A self-described “perpetual student,” Kelsey Priest has spent years focused on addiction issues throughout her master’s in public health and Ph.D. studies. With her medical degree soon in hand, she’s now preparing for a psychiatry residency,
She’ll become part of a new wave of addiction doctors willing to throw out the rulebook and use a by-nearly-any-means-necessary approach to save lives. To Priest, that means giving patients a say in their own care, and making sure they don’t have to jump through hoops to access treatment. Much of Priest’s public health research has highlighted the need to employ a simple but rarely used intervention: offering addiction-treatment drugs to patients with opioid use disorder while they’re in the hospital.
“Some of the things I’m talking about, like policy changes and a safe drug supply — a lot of that thinking comes from my public health training, that you wouldn’t necessarily get as an addiction doc.”
Priest’s philosophy, however, also espouses several tactics that she acknowledges might make some doctors squeamish. She’s still inspired by a monthlong research visit to Vancouver, Canada, where she witnessed firsthand two harm-reduction approaches that Americans still don’t have access to: namely, supervised injection facilities and a clinic that prescribes pharmaceutical-grade heroin so that its patients won’t use unregulated drugs tainted with fentanyl or other lethal compounds.
“Some of the things I’m talking about, like policy changes and a safe drug supply — a lot of that thinking comes from my public health training, that you wouldn’t necessarily get as an addiction doc,” she said.
To Priest, addiction is a systemic issue deeply intertwined with structural racism, economic injustice, and decades of policy that has treated drug use as more of a criminal issue than a medical one. Harm reduction and engaging patients in “shared decision-making,” she said, are key elements of a 21st-century addiction doctor’s job. But so are advocating for structural changes and a fundamental shift in how society treats people with addiction.
“The drug supply is contaminated,” Priest said. “As long as we are enacting prohibition-based policies, there will always be this alternative, unsafe, unregulated drug supply that is going to kill people.”
— Lev Facher