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Prescriptions and the Law

Have you ever wondered why you go into your physician with a pain syndrome of any kind and suddenly they become the long arm of the law?

No sir, or no mam, we can’t give you any pain meds for your broken ankle. You will have to go to a pain clinic for that. But it’s Friday night and we can give you enough pain meds to last until Saturday night and then you can come back on Sunday morning and we can see if you are still in pain. Oh, by the way we are not open on Sunday so just go to your local emergency room and they can make that determination.

How on Earth did we ever get to this point? We now have a cadre of physicians that cannot make even the most basic determinations when it comes to prescribing a medication labeled as a controlled substance by our federal government.

The following excerpts were written by C.E. Terry in The American Journal of Public Health. I cannot find the date but assume it is 1914, the year the Harrison Narcotic Act was passed. Here is part of the reason for some of our troubles today. I am going to paraphrase some of this material from an obviously somewhat hysterical author.

Mr. Terry explains, “It is daily becoming better known that opium, its derivatives and cocaine are being used at alarming rates all over this country.” My following sarcasm is intended. I personally am certainly glad that has changed in modern day.

According to Mr. Terry the main culprit causing this problem seems to be the physician. He feels that the physician has been exempted too much in the Harrison “Anti-Narcotic” Act which went into effect March 1, 1914.

According to Mr. Terry, it has been shown repeatedly that the physician is the single greatest factor in drug addict formation. The physician is worse than the patent medicine man, worse than the criminal druggist, worse than dissipation and vice, whatever that means.

Perhaps it was this type of hysteria that led to the federal government getting involved in the practice of medicine. I am not sure that is entirely the cause. If a physician can blame the government for giving a five day supply of a controlled substance for a chronic condition, isn’t that much better than the physician saying I would like you to come back six times per month so I do not come under scrutiny by the “Federal Drug Marshals.” So please blame them for your six office calls. It is not my fault.

Next time you run into this problem, ask your physician how often he or she has been approached or reprimanded for their misuse of prescribing privileges for narcotics or controlled substances.

The most likely answer is never. The physician beyond question can say, “Yes officer, If someone has a chronic pain syndrome, I only prescribe thirty pills at a time but do it with thirty different office visits. I am beyond reproach. This way I also know if their problem ended on the 29th visit and they do not get an extra unnecessary day of medications.”

Of course I am being very facetious, but I am sure you get the point.

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