Nurses against Narcotic Abuse

Nurses General Nursing

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As an Emergency Room Nurse for 5 years, and a Critical Care Nurse for 3, I still think the most harmful disease by far is prescription drug abuse. And with the advent of patient satisfaction driving revenue for vastly underpaid hospitals, prescription narcotic abuse has become a public threat. I have seen Percocet get prescribed to people with chronic back pain, abdominal pain with no known cause, chronic "fibromyalgia", and ovarian cysts that have ruptured months and sometimes years ago. I've seen patients receive up to 30 pills at a time, some people I see back a few days later, looking for more narcotics. I really think this is a symptom of our everything-right-now society, and I think it's probably the most harmful thing we as healthcare workers are doing to patients. A lot of Emergency room physicians have become drug dealers. They get asked for by name, because they order the right combination of Dilaudid, Phenergan and Benadryl, with a Percocet or Vicodin prescription to go home with. The entire practice has become exactly against what modern medicine was meant to stand for in the first place.

I would like to do something about this. I'm writing this to see if there are any nurses with kindred spirits out there who would like to help. I'm envisioning a letter-writing campaign to Washington, and to your state senators, followed by a public campaign/education project to really teach society how bad/insidious these narcotics really are. I think a large group of nurses is what it will take to get this issue under control; the public still trusts nurses more than any other professional. Anyone with me? Feel free to pm me or reply to this thread with any comments.

Personally, I feel that my ED physicians, my back pain specialists, my chronic pain specialists (I say "my" in reference to those MD's in my network) are fully aware of the narcotic seekers, and only prescribe accordingly.

The problem rests with the DEA. They need to be investigating these physicians and start pulling licenses accordingly.

I agree with a lot that has been said, but what often happens with this POV is that all patients using pain meds are lumped together as "drug seekers." You may not do it, but you know you've seen it. Patients with legitimate need for narcotics should not be treated like addicts who are only looking to get their high. Yet they often are.

And there IS a difference between someone with legitimate need for narcotic pain relief, who uses it for that reason rather than non pain related needs, and who WOULD go into physical withdrawal if it were removed, and an ADDICT who is only trying to score his euphoria. Yes, dependence is in fact distinctive from addiction. Nurses who don't believe that really need to re-examine their judgmental attitudes.

And we could all probably benefit from a little dose of compassion even for those who have become addicted to the non pain relieving effects of certain drugs. Yes, they need limits, they need accountability, but they also are suffering. PIA, yes, but still not necessarily bad people.

Specializes in Family Nurse Practitioner.

And we could all probably benefit from a little dose of compassion even for those who have become addicted to the non pain relieving effects of certain drugs. Yes, they need limits, they need accountability, but they also are suffering. PIA, yes, but still not necessarily bad people.

I agree 100% and my frustration lies with the providers who have created these situations but my first concern is patient safety. Many of these egregious pain regimens in addition to being ineffective also include some or all of the following: opiates-short and long acting, muscle relaxers, antiepileptics, benzodiazepines, stimulants and are flat out unsafe. So yeah I'm the bad guy when I start looking at ways to reduce this polypharmacy mess.

Specializes in Critical care.

I blame JACHO for telling everyone that patients are not allowed to have pain. After the patients get hooked they are cut off and switch to heroin.

Specializes in Family Nurse Practitioner.
I blame JACHO for telling everyone that patients are not allowed to have pain. After the patients get hooked they are cut off and switch to heroin.

I laughed when I read this but seriously many people actually think their pain score should be a zero! Heck mine is higher than that on a daily basis just from dragging my old butt around the hospital all day.

Specializes in Hospice.

I'm sorry, but this whole thread is one big witch hunt.

Pain relief is not a moral issue. And here's a thought: neither is drug addiction. Wanting pain relief is not a sign of mental or moral weakness.

Vulnerability to addiction - which IS different from dependence - is a complex phenomenon that cannot be adequately addressed in an acute setting.

It's perfectly reasonable to be concerned about enabling addiction. But that's not what I'm reading here. Apparently, showing junkies who's boss is more important than taking care of people who hurt.

Nothing suggested in this thread is new. It's all been noted and acted upon in our ongoing, very expensive and totally unsuccessful "war on drugs".

And you know what they say about doing the same thing over and over and expecting different results.

It's time to change the paradigm.

Specializes in Pediatrics, Emergency, Trauma.
The problem rests with the DEA. They need to be investigating these physicians and start pulling licenses accordingly.

The DEA does investigate and will flag physicians for giving too much narcs; as well as prohibit docs from prescribing certain narcs and medications to help with pain management, unless they are pain management specialists.

They pass information to the FBI; here's one example; not everyone makes the news:

Philadelphia doctor, receptionist charged in 'pill mill' operation | 6abc.com

Doctors that I have interacted with in my area act very judiciously and will prescribe and/or give many non-narcotic medications, as well give us support to provide non-pharmacological interventions that we learned in nursing school, ie CAM, etc.

I'm sorry, but this whole thread is one big witch hunt.

Pain relief is not a moral issue. And here's a thought: neither is drug addiction. Wanting pain relief is not a sign of mental or moral weakness.

Vulnerability to addiction - which IS different from dependence - is a complex phenomenon that cannot be adequately addressed in an acute setting.

It's perfectly reasonable to be concerned about enabling addiction. But that's not what I'm reading here. Apparently, showing junkies who's boss is more important than taking care of people who hurt.

Nothing suggested in this thread is new. It's all been noted and acted upon in our ongoing, very expensive and totally unsuccessful "war on drugs".

And you know what they say about doing the same thing over and over and expecting different results.

It's time to change the paradigm.

You said some of the things I was thinking but was unable to express so eloquently.

Thank you.

Specializes in Family Nurse Practitioner.
I'm sorry, but this whole thread is one big witch hunt.

Really? I must have been reading a different thread. Sorry but I don't feel it. Speaking only for myself the only witches here are the negligent prescribers. :bored:

Specializes in Hospice.

Really? Then why no passionate outcry against negligent prescribers of, say, antibiotics. They've created a problem that's arguably much more dangerous than addiction.

What would you do that the DEA isn't?

Specializes in Family Nurse Practitioner.
Really? Then why no passionate outcry against negligent prescribers of, say, antibiotics. They've created a problem that's arguably much more dangerous than addiction.

What would you do that the DEA isn't?

Cause we were talking about addictions????? Sorry I'm not trying to be dense but you have totally lost me.

Specializes in OR, Nursing Professional Development.
Cause we were talking about addictions????? Sorry I'm not trying to be dense but you have totally lost me.

Actually, negligent providers have been brought up in several posts. Aren't those who are overprescribing or inappropriately prescribing antibiotics just as guilty of poor prescription practices as those who overprescribe narcotics?

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