Any legitimate reason for prescribing the Holy Trinity?

[SpartanLaser]

I have this MD that gives literally every other patient this combo:
1. percocet or norco 5/325-10/325
2. a benzo
3. soma

Is there really any legitimate medical reason for prescribing this? If they are having muscle pain, why not zanaflex or baclofen?

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[PharmacistReb]

I had one that would write for Xanax, Percocet, and Adderall to essentially every patient. We started turning away all of his cash patients (pay $100 in cash, name your prescription). Eventually, the DEA raided his office and he was out of his mind drunk. He had nighttime hours. Come in the veil of darkness and get fixed up. He also lived in his clinic; it doubled as his love shack.

Rural healthcare baby

 

[Deja]

lol everyone gets this where I used to work, even from big hospitals in the area too

 

[Digsbe]

Haha I didn't know others referred to it as the Holy Trinity either. It seemed many patients were on all 3 of those meds, seemed way more frequent than it should be. Everyone had work related injuries resulting in anxiety, muscle spasms and chronic pain at age 35.

 

[SpartanLaser]

This patient called me requesting her diazepam, clonazepam, and trizolam all be refilled at once because her "work was very stressful". Sigh....

 

[BenJammin]

I call them the triplets.

I had one that would write for Xanax, Percocet, and Adderall to essentially every patient. We started turning away all of his cash patients (pay $100 in cash, name your prescription). Eventually, the DEA raided his office and he was out of his mind drunk. He had nighttime hours. Come in the veil of darkness and get fixed up. He also lived in his clinic; it doubled as his love shack.

Rural healthcare baby

I remember hearing about a doctor like that but in Tulsa. It was a her. She lived in her office and saw patients 24/7. Xanax, Norco, and prometh/codeine. Eventually got busted. There is a good story about a doctor in Oklahoma City who was busted as running a fake pain clinic and had his medical license revoked. He blamed it on racism.

 

[SClENCE]

The fact that he/she always throws in a benzo for good measure it what really makes it questionable, and the fact that it is soma as opposed to zanaflex as you mentioned.

 

[zelman]

I have this MD that gives literally every other patient this combo:
1. percocet or norco 5/325-10/325
2. a benzo
3. soma

Is there really any legitimate medical reason for prescribing this? If they are having muscle pain, why not zanaflex or baclofen?

No.

"The three drugs include: hydrocodone, a narcotic known by brand names like Vicodin; alprazolam, an anti-anxiety drug known as Xanax; and carisoprodol, a muscle relaxant known as Soma.

Dr. C.M. Schade, past president of the Texas Pain Society, says he knows of no legitimate medical reason for a doctor to prescribe all three together."

 

[npage148]

How else do you treat "terribly sad life syndrome"? Or, after I put on my flame suit, fibro,migraines, and/or chronic fatigue?

 

[BearDog]

If I know nothing of/have never seen the Holy Trinity, does it mean I'm bound for the fiery depths?

 

[kevin martin]

This patient called me requesting her diazepam, clonazepam, and trizolam all be refilled at once because her "work was very stressful". Sigh....

lol

 

[BidingMyTime]

I don't know if I work in an unusual area, or maybe I don't work enough retail, but I have never seen this combination. I could maybe see if for short term use (the person needing pain medicine & a muscle relaxer for a physician condition, and needing Xanax PRN until her SSRI kicked in....) But long-term? I'd want to see it prescribed by some big-shot expert, not by a rank & file FP or internist doctor or NP.

 

[marscole]

Often time, chain stores don't feel comfortable to dispense these meds. I saw lots of this combo at independent store. Adderall, Klonopin and Vyvanse too.

 

[SClENCE]

I see Adderall and Xanax paired together more than I'v seen the "holy trinity". It really doesn't make sense as to why someone would be on this.

 

[zelman]

I see Adderall and Xanax paired together more than I'v seen the "holy trinity". It really doesn't make sense as to why someone would be on this.

Yes it does. It gets you high as balls.

 

[DAW2]

sometimes they toss in ibuprofen and a multivitamin

 

[radio frequency]

I see Adderall and Xanax paired together more than I'v seen the "holy trinity". It really doesn't make sense as to why someone would be on this.

I also see this a lot. A psych NP in my town is notorious for questionable prescriptions and she writes for this combination daily, practically...everyone in town has unquestioningly filled her prescriptions forever.

 

[ExpressMaiL]

I have this MD that gives literally every other patient this combo:
1. percocet or norco 5/325-10/325
2. a benzo
3. soma

Is there really any legitimate medical reason for prescribing this? If they are having muscle pain, why not zanaflex or baclofen?

I like taking those with a few shots of scotch after a day of good work.

 

[BidingMyTime]

I like taking those with a few shots of scotch after a day of good work.

I imagine it works even better for you after a bad day of work.

 

[BidingMyTime]

I also see this a lot. A psych NP in my town is notorious for questionable prescriptions and she writes for this combination daily, practically...everyone in town has unquestioningly filled her prescriptions forever.

NP's.....there are some fantastic NP's, my doctor uses NP, an NP even delivered at least a couple of my children. And I have seen wonky things from MD's, but consistently the craziest stuff I see comes from NP's, while DO/MD training seems more standardized, it really seems NP training is all over the board depending on the program they went through.