drug seekers

[pikachu]

they are destroying my faith in humanity (such as it was). lying, playing off one doctor against the others, not wanting to seek actual treatment (such as getting infected teeth extracted), just wanting the Percocets "Aw, Doc, it's just to get me through the weekend until I can follow up with the dentist" from someone who clearly hasn't been to any dentist in decades...The thing that really kills me is that the people who really have pain (e.g. the ones with bone cancer) are the ones who are the most reluctant to take narcotics! eeaarrgghh - just venting -

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[EctopicFetus]

This is totally true. The key thing is that those with Bone CA or other CA generally can get all the meds they want. The Cancer patients make a choice. The thing about the drug seekers is this.. which I believe is a major question in medicine. sometimes espically with Sickle Cell patients we give them morphine (often more than they need) and then we complain when they come back every week for more morhpine or (GULP) stronger meds. The key with drug seekers is to DENY DENY DENY!! Once they get it from you they wont leave and once you break the law for these people you are on the hook big time. Many doctors just give in to these patients so that they dont have to deal with them. It is kind of sad if you ask me. There are many people like this and once you give them these meds... it is over for you..

 

[greets fr. nyc]

arggh.... friggin' annoyin.
i concur.

when this has happened in the past,
1) i say to myself... just chill!.... why should some dirtbag ruin your day, let alone ruffle yourself for a half and hour or so.
is it worth it? hellzzz no!
save your energy for those who really need your efforts.

2) it'a a great time to practice that "even-tho-you(the drug seeker)-are-time-sucking-me" i'm gonna be respectful, calm and cool, and clear as i give you a big fat look in the eye and say a solid, "no is no."
you could give some sarcatic remark, but why hassle the poor laddie and lower yourself?

3) if you're really sure this dude is jivin' with yas, finally say outloud, "if you really need the meds, i need to let the authorities (and the hospital administration) (and my superiors) <--(use more people if he's/she's a tough leech to remove)....i need to let them know that you've been actively seeking pain medications. we can get you help(!), we really can.

or

i've asked you to understand that we will not give you any more pain meds, but you keep persisting. To that end, it's a fine time to seek more people to get involved. look we can even DOCUMENT IT, why don't we do that. you can sign too. then we can really find someone to get to the bottom of this."

hmm.... has worked in the past.... but then again, every case poses its unique challenges.
best of luck.

 

[Mirror Form]

they are destroying my faith in humanity (such as it was). lying, playing off one doctor against the others, not wanting to seek actual treatment (such as getting infected teeth extracted), just wanting the Percocets "Aw, Doc, it's just to get me through the weekend until I can follow up with the dentist" from someone who clearly hasn't been to any dentist in decades...The thing that really kills me is that the people who really have pain (e.g. the ones with bone cancer) are the ones who are the most reluctant to take narcotics! eeaarrgghh - just venting -

If you think you're mad now, wait until you've just finished your work on overnight call and are laying your head down on the pillow, about to get 2 hours of sleep . . . and then get paged to go to the ER for some blatant scum bag drug seeker.

 

[Trisomy13]

If you think you're mad now, wait until you've just finished your work on overnight call and are laying your head down on the pillow, about to get 2 hours of sleep . . . and then get paged to go to the ER for some blatant scum bag drug seeker.

some of these blatant scum bag drug seekers recover and become productive members of society. i know a number of people (through previous jobs) that have achieved high positions in prestigious universities who were at one point in time straight up junkies. most of them have families who would rather have their son/daughter/mother/father back to normal again too.

i understand that many of them annoy you, but unless you have fought an addiction of that magnitude, you can't really understand the drive behind it. it's not personal and they don't seek drugs just to piss you off.

 

[Gauss]

some of these blatant scum bag drug seekers recover and become productive members of society. i know a number of people (through previous jobs) that have achieved high positions in prestigious universities who were at one point in time straight up junkies. most of them have families who would rather have their son/daughter/mother/father back to normal again too.

i understand that many of them annoy you, but unless you have fought an addiction of that magnitude, you can't really understand the drive behind it. it's not personal and they don't seek drugs just to piss you off.

finally an intelligent response
addiction is an illness, treat it as such
if you don't know how, send them to someone that does.

 

[InductionAgent]

finally an intelligent response
addiction is an illness, treat it as such
if you don't know how, send them to someone that does.

Yes, addiction is an illness, the treatment of which is NOT the substance to which they are addicted. These people don't come to the ER seeking treatment for their disease; they come seeking the disease itself.

 

[kchan99]

Yes, addiction is an illness, the treatment of which is NOT the substance to which they are addicted. These people don't come to the ER seeking treatment for their disease; they come seeking the disease itself.

I like the way you put it.

 

[Trisomy13]

Yes, addiction is an illness, the treatment of which is NOT the substance to which they are addicted. These people don't come to the ER seeking treatment for their disease; they come seeking the disease itself.

Sometimes in order to keep the doors to treatment open you have to establish a relationship with the patient. This might mean you dole out some drugs that aren't 100% necessary rather than lose the patient to follow up (i.e. they will just go to another hospital if you deny them). You cannot talk with a patient and start any type of discourse if they are not there in front of you.

I understand many people have had no contact with addiction prior to 3rd year, and it is an ugly disease. Please understand that I am not a bleeding heart liberal when I say that these are people too, and that when treated properly they *can* recover and reclaim a productive life. I worked with one project director at a university who had been addicted to heroin for many years, shot several times, etc. before getting the help he needed. I also have relatives that are currently struggling with their own addiction. I would hate to have one land in your ER only to be called a scumbag and tossed back to the street.

 

[Trisomy13]

addiction is an illness, treat it as such
if you don't know how, send them to someone that does.

this is what i meant to say, in much fewer words, thank you.


patients with a long history of addiction can be the most challenging patients you will encounter, and arguably the most rewarding *if* they make a recovery.

 

[EctopicFetus]

this is what i meant to say, in much fewer words, thank you.


patients with a long history of addiction can be the most challenging patients you will encounter, and arguably the most rewarding *if* they make a recovery.

In my opinion this is liberal horse poop.

 

[Trisomy13]

In my opinion this is liberal horse poop.

Based on what experience? Calling someone a scumbag and turning them away? I've seen patients make recoveries and lead meaningful lives. I've seen them go from the bottom to the top, literally from the gutter to the desk job in an office.

I don't doubt that many patients with addiction problems will never fully recover, but not giving them a chance only further decreases the odds. Would you similarly choose not to treat patients with adult onset diabetes because they got fat from eating too many Twinkies when they knew it was doing them harm?

 

[Trisomy13]

Sorry, I didn't see the title of your post.

No, I am not condoning just handing out Class II meds to any addict that wanders in. With a problem like addiction it is hard to make a blanket protocol that would allow for that. You have to take in a much wider swath of information regarding their socioeconomic/psychosocial situation, desire to change, support systems, etc. This is not always practical in today's system, but I strongly think to write them all off as scumbags is a step in the wrong direction. We aid smoking cessation with nicotine patches right? Methadone for opiate dependence in some situations. Have you ever researched the trials in the UK (or perhaps Switzerland - it's been several years since I last reviwed them) that studied the prescription of heroin in maintenance trials for a small group of addicts? They functioned amazingly well. Don't even get me started on the incredible morphine habit carried by the founding surgeon at Johns Hopkins...

 

[MustafaMond]

In my opinion this is liberal horse poop.

Wow, take that to the "Everyone" forum.