our regular readers — both of them — know, I can be an [insert slang term for the anus here] at times, and I’ll ask the [insert slang term for the anus here] question: why would we care if the junkies suffer “hospitalization, amputation, and even death”? Addicts who get hospitalized might get actual treatment for their addiction, while amputees have less opportunities to steal from others to support their habits. Those who die? At least they are off the streets for good.
I would guess that Dr Turi would be appalled by my last paragraph, but it is a legitimate question: is the compassion being shown for people who are damaging our culture and our society really a good thing? Wouldn’t Philadelphia, and the United States at large, be better off without a population of junkies. Enabling drug addicts to continue using drugs ought to be seen as a wholly evil and stupid policy.