DR. PANTALON: Hi Mr. Davis, I’m Dr. Pantalon.

MR. DAVIS: Yeah, look, I need to get out of here. This is ridiculous. I fell asleep in the park and now I’m here. I did not need the Narcan, all right? I just don’t understand why I’m here?

DR. PANTALON: Oh, this is one big surprise to you?

MR. DAVIS: Exactly!

DR. PANTALON: Yeah, no it must be scary waking up, being in an ambulance.

MR. DAVIS: Yeah. Damn straight!

DR. PANTALON: Okay, well let’s say if we can take care of you here as quickly as possible. Would that be okay?

MR. DAVIS: Yeah fine, let’s just hurry it up, okay?

DR. PANTALON: All right, do you mind if we talk about your use of heroin for a few minutes?

MR. DAVIS: Oh, here we go. Yeah fine, you know, if it’ll get me out of here quicker.

DR. PANTALON: I appreciate that. No, I do. But tell me, what happened tonight? Why do you think people were…

MR. DAVIS: Look, I used some heroin, okay?

DR. PANTALON: Anything different? Why do you think people were worried about you?

MR. DAVIS: I don't know. How am I supposed to know?

DR. PANTALON: Okay, well apparently they were unable to wake you. They thought you had stopped breathing.

MR. DAVIS: I took some other stuff, like some Xanax and some stuff a friend had. I don't know.

DR. PANTALON: Well, well that may have been it. Did you use the same amount of heroin you usually do?

MR. DAVIS: Look, I know what I’m doing, okay. I’ve been doing this for a while.

DR. PANTALON: Well, I mean but these days no one really knows what they’re buying off the street, and when you’re combining heroin with other sedatives like Valium, Xanax, Klonopin, you greatly increase the risk of your—of overdosing. I mean, you know, that they both affect your breathing.

MR. DAVIS: Look, I know that I am an addict, all right. What do you want? I just need to get my stuff, all right. Everyone’s got to die of something.

DR. PANTALON: Okay. Well, and it does look like you’re afraid that that one thing will eventually be your addiction. Now, we have treatments for this.

MR. DAVIS: What, you mean like that methadone stuff? You know, I’ve had friends that have taken that and it makes them feel worse, and I know that it rots your teeth.

DR. PANTALON: No, methadone does not rot your teeth, that’s a myth, but you are right, we’re talking about appropriate medications for the treatment of addiction, like methadone, buprenorphine, commonly known as Suboxone. They help many people. They’re highly effective, they help people get on with their lives, get jobs, have productive relationships.

MR. DAVIS: Yeah okay, well you know, I do have the job. I take care of the apartment buildings near here, and I do just fine.

DR. PANTALON: Well that’s great, it’s good to know that you function well when you get there, if you get there, but frankly I’m worried you may have another overdose.

MR. DAVIS: And I’m telling you I am an addict; I do not care.

DR. PANTALON: Well let, let me tell you something. I don't—for myself, I don't even use words like addict. I think they’re stigmatizing and harmful. You have an addiction, or more accurately, an opioid use disorder. You didn’t create it, you didn’t bring it on yourself, but you do play a big role in changing it if you want. But that’s totally up to you. I can’t force you.

MR. DAVIS: Yeah, well I wish there were more people in the world that felt that way. You know, I just feel like I’ve been trying to get myself out of this hole forever.

DR. PANTALON: I’m sorry. I get that. But it sounds like you’re saying people just don’t understand what you’re struggling with, and that you can’t manage it alone.

MR. DAVIS: Yeah. Sometimes, like today.

DR. PANTALON: Okay. Well, how ready might you be to make any change in your drug use?

MR. DAVIS: What do you mean?

DR. PANTALONE: Well, for example, not using sedatives if you choose to use heroin?

MR. DAVIS: Yeah, I guess I could do that.

DR. PANTALON: All right, so it’s good to know that’s possible, I appreciate that, but why would you want to do that? How would that—what would be in it for you to take the sedatives out of the picture?

MR. DAVIS: Well, I don't want to go through this again.

DR. PANTALON: Okay. All right, that’s good. So, you don’t want to die. You have an addiction, you’re acknowledging that, you plan perhaps to continue using heroin, but you know you have to change how you use it.

MR. DAVIS: Yeah, I guess you’re right. Now really I’d like to get going.

DR. PANTALON: Okay, I can’t stop you from doing that, but we’ll get you some phone numbers, okay? So, if you want to continue this kind of conversation with someone else, another counselor, you’ll be able to do that, okay? And we’ll also have the nurse come in with a naloxone kit for you so you can reverse if you have another overdose, and she’ll give you some instructions with that.

MR. DAVIS: Okay, but what could is that going to do me when I’m the one in trouble?

DR. PANTALON: Well, if you’re alone, you’re right, it may not help, but we tell everyone if you’re going to choose to use again, the worst thing you can do is use alone. So, use with others, let them know you have the kit on you, and who knows, you may need to use it on them, or they might use it on you.

MR. DAVIS: Okay, thanks. I got it. Now really, I need to go or I will lose my job.

DR. PANTALON: Okay. We understand. The nurse is here, she’ll give you those instructions, and remember you can always come back here. Thank you for your time.

MR. DAVIS: Okay, thank you.

Casey: Hi Mr. Davis, my name’s Casey, I’m the nurse. I’m going to go over your naloxone kit, okay?

MR. DAVIS: All right.

Casey: All right.