Pain pill Contracts

[Happiness]

So as I am a news junky I came across this artical. I honestly think this would be a good idea and here is why.

A young man a few years back lost his leg just below the knee in a work related accident. This young man was in his 20's and a typical guy, went to the bars, had a girlfriend and was able to enjoy life. He had complications twice in his recovery which required the stump to be shortened and he also had a few issues with the prosthesis fitting. He developed depression from loosing the leg and was unable to return to the original work which gave him enough money to have an extra than normal life style. He was never treated for the depression as our Mental Health system here sucks the big one. He did have pain so his dr perscribed Oxy.

About a year later another Dr. (we have alot of locums) looked at his file when he came in to have his perscription renewed and told him that he was not perscribing the Oxy for him. I do not have any problem with that fact but I do have a problem with the Dr. A. not giving him something in replacement and B. not realizing that this pt may be addicted to this drug and cutting him off at the knee's. My opinion is the this Dr. should have realized there was a very high possiblity of the addiction and monitored this pt while decreasing the dosage or maybe putting him on a methadone perscrition.

So a few days go by and the guy is going through all the withdrawls, he has been refussed at the hospital, and then he does the unthinkable. He tries to rob the drug room at the hospital to get the drugs. So now he has a totally new set of problems.

So now a few years later he still hasnt gone to court for the robbery charges, he is unable to go to rehab because of the unsettled court conditions, he is still a floundering drug addict and he has become suicidal.

In the end I think a contract for Opiods would make both the Drs and the Pts more responsible for the drugs they are prescribing and taking.

Any one else want to comment please feel free

http://www.msnbc.msn.com/id/42437555/ns/health-health_care/

[tniuqs]

Inducing opioid withdraw is just NOT good medical practice bottom line, so the question remains is this addiction or required pain relief ?

But: Prescribing cold turkey from locum MD is from and where I sit on the couch, it could fall under negligent medical care and is most certainly a mitigating cause in this patients situation now.

Perhaps a decent lawyer and an understanding judge (unfortunately they too become very jaded as soon as they hear the word DRUG) but would not be a bad legal solution and directed towards the MD. The last thing for the patient needs is break and enter narcotics record. I just can't see how that will help the patient to get back on his feet, so to speak.

We do know that the oral forms are opioid's are abused and now on the radar screens of the big brother pharmacists busting MDs that were more liberal with pain medications in the past. Unfortunately the only option with present long waiting lists (to resolve the root cause of the pain) perhaps a result of our broken health care system but further complicates the MDs (self preservation) being now more concerned with licensure than best practice.

Just my 2 cents this is a direct result of a type of societal mental illness that we suffer from in North America. We punish the the majority not the exceptions, by making even more rules and regulations / restrictions, this proven to be counter productive. So is the frequency of crimes related to narcotics improving or getting worse with this type of regressive type attitude that predominates .

cheers

ps Is it any wonder why we have such a huge black market in oral narcotics, this example (my bet) is exactly the path this "victim of the system" will follow ... or worse.

Edited April 7, 2011 by tniuqs

[snoopy911]

Although I agree that there needs to be tighter methods for controlling abuse of pain medicine, I do not thinkthat this is the solution. In your example, Happiness, I cannot see how a contract would have helped. I may have had a different opinion if you have asked me this a year ago. (I do not remember if I have shared this in here, but I have gone back to school for drug and alcohol counseling/social work) But since beginning this educational journey I have embarked on, I have learned a lot. In the case given, I do not believe that a contract would have helped. Someone who is addicted to a narcotic (or any drug) is not going to think about a piece of paper when they need their fix. Also, although I agree with you that the physician should have worked with the patient to find other means to pain relief, counseling, etc, but methadone is NOT the answer. Methadone can be more addictive then heroin. In my short time of experience in the drug and alcohol field, I have met several patients and heard many stories about people who went on methadone to get off of opiates, and ended up addicted to methadone. It can be useful in some situations, but I believe it is greatly misused.

I do, however, see that it could potentially put safegaurds in place to protect physicians from liability, but I cannot see it making on impact on people that are abusing pain medicine. When you are addicted, you really don't have any rationals when it comes to getting your "fix". Nothing will stop them from buying clean urine to pass a drug test, and faking other documents. You don't think about possible consequences or getting in trouble.