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Green_T


Registered: 10/02/08
Posts: 4,042
Loc: UK
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A Battle Against Prescription Drugs Causes Pain
#13292389 - 10/05/10 08:18 AM (13 years, 7 months ago) |
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A Battle Against Prescription Drugs Causes Pain October 2, 2010 - New York Times
Roland Lorenz has surgical screws in his back and neck and a pin in his upper leg, and when his pain reared up one recent weekend, he knew he needed something strong. He had just been to a pain clinic, where the doctor ordered an increase in his dosage of Percocet, a narcotic.
It took two days to get the painkiller.
Mr. Lorenz, 75, lives in a nursing home in St. Louis. Until recently, the nurses would have sent an order to the pharmacy for the Percocet, based on instructions phoned in from the clinic — a longstanding practice for nursing homes, which typically do not have a full-time doctor on staff.
But now that practice has come under the scrutiny of the Drug Enforcement Administration. Last November, the pharmacy serving Mr. Lorenz’s nursing home announced that it would no longer dispense certain narcotics without a written or faxed prescription from a doctor.
For Mr. Lorenz, this meant a weekend of pain. The doctor at the pain clinic was not available, and the nursing home’s doctor on call would not write a prescription without examining Mr. Lorenz in person. For the next two days, Mr. Lorenz said, “I was miserable. I needed it to get straightened out. It was killing me.”
Staff members assured him that the drug was on its way at least six or seven times, said Mr. Lorenz, a former Marine and police officer.
“It’ll be there by midnight. It’ll be there by 2 a.m. The pharmacist kept saying he needed to talk to the doctor. It was real, real rough.”
Nursing homes and doctors say patients like Mr. Lorenz have become unintended casualties in the war on drugs because of a new level of enforcement intended to prevent narcotics from getting into the wrong hands. About 1.4 million Americans live in nursing homes.
The D.E.A. is investigating pharmacists in “about five states” for dispensing the drugs to nursing homes without direct written orders from a doctor, said Gary L. Boggs, an executive assistant in the agency’s Office of Diversion Control.
Earlier this year, the Senate’s Special Committee on Aging heard testimony from long-term-care professionals describing delays in delivering pain medications to patients. Two Democratic committee members, Senators Herb Kohl of Wisconsin and Sheldon Whitehouse of Rhode Island, have urged Attorney General Eric H. Holder Jr. to find a solution.
“We keep hearing the right things from the D.E.A. on this issue, but we haven’t seen any action,” Mr. Kohl said through an aide.
Mr. Boggs said the agency was just trying to protect patients. “This isn’t a matter of us being bureaucratic pencil pushers,” he said. “What we see is nurses unilaterally calling in prescriptions, or pharmacists dispensing controlled substances without a prescription, then trying to get a doctor to sign a prescription for a patient he never saw.”
In the meantime, doctors say, their patients suffer — sometimes for half an hour, sometimes for several days.
“There’s just a lot of potential for error in the process,” said Dr. Jonathan Musher, a geriatrician and past president of the American Medical Directors Association, a trade group of long-term-care doctors and administrators, which has sought a change in the requirements.
The problems are most common when patients first arrive at nursing homes from hospitals, Dr. Musher said.
For example, he recently had a patient move to a nursing home after a hip fracture. At the time, she was not on narcotic pain medication. That night the nurse called Dr. Musher to say that the woman was in pain. “I was told I had to call the pharmacist,” he said. “O.K., what’s the pharmacist’s number? The nurse has to call me back, she wasn’t sure. I get a call back with the number. I call the 800 number and leave a message. I get a call back a half hour later.
“So now there’s been a 45-minute delay. Now he tells me I have to fax in a prescription. I’m not home, so I say I will do it in 15 minutes. After I fax it, I call the nursing home, and they haven’t heard anything from the pharmacist. Finally I told them to send the patient to the hospital.”
She got her medication, “but that’s something we don’t want to do,” Dr. Musher said. “There are health issues with transfer, as well as the costs of transfer.”
Critics of the nursing home industry say the bigger problem is that facilities are not providing adequate medical care to their patients.
“If people are so sick that they desperately need pain medication, they should be seen by a doctor,” said Toby S. Edelman, a senior policy lawyer at the Center for Medicare Advocacy, a nonprofit law firm that provides legal assistance to Medicare beneficiaries. “The absence of doctors in nursing homes has been a problem for decades, and this doesn’t solve it at all.”
According to the medical directors association, a doctor at a nursing home writes an average of 169 prescriptions for controlled substances each month — which means ample opportunities for delays, Dr. Musher said.
Dr. Cheryl Phillips, president of the American Geriatrics Society, said that such delays were “daily” occurrences, especially in rural areas, where doctors might need to travel long distances to reach their fax machines or might not be able to send prescriptions by smart phone.
“I respect the work the D.E.A. is doing to prevent diversion of drugs” for sale or recreational use, Dr. Phillips said. “But the law does not serve seniors well.”
The solution, she said, “is to have the nurse act as agent to the physician,” taking the order and administering it then and there, “the way they do in a hospital.”
The change has put more pressure on nurses, who may have a suffering patient and a doctor’s order but are unable to dispense the painkillers, said Lynda Goldthwaite, a registered nurse and administrator at Elmwood Skilled Nursing and Rehabilitation Center in Claremont, N.H.
On occasion, she said, she has told nurses to go ahead and administer drugs from the center’s emergency kit without waiting for authorization from the pharmacist. “That’s a big no-no,” she said. “I could be in big trouble with the D.E.A. But I do it anyway.”
She added: “I’m a nurse. I know what I have to do for my patient.”
Mr. Lorenz said the Percocet has helped him live with his pain. But he is still angry about having had to wait for days. “I’m too old to be aggravated,” he said, adding, “I’m a victim of bureaucracy.”
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"I have sworn upon the altar of god eternal hostility against every form of tyranny over the mind of man" - Thomas Jefferson Legalize Meth | Drug War Victims
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nickc
Psyche-dult



Registered: 04/10/09
Posts: 559
Loc: Melbourne, VIC
Last seen: 3 years, 7 months
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Re: A Battle Against Prescription Drugs Causes Pain [Re: Green_T]
#13294182 - 10/05/10 03:21 PM (13 years, 7 months ago) |
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Quote:
Green_T said: “I’m too old to be aggravated,” he said, adding, “I’m a victim of bureaucracy.”
Join the club, bro.
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2859558484
Growery is Better



Registered: 01/10/06
Posts: 8,752
Last seen: 3 years, 8 months
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Re: A Battle Against Prescription Drugs Causes Pain [Re: Green_T]
#13294285 - 10/05/10 03:41 PM (13 years, 7 months ago) |
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thats fucked up. he shoulda had an eighth on hand.
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chef Jay
Me



Registered: 10/31/08
Posts: 486
Loc: Treasure Coast
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Re: A Battle Against Prescription Drugs Causes Pain [Re: nickc]
#13294305 - 10/05/10 03:47 PM (13 years, 7 months ago) |
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this kind of problem would not exist if it werent for the pain clinics handing out roxys and percs to anyone with an MRI. I find it an over reaction to people finding the loop hole. the dea is finally cracking down on the pain clinics and making it harder to get the hard opiates but those who actually need them are the ones that are going to suffer in the long run. There is an epidemic in florida and the south with roxys and every other day a new pain clinic opens to prescibe the hard shit to anyone with the money and past injuries. It is sad. I know kids 18 to 22 that go to 3 plus different pain clinics to get there pills and then sell what they dont use.
When I broke my back 8 years ago my doctor wouldn't even give me a decent script of loritabs without going to a pain clinic. he said that I was to young and the potetial for abuse was to high for him to feel comfortable prescibing me more. I go around 30 pills month of the 5mg hydrocodone. Went through them in 5 days and I was still in pain. It was a nightmare. I know what it is to live with pain and there elderly in nursing homes do to and need that shit. there is no age limit to pain but the clinics are handing them out like candy and the elderly in nursing homes are now having a problem getting what they need to be comfortable.
-------------------- Everything I say is a work of Fiction and should not be taken seriously
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2859558484
Growery is Better



Registered: 01/10/06
Posts: 8,752
Last seen: 3 years, 8 months
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Re: A Battle Against Prescription Drugs Causes Pain [Re: chef Jay]
#13294890 - 10/05/10 05:46 PM (13 years, 7 months ago) |
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thats fucked up... 30x5mg hc for a broken back? jesus those dont even help me for a toothache...
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chef Jay
Me



Registered: 10/31/08
Posts: 486
Loc: Treasure Coast
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Re: A Battle Against Prescription Drugs Causes Pain [Re: 2859558484]
#13295093 - 10/05/10 06:33 PM (13 years, 7 months ago) |
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no shit. I was 19 and it was a new dr. it took them 2 years to figure out it was broken.
-------------------- Everything I say is a work of Fiction and should not be taken seriously
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AsAboveSoBelow
The matrix has you


Registered: 02/06/08
Posts: 2,515
Last seen: 12 years, 7 months
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Re: A Battle Against Prescription Drugs Causes Pain [Re: chef Jay]
#13295293 - 10/05/10 07:12 PM (13 years, 7 months ago) |
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Im so sick of this pain med discrimination.. any person that says they're in pain is viewed as a junkie, immediately. it doesnt matter what the circumstances are or how old the person is.
It's better to give the junkies what they want anyhow, instead of letting them go out on the streets to do whatever mischief it takes to get their fix
Buck the system and fuck over the pharmaceutical companies at the same time: buy pods! or grow em! before the fucks shut all the pod seller sites down...
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You're gonna get hurt real bad They that sow the wind, shall reap the whirlwind
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