Here You Go, Honey
A government study has revealed that more than 70 percent of people who abuse prescription pain relievers obtain the drugs from friends or relatives. And here is the amazing part – usually it is given to them for free and with permission! The study also showed that about 2 percent of the U.S. population age 12 and older has abused a prescription pain killer within the past 30 days. The bottom line is that once the “pill mills” get shut down, and hopefully the feds will accomplish that, the next source is us regular docs. We need to stop liberally throwing pain pills at everything. The idiot experts who kept screaming that we weren’t doing our patients right because we weren’t controlling their pain were WRONG! Those ivory tower morons have run away and are hiding as we deal with the mess they left us. Now, we need to shut the narcotic train down. This study is for real. I can’t tell you how many times I have caught elderly patients trying to get narcs; not for themselves but because they want to help out a family member. It is sad but when it comes to prescription pain meds we must trust no one.
Despite the warning labels and Pharmacist’s instructions, some of our patients “fail” urine drug screens after using family member’s controlled medications. As the collection site and the MRO, we have no other recourse than to report the result as “positive”.
One unfortunate individual was terminated (with 15 years on the job)after his wife gave him a several doses of his daughter’s codiene-containing cough suppressant. Upon returning to work after a three day illness / absence, this middle aged man was required to have a Return to Work” drug screen. The employer had a “zero-tolerance” policy and he was given no “second chance”. We were informed that he was rehired about 30 days later, however, with loss of seniority in his position.
Ironically, many of those who fail one urine or hair drug screen, often return to our Occupational Medicine practice for post-job offer upon request of another of our many corporate clients. Of course, they often expect different results or are surprised to see the same clinic staff member consucting the collection.
Ron “Tater Salad” White was spot on when he quipped, “Ya just fix ‘stupid'”.
I mean to quote: “Ya just CAN’T fix stupid”. Guess I proved my point. (Can you fix me, Dr Doug?)
Doug, you are right on with this one.
I have been trying to tell patients and colleagues for years that this narcotic thing started with big pharma creating “pain societies” and “CME” that made physicians feel guilty if they did not give out narcs and benzos to everyone. As I have said so many times before, doctors are sheep and the big corporations continue to run the show as they always have.
Now here is another thing that I have been saying for years, and as usual, the sheep will not listen to me.
Stop using so many steoids! As primary physicians this is always right under our nose! We see the patient who got just a little steroid injection from the otho just for the rotator cuff, and then just for for the knee etc, and from the derm for just about any rash, and from the allergist for allergies and asthma, and from the rheum for whatever, and it goes on and on . And then our patients get cataracts and are overweight and get diabetes, and have all sorts of psychiatric symptoms and their joints fall apart etc etc and we keep sitting in our big fat chairs on our big fat butts writing out big fat prescriptions the entire day. Is this what you envisioned being a doctor was all about? No wonder the recent survey showed that almost half of physicians would choose another profession if they could go back.
FYI: The Drug Enforcement Administration (www.justice.gov/dea)has been conducting its annual “Prescription Drug Take Back Day” at Federal Agencies in the Washington, DC, area. A total of 845 lbs has been collected (to date). Following is the breakdown, by Agency (and, YES, I have already heard all the jokes about us Federal Staff Members having to give up our beloved tranquilizers):
RESULTS
1. Dept. of Health and Human Services: 1101 Wootton Parkway = 23 lbs.
2. Dept. of Health and Human Services: Tower Bldg = 14 lbs.
3. Dept. of Justice: Pennsylvania Ave. = 8 lbs.
4. Dept. of Transportation: New Jersey Ave. = 45 lbs.
5. Dept. of Transportation: FAA HQ = 19 lbs
6. DEA: Army-Navy Dr. = 54 lbs.
7. Food and Drug Administration = 120 lbs.
8. ONDCP = 4 lbs.
9. Office of Personnel Management = 9 lbs.
10.SAMHSA: Choke Cherry Rd. = 12 lbs.
11.Health Resources & Services Administration = 31 lbs.lbs.
12.National Institute of Health: Rockville offices = 44 lbs.
13.National Institute of Health: Bethesda Campus = 104 lbs.
14.Environmental Protection Agency = 73 lbs.
15.Centers for Medicare & Medicaid – Baltmore = 28 lbs.
16.DEA Organized Crime Drug Enforcement Task (OCDETF) = 22 lbs.
17.Pension Benefit Guaranty Corp.(see http://www.pbgc.gov/)= 14 lbs.
18.Court Services & Offender Supervision Agency for DC = 3 lbs.
19.DOJ/Exec. Office U.S. Attorneys (www.justice.gov/usao/eousa)=8lbs 20.HHS-Agency for Healthcare Research&Quality(www.ahrq.gov)=39lbs
21.National Endowment for the Arts = 8 lbs
22.United States Secret Service = 6 lbs.
23.Treasury Inspector General for Tax Admin. = 3 lbs.
24.Department of Interior = 25 lbs
25.DEA Washington Division Office = 4 lbs.
26.DEA Baltimore District Office = 12 lbs.
27.National Institute of Drug Abuse – Baltimore = 7 lbs
28.Adelphi Lab (US Army) = 6 lbs.
Total = 845 lbs.
Hey Phil, here’s some real capitalism for you: I say repeal ALL drug laws with respect to consenting adults, let docs prescribe or not as they see fit without fear of reprisal, and let’s give some of the consequences back to patients based on their choices. Doctor-shopping is a sad consequence of many things, but certainly not capitalism.
I’ve been using our state’s controlled substances reporting system religiously, and it is truely remarkable how peeps get all kinds of narcotics, benzos and amphetamines with out letting us know they did!
Thanks to our capitalistic approach to medicine, doctor shopping is a national pastime!
Ten years ago: “Doctors are Under-treating Pain”
Today: “Doctors are Prescribing Too Many Pain Medicines”
Make up your mind. Do you want too little or too much?
I agree that there is a huge problem with over-prescribing narcotics, but don’t agree that we should throw the “treat pain like it really exists” baby under the bus. There are many approaches to treating pain that don’t involve narcotics, from physical therapy to therapeutic massage to physiatry to biofeedback…..etc. Unfortunately, as a sufferer from chronic pain from bursitis and tendonitis, I find that each specialist has their own bag of tricks and is pretty unwilling to work with me to find the right treatment. I think that’s when they default to narcotics. I’ve had to do research on my own to find exercises that help…sort of.