Refusing to be put off by an abrasive welcome and remembering we are guests in their home.
Fred punches every button with the nurses and outreach doctors. He has a history of extreme abuse and unattractive survival skills. Rude and unappreciative and often seems to deliberately punch buttons. Borderline personality behavior. No please/thank you. A demand not a question. Always someone else's fault. The system is wrong no matter what.
You don't have to like the patient but they have a right to access to care. You must make it possible for him to have access to care. Remember, there is usually no support from family or friends to take over. You can say "He can get out for his drugs so he can go to the pharmacy." But access to his drugs is just ensuring his basic survival and staving off withdrawal. Going to pharmacy each day to get prophynal and pain medications is not part of survival. It ignores the reality of addiction. He does not care enough about himself to get these medications.