Friday night I spent two hours on a patient who not only attempted to overdose on Xanax and gabapentin, but also required Narcan for heroin intoxication, which the ED missed. While it's easy for me to say...uh, you actually believed her when she said she hadn't used in months? there's so much going on in the ED and the patient wasn't obtunded until I was called that I can easily understand why they missed it. Now, having said that, the patient's spouse said that she had used heroin yesterday, so the key here is that drug users lie and collateral is key--SHOCK AND AWE!! After having her opioid reversed, only then did the patient admit to snorting a bag of heroin. Still, she lied because her UDS showed cocaine and marijuana, which she had denied. So all-in-all, a very time consuming but simple consult.