It is amazing to me how many people take pain meds and such on a too-regular basis and how many practitioners are willing to hand them out like candy. Good for you for not!
Lisa, Man you are fast! I just put up this post. Thanks for supporting the proper use of medications. I look forward to the opportunity to be able to write them if I need to in the state of Florida but right now I'm glad that I have an excuse.
There is something I don't understand. When I went to the Dentist the other day, I had to have a tooth pulled. Well, the Dentist and his assistant asked me multiple times if I wanted pain killers. (Even the receptionist asked) I told them no each time and they still kept on insisting I get them.
When has society reached levels that a tooth pull requires narcotics? I take motrin and or tylenol.
Have people become such babies that druging yourself is the only way to function?
The other concern is, why they kept insisting I get a narcotic?
The medical boards wont let a N.P. write narcotics without a Doctor co-signing but, they are handing them out like candy!
Go figure.
I'm glad you are just saying "NO" I'm always shocked by our patients on a med/surg unit that we have to give heavy narcotics to around the clock (because that's what they take at home) ON TOP of whatever pain meds they are prescribed for their current affliction. It's ridiculous and sad really. Good for you!
Dawn
Hi Dawn,
It seems the whole world is going or has gone mad. Maybe people should turn off the news and turn on to life!
I completely understand where you are coming from. I work in a pain management clinic. I do a great deal of screening prior to placing patients on opiates, including a thorough exam, history, psychological screening with a licensed psychologist, a urine drug screen and of course, review of records. I also consider the severity of their disease, ie. mild degenerative disc disease vs. advanced, severe degenerative disc disease. Some patient's pain seems legit, while others are not. There are times when I feel that I am the pain control police and if I do not feel that it is appropriate for the patient to be on opiates, I will explain the reason to the patient, offer non-opiate therapy and if they don't agree, they will most likely seek out another provider, which does not fix the problem, however, at some point someone has to put their foot down. Sometimes, it is frustrating when primary care and or other providers get patients started on opiates, escalate their doses and don't consider that the patient will most likely gain tolerance and/or physical dependence. Then when the patient complains that their percocets are not working like they use to, they send them to the pain clinic. Sometimes it seems like patients have been getting long-term opiate therapy because some practitioner down the line did not have the back bone to just say no. Honestly, I think that we all need to work together on this issue and encourage and promote nonpharmacological pain relief modalities, including PT, OT, relaxation, exercise, cognitive behavioral therapy and adjuvant medications...and leave the opiates for the patients with chronic, intractable malignant pain and inoperable painful disease processes, like severe spinal stenosis and RSD etc.
Thanks for listening to the NP in NC
Editor, We are now in the "fix me now, right now" era of society. I think the numbers are higher than ever for addictive behaviors and I worry for the next generation. There is no backbone anymore and no work ethic. It's easier to just lay around and be on the government payout.
Thanks for the comment Dawn! I used to work Med/Surg and dealt with the same issues on a daily basis. The patients coming off prescription drugs were sometimes worse than the crack addicts. Sad situation!
NP in NC, thanks so much for your comment especially since you work in the field of pain management. I shake my head at people when they ask for Percocet for a headache. I do blame the primary providers for starting the process without making the patient go through other modalities first. I've seen WAY too many normal imaging studies
with patients on Oxy.. Scary. Please let me know if you ever start a blog of your own!
Sigh...pain management...
I do feel there are times narcotics are appropriate...but not for every little pain.
When I opened my office the first month or so, we had a ton of phone calls...many people wanting to know if we "did narcotics". It was unbelievable! We screen people first and constantly. I'm quick to discharge people who go against our policies.
I'm always amazed at the lies - do they really think I'm so stupid? "What do you mean there is meth in my urine? How did it get there?" "Well you know, the bear got into my backpack..." etc.
Other providers can sometimes make it difficult as well. For example, I denied one new patient percocet. He went to the ER and told them I would not write the prescription (it was right there on the ER report). Guess what? They gave him a script!
While NPs in my state can write for scheduled medications, there are days when I just want to give up my DEA number...
I totally know how you feel Barbara. I love the one where people leave it in their cars and it gets broken into. Why would you leave it in your car and in plain sight??
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