Comments on: Drug seeking in primary care http://www.kevinmd.com/blog/2007/07/drug-seeking-in-primary-care.html Tue, 14 Feb 2012 17:18:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2007/07/drug-seeking-in-primary-care.html#comment-78214 Anonymous Thu, 26 Jul 2007 13:43:00 +0000 http://clients.emmense.com/kevinmd/2007/07/drug-seeking-in-primary-care.html#comment-78214 WHICH tests might those be? WHICH tests might those be?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/07/drug-seeking-in-primary-care.html#comment-78209 Anonymous Thu, 26 Jul 2007 05:56:00 +0000 http://clients.emmense.com/kevinmd/2007/07/drug-seeking-in-primary-care.html#comment-78209 Why could you be prosecuted for prescribing someone a few ultrams, when you have diagnostic tests results to prove the claim of chronic pain? Why could you be prosecuted for prescribing someone a few ultrams, when you have diagnostic tests results to prove the claim of chronic pain?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/07/drug-seeking-in-primary-care.html#comment-78206 Anonymous Thu, 26 Jul 2007 04:29:00 +0000 http://clients.emmense.com/kevinmd/2007/07/drug-seeking-in-primary-care.html#comment-78206 Before prescribing pain medication be sure to get your local District Attorney, as well as the DEA to sign off on it. It's amazing how much medical knowledge these attorneys have! Before prescribing pain medication be sure to get your local District Attorney, as well as the DEA to sign off on it. It’s amazing how much medical knowledge these attorneys have!

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/07/drug-seeking-in-primary-care.html#comment-78193 Anonymous Thu, 26 Jul 2007 01:19:00 +0000 http://clients.emmense.com/kevinmd/2007/07/drug-seeking-in-primary-care.html#comment-78193 I guess the first poster thinks that I shouldn't worry about my quality of life in the federal pen? I guess the first poster thinks that I shouldn’t worry about my quality of life in the federal pen?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/07/drug-seeking-in-primary-care.html#comment-78182 Anonymous Wed, 25 Jul 2007 21:51:00 +0000 http://clients.emmense.com/kevinmd/2007/07/drug-seeking-in-primary-care.html#comment-78182 I usually have a half dozen chronic pain patients most of whom no-one else will touch. All of them sign a contract: one name, one doctor prescribing, one pharmacy, a regular monthly visit, accept referrals to a specialist or pain center if I recommend it, drug test several times a year. Anyone who wants a reocurring narcotic prescription signs one. I have one who is very tolerant of oxycodone but has multiple medical problems and is a borderline personality as well. I have discussed her case with the state med board legal rep as well as all of the pain clinics in the eastern part of the state and no-one else has any better ideas. I tell every one of them that I am not about to compromise my license over them and if they cross the line they are out. I have to dismiss about one or two a year. The first job in dealing with someone who needs a narcotic pain med is finding out what causes the pain. Then the best way to treat the pain. Yes, I get fooled occasionally, but this is a small community and it is pretty rare. I usually have a half dozen chronic pain patients most of whom no-one else will touch. All of them sign a contract: one name, one doctor prescribing, one pharmacy, a regular monthly visit, accept referrals to a specialist or pain center if I recommend it, drug test several times a year. Anyone who wants a reocurring narcotic prescription signs one. I have one who is very tolerant of oxycodone but has multiple medical problems and is a borderline personality as well. I have discussed her case with the state med board legal rep as well as all of the pain clinics in the eastern part of the state and no-one else has any better ideas. I tell every one of them that I am not about to compromise my license over them and if they cross the line they are out. I have to dismiss about one or two a year. The first job in dealing with someone who needs a narcotic pain med is finding out what causes the pain. Then the best way to treat the pain. Yes, I get fooled occasionally, but this is a small community and it is pretty rare.

]]> By: Petrihttp://www.kevinmd.com/blog/2007/07/drug-seeking-in-primary-care.html#comment-78179 Petri Wed, 25 Jul 2007 17:27:00 +0000 http://clients.emmense.com/kevinmd/2007/07/drug-seeking-in-primary-care.html#comment-78179 I seem to remember a doctor who tried her best to treat people's pain. Oh yeah, she was charged with murder. <br/><br/>It's just so damn complex. Your spineless doc who doesn't want to treat pain is another person's candyman, is the DEA's suspect. You have a patient who presents with mild non-specific pain, ask ten people how to proceed and the answer would vary from person to person. Some would prescribe, some would refuse, some would "street" them, some would arrest those who treated, some might just euthanize. This is the inherent problem with governing a subjective treatment with black/white laws. It won't work.<br/><br/>I personally think that this doctor's way of handling drug seekers is reasonable. I used to shadow a doctor who made his pain med patients tak edrug tests to prove they were taking it at the right dosages and not selling, he also had them sign agreements to fill at one pharmacy. If they broke the agreement he stopped prescribing. I seem to remember a doctor who tried her best to treat people’s pain. Oh yeah, she was charged with murder.

It’s just so damn complex. Your spineless doc who doesn’t want to treat pain is another person’s candyman, is the DEA’s suspect. You have a patient who presents with mild non-specific pain, ask ten people how to proceed and the answer would vary from person to person. Some would prescribe, some would refuse, some would “street” them, some would arrest those who treated, some might just euthanize. This is the inherent problem with governing a subjective treatment with black/white laws. It won’t work.

I personally think that this doctor’s way of handling drug seekers is reasonable. I used to shadow a doctor who made his pain med patients tak edrug tests to prove they were taking it at the right dosages and not selling, he also had them sign agreements to fill at one pharmacy. If they broke the agreement he stopped prescribing.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/07/drug-seeking-in-primary-care.html#comment-78175 Anonymous Wed, 25 Jul 2007 16:54:00 +0000 http://clients.emmense.com/kevinmd/2007/07/drug-seeking-in-primary-care.html#comment-78175 You're right. We always look for ways not to treat people. Anyone who would ask for pain meds must need them.<br/><br/>Funny how they never seem to need crutches when you run into them at the mall, though. You’re right. We always look for ways not to treat people. Anyone who would ask for pain meds must need them.

Funny how they never seem to need crutches when you run into them at the mall, though.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/07/drug-seeking-in-primary-care.html#comment-78172 Anonymous Wed, 25 Jul 2007 16:28:00 +0000 http://clients.emmense.com/kevinmd/2007/07/drug-seeking-in-primary-care.html#comment-78172 way to find more excuses not to treat people in pain. why is it that doctors don't give a rat's ass about anyone's quality of life but their own? way to find more excuses not to treat people in pain. why is it that doctors don’t give a rat’s ass about anyone’s quality of life but their own?

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