The pharmacy/pharmacist that has been giving me such a hard time each and every month for my pain medication. Well now, the pharmacist has a chronic pain issue herself and now she as of last month has been treating me well and thanking me for my business. Reality has struck! Big grin. She knows what pain is now! What a surprise!
Filed under: General Problems
The sweet taste of karma … When I was much younger and dumber with no life experience, I remember making little comments like “I would never …” … before I ever actually experienced it … “My child would never …” … before I actually had a child of my own. I got my a** handed to me each and every time lol. I have been forced to eat a lot of the words I said before I actually experienced something. It’s not fun, but it’s certainly wakes you up.
Hmm what would Alan G. Berg do if your patient is allergic to NSAIDS, tell them to “off themselves” or get street drugs. I developed an Aspirin/NSAID allergy after self-medicating for migraines for many years before the triptan meds came along. I was told my migraines were imaginary and should be treated with hot baths. Thanks to Glaxo people today don’t go through this anymore. I also messed up my kidney function from Tylenol – one of the leading causes of kidney failure by the way. I would have been better off living in 1900 with tincture of opium and some laudanum.
Good luck with that! For every one of those, you have a dozen (or more) of these!:
http://www.kevinmd.com/blog/2016/04/stopped-prescribing-narcotics-never-looked-back.html
Why I stopped prescribing narcotics, and never looked back
I was never a big prescriber of narcotics. I grew up “country,” in a tougher world where your parents taught you to accept pain as a part of life. Pain is how you know you’re still alive. They’d tell me, “if you’re hurtin’ you ain’t dead yet.” You fell down; it was going to hurt. You learned not to fall. Twisted your ankle doing something stupid (and it was always while doing something stupid, like jumping off the roof), well we’ll wait a day or two and see how it goes. Put ice on it, and next time think harder before you jump off the roof. Just because everyone else was doing it, yada yada yada.
So most of the time it never occurred to me to prescribe narcotics, except for severe crippling incapacitating pain. Cancer, broken bones, post-surgical pain, or severe arthritis. And after thirty years in practice, I knew I was an expert at figuring out who really needed the medication, and who was just scamming me.
And on those days when things were slow, I would sometimes play “the game” when a new patient wanted narcotics. You know how it goes. You get the history of some terrible trauma/ongoing problem/lost medications/etc. Then you ask, what were you taking? The patient can’t remember. It was “a round white pill” for pain.
I’d respond, “Ibuprofen!”
“No doc, that wasn’t it. It was kypo or depo or hypo something.”
“Ahh,” I’d reply knowingly, “It was Depo-Medrol.”
“No doc, that’s not it. Oh, I wish I could remember. It was hydro-something.”
Again, I would reply with a knowing smile: “Hydrochlorothiazide!”
Frustrated, the patient would decide to end the game and suddenly recall that it was hydrocodone. Or Dilaudid, or Percocet, or any number of high-powered narcotics. And of course, the game now over, I would deny any prescription. Sometimes they would yell or scream obscenities, sometimes they would storm out in anger, and sometimes they would just shrug their shoulders and leave. But I wasn’t worried. Because I knew the “druggies.” I could pick them out in the crowd. They were so obvious.
And then Ms. Bessie came to see me. She was 71 years old. Sweet, conversational, always on time, and followed all my instructions. She was the perfect patient. She did have bad arthritis and significant problems with her lumbar spine. Studies had confirmed this. The normal arthritis meds just didn’t allow her to be up and active. So I had been treating her with hydrocodone. One or two per day, if she really needed it. And every 90 days she would be back for a refill. We had been taught to take care of chronic pain. I had been to all of the lectures. I knew everything about how to take care of this type of patient. We had assessed her for depression, and she always filled out a pain scale. And then new recommendations came out recommending a drug screen. And so we did that too.
And on that day, even though she told me that was taking the medication as prescribed, her drug screen was negative for any codeine. It was, however, positive for marijuana. This sweet, 71-year-old grandma, was selling her codeine and buying marijuana. I was shocked. I knew who the druggies were, and Ms. Bessie was not one of them. But she admitted to the marijuana use, and told me that sometimes she would also mix a little crack or heroin with the marijuana cigarette.
And that was the day my office stopped prescribing narcotics. We posted a notice on the door and at the reception desk. Every new patient who called to make an appointment was told of our policy. When a new patient would be seen for the first time, they were informed at the front desk, and again by the triage nurse. And just like that, we stopped contributing to the ongoing problem rampant in this country with narcotics. We didn’t suffer a loss of patients. No loss of revenue. If anything we got busier. And all of the problems that used to occur with patients and their narcotics magically disappeared. No more lost medications, no more ineffective prescriptions, no more early refills, no more long conversations and lengthy documentation about proper drug use. My staff was thrilled with the change. In short, life actually became easier.
I still treat pain; but it is with NSAIDs, exercise, and physical therapy. I know that there are patients out there who truly do need help with their pain. But I will let the oncologist, the orthopedist, or the surgeon determine how much and for how long. I will stay focused on treating hypertension, diabetes, and multiple other chronic problems. Because after 30 years, I have learned that I can’t recognize who has a drug problem and I don’t want to play the game any longer. Ms. Bessie never came back to the office. And I have never looked back.
Alan G. Berg is a family physician.
She needs to become an advocate! Empathy alone will not effect change.
I work in the pharmacy field and have for over 6 years. As a pain patient myself, I do have a lot of empathy for others in pain. I know it has rubbed off on my colleagues and superiors. They get to see first hand what chronic pain does to a person and that all pain patients aren’t drug seekers. Definitely a good wake up call!
It’s sad when people who have been afflicted with addiction try to legislate laws to prevent legitimate patients to get the therapy they need. Those individuals should be voted out of office ASAP and replaced with more balanced individuals.
Thank you, Ron. We need people like you speaking up. I’m sorry you feel our pain, however!
KARMA SUCKS!!!!!
Although I’m not a religious person at all, I do believe in Karma and the fact that all things are inevitable. I’m just waiting for the day that the same affliction of chronic pain strikes down the architects of this campaign against the Humane treatment of chronic illnesses.
Just maybe out of something bad might come something good. Although I would never wish pain even close to what I feel every day on my worst enemy, it might just be a good thing that this pharmacist now is suffering from pain. We need all the advocates we can get and those who are in the medical profession are definitely needed, especially if their views were once against the use of opiates.
Karl, it would be great if you would write an article about that — your story and your empathy.
Personal experience definitely developed empathy. My time as a home infusion pharmacist working primarily with HIV patients in the early 1990s with no hope except palliative care has certainly opened my eyes to CPP and their needs. When I hear the horror stories of CPP and refusals by pharmacist I know for certain that RPh has no intimate experience with pain. It’s a sad story that it takes personal pain to empathize for those others in pain.
The good news and the bad news! Glad you told this story because it is important to hear about anyone in the medical field who deals with pain and to hear about their attitudes and opinions.
A few of the government biggies who are pushing for a non-opioid society have had either addiction themselves or a close family member has. Those people influence the papers written, guidelines proposed and spokesperson’s words against us…because of PERSONAL FEELINGS.