A Prescription for Trust

Prescription medication addiction is sweeping our country at an alarming rate.  Many people are concerned for their safety and the safety of their loved ones who are in need of medication.  Learn how to make sure you are receiving the best prescriptive care from your doctors.

How Patients & Families Can Avoid Health Care Obstacles Caused by Painkiller Addiction

Pills don’t always work the way we think they do. Half a pill doesn’t always mean half the strength, and twice the medication can quadruple dangerous side effects. Well-chosen medications soothe our pain, but a rowdy mix will use our body as a battleground. Your best guardian against the complexities of medication is a strong partnership with your physician. Trusting your doctor, and allowing your doctor to trust you, are absolutely essential elements of quality health care.

As prescription painkiller abuse has risen, the doctor-patient relationship has become more difficult. Doctors must now constantly worry that they are being misled, that their helpful prescriptions are being used in harmful and dangerous ways. In turn, they may be monitoring your prescription use more carefully. It’s important to remember that they’re doing this to make sure they’re serving you correctly. In turn, you can help by respecting your doctor’s expertise, and letting him or her support you. Remember, you’re partners.

Here are ten tips to ensure that you’ll continue to receive the best and safest prescriptive care from your doctor.

1. Always follow prescription medication directions carefully.
When it comes to medication management, there is no substitute for a medical degree. That’s why only your physician can write prescriptions. You should think of your doctors as your personal health experts, who took four years to earn their wings in medical school and then at least three years in residency to perfect their work under an expert’s watchful eye. So, leave the difficult questions of dosage in your doctor’s hands, and follow your doctor’s advice to the letter. If you have questions and suggestions, discuss them with your doctor before trying them out.

2. Don’t increase or decrease doses without talking with your doctor.
Why risk ending up in the hospital, or worse, when a simple heart-to-heart discussion with your doctor can give you an answer that keeps you safe? A sudden, unplanned change in medication can have ramifications and side effects that you are unable to take into account when planning a dosage change. This is the very reason you see a doctor—he or she can use their expertise to design a medication plan that will protect your health.

Openness, candor and direct communication are key ingredients for a mutually beneficial physician-patient relationship. Nowhere is this truer than in the risky and emotionally fraught field of pain management. When your pain is at its worst, remember that you can and should rely on your doctor.

3. Don’t stop taking medication on your own.
By now you’ve noticed a theme—if you want your medication to help and not harm, you have to follow your doctor’s instructions. Ending a treatment routine is as complex as starting a new one, so don’t quit your prescriptions cold turkey before their time. Some medications need to be continued well after the symptoms have disappeared. Let your doctor escort you off of a course of medication rather than taking matters into your own hands.

4. Don’t crush, chew or break pills.
Let’s be real here. If your doctor wanted you to find new uses for the pill, she would have told you that in the office. Don’t mistake your adult medication for a children’s chewable vitamin. Many pills are ingenious drug delivery systems in disguise, covered in layers of coatings to ensure that medication is released slowly and in strategic locations in your digestive tract. All of that ingenuity is completely foiled if you chew or crush the pill. Instead of sweet therapeutic relief, you’ll get an immediate and potentially fatal release of medication into the body.

5. Be clear about the drug’s effects on driving and other daily tasks.
There’s a reason that you need a photo ID to buy alcohol, but a doctor’s legally binding signature for strong painkillers. Prescription pain medications can affect our cognition just the same as alcohol, and sometimes more. It is important to follow not only your physician’s, but also your pharmacist’s recommendations on allowable activities while you’re under the influence of pain medication. If you drive under the influence of alcohol or prescription medication and get a moving violation, you need to let your doctor know. As always, if you don’t know, ask.

6. Learn about a medication’s potential interactions with alcohol, other prescription medicines, and over-the-counter medicines.
You never want to add something new to your body until you know whether its ying will knock your yang out of flow and off balance. So, learn about new medications before you start them. You can and should ask your doctor, even and especially if you decide to take a new non-prescription remedy. Over-the-counter medications, herbs and supplements are particularly misleading because we think of them as less harmful than their prescription counterparts.

7. Inform your doctor about your history of substance abuse.
It isn’t your doctor’s job to judge you. It IS your doctor’s job to make sure your medications don’t put you in danger, and your doctor can’t do that if you withhold information about your medical history. This necessarily includes your substance abuse history, past or present. There are certain medications that pose serious health risk to people with a history of substance abuse, especially recovered or recovering alcoholics. You doctor knows which medications these are, and your openness with your doctor will allow her to protect you from inappropriate prescriptions. If you have a history of substance abuse, you don’t need to worry that you will be left to agonize without pain medication.

8. Don’t use other people’s prescription medications and don’t share yours.
Never, never and let me say it again…. never! share prescription medications. By now you know that it can pose unexpected risks. Furthermore, it’s actually illegal! And it can create legal liability if an adverse reaction happens. If you share your prescription, you expose yourself to charges of engaging in the practice of medicine without a license. If someone you care about needs a pill or a prescription, do the responsible thing for them—tell them to see their own physician, not raid your drug cabinet. Please do not pretend to be a pharmacist. You could kill someone.

9. Don’t doctor shop or fill prescriptions at multiple pharmacies.
Doctor shopping is the practice of going to multiple doctors simultaneously to scam prescriptions. It is illegal, and prosecutors are cracking down. Filling prescriptions at multiple pharmacies is a red flag— to your physician, to state drug authorities who monitor your prescription filling actives, and to your insurance carrier. In instances when you have a legitimate need to fill medication at more than one pharmacy, simply discuss this with your physician in advance.

10. Be willing to submit a urine or blood sample or information needed to monitor your use of painkillers.
Don’t be insulted when you’re asked to pee in a cup. If you want to continue to receive easily misused drugs, it’s in your best interest. Doctors are constantly faced with patients who are addicts, either through using illicit drugs or doctor shopping. When a doctor asks for a urine sample, she wants assurance that there is no potentially lethal misinformation that could affect his or her prescription strategy for you.

Moshe Lewis MD, Chief, Physical Medicine and Rehabilitation, California Pacific Medical Center, St Lukes Campus

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