Addiction Treatment - Brain Damage - Losing Vision
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Breedlove, S
Aug 20, 2018, 7:04:22 AM8/20/18
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https://www.nytimes.com/2018/08/18/health/san-francisco-opioid-addiction.html?rref=collection%2Fsectioncollection%2Fhealth&action=click&contentCollection=health®ion=rank&module=package&version=high
In San Francisco, Opioid Addiction Treatment Offered on the Streets
By Abby Goodnough
The addiction treatment program at Highland Hospital’s emergency room is only one way that cities and health care providers are connecting with people in unusual settings.
Another is in San Francisco, where city health workers are taking to the streets to find homeless people with opioid use disorder and offering them buprenorphine prescriptions on the spot.
The city is spending $6 million on the program in the next two years, partly in response to a striking increase in the number of people injecting drugs on sidewalks and in other public areas. Most of the money will go toward hiring 10 new clinicians for the city’s Street Medicine Team, which already provides medical care for the homeless.
Members of the team will travel around the city offering buprenorphine prescriptions to addicted homeless people, which they can fill the same day at a city-run pharmacy.
At the end of a recent yearlong pilot, about 20 of the 95 participants were still taking buprenorphine under the care of the street medicine team.
Dr. Barry Zevin, the city’s medical director for Street Medicine and Shelter Health, hopes to provide buprenorphine to 250 more people through the program. That’s only a tiny fraction of the estimated 22,500 people in San Francisco who actively inject drugs, he said, but it’s a start.
What follows is a condensed, edited interview with Dr. Zevin, who has been providing medical care to the homeless in San Francisco since 1991.
Why offer buprenorphine on the streets instead of in a medical clinic?
Most health care for the homeless happens under the model of waiting for people to come in to a health center. But a lot of people never come in. There are a lot of mental health, substance abuse and cognitive problems in this population, a lot of chronic illness. Appointments are the enemy of homeless people. On the street there are no appointments, and no penalties or judgments for missing appointments.
© 2018 The New York Times Company
--------------------
https://www.nytimes.com/2018/08/16/opinion/sunday/drug-overdose-survival-opioids.html?rref=collection%2Fsectioncollection%2Fsunday&action=click&contentCollection=sunday®ion=stream&module=stream_uni
An Overdose Left Him With Brain Damage. Now What?
By Daniela J. Lamas
NORTH ANDOVER, Mass. — It was a Sunday afternoon, and in the cozy house at the end of the street, Andrew Foote sat in his usual chair while a movie played on the television.
The young man’s hands rested on two pillows, wrists bent and fingers contracted into fists. From time to time, he rocked forward as if to stand but then collapsed backward, into the chair. His few words were slow and slurred.
The simple fact that Andrew was living at home is somewhat miraculous. Heroin and fentanyl caused him to stop breathing, but he learned to breathe on his own again. His kidneys failed and then recovered. But Andrew’s brain, starved of oxygen too long, was left severely damaged.
More than four years have passed since the overdose. For Andrew’s parents, the fear that their son will die has now been replaced by a new set of realities and unanswerable questions: Is this a good life? Is he happy? What will happen to him when they grow old?
In the opioid epidemic, outcomes like Andrew’s are a largely unseen casualty. “People think that if you overdose on drugs, you either die or you’re O.K.,” his mother, Linda Foote, told me. “But that’s not true.”
Andrew was a golden child. He was the oldest of four, a high school football star who remained humble despite the trophies that decorated his room — now alongside a urinary catheter, pill boxes and equipment for his feeding tube.
“How many touchdowns did you make in high school?” his mother prompted. His long-term memory had remained relatively preserved, though it was hard for him to call up the words.
As we waited, my gaze traveled to a framed collage of family photos. There was Andrew in his letterman’s jacket, blond hair cut short, lips curled upward in a shy smile. He was still a handsome guy. Mrs. Foote took pride in this, but his expression had dimmed.
© 2018 The New York Times Company
--------------------
https://www.theguardian.com/lifeandstyle/2018/aug/19/i-was-scared-of-losing-my-sight-then-writing-brought-me-clarity
I was scared of losing my sight… then writing brought me clarity
Genevieve Fox
Paola Peretti is losing her eyesight and she wouldn’t have it any other way. When she was 14, she became very short-sighted, virtually overnight. Three years later came the diagnosis of Stargardt macular dystrophy, a degenerative disease that destroys central vision, damages colour perception and results in blindness. Two years ago, finding herself in a place of both “desperation and hope,” the 32-year-old Italian language teacher and debut novelist decided to step out from the shadow of her hereditary condition, which she only ever aired with her family, and confront her fear of the dark.
The Distance Between Me and the Cherry Tree is the result: a captivating, wise and highly visual children’s novel about living in the face of fear. Its heroine, nine-year-old Mafalda, also has Stargardt disease. A bewitching, brave little girl, she will lose her sight completely within six months, as Peretti was expecting to do at some unspecified point in her own life when she began the novel.
The eponymous cherry tree is next to Mafalda’s school. Each day, she has to get closer to it before it comes into focus. As her short-sightedness increases, so does her fear of the future. “She is losing her life as she knows it,” says Peretti, who explains that she herself can see “half of what other people see”. Mafalda has blank patches in both eyes, and they get bigger. Peretti has a blank patch in her right eye. I am seated a couple of feet from her as we talk in her publisher’s office. She says I am partially blurred.
© 2018 Guardian News and Media Limited
--------------------
In San Francisco, Opioid Addiction Treatment Offered on the Streets
By Abby Goodnough
The addiction treatment program at Highland Hospital’s emergency room is only one way that cities and health care providers are connecting with people in unusual settings.
Another is in San Francisco, where city health workers are taking to the streets to find homeless people with opioid use disorder and offering them buprenorphine prescriptions on the spot.
The city is spending $6 million on the program in the next two years, partly in response to a striking increase in the number of people injecting drugs on sidewalks and in other public areas. Most of the money will go toward hiring 10 new clinicians for the city’s Street Medicine Team, which already provides medical care for the homeless.
Members of the team will travel around the city offering buprenorphine prescriptions to addicted homeless people, which they can fill the same day at a city-run pharmacy.
At the end of a recent yearlong pilot, about 20 of the 95 participants were still taking buprenorphine under the care of the street medicine team.
Dr. Barry Zevin, the city’s medical director for Street Medicine and Shelter Health, hopes to provide buprenorphine to 250 more people through the program. That’s only a tiny fraction of the estimated 22,500 people in San Francisco who actively inject drugs, he said, but it’s a start.
What follows is a condensed, edited interview with Dr. Zevin, who has been providing medical care to the homeless in San Francisco since 1991.
Why offer buprenorphine on the streets instead of in a medical clinic?
Most health care for the homeless happens under the model of waiting for people to come in to a health center. But a lot of people never come in. There are a lot of mental health, substance abuse and cognitive problems in this population, a lot of chronic illness. Appointments are the enemy of homeless people. On the street there are no appointments, and no penalties or judgments for missing appointments.
© 2018 The New York Times Company
--------------------
https://www.nytimes.com/2018/08/16/opinion/sunday/drug-overdose-survival-opioids.html?rref=collection%2Fsectioncollection%2Fsunday&action=click&contentCollection=sunday®ion=stream&module=stream_uni
An Overdose Left Him With Brain Damage. Now What?
By Daniela J. Lamas
NORTH ANDOVER, Mass. — It was a Sunday afternoon, and in the cozy house at the end of the street, Andrew Foote sat in his usual chair while a movie played on the television.
The young man’s hands rested on two pillows, wrists bent and fingers contracted into fists. From time to time, he rocked forward as if to stand but then collapsed backward, into the chair. His few words were slow and slurred.
The simple fact that Andrew was living at home is somewhat miraculous. Heroin and fentanyl caused him to stop breathing, but he learned to breathe on his own again. His kidneys failed and then recovered. But Andrew’s brain, starved of oxygen too long, was left severely damaged.
More than four years have passed since the overdose. For Andrew’s parents, the fear that their son will die has now been replaced by a new set of realities and unanswerable questions: Is this a good life? Is he happy? What will happen to him when they grow old?
In the opioid epidemic, outcomes like Andrew’s are a largely unseen casualty. “People think that if you overdose on drugs, you either die or you’re O.K.,” his mother, Linda Foote, told me. “But that’s not true.”
Andrew was a golden child. He was the oldest of four, a high school football star who remained humble despite the trophies that decorated his room — now alongside a urinary catheter, pill boxes and equipment for his feeding tube.
“How many touchdowns did you make in high school?” his mother prompted. His long-term memory had remained relatively preserved, though it was hard for him to call up the words.
As we waited, my gaze traveled to a framed collage of family photos. There was Andrew in his letterman’s jacket, blond hair cut short, lips curled upward in a shy smile. He was still a handsome guy. Mrs. Foote took pride in this, but his expression had dimmed.
© 2018 The New York Times Company
--------------------
https://www.theguardian.com/lifeandstyle/2018/aug/19/i-was-scared-of-losing-my-sight-then-writing-brought-me-clarity
I was scared of losing my sight… then writing brought me clarity
Genevieve Fox
Paola Peretti is losing her eyesight and she wouldn’t have it any other way. When she was 14, she became very short-sighted, virtually overnight. Three years later came the diagnosis of Stargardt macular dystrophy, a degenerative disease that destroys central vision, damages colour perception and results in blindness. Two years ago, finding herself in a place of both “desperation and hope,” the 32-year-old Italian language teacher and debut novelist decided to step out from the shadow of her hereditary condition, which she only ever aired with her family, and confront her fear of the dark.
The Distance Between Me and the Cherry Tree is the result: a captivating, wise and highly visual children’s novel about living in the face of fear. Its heroine, nine-year-old Mafalda, also has Stargardt disease. A bewitching, brave little girl, she will lose her sight completely within six months, as Peretti was expecting to do at some unspecified point in her own life when she began the novel.
The eponymous cherry tree is next to Mafalda’s school. Each day, she has to get closer to it before it comes into focus. As her short-sightedness increases, so does her fear of the future. “She is losing her life as she knows it,” says Peretti, who explains that she herself can see “half of what other people see”. Mafalda has blank patches in both eyes, and they get bigger. Peretti has a blank patch in her right eye. I am seated a couple of feet from her as we talk in her publisher’s office. She says I am partially blurred.
© 2018 Guardian News and Media Limited
--------------------
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