美国国家公共电台 NPR--People struggling with substance abuse are sometimes mistreated by medical providers

People struggling with substance abuse are sometimes mistreated by medical providers

Transcript¹

A program in Seattle is helping² people struggling with addiction⁴ and homelessness overcome barriers to medical care, including discrimination from health care providers.

STEVE INSKEEP, HOST:

Drug overdose deaths in this country are at a record high. A preliminary federal count indicates they hit close to 110,000 last year. People recovering from addiction say they face a problem. Doctors treat them differently because of their history. Katia Riddle⁵ reports from Seattle.

KATIA RIDDLE, BYLINE⁶: At first, Johnny Bousquet thought he had the flu. But eventually, he got so sick, he went to urgent care. After some tests, the nurses came back. He needed to go to the ICU, they said, immediately.

JOHNNY BOUSQUET: I'm like, the flu is this bad? And they're like, we're taking you across the street. Your A1C is higher than we ever seen before.

RIDDLE: Diabetes⁷. He didn't know he had it. Bousquet, 45 years old, is also a recovering opioid addict³. He still takes methadone. He says as soon as the doctor saw that on his chart, she started treating him differently.

BOUSQUET: They're like, how are you feeling and stuff? I'm like, oh, I feel awful. And they're like, we're not giving you anything for pain.

RIDDLE: Bousquet says he wasn't asking for anything for pain, but he did need the doctor to make a call to transfer his methadone prescription⁸. She refused, implying that he just wanted to get high. Bousquet says after that, he couldn't hold it together.

BOUSQUET: I could feel the tears coming down my face. And I was so scared about what was going on with my body. Like, I've never been in ICU before. I was really scared.

RIDDLE: Bousquet works for a program called CoLEAD. They help people struggling with addiction and homelessness get off the street. He says he sees the same kind of discrimination regularly from medical providers towards his clients, like 35-year-old Nick Barrera.

NICK BARRERA: It's already difficult to seek out help for chronic⁹ illness, but then when you have that that barrier there, it makes it almost impossible sometimes.

RIDDLE: Barrera is HIV positive. At one point, he says he worked with a doctor for months on his HIV care. Then the doctor found out he was struggling with homelessness and substance abuse.

BARRERA: The nurse came in, and they took out all the syringes in the room and everything like that, just right in front of me. And, you know, I was talking down to like a child, almost. It almost became embarrassing to show up.

RIDDLE: So embarrassing, he quit going and stopped taking his medication. That led to a life-threatening infection and an emergency surgery. Dr. Herbert Duber is an emergency room physician at Seattle's Harborview Hospital. He says he has no doubt people struggling with substance abuse experience mistreatment at the hands of the medical system.

HERBERT DUBER: Yeah, I mean, there's no question that happens. Does it happen universally? No, absolutely not. But does that happen? Absolutely.

RIDDLE: Duber is standing¹⁰ outside the operating theatre of the ER. This hospital is downtown. They see many patients that are dealing¹¹ with both substance abuse and homelessness. Duber says part of the issue is sometimes people struggling with addiction do try to manipulate the system.

DUBER: Differentiating¹² that is really hard sometimes. We are human. We try to do the best that we can for the patients that we see.

RIDDLE: But he says he and his staff don't always get it right.

DUBER: There is not a clear formula that you can put together.

RAHUL GUPTA: You know, where we are today with addiction care is no different than where we were with cancer 100 years ago.

RIDDLE: That's Rahul Gupta, director of national drug control policy for the White House. He says stigma¹³ towards people with substance use disorder¹⁴ is ingrained in the medical system. It starts as early as medical school and continues with government red tape that causes many doctors to shy away from addiction care altogether.

GUPTA: Stigma is not just a consequence of providers but also policies that have allowed that stigma to prosper¹⁵ over the decades.

RIDDLE: Gupta imagines a world in which addiction is treated just like any other medical problem, with clear screening protocols¹⁶, best practices and robust¹⁷ treatment options.

GUPTA: That we begin to normalize and understand addiction as a disease. And we start to treat people who are suffering from addiction as human beings.

RIDDLE: But federal efforts to cultivate this vision are nascent¹⁸. Nick Barrera says for patients like him, getting care without discrimination means being able to do his job. He's recently started working again, delivering food.

BARRERA: You know, if I'm not medically stable, on my meds like I should be, I can't physically¹⁹ go out and do a job.

RIDDLE: Barrera's standing outside the temporary housing he's been living in. He's planning to move in somewhere permanent soon with his fiancé. And he wants to get back to receiving the care he needs. He's still struggling with fentanyl addiction.

BARRERA: It is very much a dangerous substance. And it's dumb as hell that I'm taking it.

RIDDLE: He says if he's going to kick this habit for good, he can't do it alone. He needs to rely on a doctor that he trusts.

For NPR News, I'm Katia Riddle in Seattle.

1 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

2 helping   

n.食物的一份&adj.帮助人的，辅助的

参考例句：

• The poor children regularly pony up for a second helping of my hamburger. 那些可怜的孩子们总是要求我把我的汉堡包再给他们一份。
• By doing this, they may at times be helping to restore competition. 这样一来, 他在某些时候,有助于竞争的加强。

3 addict   

v.使沉溺；使上瘾；n.沉溺于不良嗜好的人

参考例句：

• He became gambling addict,and lost all his possessions.他习染上了赌博，最终输掉了全部家产。
• He assisted a drug addict to escape from drug but failed firstly.一开始他帮助一个吸毒者戒毒但失败了。

4 addiction   

n.上瘾入迷，嗜好

参考例句：

• He stole money from his parents to feed his addiction.他从父母那儿偷钱以满足自己的嗜好。
• Areas of drug dealing are hellholes of addiction,poverty and murder.贩卖毒品的地区往往是吸毒上瘾、贫困和发生谋杀的地方。

5 riddle   

n.谜，谜语，粗筛；vt.解谜，给…出谜，筛，检查，鉴定，非难，充满于；vi.出谜

参考例句：

• The riddle couldn't be solved by the child.这个谜语孩子猜不出来。
• Her disappearance is a complete riddle.她的失踪完全是一个谜。

6 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

7 diabetes   

n.糖尿病

参考例句：

• In case of diabetes, physicians advise against the use of sugar.对于糖尿病患者，医生告诫他们不要吃糖。
• Diabetes is caused by a fault in the insulin production of the body.糖尿病是由体內胰岛素分泌失调引起的。

8 prescription   

n.处方，开药；指示，规定

参考例句：

• The physician made a prescription against sea- sickness for him.医生给他开了个治晕船的药方。
• The drug is available on prescription only.这种药只能凭处方购买。

9 chronic   

adj.(疾病)长期未愈的，慢性的；极坏的

参考例句：

• Famine differs from chronic malnutrition.饥荒不同于慢性营养不良。
• Chronic poisoning may lead to death from inanition.慢性中毒也可能由虚弱导致死亡。

10 standing   

n.持续，地位；adj.永久的，不动的，直立的，不流动的

参考例句：

• After the earthquake only a few houses were left standing.地震过后只有几幢房屋还立着。
• They're standing out against any change in the law.他们坚决反对对法律做任何修改。

11 dealing   

n.经商方法，待人态度

参考例句：

• This store has an excellent reputation for fair dealing.该商店因买卖公道而享有极高的声誉。
• His fair dealing earned our confidence.他的诚实的行为获得我们的信任。

12 differentiating   

[计] 微分的

参考例句：

• They succeed in differentiating the most commodity-like products. 在最通用的日用产品方面，它们也能独树一帜标新立异。
• The simplest and most effective method of differentiating areas is to use different colours. 区别面状要素最简单而又行之有效的办法，是使用不同的颜色。

13 stigma   

n.耻辱，污名；(花的)柱头

参考例句：

• Being an unmarried mother used to carry a social stigma.做未婚母亲在社会上曾是不光彩的事。
• The stigma of losing weighed heavily on the team.失败的耻辱让整个队伍压力沉重。

14 disorder   

n.紊乱，混乱；骚动，骚乱；疾病，失调

参考例句：

• When returning back,he discovered the room to be in disorder.回家后，他发现屋子里乱七八糟。
• It contained a vast number of letters in great disorder.里面七零八落地装着许多信件。

15 prosper   

v.成功，兴隆，昌盛；使成功，使昌隆，繁荣

参考例句：

• With her at the wheel,the company began to prosper.有了她当主管，公司开始兴旺起来。
• It is my earnest wish that this company will continue to prosper.我真诚希望这家公司会继续兴旺发达。

16 protocols   

n.礼仪( protocol的名词复数 )；（外交条约的）草案；（数据传递的）协议；科学实验报告（或计划）

参考例句：

• There are also protocols on the testing of nuclear weapons. 也有关于核武器试验的协议。 来自辞典例句
• Hardware components and software design of network transport protocols are separately introduced. 介绍系统硬件组成及网络传输协议的软件设计。 来自互联网

17 robust   

adj.强壮的，强健的，粗野的，需要体力的，浓的

参考例句：

• She is too tall and robust.她个子太高，身体太壮。
• China wants to keep growth robust to reduce poverty and avoid job losses,AP commented.美联社评论道，中国希望保持经济强势增长，以减少贫困和失业状况。

18 nascent   

adj.初生的，发生中的

参考例句：

• That slim book showed the Chinese intelligentsia and the nascent working class.那本小册子讲述了中国的知识界和新兴的工人阶级。
• Despite a nascent democracy movement,there's little traction for direct suffrage.尽管有过一次新生的民主运动，但几乎不会带来直接选举。

19 physically   

adj.物质上，体格上，身体上，按自然规律

参考例句：

• He was out of sorts physically,as well as disordered mentally.他浑身不舒服，心绪也很乱。
• Every time I think about it I feel physically sick.一想起那件事我就感到极恶心。