How are each of you dealing with patients who are abusing prescription medications? There has been so much emphasis put on the patients right to pain control (over the past ten years or so). I understand and agree with this belief.
However, there are also many, many patients who (although not always a planned thing on their part) have become addicted to prescription pain medications.
I know clinically how we handle this (pain agreements, referrals to alternative pain control specialties such as massage therapy, psych counseling, etc), but my question to you all is: How do you personally deal with this on the patient level. We are trained as nurses not to "judge", yet I find myself growing increasingly angry at these patients who knowingly abuse there medications and then come in early for more. I feel I am being "played" when they hand me a line about losing there medications or tell me "they were stolen" or any other lame excuse.
Another question I have is: If the MD does not prescribe the medication that day and the patient goes into withdrawls, is he not liable? If he does prescribe it early to keep this from happening, are there not legal ramifications for this as well? Sounds like either way we loose and in the long run the patient does too.
