Friday, December 23, 2005

Inappropriate Prescribing – A Case in Point

My Power Without Accountability posting about inappropriate prescribing drew the following response:

The subject of doctors over-prescribing addictive drugs sure hits home with me. My brother died in 1960, just 8 months old. My mother had a break down and was tied down and pumped with drugs. After that she saw a psychiatrist who prescribed cloryl-hydrate (not sure on the spelling on that), which I'm told is one of the most potent drugs around and is now rarely used. After a few years, he saw her one time a year and continued to prescribe the meds, and over time gave her higher and higher quantities. At some point she began drug seeking from other doctors and added more uppers and downers to the other med.

What started as a patient trusting that her doctor knew what was best ended in a highly addicted person who had yet to deal with the loss of a child. When I was old enough, I arranged for an intervention and got her into treatment, which did not completely succeed because she still uses some, just not as much and not all the time. It’s an unspoken compromise within the family, but we keep a close eye on her to make sure she does not do more than what I'd call a binge now and then.

The kicker? While she was in treatment, I tried to contact the psychiatrist to tell him to stop prescribing the drug. He had been retired for almost 5 years, had not even seen my mother in all that time yet continued to supply her with drugs. I called the board and reported this, and he lost his authority to prescribe meds to anyone ever again.

I don't know much about drug monitoring programs, but I do think some of the responsibility lies with the friends and family members of addicts. There are many things that can be done, I also called all the drug stores in our area and let them know my mother was getting drugs filled at all of their stores, and from a variety of doctors. They were able to watch for her name to come up, and if they had concerns they communicated back and forth. The pharmacists went so far as to talk to the doctors who were prescribing the meds, at my request.

I think that addiction to prescription medications is one of the least talked about of addictions, and also one of the most shameful addictions. It is still kept behind closed doors. As a social worker, I've worked with alcoholics and people addicted to street drugs, and they have all felt that addiction to prescription medications is far worse than their own forms of addiction. If we can bring it into the open and let it be seen as no better or worse than any other addiction, we may be able to make some progress.

cindy muggli
first care hospice
fosston, mn

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