Filed under: medicine, practice | Tags: healthcare, heroin, medicine, morphine, pain medication
True story: A patient limps into an Arizona State University health center for a follow-up appointment after being hit by a car while riding his bike. The injury the patient sustained to the left knee wasn’t healing well and needed a doctor’s evaluation.
“I thought you were just coming in for more pain medication,” said the doctor before even examining the knee. By the end of the evaluation, the doctor recognized here erred judgement and urged the patient to go to the ED at a nearby hospital because the injury had worsened since the initial exam. She felt the injury required more comprehensive and urgent attention than she was able to provide.
When did doctor’s start accusing new patients of being drug-seekers before examining them? Logically, it seems that one should demonstrate a certain behavior before being accused of it. Considering the purpose of the appointment, it truly added insult to injury.
For historical context, prior to the 1924 ban of narcotic sales by the U.S. Treasury Dept., heroin, morphine and cocaine could be found at the corner drugstore, next to the licorice and tobacco. Or, they could be mail-ordered through catalogues, complete with syringes.
According to Robert Youngson in Scientific Blunders: A Brief History of How Wrong Scientists Can Sometimes Be, the widespread availability and use of poorly understood drugs led to the addiction of over 400,000 soldiers during the Civil War, and the number of addicts in the general population was wider still.
Today, despite a vastly greater body of knowledge of these drugs, proper uses and possible dangers, narcotic abuse continues. Understandably, prescribers are cautious. Yet, statistically, the number of individuals addicted to narcotic pain medication is vastly outweighed by those who’ve benefited therapuetically through appropriate usage.
How often do healthcare providers assume a patient is a drug-seeker? How does that assumption affect the care they give that patient? How often are they wrong?
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