Over the history of this union we have asked members what are the the most important issues confronting them and the discrimination drug users are subjected to at medical facilities here in San Francisco is always at the top of the list. The stories members tell about medical access discrimination span most of their lifetimes, but there are new tales of abuse by medical personnel and the systems under which they operate coming into our office on a daily basis. There are several categories into which these discriminatory practices fall but they all start with a derogatory attitude toward drug users who present themselves seeking treatment and end with drug users being denied services. Here are a few of the categories as defined by our membership.
Denial of minor surgery as a consequence of testing positive for an illegal substance is a common practice at many facilities including San Francisco General Hospital which is the predominant service provider to the drug using community. Patients who test positive for an illegal substance are routinely told they must go to rehab and test clean for 6 months to a year before any surgery will be scheduled or performed. This leaves drug users walking around untreated with knees and hips that need replacement, cataracts, herniated discs, broken bones that need to be reset and many other painful ailments.
Denial of opiate pain medication or severely restrictive "pain management contracts" are routinely imposed on drug users who self report a history of problematic opiate use or any history of drug use at all. Drug users who are homeless and lose or have their medications stolen are unfairly targeted by these policies. Apparently many doctors would rather have their patients in pain than risk their licence and many still have issues prescribing opiate pain medications to people on opiate substitution therapy.
Denial of liver and or other organ transplants or being taken off transplant list as a consequence of having a drug use history or using legally prescribed medical marijuana. Several news stories have appeared in the last year that document only a handful of the known cases of medical boards denying life saving transplants. There are many more cases of drug users dying after being denied transplants that have yet to be exposed by the media.
Denial of opiate replacement therapy or any treatment for opiate withdrawal especially for drug users who are incarcerated. Even in a hospital setting drug users in opiate withdrawal are often either denied basic detox medications or are not given adequate, if any, treatment. If a drug user shows up at an emergency room in withdrawal they will most likely be denied any services at all until their symptoms are extreme. Incarcerated drug users in the SF County Jail are not given anything to kick with currently unless they are already on methadone maintenance. For those on maintenance they are forced to reduce their dose to an arbitrary level set by the jail. There are also reports of inmates prescribed pain medications being reduced to "non euphoric" levels which usually means their pain is no longer being treated.
We the members of the San Francisco Drug Users Union think that these practices and others in the medical facilities that serve our community are human rights abuses and should be publicized, criticized and eventually stopped for the sake of the health and dignity of people who use drugs in San Francisco. This is not to say that we do not recognize the contribution and sacrifice of doctors and other medical personnel in San Francisco who truly ascribe to a harm reduction policy in the treatment of people who use drugs. The problem is that they are few and far between and the reports from our members old and new reflect that this source of stigmatization is the current reality in San Francisco.
Our plan is to coordinate with our community partners to raise public awareness on these issues and to encourage changes all the way from the local department of health to the statehouse in Sacramento and beyond. If you have stories to tell or want to work with us on this come on down to 149 Turk St SFCA to The San Francisco Drug Users Union this is what we are all about.
