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Harvard Health Blog
Why are doctors writing opioid prescriptions — even after an overdose?
- By: Joji Suzuki, MD
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As an addict in recovery I applaud this article. It brings light to a serious issue of “stupid being stupid” even after ‘stupid’ has happened. (Make sense?)
I myself, have overdosed twice. The second time I overdosed was caused by the same prescription from the same doctor. I would like to defend the doctors though. I was NOT taking the medicines as prescribed. I was NOT only taking narcotics (Hydromorphone) from a single doctor. I was doctor shopping.
I think ultimately an addict will always find a way to take more medication than prescribed. A database at the pharmacy MAY have prevented me from continuing to fill and early fill my narcotics..?
I apologize to ramble and spew opinion but I felt the need to let doctors know that it isn’t their fault. Addicts are sneaky, liars, thives, and generally; assholes. I also would like to apologize to the genuine folks in pain. I have made it very difficult for you to get your much needed medications…
How about instead of blaming doctors for being ignorant of risks of opioids, we examine what alternatives there in the US healthcare system for treating chronic pain. There are opioids, non opioids, injections, PT. Better than all of this – there is very good data that multidisciplinary pain rehabilitation or functional restoration, is cost effective and leads to better patient outcomes than conventional pain care. It involves CBT and graded exercise and many other facets integrated under one roof. Programs run 6-8 weeks for 6h per day. There is data they SAVE money but 3rd party payers and Medicare generally do not cover them. On the other hand, those same payers will pay for monthly opioids to no end.
Wouldn’t greater / expanded use of electronic health record solve much of the communication issues. We all know that it’s an epidemic of sorts in the US; how do other countries cope i.e. Canada, UK, Scandinavia etc.
I have read a lot about this epidemic, and the alarming rate of heroin overdoses happening all over the country too. This article helped me to understand the issue a bit better. Thank you for helping me to understand why we have such a problem right now with opioids and some of the ways that the problem can be addressed, such as communication between care providers.
This is a multi faceted issue. Patients on multiple narcotic prescriptions need special screening prior to any tests with general anesthesia or conscious sedation. As a nurse case manager for a part C HMO we had access to pharmacy but it did not include diazepams; home visits and thorough interviewing techniques were key proponents to patient education and coordination of care with the prescribers.
This article simply suggested that there is a problematic
gap in communication. Does it concern you that a prescriber
is not notified when an individual under this Dr.’s care overdoses?
Truthfully, would you want your Dr. not be made aware if
by some chance you incurred an overdose?
I’m not suggesting that either of you are not being non-
complient with your medication, however, isn’t fair that
your Dr. be told (by you) if that were to happen to you?
You won’t be punished and you would exhibit some
character to show that you can be trusted to do the right
thing. You and your Dr. could then collaborate on what the
next step should be.
There are three points here: 1. With an EDB, Dr. can confirm
that He/She is your only prescriber, 2. Take the RX. to the
Pharmacy, ( The Pharmacist can call your Dr. if there is an
issue) and 3. show your picture I.D. with address.
The bottom line is communication should not be taken
for granted, especially when there is a rampant opioid
With chronic pain, Cognitive Behavioral Therapy is a great
tool, one of many options available to complement
medications. And, what are these hoops that you have
to jump through?
Just because someone overdosed on opioids, doesn’t mean that they aren’t still in pain. To cut them off, and cause them physical pain, would just be cruel. In addition, if someone has a terminal illness, treating them for addiction is a counterproductive waste of time.
I completely agree with John!! I am so sick of the backlash affecting those of us honest chronic pain sufferers. I use my pain medicine responsibly and have done so since my adult onset chronic pain condition (in late 2009). It is a horrible experience every time I go to get my script “refilled” (the prescription comes from the same Doctor since 2009). I am made to jump through hoops (answer questions, forced to give up HIPPA rights) just to get a necessary and valid medicine that keeps me physically functioning. There is never an apology just “well that’s the new rules!”
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