Why would a Dr who had a patient for over 10 years and knew the patient had an addictive personality.?

Question

and addiction problems with alcohol and drugs most of the patient's adult life perscribe a narcotic pain medication for them, especially when a spouse told the Dr that they were quite concerned because of the patient history with addiction? Serious responses please. I am trying to understand this decision and I haven't been able to. The patient did not have pain from a terminal illness, they had pulled something in their back.

And yes the patient became addicted to the med and after 4-5 years is now in a methadone program.

This particular Dr prescribed the meds for longer than a short time and then when he finally would not prescribe any more, the person had become dependent on them and went to the streets to get the med. This problem of people getting hooked on pain-killers their Dr prescribed and then going to the streets to get them is a bigger problem than is realized by most. I also know that in the med field today their are other ways and methods of dealing with chronic pain. There are Dr who specialize in treating pain without narcotics, but using other safer meds. They work in pain clinics and dealing with chronic pain is what they have been trained to do. I have been told by a Dr, who does not readity prescribe pain-killers, that many times prescribing pain-killers is just the easiest and faster and that is why some Dr go that route.

Answer 1

As a physician I have seen doctors do this. Of course, when they came to me, I refused to refill the Rx. I have no explanation. Not to lose a patient???

Answer 2

Has this person had surgery on their back? If not why has the MD let him go so long without referring the patient to a good neurosurgeon?

Were you with this person each time he went to the doctor? Narcotic pain medicine is relatively safe when used as prescribed and for a short term. If the patient abuses the medication and is constantly asking for early refills then the problem needs to be addressed.
The narcotics are masking the true problem and that is the back injury. Correcting the injury through surgical or physical therapy methods would decrease the need for the narcotics. There are also some good non-narcotic pain medicines, just ask the doctor to prescribe one.

Sometimes you have to weigh the pros and cons of giving a narcotic. The MD is treating the pain with the narcotics; this is kind of a double edge sword. On thwe one hand you get narcotic pain relief on the prescription of a board certified MD and risk addiction, then on the other hand if the MD did not treat the pain aggressively then you run the chance of the patient obtaining illicit drugs on the street and if caught will spend time in jail and the back injury would likely be swept under the rug so to speak.

I hope this helps. The best thing is to support and encourage the patient. Be positive and reassure.

Answer 3

a question like this is hard to answer without knowing all of the facts, i work in an orthopedic office as pts like this have come thru our office often, yes there are those who are addicted to these meds, yet back related back has been known to be as terminal. The doctor has no control over the illegal drugs .. this is a hard situatin to determine as unless you can truly understand that chronic back pain is something none of us ever want to have to endure than you can hope that the doctor is making their best judgment for the patient... this is something you should speak to the doctor about if you have geniune concerns.

Answer 4

I sympathize with the heartache. There is probably no way to know what the doctor was thinking about other than relieving pain. It is also true that NA and AlAnon, along with Rational Recovery all teach that if you allow the user to not be responsible for their actions, recovery will not be possible. It's harsh but they seem to know what they are talking about.

Answer 5

Perhaps the Doctor thought it was in the best interest of the patient, but this condition should have been considered.

Answer 6

More money, more money, more money.

Doctors are in it...
1) For themselves
2) For their patients

Why do you think most of them accept the lunches from drug reps almost every day? Is it really only concern for patients?

Answer 7

Wisdom and intelligence are not the same. Also, many do not become a doctor just because they 'care' a lot. It's just a job for many of them.