The US Opioid Crisis

[SunsetBengal]

(08-09-2017, 11:41 PM)oncemoreuntothejimbreech Wrote: There is no one root cause. It is multi factorial. When it comes to prescription pain medication there isn't a test you can order to verify their pain. Many providers, including me, usually give a new patient the benefit of the doubt when treating their pain. Unless they give me a reason to doubt them or they are blatantly faking. Usually it takes several visits to determine who the drug seekers are. The most successful drug seekers I've seen had me totally fooled. I didn't even suspect them they were that convincing. And I'm pretty good at detecting drug seekers and determining who is trying to bullshit me during an exam. Insurance companies are incorporating patient satisfaction surveys into reimbursement rates. Pain management is included in those surveys. Doctors and hospitals can see their revenue decrease because patients aren't given opioids they don't need, but demand anyway. Disgruntled, demanding patients who are drug seeking can can cause problems with their complaints. I've had them threaten me with their complaints. Basically, give me what I want or ill complain to everyone I can. My answer is, " Go ahead." Not everyone is willing to take that chance. Also, there isn't a national database for opioid prescriptions to help identify who is abusing opioids and doctor shopping. In Georgia we have PDMP. It is a state wide monitoring program for controlled substances so prescribers can check prescription histories to know who is getting what from the whom in what amounts and when and if they are getting multiple prescriptions from multiple providers filled at multiple locations. We've had it for about 5-6 years and membership and use has been voluntarily. Starting in 2018, the new law requires every provider to check PDMP before writing every prescription for a controlled substance for every patient every time IOT reduce misuse and abuse. But, that's only Georgia. Fill your prescriptions across state lines and I don't have any idea what you're taking if you aren't honest with me. There needs to be a national drug monitoring program. Just that one program would go along way ho cutting down on drug seeking behavior. Before PDMP, if I suspected drug seeking I would have to task a nurse to call all the pharmacies to check on the patient. That's one nurse not taking care of patients and instead doing my detective work for me. I'm not a damn detective. While we are doing that, it slows down the whole patient flow which means less patients which means less revenue for my employer.

That's just some of the BS just related to legal prescriptions.

Thanks for the info.  That is much like what my own family physician says about pain med abusers.  My Othro shared notes with him, during my shoulder surgery rehab, and he saw that I never refilled my pain meds.  He (my family doc) asked why, and I told him.  I don't want to be a statistic, I'd rather feel what's going on with my rehab and deal with it.