I know this question is odd, but unfortunately we have a lot of unhoused addicted people in my city. I often see them sitting on a bench bent at the waist in half like a rag doll, or standing somewhere half bent over, like stooped over nodding out I guess? I don’t really know anything about substance use, but it’s such a strange sight, what substances cause them to bend over like this?
Poor souls. The mayors of big cities here have asked the provincial government to declare a state of emergency due to homelessness and addiction being so rampant, but Doug Ford doesn’t give a shit about them.
It’s the fent fold / bent / drop / lean. Most likely fentanyl or carfentanyl, but almost definitely some kind of opiate (of which they’re the most potent). Some of it might be neuromuscular / specifically opiate related but there’s also just the practicality of it. The drug might be cut / mixed with another sedative for potency such as a benzo or barbiturate, but it also might be mixed with with a stimulant such as methamphetamine or cocaine to counteract the sedation.
You’d want to counteract the sedation either to increase enjoyment (similarly to the relaxed buzz of a caffeinated alcoholic beverage) or because they feel too much distress from being sober / unsedated but also know that they’re in an unsafe area to be sedated. Even if it’s not cut with a stimulant they may still be forcing themselves to stay awake either because they know they’ve taken enough that they might stop breathing, or because, as I said, they know they’ll get mugged or otherwise attacked if they relax into the high.
Being homeless / generally in poverty is often too emotionally stressful to tolerate sober, but too unsafe to be navigated zonked, so they just put themselves into a never sleeping but never really awake haze until they either intentionally or unintentionally die or almost die or experience psychosis, in which case they either go to a morgue or to meet up with me on the psych unit.
That sounds like actual hell.
An inability to cope with people who don’t get it and don’t care to is a significant part of my social isolation.
Just because it would be a significant change to the competent you upvoted:
We had a patient who was consistently verbally abusive and otherwise unpleasant during a long stay and completed after discharge and the most emotion I could summon was a melancholic relief that their pain had ended. We did not have the resources they truly needed and neither did anyone else. They were so deep in that despite being cognitively intact they were unable to meaningfully interact with anyone socially.
They would have needed extensive social support and interpersonal skill building to be properly rehabilitated and nobody does that. Most of what we do for that type of patient is to get them sober and give them a second chance to seek help. Even that takes a lot of resources so we don’t really have the resources to do more than point them in the right direction if we can even find a decent place for them to go. Many get sobered up and discharged to the bus stop with a month of pills and directions to a shelter that’s probably at capacity.
That was this person’s only way out and I honestly respect their decision. At this point I’ve contented myself with caring for homeless people who are faking or exaggerating suicidal ideation of psychosis for 3 hots and a cot. Some of them are obvious but ultimately I don’t want to be responsible for deciding who is and who isn’t, and the deeper truth is that I’d probably do it too. And 3 hots and a cot is more and better care than I could give them pretty much anywhere else in this current system.