Me: "What brings you in today?"
Patient: "I need refills on my pain medications."
Me: "It says here that your doctor referred you to a pain clinic for these a year ago."
Patient: "Yeah, I just don't like my pain doctor."
Me: "Why is that?"
Patient: "He switched my oxycodone to this new medicine. It's still oxycodone, it's just not the same."
Me: "Oh, you mean he switched you to Oxecta?"
Patient: "That's the one."
Me: "That's the new version that's supposed to be abuse resistant."
Patient: "Yeah, those things are impossible to crush, not like my old ones."
Me: "You aren't supposed to crush oxycodone. Ever."
Patient: "Well, I only did it when I was mixing myself a drink."
#sigh
As a side note: I recently read a study that showed that introducing tamper-resistant oxycodone into the general population did not change the percentage of people abusing drugs, it just made them switch to harder stuff to get their high, even heroin.
2 comments:
When I was in the emergency room last week they brought a man in who called an ambulance because he'd scraped his knee. He said he had MS and had only small bottle of Makers Mark and that he was allergic to toradol. He yelled no stop for two hour. My blood pressure monitor would start beeping and he'd yell with every beep. It was disgusting. I started mocking him and telling him exactly why nobody believed him.
Him: "Owwww! Somebody help me!"
Me: "You know people in real pain don't yell like that. There is nothing urgent in your voice. People in real pain mostly moan and sometime cry out. You can tell the difference."
Him: "Owwwww, my back hurts so bad! Can someone please get this b to shut the f up?"
Me: "See that guy over there. He's got cancer. He's not yelling like you. And see how pale he gets before before he cries out? You can't fake that."
Him: "Can you shut the f up? Owwww, I'm in pain. I need some dialudid. (sorry don't know how to spell it.)
Me: "Nobody's going to give you that fool. They had your number the moment you told them you were allergic to toradol. If your doctor gives you a tylenol it just shows that he is spineless."
The guy was awful. I was so glad when the CT scan results came back negative and I could leave.
Oxy is the most prevalent drug of choice here in San Diego, they cross the boarder and bring it back to support the habit. I know it must have a place in medicine. However there seems to be nothing as addictive as Oxy. Please prescribe with the ultimate of care.
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