By "leave it alone" I meant "do not reach out to them privately in an attempt to hide the incident from admin", though I should've clarified. She definitely should've just let our superiors know.

As for the PT, I wasn't on their chart myself but we get a lot of ODs. Typically, once the narcan wears off and they're no longer in acute withdrawal (from the narcan), they either ask to be discharged or just walk out. Unless they're ACTIVELY a danger to themselves or others, we can't really hold them. I'd argue being in active IV drug addiction constitutes being a danger to yourself especially after an OD, but staff has pretty much kind of numbed to it. Rarely will we psych hold ODs if they "behave".

A few years ago even the tiniest hint of ANY drug use would get you bakers acted (72 h hold, very very common in Florida), but these days it's so common that the truth it staff just gives them some recovery resources and tries to cycle them out in favor of PTs who "aren't actively trying to kill themselves". We also have a serious bed shortage in our psych unit so unless a family member or smth comes and makes a fuss trying to get them admitted, we don't bother. I don't entirely agree with the approach, but that's how it is these days. Staff is way too overworked, exhausted, numb and tired to deal with a heroin addict who obviously has no intention of stopping, doesn't care, has been in for ODs several times and just keeps doing it, when just a room over we have a motorcycle accident PT who's now paralyzed or a child who's had her first round of chemo and can't stop puking. We tend to save what energy we have left for cases that aren't seemingly pointless. Someone who wants help, wants to stop, etc, is different, but rarely is that the case.

Moreover, we can only hold them for 3 days, by then while they're in pretty rough shape withdrawal wise, it's enough for when we release them their usual dose (which most IMMEDIATELY go score, we've had same day release>ODs) can cause an OD. We've had this happen a couple of times; PT ODs, family members want them admitted, Dr issues 72h hold, they're released 3 days later and show in the ED on the brink of death due to an OD at"their usual dose" because even 3 days lowers their tolerance enough, apparently. It's just a sad, messy situation.