I know some drs who give cortisone injections , but sparingly because of the potential long term side effects.
Our own PCP is VERY reluctant to prescribe just about anything…my daughter was prescribed a mild anti- anxiety pill from a Dr at her university and it has been really difficult to get it filled here where we live. The pharmacist has told us that this is not an addictive med .
We are going to have to deal with this really soon when the school year comes to an end
Seems like there is a lot of variation. I remember one PCP who seemingly wanted to order every test possible and pulled out the prescription pad way too easily – the opposite of what you describe. I changed to a different PCP. Perhaps you (or your daughter) can also.
All my docs know I have a very high pain threshold (I was joking during my labor and delivery), and they have to urge me to take pain meds and stay ahead of pain because I tend to under-medicate and be miserable. My kids are fairly stoic too but know the value of staying ahead of pain, since they’ve had chronic illness and sometimes pain accompanying it. It really makes a difference to take SOME pain medication before it gets unbearable and nothing will help much, then it is more manageable and doesn’t become all-consuming.
It’s sad that healthcare professionals don’t learn more about pain management and teach patients more about the value of getting ahead of the pain and various options for pain management, as well as potential risks of long term treatment with different meds, including OTC medications that can cause permanent damage.
Pharmacy has education on spotting forged prescriptions and addictive behavior. Narcotic prescriptions are now written on special prescription pads with special paper that is different from a regular prescription (at least in our state) which cuts down a lot of forging opportunity. Called in scripts are not allowed.
Pharmacists look for “doctor shopping”–someone who has multiple doctors who both may be prescribing the same drugs, And also pharmacy shopping–the professional community can sometimes track individuals who visit several pharmacies with multiple scripts for the same drug. They know their doctors too and who to question and when as to the validity of a script.
Some addictive behavior looked for in hospitals (especially ER) is the person who insists on a specific drug and won’t accept another alternative
post 140–lje–Depending on the drug it probably would have been better to have the script filled in her university town (at least initially) rather than bringing it home. Scripts (although legal) to be filled at any pharmacy in the state require some phone calls usually and since it can be difficult to verify the validity of the script sometimes will not be filled.
Once the script is filled initially any refills could be obtained by the pharmacy requesting a transfer of the script to your home town pharmacy.
NYT just ran a story on this very subject.
http://www.nytimes.com/2016/03/17/health/er-pain-pills-opioids-addiction-doctors.html?_r=0
Yep, the “I’m allergic to everything but IV Dilaudid, and you have to push it quickly. And don’t dilute it!”
NYS just this week started requiring that all prescriptions be filled electronically. No more stolen prescription pads!
@gouf78 , she did have it filled there first. The Dr wrote her a low dose and then upped it slightly after a month. It was then time to come home for Christmas break and because her pharmacy near campus has extraordinarily long wait times , we tried to get the script at home ( CVS ) They wouldn’t fill it because the Dr was from another state so they suggested we call PCP and have her write it. We never did talk directly to her , but staff member said she spoke to Dr and she wouldn’t do it and claimed that my daughter hadn’t been there recently ( which was nonsense because she had her physical and also shots shortly before leaving for school )
The pharmacy found it odd , We tried long before to get her treated for her anxiety where we live and basically just got jerked around . She did a lot better at her school and also doing a lot better with the medicine she has been taking
@oldmom4896 is that still a common practice? I haven’t seen a paper prescription in years.
I’ve gotten paper prescriptions as recently as a year ago. But as of this week, no more in NY.
Interesting.
Good change. Those paper ones were a PITA and too easy to lose or have some other mix-up.
We still have paper in my area …Drs will call in some scripts , like antibiotics and steroids
Docs around here can call in Rx or use the computer. They rarely use paper Rx these days.
I love the electronic system of prescriptions. No more waiting in the pharmacy while you’re sick. (And no more needlessly spreading germs!) My scripts are generally ready in the time it takes to go from the clinic to the CVS.
Plus it’s easier to keep track of all of your scripts that way (since they go directly into a patient portal at the same time they’re ordered by the doctor)… helpful for those of us who end up in urgent care or the ER too often and don’t think to bring our list of meds
Just to be clear–no called in scripts for narcotics or other classified drugs. Other scripts can be called in.
lje62–some docs just won’t be very helpful if you are seeing another doc. They are being asked to trust another doctor’s judgement.
I just got paper prescriptions two weeks ago for an outpatient procedure,and one was for oxycodone.
Wow… Saw this in the paper today!
http://www.doh.wa.gov/Newsroom/2016NewsReleases/16025RiegelDanielFinalOrder
How stupid can one be? This guy and another MD opened membership-only “personalized” practice just a few years ago. We got bombarded with glossy postcards inviting us to become members; they sent cards so often that I remembered his name when I saw it the paper.
" lje62–some docs just won’t be very helpful if you are seeing another doc. They are being asked to trust another doctor’s judgement. "
This is a dilemma for me. We switched from her pediatrician to my PCP , who I really like. We went to her in the late summer of 2014 because my daughter was going through a lot of anxiety. She had been seeing a counselor on and off since she was a sophomore in HS and we had discussed her taking something for it. The PCP wouldn’t do it , but she did give us a referral to a pediatric psychiatrist . The very long, drawn out process of even getting an intake evaluation appointment resulted in the practice to deny her appointment with the actual psychiatrist ( because she wasn’t suicidal ) So with another 3 month wait to get to see a counselor , we decided to stick with her original counselor .
So flashforward to first semester of college , where she got in touch with the campus counseling center and began seeing a counselor and was able to see the psychiatrist who prescribed the med she has been taking for anxiety and it has made a big difference for her, thankfully !
@BunsenBurner , my wife showed me the story last year, not sure where she found it. He had some pain patients on huge doses of opiates.
A number of independent primary care clinics are going to the concierge medicine model in order to survive in the face of reimbursement cuts from the insurance companies and to avoid having to see 75 patients a day. Primary care really isn’t worth pursuing a medical degree anymore.
I talked to D (the RN) about opioids. It was a bit distressing - she really thinks that they are bad for people and even post-op patients should get up and get rid of them as soon as they can. Constipation and liver damage were worries beyond addiction. It should be said that she was always very stoic about pain but not everyone is like that!