In my opinion, although opiods are a critical concern to public safety, our bias in our patients are preventing them from getting the treatments they need. Our number one goal is the patient. Lets admit it, if a patient goes to a doctor and say that I need more pills, chances are that most doctors will think addict before thinking that it can be a sign the disease is progressing to the next level. Are opiods being over prescribed? You betcha. Are there really any long term studies that say opiods are good for mangement of chronic pain? I dont think so. However, lets still not forget that the patient still comes first and I agree with most of the doctors there in saying that we shouldnt let our prejudice in preventing a patient from getting his medication (especially if it is for some serious pain).
That being said, I have dealt with untold stories of addicts and "Drug dealers" as I worked in several environments including the "projects". I usually deal with them depending on the situation. If there is a sign that the patient is an addict or dealer (such as a new customer, time the patient brings the prescription in), I will say that we run out politely and refer the patient to another pharmacy. However there are some addicts and dealers who just insult my intelligence (from obvious fake prescriptions and asking why I cant fill it despite red markers, no date, no doctor signature or DEA, wrong spellings, etc), and I usually just tear it up and tell them to never come back. In the poorer neighborhood, most people will accept that they ve been caught and lucky I dont call the DEA on them, but in the more richer neighborhoods, I get a bitching before they leave. I also got complaints that some of the patients were being hassled right outside of the pharmacy with ppl searching through their prescriptions (have to call the cops there).
Have I turned away patients with legitimate prescriptions? Probably and it does hurt me to say that I have neglected my professional duties. That is why I say we are too biased. It is interesting to see how we will evolve in the pain mangement of patients.
