Like most ED’s we see a lot of people who have spent a life time on drugs or alcohol. Most of the time you kinda just shrug your shoulder’s at them, you know there isn’t much you can do to help their addiction, until they are ready to receive it. What does get me though, is when they are young. I had this 21 year old girl the other night, who was probably in deeper than anyone I had seen before. Heroin and crack were her drugs of choice. She had been brought in from a detention center after being arrested that morning and having a seizure in custody. She just had that look, you could tell that nothing mattered except her next fix. She had already been diagnosed with endocarditis earlier last month, but left the hospital AMA. She had a badly broken ulna, where she had been beaten with a 2×4 the week previous, and had just been walking around with the fracture. She was covered in dirt, but well dressed comparatively, giving the sense that once up on a time this was a young person with potential. But now she was covered in track marks all over her body, not just on her arms. You know you are skilled at injecting when you have track marks in your neck. She had no ID, no money, no nothing, so I could only imagine what she did to score her dope. All she wanted was pain meds, she didn’t care that she had a seizure or what may or may not be broken. We told her she couldn’t have any narcotics, at least until we got her a head CT. So when no one was looking she slipped out the door and back onto the street, broken arm hanging to one side, in search of a scratch for her itch.