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jclalor

DRUG SEEKER IN ER

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She refuses to go the ER, just because she doesn't want to be "one of those."



I'm with her. Two months before an neurosurgeon cut me open to find that my lower spine was so unstable that he had to fuse three vertebrae, I went to the ER because I was in incredible pain.

That fucking bitch wearing a nurse's uniform gave me a shot right into the spasming muscle, then told me "you have chronic back pain and you just need to get used to it". I hope every disc in her back goes out and she has to have her entire spine fused. And I could get hit by a car at that ER's doors and I would insist on being taken elsewhere. Ten years ago and I'm still that pissed at that bitch.

So for those working in the field - not every patient with pain you can't see is a junkie...

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That is more true than you can imagine. And it happens in all fields, not just the ER. Years ago, I was working urgent care, and had a young guy complaining of headache. I gave him a non-narcotic prescription. He asked, "What if it doesn't work?" I told him to call me. Hours later, he called and as I was about to order narcs on the phone, I asked the pharmacist for his background. He said, "Oh, you mean the headache guy?!" He had been doctor shopping and had over a hundred prescriptions for narcs from local doctors. I gave him prescription Advil. He never came to our clinic again.

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Unless it's totally unavoidable, I only go to the hospital that's got electronic records linked with my neurologist. They pull up my records with two clicks, confirm that yes, I do have migraines, and treat me accordingly. Thank you, technology! When I'm out of town, I have to choose between going to a hospital where I know I'll probably be treated horribly or living with an out of control migraine for maybe three days. That's a really sucky position to put a patient in.

Unfortunately, I think that doctors try so hard to keep opiates out of the hands of addicts that they've created an environment where people needing legitimate pain relief for "invisible" conditions are afraid to ask for help. That's not a good thing.

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Forgive me if I'm over-simplifying, but are you not able to keep a supply of meds prescribed by your own doc on-hand for such situations? Elderly people, for example, travel with their meds, in labeled prescription bottles, all the time.



ROFLMAO! Of course I travel with my medications. However, pills do me no good at all when the migraine is so bad that I keep throwing up the medication. And throwing up makes the migraine worse. And the doctors, for the most part don't care that a neurologist has prescribed you migraine preventatives and triptans to treat migraines even when you show them the prescriptions with your name on them. It's been my experience that if you go into the ER with a migraine, you must be an addict despite evidence to the contrary. And unfortunately, in talking with my neurologist and with other migraine patients, my experiences with emergency rooms seem to be the rule rather than the exception.

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We deal with people in pain every day. There are obviously many (most) with legitimate pain that needs addressed. But chronic pain is not best treated in the ER, although acute exacerbations may need to be. We try to sort out who is legitimate and who (also many that we see) are simply addicted and drug seeking. I personally try to err on the side of treating legitimate pain and realize that I will be scammed sometimes, rather than hold out inappropriately on someone truly suffering. But it is judgement, and my judgement is not perfect. Electronic records linking all the ER's in the county help in sorting out who is drug seeking.

All in all, a difficult situation from both sides of the fence.
"We saved your gear. Now you can sell it when you get out of the hospital and upsize!!" "K-Dub"

"

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Forgive me if I'm over-simplifying, but are you not able to keep a supply of meds prescribed by your own doc on-hand for such situations? Elderly people, for example, travel with their meds, in labeled prescription bottles, all the time.



Hi A

Some old folks have large bottles of pills:(

Wife went thru TSA security at the airport and "The new guy"[:/] wanted to count her meds in the labeled script bottle:S.

The wife's script is for a 2 week supply, and the bottle was half empty.

After the wife's return we returned to the drug store and asked for a smaller empty container with a label on it.

No problem now when she travels she can take a smaller amount of meds with her.

BTW the TSA guy did not touch her meds or open the bottle after the supervisor asked what the problem was.

TSA OJT[:/]
One Jump Wonder

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<<

>>>


We deal with people in pain every day. There are obviously many (most) with legitimate pain that needs addressed. But chronic pain is not best treated in the ER, although acute exacerbations may need to be. We try to sort out who is legitimate and who (also many that we see) are simply addicted and drug seeking. I personally try to err on the side of treating legitimate pain and realize that I will be scammed sometimes, rather than hold out inappropriately on someone truly suffering. But it is judgement, and my judgement is not perfect. Electronic records linking all the ER's in the county help in sorting out who is drug seeking.

All in all, a difficult situation from both sides of the fence.



Yes, it is difficult for everyone involved. I agree that the ER is not the place for chronic pain patients in most circumstances. People in my situation have preventative meds (topamax and the like), treatment meds (imitrex, etc), and when all those fail for one reason or another, we end up in the ER because there's nothing else we can do to help ourselves.

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Unless it's totally unavoidable, I only go to the hospital that's got electronic records linked with my neurologist. They pull up my records with two clicks, confirm that yes, I do have migraines, and treat me accordingly. Thank you, technology! When I'm out of town, I have to choose between going to a hospital where I know I'll probably be treated horribly or living with an out of control migraine for maybe three days. That's a really sucky position to put a patient in.

Unfortunately, I think that doctors try so hard to keep opiates out of the hands of addicts that they've created an environment where people needing legitimate pain relief for "invisible" conditions are afraid to ask for help. That's not a good thing.



From my side, addicts have created such chaos in the medical environment that doctors are jaundiced about treating pain. While it is no longer my speciality, I have been burned on many occasions because I was willing to be empathetic about someone who was feigning illness to get high. As addictions is part of my training as a psychiatrist, I have heard many stories directly from addicts about their ploys to get narcs out of physicians. Furthermore, writing an "excess" of narcs can trigger investigations of doctors, putting undue duress on the doctors already busy, underpaid, overworked, under-appreciated workload.

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