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.

Specializes in Hospice.

I can't see how penalizing providers addresses narcotic abuse in any meaningful way.

Specializes in Family Nurse Practitioner.
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?

Ok sure but what is the problem with this? We shouldn't expect providers to be skilled and prudent? Are you saying providers who are prescribing wrong or inappropriate doses of medication aren't negligent? Addressing this, requiring education and possibly license restrictions sure wouldn't hurt imo. There are statistics on prescribing habits. I'm going to bow out now because I'm either not getting your points or I'm totally disagreeing and thats cool.

Specializes in Hospice.

The point is: intimidating prescribers will not affect the rate of narcotic abuse in any material way.

That was the stated goal of the letter writing campaign proposed by the OP. It's been done. It didn't work.

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?

I agree that the problem is essentially the same.

I work in an environment are clearly over used. When I use the term "over used", I don't mean that in my personal they shouldn't be prescribed. I mean ABX for sinusitis x 2d. Or similar practices for which all evidence points away from ABX treatment. Or a super low threshold for treating pediatric ear infections. Or for something far more likely to be viral.

Most of the providers I work with are well aware of the evidence, but choose the path of least resistance.

But, all things being equal, the person who leaves with a prescription will leave more quickly, and more satisfied.

Not all that different than prescribing narcotics which alleviate the symptoms, but have no effect on the cause.

Having chronic pain should be treated the same as having diabetes.

It is not the diabetics fault, weakness, drug seeking behavior, that they have diabetes and "seek" insulin. It is the same for patients with chronic pain.

What if we lived in an alternate universe and diabetics were labeled drug seekers, went from ER to ER seeking their insulin fix, were frequent flyers. In the ER we gave them a shot of insulin and sent them on their way...well of course that is crazy. We admit diabetics, they go to classes, they get one on one teaching with diabetic educators, they see their endocrinologist frequently.

Pain patients have a physical illness and need the same treatment, education, and compassion. Giving them a shot of dilaudid and a prescription for Vicodin in the ER and sending them on their way is crazy. Yet that is how we are dealing with it.

Yes something needs to be changed. I can't blame ER nurses for being fed up, they know something stinks with the whole system.

Specializes in Psychiatry, Forensics, Addictions.

I find it interesting how judgmental people are with chronic pain patients when they have never dealt with severe, chronic pain. I thought "pain is whatever the patient says it is." Why do we continue to label pain patients "med seekers" or worse? There is a distinction between addiction and dependence.

Specializes in Psych, Addictions, SOL (Student of Life).
Why not both?

Because one is unpleasant.

Working in the ER, I see a lot of chronic problems, most of which are exacerbated by lifestyle choices.

Smokers with a cough get a good talking to. Walk in complaining of GERD and eating a cheeseburger, we'll probably mention the connection.

But come with an extra 150 lbs of you, complaining of an arthritis flare up, or your bad back, and there is a good chance nobody will mention the real cause of your pain.

But- my real point was that as long as we are locked into this ridiculous customer service model, this problem will be difficult to overcome.

We can't ignore the terrible impact of basing re-reimbursement, career advancement, etc on customer satisfaction. Narcotics arejust one part of the problem.

I for one always talk to my parients about pssible causes of their chronic conditions. If they a morbidly obese I talk to them about diet if they appear addocted or dependent on narcotic I talk about resources to cut back or stop alltogether. Most fear the pain and discomfort of detox more than the actual pain they are experiencing.

Hppy

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