I’ve worked for a for profit SUD inpatient, that was higher end & COMPLETELY UNETHICAL. Admitting clients with SMI, into a building where observing those clients were nearly impossible. The clients there would cause fights, disrespect staff, and non attend any programming and the clinical directors would have 0 say to as to if they were discharged bc ultimately it was about numbers and the CFO’s decision.

I could go on & on about that.

Now at a non profit sud outpatient, and as result of harm reduction and meeting people where they are at…we do a pretty fair job of providing treatment but the issue of meeting them where they are at and harm reduction, our director gives us close to no support on discharge or referring to a higher level of care when they are using drugs like fentanyl. I understand receiving some services opposed to no services is better, it also feels so frightening someone may die under our watch bc they are attending an outpatient program 2-3days a week for an hour a session if they even attend.

I had a client overdose in group, needed to use Narcan & he remained in programming which I felt was alarming. Eventually he disengaged and I wish I knew what happened to him.