As an ER doc, the POS drug seekers have NO interest - ZERO - in quitting. I had one patient over the weekend to whom I said I'd write for some Tramadol ER. She said, "Why don't you just give me 20 of what I always get? I've never taken that. I don't know what will happen." I said that there was a time when she'd never had Tramadol, and she didn't know what would happen. I told her that she was lucky she was getting anything, and, for bargaining, I should just discharge her. She said, "I'm not bargaining" (less than 1 minute after saying "Just give me 20").
She goes to the two pharmacies right next door to the hospital. One pharmacist calls and says that the Rx is not covered - and she's complaining about this! Hand, gift horse, bite, etc.
But wait - there's more! Even though I told her that I would not write for anything else, she came back - immediately. Signed in, and told the nurse that she just needed "a two minute conversation". He told her that, no, it would be MUCH longer than that, and that nothing would change. Moreover, I had to see another patient ahead of her.
Because of this, she left again.
She probably came back the next day. I work tomorrow, and I'll check then.
I, for one, want NO part in buprenorphine. ZERO, nada, do not want.