Getting Painkillers to Those Who Need It and Away From Those Who Don’t
ScienceDaily recently did an article called Doctor’s Offices Can Help Stem Abuse Of Oxycontin, Other Narcotic Painkillers, summarized as, “a new study shows how doctor’s offices and clinics can identify patients who may be diverting or misusing narcotic painkillers such as OxyContin, and steer them to help, while preserving access to the drugs for patients who truly need them to control their pain.”
To me, this sounds like a really nice dream with a ton of potential for failure, lawsuits and a growing mistrust between doctors and patients. Doctors don’t want to go to jail for unwittingly helping someone sell their medication or abuse their prescriptions. On the other hand, people need to manage their pain and for every person who misuses the drugs they are prescribed, there is another one who has a legitimate need for the painkillers and still others who aren’t getting a dose high enough or a medication strong enough to handle their pain.
Do what did they come up with to better police the prescription drug situation? A “policy that logged and carefully screened all patients who were receiving the drugs for non-cancer pain,” as well as a contract of sorts between prescribing doctors and opioid painkiller receiving patients that both are required to sign. The study showed that 35 percent of the 167 patients that received opiates either turned in dirty drug tests that revealed the use of illegal street drugs or turned up on state prescription records showing that they were receiving multiple opiate prescriptions from various doctors simultaneously. Recipients of OxyContin or oxycodone were twice as likely to abuse their prescription as recipients of other opiate drugs.
The study author is Jennifer Meddings, MD. She says, “Many of us in the clinic were surprised at what we found, because a doctor’s job is first and foremost to trust the patient as they tell us about their pain, but in order to confront this issue and protect our ability to prescribe these drugs to the patients who truly need them, we need to have a uniform approach for all patients.”
If they can come up with a way to effectively help those who are abusing pain medication rather than simply turning them away, belittling them or reprimanding them, then this could be the beginning of something great. The threat of abuse from patients who are drug-seeking as well as legal repercussions for the prescription abuse of their patients are turning many young would-be doctors away from a field that is already severely lacking in qualified professionals. However, strict regulations can turn those who are legitimately in need of pain management to illegal sources for their medication, which only increases harm.
I don’t envy the position that the medical community is in. Anyone have any ideas on how to handle this problem?
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April 18th, 2008 at 8:59 pm
A doctor in Georgia is drug testing her patients. If she gives them a prescription and then they drug test is clean she knows they are selling the painkillers. She seems to keep a tight control on the prescriptions she writes. Helping those that are abusing may start with a prescription monitoring system that may force those that are into treatment. Hopefully the majority won’t commit crimes to get their pill.
April 18th, 2008 at 9:53 pm
That’s an interesting approach. But what if they’re taking some of the pills and selling the rest? And if you’re getting multiple prescriptions, you’re going to test positive for sure. The problems are endless. I definitely do not envy them their job of policing people. It’s not only irritating but it makes you mistrust everyone, which is why so many who really need the painkillers are complaining about being treated so badly.Let’s hope they come up with something soon because the system is definitely broken.
April 22nd, 2008 at 12:05 pm
Every patient should have a card that they have to have in order to fill any pain medicines and any other controlled substances and the card will have their pain medicine history on it, this would prevent doctor or pharmacy jumping. The prescription would not be filled without this card. I have three young children and it scares me to death how easy it is for kids to buy drugs. My oldest is in highschool and he told me that there are kids getting busted all the time at school for having drugs. Something has to be done to stop this!
April 22nd, 2008 at 2:10 pm
That’s an interesting idea, Lavonna. The problem is, of course, fake cards, but I’ve seen it work in California for those who are medical marijuana. It’s a picture ID. Take this and computerize it the way you suggest to show narcotic pain management history and we might just have a winner.
April 22nd, 2008 at 9:24 pm
If you put something in the card like is done with currencies you could avoid counterfeits. Good idea Lavonna
May 7th, 2008 at 10:46 pm
Encourage your patients to take advantage of the resources a good pharmacist/pharmacy can afford them. Get to know your pharmacist and staff. Patronize one pharmacy for all of your prescriptions and those of your entire family as well. Make the pharmacist aware, in advance if at all possible, of ANY CHANGES that are made to your prescription including drug, dosage form, strength, directions for use, newly discovered drug allergies or sensitivities, newly diagnosed disease states, or any changes in the health care professional that is treating you. Realize that your pharmacist can best serve you when he is adequately informed of your situation. Anticipate and make plans for any circumstances that may impact the routine delivery of pharmacy services. Help your pharmacy help you. They will appreciate your hard work!
May 27th, 2008 at 1:10 am
There are many thing the physicians can do to protect themselves from drug addicts. First off, people in chronic pain that take opiode medication are not necessarily addicted. Many studies show that people that finally get a diagnosis and can be weaned off or down off of opiodes, only about 3%, give or take, will be pshycologically or physically addicted. It is a very low number. Also, the side-effects are so harmless compared to medications that are synthetic, like the two stomach mediciations that were taken off of the market for killing many people. I do not want to say thier names. They were used a lot because so many, many people are afraid to take something natural. They believe it is dope, as my father-in-law State Police officer calls it, or they are afraid they will get addicted. The chances of addiction are so small IF you are truly in chronic pain. What the opiodes do that all other synthetic meds do not do, (synthetic meds are addictive also and for all I know more so). What oxycontin or oxycodone (with no percocet) does, is replace our natural endorphins that our own bodies make to kill pain. When our body has chronic pain, (over 6 months)cannot make enough endorphins, then we needs something to help make them. That is how oxycontin works. It is taken up by the dorsal hone of the spine and the body uses it to do a wonderful job at killing pain. Better than any other drug. Why do you think God put poppy flowers on this earth? That’s right, opiodes. There are two side-effects that can be managed. 1. constipation-take miralax or lactulose and you are good to go. 2. Drowsiness that should go away after your body is used to the medication. If you are not taking too much, the drowsiness, not a high, drowsiness,will go away if you even get it.The only people that i know have been drowsy were taking way too much. I take 320mg of Oxycontin, 3 times a day. I take IR oxycontin in between for breakthru pain and I also use the Duragesic patch - 2- 100mcg patches every 3 days. I plan on stopping the Duragesic patches and I am going to trade them for a rescue dose of some opiod medication. If you saw me, you would never know that I take 320mg of oxycontin, not 20mg, not 40, but close to 1,000mg a day. Plus the break thru meds also.I am coherant, do not slur my words, have a witty mind and a great memory.
Physicians can avoid being scared by doing things that have already been mentioned. Drug test the patients, have them sign a contract and both the patient and physician have to trust each other, have the patient sign a contract,(I do not know why the physician does not have to sign a contract stating as long as the person is not abusing the meds, they have to continue to prescribe them. But there is no such contract as of now). All of the rules are to protect the physician and there are no laws at all about prescribing pain meicine that protect the patient or the physian. The advocacy groups need to get more people on-board to get some laws passed. The DEA tells the physicians that are prescribing opiodes that they have their blessing if it is done correctly, but the DEA stalks physicians and ends up busting them when just one, only onem patient is very good at pulling the wool over their eyes. The physician needs to take continuing education classes because pain management is a the new frontier, they need to drug test patients, count their medications,they also need to find cheaper health insurance (I heard it costs the pharmacies, $25,000.00 a month for insurance and a physician even more!), they physician needs to communicate with the patient, they need to ask the patient what their pain levels are when they come in the office and most importantly, the physicians need to keep excellent records of everything that happens and everything that the patient reports to them. If they do these thing I do not see what they should be afraid of. The only problem is that people in chronic pain take a while during an office visit.I was told by an attorney for a physician that a physician is alotted about 7 to 15 minutes per patient. I cannot see me getting my scripts written in that amount of time and being able to tell the physician what has been happening. That is not going to work. The insurance company and attorneys are all down their throats about getting the patient in and getting them out. That is all that they care about. Most of the physicians just do not want to do the extra work that would keep the physician out of the DEA’s microscope because it is easier to do runny noses instead and make more money. I have been in chronic pain for 10 years and have suffered tremendously. Someone has to change the way it is and make some real laws that protect the patient.
May 30th, 2008 at 2:22 pm
One thing everyone speaking here has to realize…that is, that “addicts” will go to crazy lengths to breach the system, whether it’s medical credit cards, doctor’s “keeping a better eye on their patients”, or whatever, they will always be fighting with one foot in a bucket.
Just like the billions of dollars poured in to anti-drug campaigns.
I am a former addict, and I believe that drugs are at the core of most crimes/violent crimes in the world.
But I hope parents who read this, if you find that your child has become addicted to a drug, letting them know that you’re there for them is sometimes the only hope some of us have.
There were so many times that my Dad could easily have sent me out of the house (w/ no where to go), but where would I be today?
I’m a successful 26 year-old business rep., and father, whom is able to LIVE.
In the end, sticking it out, no matter how bad it may seem, is the only way.
B/C, my focus in life, especially as I grow old, is to take over my parent’s company and let them enjoy life as a way of saying “Thank you” for sticking it out for so long with me…
So any parent’s reading, just realize you’re child being addicted to drugs is not something they planned on, and is very embarassing to talk about. The more you are at ease when they tell you, or you find out; the more they will be willing to let you know what is going on in their lives…
May 30th, 2008 at 9:06 pm
Chris i think your point about getting the help you needed is important for people to understand. Sometimes it takes more then one, two or three tries. Your lucky your parents are so understanding. But i am sure they are proud of the fact you turned things around.