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Prescribing painkillers a dicey business Date published: 4/29/2007
MOST patients take medicines only grudgingly if at all. Even if it's something absolutely essential, like diabetes medicine or blood pressure pills, they will let themselves run out and give us fits for fear they'll have a heart attack or stroke. But there is one subset of patients who are just the opposite. They turn up in the front office and make a scene. They call every hour. They falsify scripts and generally act thoroughly nasty if they are even close to running out of their medicines. These are people on benzodiazepine tranquilizers and pain medicines, and they cause my colleagues and me a lot of anguish. 'MOTHER'S HELPER'Benzodiazepines are technically tranquilizers, but that makes one think of elephant guns and veterinarians. The politically correct term is "anxiolytics," meaning they treat anxiety. Valium was the first The sages of our profession nowadays recommend weaning people off the drugs. But tell that to some highly strung old lady who's been on Xanax three times a day for 15 years and is thoroughly dependent. See how popular it makes you. Painkillers are the other big class of medicines that cause dependency. Virtually all of the major painkillers (including the different types of codeine) are derivatives of the parent compound, morphine, itself a derivative of opium--which of course comes from those pretty poppies the Afghans are so fond of growing. Most infamous among these are Percocet, Oxycontin and Vicodin (made famous as the drug of choice of TV's Dr. House). The list is very long. In my practice and those of many other providers, there are multiple patients with painful conditions such as back pain, arthritis and fibromyalgia who consume massive quantities of pain pills. It makes me uncomfortable.
1. Be respectful. No personal attacks.
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