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.