May 7, 2024 – Over many years, I have resuscitated countless numbers of patients dying from a drug overdose while working as an emergency physician. I knew I had to stop everything else I was doing and treat the overdose patient immediately because they could die within minutes. We had to clear a resuscitation room and start ventilation on arrival, get an IV into their scarred veins, and quickly inject naloxone (Narcan). They usually started breathing again and woke up confused and angry, suddenly in acute withdrawal, writhing in pain, vomiting, and moaning in agony. Most ripped out their IVs and looked for an exit. If they had to fight their way out, they did. Nobody said, “Thank you.”

For years, I was angry and didn’t try to stop them from heading back to the street. Eventually, I was able to put my emotions aside and focus on the rest of the patients I had to see. I never thought about why overdose patients acted that way. Even as faculty at Johns Hopkins and Harvard, I knew nothing about the treatment of addiction…