Dr. Dawn Obrecht
“The prescription drug epidemic” is a topic discussed everywhere in the U.S.; and talk is cheap. I have just been made aware of a new city policy in New York. Narcotic prescribing by physicians in Emergency Rooms in public hospitals will now be restricted. The new policy will allow doctors to prescribe no more than 3 days worth of any narcotic, and none of the big-time Oxycontin, Fentanyl and methadone. No “stolen”, lost or eaten-by-the-dog scripts will be refilled. Halla-flippin’-luia! It is about time someone in authority did something concrete. I congratulate Mayor Bloomberg for taking a stand on the national epidemic of prescription drug abuse. Maybe a policy will be more useful than discussion. Yes, there is much more to do, but at least someone is doing something.
Two years ago I worked in a clinic in a small town for several months. (I am a traveling doc when I am not at home writing). I was based at an “Urgent Care Center” that had a longstanding policy to not prescribe narcotics. Whew, we providers were off the hook and could simply say to the drug seekers that we don’t keep narcotics on the premises, nor are we “allowed” to give out prescriptions for them. End of story. Make the clinic the bad guy and avoid lengthy discussion with each drug seeker. Word spread rapidly that this clinic was not the place to go if all you wanted was drugs; the staff was able to focus on patients with genuine medical needs. Very few conditions require narcotics, so this policy did not prevent appropriate medical care. In the rare case of a patient in that facility having severe pain, alternatives to narcotics were available. They could also be referred to the local hospital or back to their own doc or the appropriate specialist.
Meanwhile, non-narcotic medication really works, especially when combined with ice packs or warm baths, two luxuries we have in this country; and especially when we are otherwise drug free.
I have written about my medical missions to developing countries in, Mission Possible, A Missionary Doctor’s Journey of Healing, 2008, Amazon. The profound gratitude I repeatedly receive from my patients is overwhelming…when we are of service, we really do get more than we give.
On a mission to Kenya to work with the Maasai, we had three pain meds to offer: ibuprofen, aspirin and acetaminophen. None of our patients expected more and all were grateful to receive a few pills to ease the discomfort of an earache, headache, back pain, minor surgery or dental procedure. In Indonesia, after the tsunami of 2004, one of my patients had a traumatic amputation of his leg. He received antibiotics and aspirin initially, as that is what the “hospital” had. When I saw him the next morning, I gave him a low dose of Tramadol, an excellent painkiller, while nowhere near the potency of Oxycodone. One hour after ½ of a tablet, when his pain was significantly lessened, he thanked me profusely.
Those of us in recovery can make our amends to the medical profession by teaching doctors that we don’t need narcotics for every minor ache and pain. Tell your doc to save the narcotics for someone who has just had surgery or has broken a bone. Make it clear that you don’t need it for your minor muscle aches. Given a chance, other methods will work.
Next week: Dangers of using pain pills for addicts in recovery.
Copyright, Dawn V. Obrecht, M.D. Jan, 2013
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