Opinionated

I just read an article online from the Daily Herald about the problem of prescription drug abuse.  And because of the unfortunate timing, I have to leave a little rant here...

I understand that RX abuse is a big issue and every bit as dangerous as any other drug abuse.  It needs to be addressed.  I have been on narcotic pain relievers enough over the last few years to be very aware of the risks involved.  I have been exceedingly careful with my pain meds and often will make-do with pain for some period of time just to keep my body from becoming dependent or addicted to the meds, and to assure myself that I am still the one in control -- not the meds.  I understand there are people who have to take pain meds frequently for severe pain, and I am not judging them at all.  I really understand where they're coming from.  So don't anyone think I'm discounting severe pain or pain from unknown sources.  Those are my disclaimers.

The current newest law they're discussing is sending a letter to the doctor for patients who come to the ER overdosed on prescription meds.  They want to make the doctors more aware of the issues they may be inadvertently causing by prescribing narcotic pain relievers to particular patients.  Okay.  Fine idea.  Except I can think of probably half dozen ways people will easily get around that if they really want to just get the drugs!  They say right there in the article that the system will run about 3 weeks behind the times.  So if you really wanted to get drugs all you have to do is go ER hopping over the course of a couple of weeks and you're set.  Doesn't really help. 
I'm sure there are legitimate cases of accidental overdose.  In those cases education of the patients is what needs to happen.  Whether they need to better understand the potential danger of the meds (I'm often shocked by how many people -- even people who have been taking these sorts of meds -- don't understand the dangers associated with them) or put in place better safeguards so they don't forget they've already taken them or whatever the problem was.  I don't see how doctor information will stop that sort of abuse.  And unless they catch up the database faster than 3 weeks, that's not really going to be a big help either! 
I'm glad they're trying to make a difference, but I dont' think this is the only right answer.  I can think of a few things I think would help at least as much:

*Coordinated care between doctors and specialists: I currently have half a dozen doctors in my phone.  I have the dentist, pediatrician, my regular doctor, Otolaryngologist, Urologist, and Gastroenterolotist.  I have seen each of these doctors within the last several months.  (Well, ignore the pediatrician, cause I don't see him for me of course :))  Almost all of those doctors have prescribed me lortab or percocet at some point.  My urologist, who had to control my pain for several months (those pesky kidney stones, as you may recall), did ask me a few times if there was any other doctor treating me for pain.  He also was very up front about the risks of long term or regular use or overuse of pain meds.  When the cause of the pain could no longer be found he discussed long term chronic pain treatment through a chronic pain center.  Fortunately for me, I managed to get the pain under control before having to deal with that issue. I think he handled the situation quite well.  My pain was controlled, a long term solution was discussed, and other sources of meds were checked.  However -- it would have been really easy to lie.  Perhaps a centralized database that they could check -- pull up the database, type in my name and birthdate and see if / when I was last prescribed pain medications.  Maybe that's not as easy at it sounds to me, but if he could type in my info and see that the last time I was given lortab was, say, a bottle of 10 'X'mg pills last June then he has a pretty good idea that I'm likely out and really need more.  OR he could see that my doctor prescribed a bottle of 30 pills two weeks ago, and then he'd know he needs to discuss that further -- is the pain really that bad?  or am I just pill hunting?  Doesn't that sound easier?

*Speed of treatment:  To first get in to see a specialist of any sort is often a 3-6 week wait.  If you're directed to a specialist there's probably already a pretty major concern, but you have to just deal with it until you can get in to be seen!  This last month I've been suffering through a severe ear infection.  I've had a couple of appointments through my regular doctor until it was clear that the meds he was prescribing weren't helping.  So then I had to get in to see the ENT specialist (That's the Ear, Nose, Throat guy -- Otolaryngologist).  They were going to make me wait nearly a month!!!  I was able to sweet-talk my way into an appointment in 15 minutes from that time :)  but I really had to be convincing.  (It helped that the last time they treated me for an ear infection there it had already gotten to the bone before they saw me.)  I saw the doctor last Friday.  They removed my ear tube from my ear canal (pushed out by the infection) and gave me an even stronger antibiotic and more ear drops.  I was supposed to be feeling at least some better by yesterday.  Well guess what -- I slept on the recliner again last night because it's getting more painful, etc. again.  I called today and have been jumping through hoops all morning hoping they'll let me get in to see them before the follow-up appointment already scheduled in another week and a half.  What option do people have while they're waiting to see the next doctor?  Basically they have to manage their pain.  Which frequently translates into more pain medication.  If treatment or resolution of pain was able to be addressed more quickly then fewer pain meds would be needed and therefore less likelihood of pain med abuse or accidental overuse.

*Patient awareness: Every patient who walks out of the doctor's office or hospital with a prescription for narcotic pain meds needs to understand the risks associated with those meds.  If accidental pain medication abuse could be reigned in then people will be much better off.  Just the "may cause dizziness" or "may cause drowsiness" labels on the prescription bottle isn't enough.  Actual patient education needs to take place.  This doesn't have to take a long time, but the patient needs to be in control of their own health and body.  I had a friend several years ago whose sister was prescribed pain pills after a car accident.  She ended up forging some paperwork to get more pain pills, not understanding why she "needed" them so much.  She was arrested and went through a long and difficult process trying to get through withdrawals and come to terms with the fact that the medications she thought were helpful were also addicting.  She had honestly never been told that the meds were addictive!  This should never happen! 

Okay, I'm done.  There's your essay of the day :)  I'm still waiting to hear back from the doctor's office about this infection.  Hopefully they can fix the problem instead of just stringing this issue along.  I'm ready to be able to be more involved in life :)

(Picture: Sabrina cuddled up on Grandma Abuela's bed)