Question regarding narcotic addiction

[bethin]

The nurses and aides have been arguing for some time about addiction. A nursing student told a nurse that a patient cannot get addicted to narcotics IF they only take the medication when they are in pain and they take it as prescribed concerning time and dosage. Makes sense. She said a pain specialist came to her university to discuss this with them.

Many nurses disagree. Our hospital is notorious as one that believes if you take a narcotic pain medication more than once a day then you are addicted. If an order is written for 1-2 pain pills the nurse will only bring one, even if pt requested 2. Then, if one hour later same pt is still in severe pain they will not administer the second pain pill. Is there anything wrong with taking the second pain pill an hour later than receiving the first?

Can anyone give me some good reliable links regarding these questions while posting your thoughts? It angers me that people think if you take a narcotic then you are an addict. Right me if I'm wrong, but I always thought an addict takes medication without having pain, purely to get high and takes more than the required dose.

A pet peeve: the nurses that roll their eyes when I tell them that a pt needs pain meds even if they're post op. Like I said, we are notorious.

[Patient]

Hear hear! From a chronic pain patient on the 50 mcg fentanyl patch with norco 10/325 for breakthrough pain, I can speak from personal experience. Am I physically addicted to narcotics? You bet! I take these meds exactly as prescribed and very responsibly, but still get dirty looks and snide remarks from doctors, nurses, and pharm techs. If I need yet another procedure, I make sure all doctors and nurses involved are aware of what I am taking. Inevitably, someone will make a comment like, "We sure had to use a lot of medication on you" accompanied with a gimlet-eyed stare. Sheesh! I'm sick of it, but some people refuse to be educated and I've finally learned to let it go and not engage the ignorant.

[NurseyBaby'05, BSN, RN]

The other thing is, if someone is drug seeking, you're not going to cure them in a day. That's for pain service and the pt's PCP to resolve. Do I give them their PRN IV Dilaudid round the clock? No. If they ask, yes. (And are still awake to receive it when I get back to the room.) If the pt is gorked out of his mind and it's taking a lot of effort to arouse him, no way am I giving it. But if he's awake, appropriately responsive, and in pain, I'm going to give it. I'm not there to treat his addiction. We can make referrals to pain service and detox for that.