John Talmadge, an eminent Dallas-based addiction psychiatrist, reports stumbling on this while browsing the web (misspellings courtesy of the author):
“A good doctor is harder to find than a good dog. Pay cash, don’t go to a doctor that has every client in need of pain meds. If you have X-rays and can prove you’ve taken the meds before, you still may have to shop around. Be strait with the doctor, but don’t tell your life story. Be percise and to the point; ‘Iv’e been on many different med’s in the past (don’t say the word methadone)… I read and I’m on the internet over 12 hours a day…. I have to fly over a thousand miles each month to see my doctor, because when Iv’e started calling #’s in the phone book, they ask too much personal info.”
It’s advice you’d expect to see about finding a job or picking a romantic partner, except the subject is how to manipulate a physician into feeding your addiction. Reminds me of a story I heard from a recovering woman about a house meeting at her communal residence, where the goal was to figure out how to keep one resident’s foot injury from healing so the doctor would continue to supply pain meds that they could all share. This type of reasoning may seem quite immoral to observers, but to an active addict, it’s mostly a question of need— they need the drug, the physician has the drug, so the only real issue is what must be said or done to convince the doc to provide it.
This is a very, very old problem in medicine. But now we happen to be in the midst of an epidemic of prescription drug abuse and dependence— 2.1 million persons involved, last I looked— during an era when doctors have ready access to more (and more potent) addictive medication than ever before. Most of those meds are prescribed by persons with little practical training in addiction, within the context of a hurried 15 minute office visit. Not a model that lends itself to thorough assessment and careful decision-making. And now there’s the emergence of ‘tip sites’ on the Internet, dedicated to turning the reader into a better-prepared, more successful drug-seeker.
It’s a setup, of course, without a perfect solution. But in future posts, we’ll look at some practical suggestions for healthcare practitioners seeking to reduce the risk of being manipulated.