Thursday, November 6, 2014

Looking at Prescription Drug Addiction in Our Patients

Prescription
Prescription (Photo credit: Wikipedia)
Drug companies use direct-to-prescriber advert...
Drug companies use direct-to-prescriber advertising in an effort to convince prescribers to dispense as written with brand-name products rather than generic drugs. (Photo credit: Wikipedia)

Anyone who pays any attention to the news knows that in general populace addiction to prescription drugs is seen by some experts as being at a record high. Many folks feel like they can hide their addiction because no one really questions you're going to the pharmacy to get just what the doctor order. Prescription drug use and abuse does not have the same stigma for the abusers as 'street drugs."


Many people feel sorry for the prescription drug addict, because the doctor gave them the drugs and the addiction is viewed as some unfortunate medical accident. We seem to overlook the fact' like all addicts, prescription drug addicts lie, steal, and cheat to keep themselves in the prescription drugs they are addicted to.
English: A graphic map showing the rates of ac...
English: A graphic map showing the rates of accidental prescription drug overdose deaths for the state of Ohio by counties for the years 2004 to 2008. Information obtained from here and here. (Photo credit: Wikipedia)





All medical assistants should has a basic understanding of how prescription pain drugs pose a threat to the patient’s health. Yes, physicals and nurse practitioners prescribe drugs, but medical assistant take medical histories and obtain medical records. You may be the first person to notice that a new patient has be doctor hopping or has gotten multiple prescriptions for different kinds of pain drugs. T
These are red flags in a patient’s medical record. Many times addicted patients return again and again to their primary care physicians with complaints of headaches or back pain that no apparent cause can be found. Many times if these patients are referred to specialists or for further testing, they put up a great deal of resistance. They will balk at the suggestion of physical therapy for pain related to an injury. They want pills and many times will even suggest to the doctor the kind of narcotic that works best for them. You as a medical assistant may be the first to notice this type of behavior.
A busy doctor may be just too busy to notice these types of behavior. It might be helpful to tell the doctor you think a patient might be engaging in drug seeking behavior,  Be sure to back you suspicions with information from the patient’s chart. 

When retrieving records for new patients , be sure the prescriptions the patient’s says they are on, match the patient’s record. Many times the patients forget to tell you about the prescription for pain killers from the dentist. They are bold enough to complain of back pain and get another prescription from you. Many times pain killer addicts use multiple pharmacies;so it may take a little extra work for you to get an accurate picture of what drugs your patient is really taking.
.Those who are addicted to Vicodin, Zanax, or Oxycontin tend to miss a lot of time at work. Many sit at home in a stupor  making up ailments to gain more access to the prescriptions they are addicted to. I am not sure we will actually know how much property damage or death is caused by drivers addicted to prescription drugs. Only those who appear seriously impaired would probably be tested by authorities at an accident scene . Someone impaired on Vicoden does not reek of alcohol.

There is a public awareness of the problem of teens getting high out of their parent's medicine cabinet. Those five  pain pills that are a couple of years old patient’s  have left over in their  medicine cabinet; are not the real problem. The 20 pills  a teen takes regularly out of the  mom’s hundred Vicoden is the source of serious teen addiction..  Patients may deceive health care providers with complaints that they have a chronic pain condition. Over use of painkillers leads to the painkillers not being effective anyway. The dose must be upped on many drugs for them to work for patient pain.
States are now using computers to track the distribution of  controlled substances from pharmacies. Still an addict will not hesitate to cross state lines to bypass these types of obstacles. Even older patients are at risk for pain killer abuse. That sweet Mrs. Jones may have several active prescriptions at pharmacies in Florida as well at the corner drug store.  

Ask about any prescriptions that might have been obtained by the patient on vacation or when wintering outside of your own state.

There are alternative methods of treating people with chronic pain. Acupuncture, bio feedback and just losing a few extra pounds have brought pain relief to thousands of patients. Still there is no magic cure for chronic pain and certainly no magic pills.. We must make sure our  patients understand that just because it came from doctor does not mean prescriptions are a real cure all for chronic pain.

We need to discuss prescription drug addition with teens because once they are addicted from raiding mom’s medicine,t the next level of addiction will have them forging prescriptions or ordering mail order prescriptions off the internet. The cost of most of the addictive drugs is not as draining on our teen wallets as the street drugs. Most teens will not get caught popping a pill at the water fountain in the hall at school. We need to examine our own attitude to the popping a pill for every small ailment. It is better to show your patients healthy ways to deal with pain, Doctors and supporting staff need to show patients  the ultimate solution to pain management does not come in the form of a pill.

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