Paralysis by Urinalysis

doctor-with-urine-sample-via-shutterstock-615x345Paralysis by Urinalysis

If I fail a urine screen I am then discharged from treatment by my doctor.  This has become an all-too-common practice at many .. practices. Isn’t this ridiculous?  I mean, hypothetically, if I decided to go to an all night 70’s disco cocaine party and decided to partake (hypothetically) then I am in danger of losing the services of my orthopedic surgeon who is helping to mend my back after a near-paralyzing car accident?  Ridiculous.  A joint to help me sleep?  Say goodbye to my recovery from spinal injury.  Is there even a justification for this?  I will play devil’s advocate and try to defend the indefensible here.  Note:  Any position that isn’t mine is indefensible.

We can’t be providing opioid medications to patients who are themselves drug users.  There could be dangerous interactions and other irresponsible behavior that would cause them to harm themselves.  They would need a doctor.  They should be discharged from my (doctor) practice.

We have to test their urine frequently to be sure that we are not contributing to a patient’s drug problem or addiction issue for which they should be seeking professional help.  They would definitely need to see a doctor if they had an addiction problem.  These patients definitely should be discharged from my (doctor) practice.

By testing our patients’ urine, we can see who is a complicated patient so we can quickly discharge them from our practice, thus leaving us with the simple patients who quietly come and go, pay their bill on time, and allow us to pack in more patients (more money!)  Complicated patients take up too much time and cost us too much money (not to mention effort).  Money and effort should never be expended needlessly in our line of work.  Just tell them we can lose our license (an incredible irony when you consider that by KEEPING them as patients and TREATING their destructive tendencies by way of referrals or their addiction we would be acting MORE like doctors and thus be MORE worthy of our licenses) and keep having them make the walk of shame from bathroom to waiting room holding their leaking urine vials.  I became a doctor to get rich not to treat people who have unhealthy habits or dangerous behaviors.  Those people should go get their heads examined.  …by a doctor, I guess.  I’m confused.

Doing drugs is unhealthy although often a lot of fun.  If you choose to do something this stupid (awesome) then you should not be in danger of losing the services of a competent medical professional.  It should be noted, however, that if your doctor discharges you for failing a urinalysis, subjecting you to both withdrawal and the care that you deserve due to an injury or illness, the maybe your medical professional isn’t so competent after all…

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Oh Oxycontin, You Make Me Feel So Itchy

I wonder many times about the ill effects of each and every illicit drug sold on street corners and internet sites.  Then I wonder the same about the ones that are prescribed to us.  I have a story I would like to share and I hope that it will inspire some of you to comment and share some similar experiences.  I won’t even lie, this story is about me, not some “friend” or nameless individual.

In 2001 I was riding home with my (then) girlfriend from a nice dinner in a waterfront town.  We obediently stopped at a bright red traffic light.  Then we saw bright lights behind us.  Those lights belonged to a drunk driver in an SUV who was, apparently, not so obedient towards the red light.

He collided full speed into us (who were at a dead stop – no pun)  the little Mistubishi was a mass of junk metal.  My mouth wasn’t working.  I was taken to the ER and they fixed my jaw which had been badly busted in the accident.  They referred me to an Oral Surgeon.

I went to the OS and he was super-de-duper-nice.  He examined me, prescribed physical therapy and gave me Endocet, a generic form of the celebrity Percocet.  The drugs eased my pain and I began to look forward to taking them each night.  Each morning.  At lunch.  Then when I was bored.  Needless to say, my “pain relief” got a bit out of hand.  I told the doctor what was happening and he said that, although they were addictive, if you wanted to stop, you’d feel like crap for a dy or so, then be back to tip-top shape in no time.  I was pleased.  He handed me another script.

And so it went until 2005.  This was the year that I became a strong believer in angels.  I was, again, passenger in a car headed down to South Jersey so we could help a friend move.  I was reading a magazine, then looked up to see a van with its hazards on STOPPED in the left lane of the NJ Turnpike.  What happened next I don’t know.  All I know is that I awoke in a furry haze of giddy numbness to a throng on onlookers asking “Is he dead?”  Soon I realized they meant me.  I was wrapped in metal and covered in blood.  A super Paramedic with a very concerned look on his face was stabilizing my head and trying to keep me from dying.  I haven’t told my family this, but I was resuscitated at the scene because I had no heartbeat.  I was dead for a bit.  Wild.

I came to and began a long rehabilitation process which involved consistent pain management.  the pain management clinic gave me more Percocet – the strongest one available.  I had to take it to stop the pain and be functional, after my teeth were all reconstructed – they were shattered in the accident.

Now comes the critical mass of where medicine can force and addiction on a patient and cause more harm than good.  I couldn’t go a day without my pills and if I ever ran out, Hell engulfed my body and ripped me to shreds from withdrawal.  Some catch-22, huh?  If I take the pills, I’ll feel fine but be a junkie.  If I don’t I’ll be a throbbing mess of pain and healing bones, herniated discs, etc.  I wouldn’t be able to live any semblance of a normal life.  Addiction was part of my treatment.

And such is the way of modern Pain Management.  I don’t question their integrity, but their tools are far too limited.  Percocet works great, but do you think we could take out the “strung-out-on-heroin” part?  I am a fan of technology and know that Lexus just released a car for idiots who can’t park for themselves.  It will parallel park for you.  If we can do that, can we work on a drug that won’t turn me from victim to junkie?

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