Pill Heads in the Waiting Room

I am by nature a quiet man who avoids conflict except in the most unavoidable of circumstances, and as a recovering drunk with going on 14 years of sobriety under my belt I tend to cut people in recovery more slack than perhaps I should. But I have zero sympathy for junkies or addicts who refuse to admit they have a problem, and thanks to prescription drug abuse in this country there are millions of people staggering around who fit both profiles.

I just heard from Dr. Wife that there was a young woman screaming in her waiting room because she would not refill a prescription for 90 Xanax, along with others for pain killers, muscle relaxants and Ambien she somehow got from a variety of other doctors. Dr. Wife examined her and  found there was no medical reason for her to be on those medications and she was not going to prescribe them. Dr. Wife tried counseling the woman about the dangers of prescription drug abuse, how it’s easy to kill yourself and usually makes pain worse, and offered to help her get off the meds, but the junky started screaming obscenities at her and the staff.

I recommended punching her in the head but Dr. Wife and her staff got her out of the office without resorting to violence. I still think a punch in the head is warranted, perhaps two, but then again I’m not a doctor so I don’t know what the dosages are for punches to the head. Perhaps I should check with the LAPD.

There’s a special circle in hell reserved for the doctors and nurse practitioners who supply these junkies. It’s a lot more difficult to try to help these people than throw drugs at them. Helping them takes longer; it takes seconds to print out a script for OxyContin, sometimes 30-60 minutes to talk a junkie down, and what’s the billing code for that? Dispensing pills like some white-coated Santa Claus throwing candy off a firetruck will make you popular with your patients too, but at a price.

A few years ago in a nearby county one of my wife’s patients, an 11 year old boy, died in a car accident. His parents were pill-heads and high when they made an illegal turn in front of a tractor trailer. All three were killed instantly. I spoke to one of the first responders on the scene. He told me how the car had rolled over and how he found the boy hanging lifeless in the backseat. Empty pill bottles littered the scene. The accident happened in front of a popular restaurant in the county and every time I drive by it I can’t help but think of that little boy. I never met him, and it’s hard for me to explain, but I can’t help but sense there’s a hole in the fabric of spacetime where an innocent child died because of the mistakes made by his parents abetted by their health care providers.

Whenever Dr. Wife tells me about the grief she gets in the office from demanding pill heads, I think of that accident. There were the names of many doctors on those bottles, but not my wife’s. She cares too much for her patients to help them kill themselves – and others as they so often do. But other health care providers don’t give a crap, or worse, think they are helping these junkies by giving them the pills they request. These pill dispensing Florence Nightingales are just as delusional as their addict patients.  They wouldn’t think of handing car keys and a case of scotch to their teenage patients even if they begged for them, yet they can’t say know to adults asking for medications that are much more dangerous than alcohol. And it’s left to responsible health care providers like my wife to clean up their messes.

With Obamacare, falling reimbursement rates, unpaid paperwork and non-compliant patients doctors don’t need another burden in their professional lives, yet everyday they deal with addicts, and sadly, it’s a burden that the profession is partly responsible for creating.

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  1. Lee:

    I went to a doctor* not long ago for back pain. I wanted: A) To make sure there wasn’t anything more seriously wrong than bad posture and being out of shape; and B) Exercises if my suspicions were correct that it was just bad posture, being out of shape and an old injury all combined with getting old.

    I got a prescription for some muscle relaxants. I took them many years earlier when I had first injured my back, and they were gone for the day or woo of agony, but once agony subsided into “sore,” I hated the muscle relaxants.


    I explained that I didn’t WANT that. I explained my PRIMARY interest was that there was nothing else wrong with me. (I had had a friend who complained of back pain for some time. She went to an acupuncturist and a chiropractor, but not a real doctor until it was too late. She had had metastatic breast cancer that had gotten into her spine. She died less than a month later. At the time i went to the doctor, I was dealing with my mom who has spinal stenosis. But I also have two old injuries, bad posture, and I’m out of shape. Of were that was my trouble…)


    He took the original prescriptin back. I left with a prescription for naproxen sodium and a list of exercises.

    • Since O-care started kicking in, my doctor’s office has been a revolving door of doctors. They should quit putting their names out front—it’s a new one ever month. My insurance only slightly changed, and the same PRACTICE is still in my plan—it’s just the DOCTORS keep changing. Sigh.
  2. Scott Kirwin:

    My mom has bad spinal stenosis too and is on enough oxycontin to make half the county high. Unfortunately the drug makes here sleepy and really only does enough to take the edge of her pain, but at 93 it’s the best modern medicine has to offer. My father-in-law’s metastatic cancer also presented as back pain. You can read about that experience here. http://www.therazor.org/?p=340

    For most people with acute pain caused by injuries, it’s better to suffer through it. Exercise, mindfulness/meditation and even acupuncture offer ways of handling it than prescription drugs. People have these expectations that drugs are like some magic eraser that wipes out the pain, and they don’t work that way.

  3. lee:

    After the agony of my original back injury started to subside a bit was when I learned that for most back pain, exercise and acupuncture work really well. I’m no longer living in a big acupuncture place, alas. So exercise alone. I’m terrible at the mindfulness. Took a million sessions in it. I think the acupuncture helped less because of anything behind the theory of it than because it was sooooooooooo relaxing.

    A really good office chair also helps.

    The other thing I learned about much muscle pain is that the pain helps keep you from doing something stupid.

    My mom didn’t get much for her back pain. She passed away last year at 86. By that point, her back pain was pretty bad.

  4. florenceva:

    I work in a city emergency room. 90% of our patients are seekers and frequent flyers. One evening we had a substitute doc from DC come in. A few hours after his arrival we had to call security. The patients were going crazy because he wouldn’t prescribe narcotics—I think his choice for most was ultram. That was quite a change from our doctors who passed out Loritab like candy.

    I must say after 20 years of working here it is getting better. Our physicians are becoming alot more reluctant to prescribe narcotics.

    Addiction is a plague—young people are addicted to painkillers, tranquilizers at alarming rates. It’s haunting how this has developed over the last two decades. But think about it—a very powerful drug like Ritalin was mainstreamed into our culture and when you have chemical solutions for children experincing emotional and spiritual angst that manifest in their behavior then it’s no wonder everyone is on something when they grow up. It’s so sad the little boy was the victim of his parents’ behavior. I am Catholic and in recovery for 25 years and I believe he is with Our Lord.

  5. The Razor » Blog Archive » Council Submissions: October 1, 2014:

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