Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
A. I've been an ER doctor for 14 years. I have never (nor do I know anyone) who has ever written a PERCOCET rx out of the ER. That would have required triplicate scripts.
B. 99% of every rib fracture patient I have ever had (and I've had many - always worked at a trauma center) has not been pain-controlled with over-the-counter meds. We can use weaker narcotics, but some have even had to be admitted. Some are supposed to be admitted bc of protocol.
C. There are a lot of people who will not use NSAIDs (ibuprofen, naproxen) for fractures bc of evidence that it delays bone healing (and acutely increases bleeding when that is relevant).
Two years ago, hydrocodone went Schedule II. Which means ER docs (the overwhelming majority of whom do not have triplicates/special rx pads) would have to buy special rx pads to even prescribe it.
I bought 9 pads of 50 rx apiece. August 2014. I'm not even halfway through the first one. Most of my colleagues didn't bother to buy the pads at all. They're functioning entirely with other medications. I decided to do the pads bc sometimes (like, oh, a femur fracture) there are times for narcotics. But I discovered that most people did ok with the other meds. The people I wound up using the pads for were those who couldn't take the other meds (pregnant patient, real documented allergies, etc). And I see 6000 patients a year at 2 trauma centers.
During all this, we were lambasted and yelled at and all sorts of nonsense if we didn't "address pain quickly and appropriately." Surveys. Questionnaires. CMS and JAHCO requirements. Did you know the government DEMANDS we give a pain medication to any patient who MIGHT have a long bone fracture within a certain number of minutes of arrival? So basically they demand we narc up anyone who MIGHT have a fracture (bc no way are you going to have an xray done and read in 30 minutes) as soon as they hit the door?
I mean, stupid stuff like these protocols and tying compensation to 'satisfaction' scores are a HUGE part of the problem. And you're not talking about a slap on the wrist. You're talking about big fines and even being fired. And they'll send a drug seeker a survey just as fast as they'll send a legitimate patient a survey. And don't get me started on that stupid campaign...'Pain is the fifth vital sign' nonsense.
There are now whole committees dedicated to ferreting out who is a drug-seeking patient and sending them letters that say they will not be given narcotics if they come. There are signs being posted. Tons of time is being spent combating the abuse of narcotics. It's infuriating, bc if they didn't meddle in the first place, a lot of this problem wouldn't exist.
Agree with all of your comments except one. Triplicate prescription for narcotics are not required in all states. IN NY one required triplicates. Looks like same law in Texas. In NJ one can write only one controlled subscription per page but not needing triplicate ( that was years ago).
Here in SC you can write any controlled substance on a single regular prescription pad, and can even fit two in a single page if written in tiny letters ( Oxycontin plus oxycodone prn).
The pain as the 5th vital and the range from happy to sad faces as way to measure pain is BS. And you have another set of BS of Press Ganey satisfaction scores tied to compensation, and JACHO visits to make sure pain is adequately addressed and treated fully. The whole system is screwed up.
Growing up in a hick semi-rural neighbourhood I witnessed the wrath of crystal meth. This was almost over 35 years ago. I personally knew these people. I saw them shoot up. Some had not even smoked pot yet and went to the hard drugs immediately.
People do not realize that this stimulant makes all other drugs look like mother's milk. I saw young robust men drop from 180 pounds to 120 pounds...I saw them not eat or drink for days at a time...some of them would go on "runs" that lasted two weeks where they would literally not be still or sleep.
There motto was "I am here for a good time-not a long time"..They were called speed freaks...All of them died..all 17.
What I did notice about hard drug users was survival depended on the level of intelligence. There were those who tired all the substances and put them down when they felt the drug was harming them...Then there were those who were harming themselves who just kept on going...Stupid people....die...Intelligent ones save themselves.
Growing up in a hick semi-rural neighbourhood I witnessed the wrath of crystal meth. This was almost over 35 years ago. I personally knew these people. I saw them shoot up. Some had not even smoked pot yet and went to the hard drugs immediately.
People do not realize that this stimulant makes all other drugs look like mother's milk. I saw young robust men drop from 180 pounds to 120 pounds...I saw them not eat or drink for days at a time...some of them would go on "runs" that lasted two weeks where they would literally not be still or sleep.
There motto was "I am here for a good time-not a long time"..They were called speed freaks...All of them died..all 17.
What I did notice about hard drug users was survival depended on the level of intelligence. There were those who tired all the substances and put them down when they felt the drug was harming them...Then there were those who were harming themselves who just kept on going...Stupid people....die...Intelligent ones save themselves.
And cannabis is schedule 1, while meth is schedule 2, with medical benefits.
Fentanyl and other opiods cannot be taken by people who are recovering addicts UNLESS they are watched over like a hawk. They need to be watched closely and a good doctor KNOWS who the recovering addicts are. Usually they will eat up their drugs faster than what the prescription says. I know all about this as my brother who is now deceased went through this. He would run out of his vicodin too fast. He was a recovering meth addict. It's terrible.
The people who pay the price are people like me - who has been on an Opioids since 2005 due to chronic pain from RSD. We get frowned at when we go to pharmacy (not always) but most of the time. It's disheartening. I function fine - I take my medication as prescribed...I do not drink because I know alcohol can interfere with my medication. In other words I am a responsible pain medication user. I am in constant touch with my physician and have a good relationship with her as well as my other doctors.
I feel bad for these people who are overdosing. It's sad. Very sad.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
