A recent article about the dreadful murder of little Tori Stafford details the widespread OxyContin, aka “Hillbilly heroin,” addiction problem in her hometown of Woodstock, ON.
I don’t understand how all these people are getting enough OxyContin to maintain their addictions. You can’t make it yourself. I’m not hearing about any big pharmacy heists. I know for a fact that if any of it goes missing in the supply chain, like from a warehouse, it’s a huge goddamn legal storm - it would quite literally be easier to rob a bank. And I had enough trouble getting my dentist to give me frigging Tylenol 3 when she screwed up my tooth. Pharmacies track this stuff, too.
Who’s getting the OxyContin? It seems to me it should be easier to get actual heroin.
There are a couple ways to get it, the most common way is to go to a doctor who will write you the script for $$$. There are plenty of doctors out there that will pretty much write anything for the money. The other way is through theft. There have been a bunch of break-ins in pharmacies down here in Georgia lately, the crooks break in through the roof, and steal all the good medications. I know of at least 5 pharmacies that have been broken into just in the Savannah area.
For the record, the oxycodone capital of the U.S. is in Broward county, Fl.
There are also ‘patients’ who can tell a very good story and put on quite a convincing show for certain pain syndromes. They often go to dozens of physicians across a region, present themselves, and end up with a prescription for the damned stuff from each prescriber. End result: Dozens of month-long supplies of the drug to sell and trade.
It’s easier to trip these folks up than it used to be, due to cross-checking by pharmacies to see prescription histories. But it still can be done.
I rarely prescribe oxycontin. While effective, it’s far too abusable, and there are usually equally effective narcotics which are a little bit harder to abuse. Methadone for one, but even long-acting morphine sees less abuse than oxycontin, due to the extremely rapid onset of action you can get with the latter, when it’s misused.
It frustrates me to see just how gullible a lot of my colleagues are out there. I get literally hundreds of patients who managed to convince their physician that they truly needed 160 mg of oxycontin 3 times a day for their musculo-skeletal back pain. I find nothing on their physical exam that confirms such a dire problem, and I see from their pre-sentence investigation that they’ve been convicted of knocking over pharmacies and selling drugs since they were teenagers.
This raises an interesting question. To what extent can doctors run a criminal background check on patients? Obviously, you’re in something of a unique position in knowing your patients’ criminal histories. I can’t see it becoming standard, but is that something a doctor specializing in pain management could do? Or be required to do by the state?
My husband’s aunt is a small animal vet (now mostly retired). She’s had several break-ins in her office over the years, and each time the thieves have stolen what she assumes they believed was Oxycontin.
Unfortunately for them, it was canine oxytocin. Which won’t get them high, but it just might induce lactation…
I find the whole system unbelievably frustrating and illogical: when my husband had 12 teeth pulled in one day, the dentist, who has known him for 2-3 years, still won’t prescribe more than 15 vicodin. But when my husband has, on a couple occasions, gone to urgent care when an abcess has suddenly flared up in a tooth (he has hereditary rickets, and his teeth are a ruin), the doctors there, who don’t know him from Adam, inevitably prescribe 30 vicodin without even being asked. I went into an urgent care one time with pus and blood running out of my infected ear in frankly disturbing quantities and was told to “look for drops at the pharmacy”, but I have friends who seem to have infinite prescriptions of every pain-killer and tranquillizer out there. I truly do not understand the system.
I’m able to get pretty much anything I ask my doctor for, but he also knows that I take exactly what I need when I need it, and it doesnt leave my possession. I hate pills, but recognize that pain control is a good thing … so I will take them when I absolutely need them.
Funny (I guess) story. I was on Vicodin for more than a month for severe back pain. It did not help enough, so doc put me on morphine. I had just filled a Vicodin scrip for 90 days, so all those pills were left over. I was wondering if I should go downtown and try to sell them
Fortunately, our town has a drug recycling program, so I could safely dispose of them.
Just go anywhere in South Florida and look for a ‘pain management clinic’; it shouldn’t be too hard, you can’t swing a dead cat without hitting one. Complain about anything from an excruciating back injury to a hangnail and they’ll set you right up.
How does drug recycling work? I thought that, once dispensed, drugs could not be returned. The patient has to either use them, save them, or dispose of them.
Hmmm. I haven’t gotten prescriptions to an opiate pain med, a least in years and years, but let’s keep the option open. I don’t generally take non-narcotic OTC pain meds, not because I’m apprehensive of any dangers, but because, as far as I can tell, they do squat. I can’t recall that I’ve ever taken any “pain reliever” or prescription non-narcotic pain med, and experienced any pain relief. I recently had a flare up of lower back pain, and took it do a sports doc, preparatory to a round of PT. I had to leave town for a while, and the back pain resolved so I passed on the round of PT, but he gave me a scrip for an NSAID, Meloxicam. Yep, I took 'em, and yep, it did zippo, as far as I could tell. One of these days a condition of that sort is going to have me talking a doctor into some vicodin or something like that to see if THAT works.
Yeah, i disposed of them to the drug recyclubg place.
I never thought to ask how they get rid of them (they insist that only the pills or capsules be put in a baggie, without the pill container). I know you should not flush them, so perhaps they burn them? I’ll ask next time they have the monthly collection.
There were also more than a few stories a few years back of Pharmacueticals distributors turning out to be little mini offices with minimal signage. Apparently it was much easier to become a pharmaceuticals distributor for a while than many believed.
Probably because you’re confusing individual prescriber decisions for a system. There is no system as you’re thinking of it. Prescribers have many, many resources that recommend for X condition there are Y drug treatment options, but there’s nothing that says to always prescribe vicoprofen for every broken rib (for example).
There are too many factors to ever create such a system: What’s the patient’s abuse history? What’s their liver and kidney function? What other medications do they take? What other conditions do they have? What’s their weight? Are they male or female? What level of success has the prescriber seen when prescribing this drug for that condition? What are the local pain management protocols? Has the DEA ever visited or investigated this prescriber? What did the prescriber learn from his or her teachers about this condition?
All these questions, and more, go into every decision about prescribing drugs, narcotics especially. As a patient, you don’t see any of this process, just the end result.
“recycling” in this case doesn’t mean “give out to somebody else to take as 2nd hand medicine”, but rather “destroy & dispose of the residue in an environmentally safe manner”.
I really don’t think it’s always that rational–again, urgent care docs load my husband down with stuff for his teeth, but our dentist would look at the exact same condition and suggest ibufrophin.
Ugh, I’ve always wondered the same thing. I have severe nerve damage in my right foot after it was surgically immobilized, anything that puts pressure on my foot causes pain. Yes, socks hurt. I couldn’t get my doctor to give me anything for pain. He ‘didn’t want to treat this with drugs’. Apparently, what he wanted to treat it with was some ‘don’t need to see you anymore, you’re better now, get out’.
