Law Requires Drs. & Pharmacists to Inform on Patients
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bwaites
Flashlight Enthusiast
Gadget,
My point is not that none of those things happen, but that we are barking up the wrong tree about drug addiction.
For every life damaged by illicit drugs, I see scores damaged by the legal ones like tobacco and alcohol. Look at the figures, roughly 600,000 dead annually from alcohol and tobacco, to 20,000 for illicit drugs. Interestingly, opioid narcotics and benzodiazepines, the two most abused presription groups, cause little or no physical damage to the addict. Unlike alcohol and tobacco.
I'm not saying they don't screw up people's lives, they do, but alcohol and tobacco do it cheaper, and to many, many more!!!
As far as an employer getting that info, they won't have to do it illegally, they'll ask for your permission to get a health report, and you'll sign, and they'll get access to the database, and "away we go"!! If the database exists, they will find the info. If you don't give them permission to get health info, they'll just say, "you didn't complete the application process."
Bill
My point is not that none of those things happen, but that we are barking up the wrong tree about drug addiction.
For every life damaged by illicit drugs, I see scores damaged by the legal ones like tobacco and alcohol. Look at the figures, roughly 600,000 dead annually from alcohol and tobacco, to 20,000 for illicit drugs. Interestingly, opioid narcotics and benzodiazepines, the two most abused presription groups, cause little or no physical damage to the addict. Unlike alcohol and tobacco.
I'm not saying they don't screw up people's lives, they do, but alcohol and tobacco do it cheaper, and to many, many more!!!
As far as an employer getting that info, they won't have to do it illegally, they'll ask for your permission to get a health report, and you'll sign, and they'll get access to the database, and "away we go"!! If the database exists, they will find the info. If you don't give them permission to get health info, they'll just say, "you didn't complete the application process."
Bill
binky
Flashlight Enthusiast
I'm not surprised by this, but I do not like it.
Doctors are asked to inform on patients for other things too --
My wife confirmed a report I'd heard around the gun club, that in Massachusetts, pediatricians are asking our children if their parents own a gun. I can only imagine that it's the anti-gun lobby who's ultimately doing the tallying. Every time I think of that it makes my face red hot with anger for many reasons, especially that I'd call it abusive to the children, considering they should be able to trust their doctor. Oh, and at the time my oldest son was only 5 yrs.
Doctors are asked to inform on patients for other things too --
My wife confirmed a report I'd heard around the gun club, that in Massachusetts, pediatricians are asking our children if their parents own a gun. I can only imagine that it's the anti-gun lobby who's ultimately doing the tallying. Every time I think of that it makes my face red hot with anger for many reasons, especially that I'd call it abusive to the children, considering they should be able to trust their doctor. Oh, and at the time my oldest son was only 5 yrs.
Last edited:
pedalinbob
Flashlight Enthusiast
An interesting topic, and I can see positives and negatives to both sides.
However, I am aware that we already have databases that allow us to track narc use (to some extent, since it is limited from state-to-state). IMHO, making it more universal would be helpful to me.
I am a pain specialist, and one of the common problems I face is when patients scam our system (or they are simply incredibly poor historians), but we cannot find out info on the patient's history. These people drain our resources, cost the hospital thousands of dollars in care (not to mention revving up our legal department and disrupting our practice), and pull us away from helping those truly in need.
We recently had a patient from out of state that had a murky history, but we became quickly suspicious based on his behavior. We were able to gather some info (legally) that proved our belief that he was scamming us to get his fix, but it took nearly a week to attain it. He left AMA as soon as we outed him.
We get one of these cases about every two weeks. Over the course of a year, the costs are staggering. The head of anesthesiology showed me a printout about a month ago that showed we ate over $250,000 in un-recoverable charges in less than one year.
There is another upside to rapidly identifying "seekers" (or poor historians): we can initiate a detox program for them, if they follow our advice. Without going into too much detail, access to narc use info has saved some lives, because we were able to ID the source of patient instability (SEVERE withdrawal due to INCREDIBLY high narc abuse) and initiate treatment, which stabilized the patient.
I am aware that there are privacy and other issues, but I personally like the idea of being able to quickly access this info when needed.
Just my two cents!
Bob
However, I am aware that we already have databases that allow us to track narc use (to some extent, since it is limited from state-to-state). IMHO, making it more universal would be helpful to me.
I am a pain specialist, and one of the common problems I face is when patients scam our system (or they are simply incredibly poor historians), but we cannot find out info on the patient's history. These people drain our resources, cost the hospital thousands of dollars in care (not to mention revving up our legal department and disrupting our practice), and pull us away from helping those truly in need.
We recently had a patient from out of state that had a murky history, but we became quickly suspicious based on his behavior. We were able to gather some info (legally) that proved our belief that he was scamming us to get his fix, but it took nearly a week to attain it. He left AMA as soon as we outed him.
We get one of these cases about every two weeks. Over the course of a year, the costs are staggering. The head of anesthesiology showed me a printout about a month ago that showed we ate over $250,000 in un-recoverable charges in less than one year.
There is another upside to rapidly identifying "seekers" (or poor historians): we can initiate a detox program for them, if they follow our advice. Without going into too much detail, access to narc use info has saved some lives, because we were able to ID the source of patient instability (SEVERE withdrawal due to INCREDIBLY high narc abuse) and initiate treatment, which stabilized the patient.
I am aware that there are privacy and other issues, but I personally like the idea of being able to quickly access this info when needed.
Just my two cents!
Bob
bwaites
Flashlight Enthusiast
PedalinBob,
I too, see many chronic pain patients, though in an internal medicine office where the closest pain clinic is 180 miles away.
The problem with this system is where the information goes.
If it was easily accessible to medical providers, that would be one thing. It won't be, it WILL eventually be accessible to law enforcement, though. Then everybody on the force gets to decide who prescribes too many narcotics and will see that many public figures are on pain management of some type.
That neither benefits patient care, (this bill was never intended to do that, anyway) or is cost effective. All it does is shift the information around, changing the costs to the court system from the medical system.
A national database of pain management WOULD do what you want, and should be implemented, accessible only with appropriate releases by medical providers. Every pain management patient, (anyone receiving pain meds for anything except acute pain) would be entered by the providers staff, and those releases would be required if you desired staying on pain management.
That way doctor shopping is stopped before it starts, and people with problems are easily seen and helped.
This does neither.
Bill
I too, see many chronic pain patients, though in an internal medicine office where the closest pain clinic is 180 miles away.
The problem with this system is where the information goes.
If it was easily accessible to medical providers, that would be one thing. It won't be, it WILL eventually be accessible to law enforcement, though. Then everybody on the force gets to decide who prescribes too many narcotics and will see that many public figures are on pain management of some type.
That neither benefits patient care, (this bill was never intended to do that, anyway) or is cost effective. All it does is shift the information around, changing the costs to the court system from the medical system.
A national database of pain management WOULD do what you want, and should be implemented, accessible only with appropriate releases by medical providers. Every pain management patient, (anyone receiving pain meds for anything except acute pain) would be entered by the providers staff, and those releases would be required if you desired staying on pain management.
That way doctor shopping is stopped before it starts, and people with problems are easily seen and helped.
This does neither.
Bill
FlashlightOCD
Enlightened
Opiod pain relievers are cheaper, more effective and have fewer systemic side-effects than there Non-opiod and OTC [NSAID] counterparts. The only major disadvantage is they have a high potential for abuse and addiction.
AARP magazine had an article in it last month that stated many people with severe and chronic pain were under-medicated because doctors were already too afraid of the DEA to prescribe stonger medications. There are also the idiotic cases where terminally ill cancer patients are denied pain relief for the same reason. Would a doctor deny a terminally ill cancer patient pain relief based on the fear the patient might become addicted? No ... it is because they fear a response from the DEA.
The pseudophedrine laws are ludicrous. I think there were some instances where persons would go into stores and buy a couple hundred boxes of pseudophedrine for [obviously] illegal purposes. The very first laws on the books were implemented to restrict sales to something like 3 boxes per customer. That was a reasonable response to the problem, making it a prescription drug is total over-reaction. In any case I've never seen any documentation showing that the laws have been effective in reducing methamphetamine production.
AARP magazine had an article in it last month that stated many people with severe and chronic pain were under-medicated because doctors were already too afraid of the DEA to prescribe stonger medications. There are also the idiotic cases where terminally ill cancer patients are denied pain relief for the same reason. Would a doctor deny a terminally ill cancer patient pain relief based on the fear the patient might become addicted? No ... it is because they fear a response from the DEA.
The pseudophedrine laws are ludicrous. I think there were some instances where persons would go into stores and buy a couple hundred boxes of pseudophedrine for [obviously] illegal purposes. The very first laws on the books were implemented to restrict sales to something like 3 boxes per customer. That was a reasonable response to the problem, making it a prescription drug is total over-reaction. In any case I've never seen any documentation showing that the laws have been effective in reducing methamphetamine production.
Outta curiosity, how do you deal with this problem without the database?
FlashlightOCD said:
It has indeed reduced domestic methamphetamine production. The difference is, more meth is coming in from Mexico to meet demand. There was a big article on the changes of meth in Oklahoma recently, one of the first states to crack down on PSE.
Net effect: Meth supply remains constant, people with allergies and colds get annoyed
I just ran across this article about a similar law in Pennsylvania. It says that there is a Pa law requiring doctors to tell police if a patient has an "impairment" that could affect their ability to drive safely. I'm sure impairment was meant to mean a physical or mental condition that would make you an unsafe driver.
"A judge ruled the state can suspend the driver's license of a man who lost his driving privileges after his doctor reported to police that he drank a six-pack of beer a day.
But the judge also said Keith Emerich (search) may obtain restricted driving privileges as long as he uses a device that tests his blood-alcohol content before starting his car.
Emerich, 44, a printing company employee, was notified in April he would lose his license, about two months after he disclosed his drinking habit to doctors treating him for an irregular heartbeat."
http://www.foxnews.com/story/0,2933,129232,00.html
"Before he can drive, Emerich will have to install an "ignition interlock," a built-in blood-alcohol breath test that requires the driver to exhale below 0.025 percent before the car will start. The state's legally prohibited level for most drivers is 0.08.
About 230 Pennsylvania drivers lost their licenses last year after doctors reported their drug or alcohol addiction, the Pennsylvania Department of Transportation said."
I find this scary. This guy was only drinking at home.
"A judge ruled the state can suspend the driver's license of a man who lost his driving privileges after his doctor reported to police that he drank a six-pack of beer a day.
But the judge also said Keith Emerich (search) may obtain restricted driving privileges as long as he uses a device that tests his blood-alcohol content before starting his car.
Emerich, 44, a printing company employee, was notified in April he would lose his license, about two months after he disclosed his drinking habit to doctors treating him for an irregular heartbeat."
http://www.foxnews.com/story/0,2933,129232,00.html
"Before he can drive, Emerich will have to install an "ignition interlock," a built-in blood-alcohol breath test that requires the driver to exhale below 0.025 percent before the car will start. The state's legally prohibited level for most drivers is 0.08.
About 230 Pennsylvania drivers lost their licenses last year after doctors reported their drug or alcohol addiction, the Pennsylvania Department of Transportation said."
I find this scary. This guy was only drinking at home.
pedalinbob
Flashlight Enthusiast
Frangible said:
The patients sign a form releasing prior medical records to our care--but, those records were from out-of-state, and the patient wasn't giving out (intentionally covering up) WHERE the records were.
Some of our NP's had to do a LOT of digging to turn up the info.
Quite a mess!
Bob
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