I get really tired of feeling sorry for a new time server, who claims to have degenerative disc disease, and a torn ligament or whatever, send me on a wild goose chase for records to clarify DX. I had this guy come in with a bottle of Methadone, original fill date 2-25, fill date 2-25, 180 pills dispensed, it's 10 days later, he knows he's gonna serve 85 days and the bottle is empty. He tells the booking officer " my doctor said dump it out at home and the jail will fill it". I said like **** we will! I open the bottle and sniff, and it smells like weed,
in fact, there's even some green flakes in the bottom of the bottle. He says "gee, how could that happen?". I asked him if he thought I was retarded or something. I called the jail doctor and were not giving anything for pain until we see some records, by the way the prescribing doctor for the Methadone is not responding, just says " yea yea I will I will".
This is one time when they will not get the med they say their supposed to be on. I know there are Doctors out there that will prescribe just to get the low life out of their office, but please, have some back bone. SHEESE!
Apr 11, '05
Thank you for all the answers to my question regarding the withdrawal from prescribed pain medication. You all made interesting points, some I had never considered. NurseT, you had said something about elderly people going through a withdrawal and I think that is something I have heard colleagues say, I was thinking about it after that and this is probably the case with a lot of elderly patients since they would tend to metabolize and secrete the medication differently, more slowly, than the younger patient. BSNTX-Thanks for the info on withdrawal from the other meds, this is something I never really knew. I know that you can't just STOP certain psych meds, especially benzodiazepines, but some of the hypertension meds you mentioned I was unaware of. What I tend to have a problem with is when an inmate tells me on intake that he or she only takes their medication (pain meds) as Rx'd then they end up having this terrible withdrawal episode because, in truth, they eat the things like candy...such is the "nature of the beast", I guess. One of you had said that it depends on the type and severity of withdrawal...this has been my experience, as well, as our one psychiatrist used to say, "You can't die from narcotics withdrawal...you'll feel like crap for awhile, but not life-threatening." Of course, my experience bares that, the worst withdrawal symptoms I have seen have been alcoholics. They, of course, need a longer monitoring period as they can sometimes not have withdrawal until later when all the ETOH finally starts to get cleared from body. I am always watchful of the alcoholic that admits to drinking a case or two of beer a day, since alcoholics always tend to minimize their habit...if he admits to 2 it's more like 4 or 5. Has that been you experience? How about the narcotics withdrawal? Anyone ever experienced an inmate with life-threatening problems r/t narc. withdrawal? And I have a hard time feeling sorry for these inmates who lie on intake and say they don't use then later they are in the unit c/o withdrawal...only then do they admit to use...have you had this experience? Thanks for your input!
Last edit by crjnursewarrior on Apr 11, '05