A plea to the future of medicine

[bigbassinbob]

Today, my friend was arrested for the sixth time in relation to a drug overdose and subsequent illegal actions. I got a phone call from him at the prison, asking me to bail him out again. This time, I couldn't afford the $375 bail bond, and even if I could I don't think I would have paid it. My friend has destroyed his life. The drugs he has consumed have ruined him. Talking to him is like talking to a zombie; there is neither emotion nor personality in his voice or in his head anymore. He is gone. And what kills me is that the drugs that have stolen my friend from me are all completely, 100% legal. Klonopins, Xanax, Perkeset, you name it, he was prescribed it. By a doctor. By several doctors. By the very people who should have been there to help him, not help him ruin his life. Every visit to a new psychiatrist, he was given a new "medicine," destroying a different part of him each time. It depresses me when I think back on all the things we went through together. Elementary school, middle school, high school, and the better part of college are memories I will always have, but it is such a shame that we couldn't have continued our friendship into adulthood.

This story is sad, but it is not as sad as the bigger picture. This is not an uncommon phenomenon. I've met countless individuals who have thrown their lives away in favor of a 24/7 prescription drug binge. And to those of you who say that it was these people's own faults for abusing their medications, you are right. It was their own fault -- the first time. The second, third, fourth time, it was their physicians' faults. When these addicts went back to their doctors for advice or help, all they were given was more medication. The situations these people are in are analagous to a doctor offering a drink to an alcoholic as soon as he finishes his 12-step program. It sickens me. Physicians just don't know what to do with all the medications they are allowed to prescribe. In my opinion, their power to prescribe is far too great. How can a single person know how 10 drugs mixed together are going to interact with each other, when there are thousands of prescribable drugs? He can't. Nobody can.

What I ask of those who decide to read through this is that you all remember the level of responsibility you carry as a physician, and use your heads when prescribing drugs to your patients. If your patient comes to you and asks specifically for an addictive painkiller, look a little deeper into the situation. Do a background check, or check previous physician references to find out what is going on. I know this may seem like common sense, but I guess we all get a little carried away with routine or time constraints sometimes. As medical science advances, this problem will become more widespread with the additional power to prescribe more an more drugs. So PLEASE, remember that we chose this occupation to help people, and to do that it requires a little extra effort sometimes. Thanks for reading.

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[dopaminophile]

Today, my friend was arrested for the sixth time in relation to a drug overdose and subsequent illegal actions. I got a phone call from him at the prison, asking me to bail him out again. This time, I couldn't afford the $375 bail bond, and even if I could I don't think I would have paid it. My friend has destroyed his life. The drugs he has consumed have ruined him. Talking to him is like talking to a zombie; there is neither emotion nor personality in his voice or in his head anymore. He is gone. And what kills me is that the drugs that have stolen my friend from me are all completely, 100% legal. Klonopins, Xanax, Perkeset, you name it, he was prescribed it. By a doctor. By several doctors. By the very people who should have been there to help him, not help him ruin his life. Every visit to a new psychiatrist, he was given a new "medicine," destroying a different part of him each time. It depresses me when I think back on all the things we went through together. Elementary school, middle school, high school, and the better part of college are memories I will always have, but it is such a shame that we couldn't have continued our friendship into adulthood.

This story is sad, but it is not as sad as the bigger picture. This is not an uncommon phenomenon. I've met countless individuals who have thrown their lives away in favor of a 24/7 prescription drug binge. And to those of you who say that it was these people's own faults for abusing their medications, you are right. It was their own fault -- the first time. The second, third, fourth time, it was their physicians' faults. When these addicts went back to their doctors for advice or help, all they were given was more medication. The situations these people are in are analagous to a doctor offering a drink to an alcoholic as soon as he finishes his 12-step program. It sickens me. Physicians just don't know what to do with all the medications they are allowed to prescribe. In my opinion, their power to prescribe is far too great. How can a single person know how 10 drugs mixed together are going to interact with each other, when there are thousands of prescribable drugs? He can't. Nobody can.

What I ask of those who decide to read through this is that you all remember the level of responsibility you carry as a physician, and use your heads when prescribing drugs to your patients. If your patient comes to you and asks specifically for an addictive painkiller, look a little deeper into the situation. Do a background check, or check previous physician references to find out what is going on. I know this may seem like common sense, but I guess we all get a little carried away with routine or time constraints sometimes. As medical science advances, this problem will become more widespread with the additional power to prescribe more an more drugs. So PLEASE, remember that we chose this occupation to help people, and to do that it requires a little extra effort sometimes. Thanks for reading.

First, I'm sorry to hear about your friend. I know what it's like watching friends/family members destroy themselves.

Secondly, and more to the point of your post, I think that doctors now are far more aware of seekers than they were in the past. Prescribing morphine to tide over heroine addictis until they got into a clinic was common practice just a few decades ago. Now, most physicians' red flags go up if someone comes in and asks for a specific addictive drug (benzos, narcotics, etc...) especially if that person is a new patient. The FDA specifically targets physicians with unusually liberal prescribing practices because the law states that the prescription must be objective and beneficial. Notably, there are physicians in jail for prescribing narcotics and benzos on demand. If you feel that your friend's physicians are acting irresponsibly or illegally, this would be a situation to contact the FDA or your state's medical licensing board.

On the point that physicians' prescribing practices are too broad, I don't agree with this. There are many privelages that physicians and surgeons are given that can be used far outside of the bounds of knowledge and ethical practice. Federal regulations and states' boards are in existance to ensure that this doesn't happen and I think they do a reasonably good job. Those that are grossly negligent (as well as countless that aren't) will inevitably be picked up by our worthless litigators.

In reality, drug interactions are usually very well known. Those that aren't are picked up on very quickly. While there are hundreds (or thousands) of different medications out there, there are relatively few classes of medications and the interactions between them are predictable. Furthermore, computers make highly specific interaction checks very easy.

Your point is valid, that many docs are pill-pushers. I understand how that often seems the case. However, I think that it's still by far the exception rather than the rule. Most doctors are responsible, intelligent people.

All the best to you and your friend.

-dope-

 

[GuyLaroche]

-dope-

Very interesting sign-out given the topic at hand.

 

[dopaminophile]

Very interesting sign-out given the topic at hand.

haha... true... didn't even think about it.

 

[45408]

It's a difficult situation, because you can walk into an ER and tell them that you've got pain in your <blank> that is exacerbated by <blank> and started acting up when you did <blank> and got worse after eating <blank>. You deny any prescription medications and haven't been to this ER in the past year. So, the doctor gives you a pain killer.

Of course, you were just at the ER down the street and gave them the same pitch, but their computers aren't linked together, or maybe you hadn't had the prescription filled yet, so it's not in the system anyways. Your next stop is the ER ten minutes from there.

Who could prevent that? Are some doctors Rx-happy? For sure. Can you easily manipulate the system? Yep.

 

[dopaminophile]

It's a difficult situation, because you can walk into an ER and tell them that you've got pain in your <blank> that is exacerbated by <blank> and started acting up when you did <blank> and got worse after eating <blank>. You deny any prescription medications and haven't been to this ER in the past year. So, the doctor gives you a pain killer.

Of course, you were just at the ER down the street and gave them the same pitch, but their computers aren't linked together, or maybe you hadn't had the prescription filled yet, so it's not in the system anyways. Your next stop is the ER ten minutes from there.

Who could prevent that? Are some doctors Rx-happy? For sure. Can you easily manipulate the system? Yep.

But it's not going to last very long. Sure, if you live in NYC you can do this maybe 10-15 times. Then, when you're totally addicted, you're in the systems as a seeker. You probably don't have any money left by then either so you can't move to a different city. Doctor's aren't dumb and they've been dealing with seekers for years. I imagine that it's significantly harder to perpetuate an addiction like that without either a whole lot of cash or some other source of the drugs.

 

[beanbean]

Drug addiction is a disease and the decision to accept the diagnosis and treatment lies with the addict. An addict, sick as they are, is still responsible for his or her own actions. The vast majority of doctors do not push addictive medications on their patients. The addict patient is the one seeking these medications as a result of their illness. In addition, medications such as benzos and narcotics can be very beneficial to patients who need them and use them correctly.

Manipulation and denial are unfortunately part of the disease of addiction and part of recovery is taking responsibility for your own actions. It is a tough road, but many addicts do find recovery. I hope your friend is one of them.

I am sorry your friend has been so devastated by his addiction. I urge you to contact al-anon or NA to learn how to best support (but not enable) him.