Drug Abuse Among Us??

jude11142 · Jan 8, 2003

Originally posted by Jen911
Okay, now a view from the other side of the fence. I have a chronic pain problem for which I have prescribed narcotics. I'm always careful never to take them on work days, never go to work impaired, and refuse to take them within 24 hours of the beginning of a shift (would rather suffer than to go to work impaired or call in sick which is very rare). I've asked my physician to change me over to a longer acting *non*narcotic pain med, but he doesn't feel it would work, and I would still need just as many narcotics as I currently do now for breakthrough pain.

Everyone I work with knows I have chronic pain. I'm always careful about my narcotic wastes because the LAST thing I want to do is be accused of diverting narcotics from the ER. I've had RN's sign off on wastes with me, then start to leave the med room before I actually waste the drug, I make them come back in and physically watch me waste that drug. Yeah, it's a pain for me (and for them) to do this, but I'm covering my butt. Once I remind nurses about my reasoning, they're very understanding. Perhaps in some places we make it just a little too easy for our co-workers to divert these drugs....

Just my own little 2 cents....

Hi Jen,

I am also a nurse who suffers from chronic pain that requires strong pain meds. I am also very careful not to take them while working/driving etc.....When I worked in the OR, it was in the height of my many surgeries and the beginning of my life of chronic pain, It didn't really affect my job nor did anyone really know about it, other than I have had some surgery. I left when I had children and was able to be a stay at home mom. After the kids were in school, I went to work in a short-term surgi-center and several co-workers knew about my "health issues"....I am sorry that I chose to tell them because in more than one instance, scripts were stolen/narcs etc....I never got confronted by administration but did overhear several coworkers trying to "figure out" who the culprit was and was shocked when I heard my name mentioned. Not only shocked but very hurt. To make a long story short, then investigated and it was found out that an anesthesiologist had a drug problem.

Now, I don't let anyone at work know about my prior surgeries and the daily pain that I have. I am also very careful with the narcs, like you when I have to waste a narc, I will also call back the other nurse if she/he walks out before I discard it. I never want to be in a position where I would be questioned as a suspect if narcs were stolen/abused etc....I have found that when people(not just coworkers but family/friends)find out that you are on narcotic pain meds, many assume that you are addicted to or are unable to think clearly when taking them. Even once, when I was having a real bad day, the pain was unbearable, nothing worked etc....I had a family member say to me, "what's the matter, are you out of your pills?"....I was sooooo mad, same person joked with another another family member that I take pills strong enough to knock out a horse....what jerks.....It's no fun living with a chronic condition, let alone work with it. I have chosen not to let it control my life and I try and work very hard at trying to live a "normal life"....I refuse to have others judge me, doubt me, accuse me of things because I have chronic pain. lol, I'm sorry, guess that I am getting off subject and getting alittle sensitive.

JUDE

RN2B2005 · Jan 8, 2003

Not really on-topic, but...

My mother calls me at work. She's on her cell, driving down the freeway. She has chronic LBP, and has just seen her (new) physician for an exacerbation of the pain. The doc has Rx'd some pain medication, which my mother has picked up and has already taken.

So...I ask her, what did the doctor prescribe? She says, I don't know, but it's working already. I ask her to look at the med bottle and read me the label. She says, OK, well, it says "hydrocodone/APAP". I say, Hydrocodone? With acetominophen? Mom, that's Vicodin.

My mother laughs and says, "Oh no, honey, I wouldn't take Vicodin, that stuff makes me all loopy."

She ended up pulling over, and I went and picked her up. She thought she wasn't impaired...but she was, and in fact fell into a narc-induced sleep on the way home. So psychnurse is right, the PERCEPTION of impairment on the part of the narc or alcohol-impaired individual is usually wildly different from the ACTUAL impairment of the individual.

SmilingBluEyes · Jan 8, 2003

Originally posted by FutureRN_Mandi
Ive worked under the influnce of vikoden. Either I had o have vikodin or I was not going to be there. I was in TOO much pain. I had a horrible ear infection with throbbing pain, and blood and puss was just running out my ears, down both sides of my neck, it was so awful. I was in so mch pain that i wanted to curl up in a little ball, and then croak. [/quote
you do realize being under the influence of ANY drug, whether prescribed to you or not, is still a problem when working?? You are liable for what you do whether you use this drug or not. Vicodin, like any narcotic, can impair judgement and reflexes. I personally would NOT work if I had to be using a strong narcotic to get through my day.
Plus, as sick as you were (pus draining from your ear?) you had no business at work anyhow....for YOUR sake and the SAKE of your coworkers and patients . You could be contagious! Sometimes, we need to let common sense rule over our sense of duty to be at work!

SmilingBluEyes · Jan 8, 2003

Originally posted by Kizomo
all narcs had to be counted with 2 persons... one of whom had to be an RN... 2nd could be a student. Drugs such as Tyl 3s also had to be counted by 2, but both counters could be students. I'm not sure if it's still that way today... it's been 20 years since I worked there, and there have been sooooo many changes all around. I realize that using 2 people to count is quite impractical these days, but hey... it sure did make it difficult to divert any wasteage. I remember being dumbfounded when I first came to Canada, and discovering narcs only needed 1 person to count.... it really is a recipe for disaster. I wonder, that if in-hospital training were brought back, there would be a steady supply of students, making it easier to do a 2 person count... just a thought...

when I went to school students were not allowed to TOUCH narc's period. We had to get an instructor or licensed nurse to sign them out and give them. This was in 1997. Also, having 2 people count and witness waste is the ONLY way you can cover yourself in the event suspicion is raised. I will NEVER waste ANYTHING w/o a direct eye witness, period. It keeps everything above-board and keeps me in the clear. No amount of convenience or time-saving is worth the aggravation and pain of an intense investigation because procedure was lapsed and people have not followed-though.

I remember, once, several years ago, when I was working nights, I found a vial of Ketamine (appeared to be full but seal was broken) laying behind a couch in the breakroom. What fun it was, turning that in. The paperwork involved. I automatically self-submitted to a urine drug screen as did all of us on that shift. In the case of any suspicions, we wanted our names in the clear. My conscience and record are crystal-clear and I want it to stay that way.

duckie · Jan 8, 2003

The attitude I have gotten from many posts here that if anyone routinely takes a narcotic pain relief med, they should not be working. I am speaking for myself and on my own views here. First drug abuse is much different than taking meds scripted by your MD to improve the quality of your life and the ability to maintain having a life. I have a spinal fusion involving 3 disc's in my lower back with radiating nerve damage down my right leg. I also have severe athritic knees from 22 years of walking hard cement floors caring for loved ones of people intrusted into my care. I fought very hard not to start taking pain medications. But when you reach a point, where you are on your knees doing a treatment and your patient has to call a staff member to help you up off the floor because the pain is so great you are frozen, something has to give and this happened to me more than once. My knees are beyond saving . Pain control is the only way to keep me working. I am 46, should I be kicked out of nursing? Should I be expected to work 10-12 hour shifts in so much agony that the tears rolls down my face without my ability to control them. Or should I be taken out and shot like a lame horse, because I am unable to meet the potentil I once did as a younger nurse, and I might add that even on the days of my greatest pain, I can still work circles around many of the whiny new breed intering our facility that calls off because they have a headache. I have finished med passes while passing kidneys stones on 2 occassions. I routinely take pain meds every four hours while working with another narcotic available if that does not make it tolerable. My work performance is not hampered. I think clearly, make vital decisions and have not had a med error in over the seven years at my current facility. So am I empaired. I have ran codes, worked an entire unit alone that was a 2 LN unit, due to call offs, and my average day is 9 - 12 hours. My supervisors know all meds I take. They back me 100% because the old me is back now that my pain is controlled and I can be me again. Please do not" critisize and accuse until you walk a mile in my shoes." My supervisors have even "noticed my pain and asked me to "take a break and give my meds a chance to kick in, to rest a while in the lounge. They do this because they know I never take breaks, I'm there for my patients from start to finish and will work as late as I have to to make sure they have received the very best of care. The discussion at hand is "drug abuse" not medications that are taken as ordered for a good quality of life. If that is the case, then any LN taking an antidepressant or antianxiety medication should also not be allowed to work, because they are also "mind altering". Now instead, let's all go out and get totally drunk the night before, come in hungover and what the dickens and " can I take care of your loved one?" I think not, I'll continue to do it my way and with a very clear peace of mind. Don't judge me till you've felt my pain and walked in my shoes. I would also like to specify that I do not feel "any buzz" from my meds, they have been titrated to minimum dose for maximum effect without those side effects and the principle is keeping the drug level consistant to control pain but not to produce a "High".

Furball · Jan 8, 2003

Hey Duckie, you're one tough cookie! Quick question...what does a kidney stone FEEL like? I'm asking because I had a weird, horrid crampy, knife like pain in my side last night at work...it took my breath away, kinda came and went, then came back again.

Thanks from a hyperchondriac!

duckie · Jan 8, 2003

Originally posted by Furball
Hey Duckie, you're one tough cookie! Quick question...what does a kidney stone FEEL like? I'm asking because I had a weird, horrid crampy, knife like pain in my side last night at work...it took my breath away, kinda came and went, then came back again.

Thanks from a hyperchondriac!

Actually that is the way both of mine started. The pain continued to build and I rushed thru my med passes, made it to the hospital the second time as my B/P hit 240/170, Dilaudid is a wonderful drug, passed that puppy in two hours once I could relax. We can actually pass kidney stones and not realize it, they can be so very tiny but the ones that are slightly larger, the size of a pin head, with the sharp edges are the killers. I've had three total, run in my family but none of us have had them since I put everyone on cranberry pills BID. Works wonders cause they keep the "Demons" from forming ....... ah, what a relief! Hope that helps.:)

KaroSnowQueen, RN · Jan 8, 2003

I cannot believe the uninformed judgmental attitudes of some of these posters. People with chronic pain who take the proper medications CAN work, CAN function in an appropriate manner. I suffered from SEVERE headaches and I could take Lortab and work and concentrate. Motrin, Tylenol, all were useless. My supervisors and co workers were aware of my pain and my medications. I asked both my supervisor and my charge person to be sure and tell me if they noted any problems with my functioning, etc. Instead, they would tell me to go take my medicine and a break and come back when I began to feel better.

Now some other narcs, Flexeril, oh boy, I couldn't take one and stand up for more than ten minutes.

EACH person HAS meds that help them without messing them up. This was mine.

PAIN MANAGEMENT is a big thing now, and I can see why. People do take pain meds because they are in pain and want to function fully, NOT just to get high.

SmilingBluEyes · Jan 8, 2003

Originally posted by KaroSnowQueen
I cannot believe the uninformed judgmental attitudes of some of these posters. People with chronic pain who take the proper medications CAN work, CAN function in an appropriate manner. I suffered from SEVERE headaches and I could take Lortab and work and concentrate. Motrin, Tylenol, all were useless. My supervisors and co workers were aware of my pain and my medications. I asked both my supervisor and my charge person to be sure and tell me if they noted any problems with my functioning, etc. Instead, they would tell me to go take my medicine and a break and come back when I began to feel better.

Now some other narcs, Flexeril, oh boy, I couldn't take one and stand up for more than ten minutes.
EACH person HAS meds that help them without messing them up. This was mine.
PAIN MANAGEMENT is a big thing now, and I can see why. People do take pain meds because they are in pain and want to function fully, NOT just to get high.

Duckie and Karo, the people I am referring to as potentially "impaired" when using narcs are the ones who are likely to be more narcotic-naive in the first place, not chronic pain sufferers who use them daily. The ones who don't use them routinely for months and years have NO business working until they know no untoward effects that could hamper judgement or reflexe

SmilingBluEyes · Jan 8, 2003

Originally posted by KaroSnowQueen
I cannot believe the uninformed judgmental attitudes of some of these posters. People with chronic pain who take the proper medications CAN work, CAN function in an appropriate manner. I suffered from SEVERE headaches and I could take Lortab and work and concentrate. Motrin, Tylenol, all were useless. My supervisors and co workers were aware of my pain and my medications. I asked both my supervisor and my charge person to be sure and tell me if they noted any problems with my functioning, etc. Instead, they would tell me to go take my medicine and a break and come back when I began to feel better.

Now some other narcs, Flexeril, oh boy, I couldn't take one and stand up for more than ten minutes.
EACH person HAS meds that help them without messing them up. This was mine.
PAIN MANAGEMENT is a big thing now, and I can see why. People do take pain meds because they are in pain and want to function fully, NOT just to get high.

Duckie and Karo, the people I am referring to as potentially "impaired" when using narcs are the ones who are likely to be more narcotic-naive in the first place, not chronic pain sufferers who use them daily. The ones who don't use them routinely for months and years have NO business working until they know no untoward effects that could hamper judgement or reflexes will affect THEM while driving or caring for patients. Again, common sense needs to be used here. And obviously, most of thdse posts did not refer to YOUR situations.

duckie · Jan 8, 2003

Originally posted by KaroSnowQueen
I cannot believe the uninformed judgmental attitudes of some of these posters. People with chronic pain who take the proper medications CAN work, CAN function in an appropriate manner. I suffered from SEVERE headaches and I could take Lortab and work and concentrate. Motrin, Tylenol, all were useless. My supervisors and co workers were aware of my pain and my medications. I asked both my supervisor and my charge person to be sure and tell me if they noted any problems with my functioning, etc. Instead, they would tell me to go take my medicine and a break and come back when I began to feel better.

Now some other narcs, Flexeril, oh boy, I couldn't take one and stand up for more than ten minutes.
EACH person HAS meds that help them without messing them up. This was mine.
PAIN MANAGEMENT is a big thing now, and I can see why. People do take pain meds because they are in pain and want to function fully, NOT just to get high.

Thank you, my sentiments exactly! I would never work impaired or take a drug that caused that. My medications orders were settled after many months of tring different combos and finally coming up with a winner. BUT I also refuse to walk on my feet all these hours with tears streaming down my face when a pill can bring me back to normal living.

SmilingBluEyes · Jan 9, 2003

Originally posted by Duckie
Thank you, my sentiments exactly! I would never work impaired or take a drug that caused that. My medications orders were settled after many months of tring different combos and finally coming up with a winner. BUT I also refuse to walk on my feet all these hours with tears streaming down my face when a pill can bring me back to normal living.

you would not but MANY others do.......i think if you re-read the posts, you would see most do NOT refer to cases like yours! we are referring to different cases, here ya know.