Why are doctors so concervitive?

[streetsurfer]

As a nurse I am constantly amazaed and frustrated by doctors concervitive perscribing of medication
For example
IVDU patients that have an orthopedic injury, lower tolerence to pain already, higher tolerence to analgesia, yet they perscibe these piss ant doses of endone or the like and it's us nurses that get abused all fucking day.
What are they afraid of? They don't want methadone, they don't want to stop using heroin, why not put them on a high dose???? Who fuckin cares if they are a little intoxicated? Give them a bit of stabilty, a break from their manipulative behaviour, hell maybe they could get their lives together a bit while they were in...
Or psychotic/demented patients, just about ripping the rails off the bed, and they are given tiny doses of benzos and antipsychotics, it pisses me off

And I have had a taste of it first hand, coming off effexor, Discontinuation sydrome, Angry and agitated like you wouldn't belive. Went to my GP, Cunt wouldn't give me anything, called my ADHD specialist and he said he would post me a script for 5 lousy valium, Gee, better not take em all at once!

I know this is a rant but I really want to know and I figure the people that can provide me with an answer lurk here.

Peace

 

[BilZ0r]

Because they can get fired if they are seen to be indulging peoples drug habits. Because they are educated that drug abuse is very very bad. They probably also believe that why should the hospitals money be spent on giving people large doses of drugs, when they induced that tolerance on themselves.

 

[streetsurfer]

I reject cost as a factor absoluely cos opiates are cheap as asprin and while not meaning to be insulting to you Blizor, the circumstaces that people become addicted are many and complex and to just to lay blame at their feet is something I reject entirely.
Lets push the obese, the COPD patients, the guys with motorcycle injurys, fuck it, if you left the house in anything less than full body wrapping I got no time for you!

I see what your saying as your first point, but why are they trained to be so EXCESSIVELY concervitive?

 

[BilZ0r]

No, I'm not saying its a legitamate, and I don't really mean it like they actually think of the cost, but in the same way the wont feed the obese patient more in hospital.. you know, they're just a bit "fuck you".

And if you think doctors are nice to obese patients who ruin their body, think again... in my experience at least.

And I can see where they're comming from. There is absolutely no excuse for addiction.

 

[stropharia]

Don't forget that doctors are having to make a risk/benefit calculation for another person, and they are going to be much more conservative than you'd be if you're making that calculation for yourself. How many times have you advised people not to do something that you're willing to do yourself?

If a doctor does something and thereby causes harm, it's a sin of commission; if harm is caused by not doing something, it's a sin of omission, which is judged less harshly.

 

[streetsurfer]

Sorry but I call bullshit Blitzor, stupid people, desperete people, sick people, imressionable people turn to drugs to aleviate their suffering and before they know it it gets out of control.

Addiction is an illness not a charecter fault but that doesn't mean you don't own it and can't help urself.

Peace

 

[frizzantik]

doctors have to be conservative because if they don't they may be persecuted for dispensing drugs to those who don't really need them. it's all due to prohibition

 

[EsourceR]

i share your sentiments

I agree ... doctors in general don't take pain into consideration enough. "conservative old skewl thinking "
....especially since they aren't spending any time with the patient. are they supposed to just take the word of the patient? the situations between doctor and patient can be akward, and at worst ... the patient can leave feeling completely unhelped. I find this very sad. Ok... you can't solve a problem in a day
then ... at least try to find a reason or plan to help the patient before they leave out the door. it's a hard job. it's what makes a doctor good at times. some ego's and attitudes also get in the way of making an informed patient focused decisions regarding care (or referral to someone who CAN help). Doctor's are not gods, ..only resources.

....now to nurses
nurses DO .... spend at least as much time with a patient as the doctor would! ... in some setting such as hospitals...this means 24 hours a day -7 days a week.
we get to know people well. this ability to see the patient instead of the case ......is our "learned" inherant behavioural and cognitive common sense. it's a gift.

good doctors will use their resources including a good nurse to assess a patient's condition more personally. a good doctor or medical provider will also know what pain and it's treatment encompasses.

unfortunately ... the education surrounding PAIN is pityful due to outdated information. old skewlers objectify pain with symptoms, tests, injury ect. new skewl thinking uses subjectivity including, history of drug use (illegal or legal alike), tolerance, qualitative scales and a general belief that the patient could reasonably be in pain.
There is a decision tree process for pain management. It's not difficult, not lifethreating (if used correctly) ... and is responsible for the doctor and on behalf of the patient. Commanding research has been done to back this up.
Patient controlled analgesia is a great outcome of the new skewl thought.

I find the general practitioners in my area are hard asses with narcotics... or hell any med for that matter.
I'm sure the good docs are around, but they are being all taken up by users (... or something wacked, i can't seem to find a good one for me!) The rest of the bunch ...of private practioners
....have extra medical malpractice insurance. nice.

We don't "quite" have a two tier system as the US does, ...yet.

Where I come from (acute care mostly)... most of the docs get recommended a plan (ie."drug") of action....by the nurses. OR ELSE.

nurses having a lot of "free reign"
it keeps the docs focused and attentive of our "suggestions".

thus, IMHO ...ensuring better patient care considering the appauling conditions of ontario's present major hospital systems.

however in a canadian health care setting, money or accountability isn't such a pressure as in the very profitable ... and private medical field.

my rant ... peace, thanks for sharing

 

[fairnymph]

Because so many people go to dr's when they DON'T have legitimate issues and try to scam benzos and opiates.

 

[fastandbulbous]

^ And so docs get sick of people fishing for drugs so that when they come across someone who is addicted, they see them in the same light as the aforementioned scam artists. They make generalizations just like every other person

 

[fairnymph]

Oh...and stims too. Forgot about those.

 

[BilZ0r]

Sorry but I call bullshit Blitzor, stupid people, desperete people, sick people, imressionable people turn to drugs to aleviate their suffering and before they know it it gets out of control.

Addiction is an illness not a charecter fault but that doesn't mean you don't own it and can't help urself.

Now that is bullshit. Addiction is an illness, caused by a character fault, just like obesity can be. You do a stupid thing, you end up hurting yourself. That's what it is. Anyone who doesn't know that certain drugs can be addicting, is patently retarded.

Also, how are you gonna judge how much tolerance a patient has? People with chronic pain are often put on patient activated morphine drippers, but shit like that isn't practical in an outpatient situation.

 

[stropharia]

Now that is bullshit. Addiction is an illness, caused by a character fault, just like obesity can be. You do a stupid thing, you end up hurting yourself. That's what it is. Anyone who doesn't know that certain drugs can be addicting, is patently retarded.

Ah, free will versus determinism.

 

[Donbon]

We are all addicted to 20 amino-acids
To make neurotransmitters, who we are also addicted to
We are all addicts
So i dont think its a character fault
Its called genetic
Opiates is just to name one of many substances, man is addicted to

An addict is soneone, taking drugs who are not of your own preference

 

[PGTips]

^ There's a difference between requiring amino acids and requiring opiates.

Our entire biochemical "machinery" requires fuel and maintanence, which is provided by sugars, proteins, vitamins and minerals. You cannot avoid eating them, because your body needs them to work, just like a car needs petrol to run.

Opiates, and other drugs are not essential to our body (just like alloy wheels aren't essential to a car). Its nice if you've got them, but you can live without them.

 

[lifeisforliving]

Now that is bullshit. Addiction is an illness, caused by a character fault, just like obesity can be. You do a stupid thing, you end up hurting yourself. That's what it is. Anyone who doesn't know that certain drugs can be addicting, is patently retarded.

Also, how are you gonna judge how much tolerance a patient has? People with chronic pain are often put on patient activated morphine drippers, but shit like that isn't practical in an outpatient situation.

Wow. That's a pretty wholesale condemnation of drug addicts.

Other mental illnesses such as depression may also increase the tendency towards addictive behavior. To declare addicts as people with simple character flaws is something I am extremely surprised to hear from a MOD on Bluelight.

 

[lifeisforliving]

Bilz0r, you need to rethink your stance and have some greater understanding of what being human is.


Methadone

This type of treatment views addiction as a disease rather than a psychological disorder or character flaw

“People addicted to opioids like heroin and prescription pain medications are faced with a number of obstacles to getting effective treatment,” says Herbert Kleber, MD, director of the Division of Substance Abuse at the College of Physicians and Surgeons of Columbia University and the New York State Psychiatric Institute. “We need to change the way we think about addiction. Science has shown that opioid addiction is a chronic, relapsing brain disease, not a character flaw, failure of will, or lack of self-control. So we need to stop talking about ‘addicts’ and start referring to them as ‘patients’ — people who have a disease that medication can relieve.”

Pain Relief

If you're a chronic pain sufferer you have undoubtedly heard this from at least one health care professional "We're concerned about your continued use of opioids for pain. We think you might be an addict." According to the publication The Nurse Reporter, Vol. 1, No.1 (from the American Society of Pain Management Nurses);

"...chronic pain and the disease of addiction have been described as “a chronic, relapsing condition” that “may be disabling, even in the absence of clear physical impairment” for many people. Pain and addiction are both “primary illnesses,” not “character flaws.”1,2 The primary goal for treating addiction is the same as the reason for treating pain—to relieve the suffering of the individual. It is important to remember that the reason health care providers exist is to alleviate human suffering for all people."

 

[lifeisforliving]

Oh, and MORE Bil0r


Partnership for a drug Free America

Myth #2: More than anything else, drug addiction is a character flaw.
Drug addiction is a brain disease. Every type of drug of abuse has its own individual mechanism for changing how the brain functions. But regardless of which drug a person is addicted to, many of the effects it has on the brain are similar: they range from changes in the molecules and cells that make up the brain, to mood changes, to changes in memory processes and in such motor skills as walking and talking. And these changes have a huge influence on all aspects of a person's behavior. The drug becomes the single most powerful motivator in a drug abuser's existence. He or she will do almost anything for the drug. This comes about because drug use has changed the individual's brain and its functioning in critical ways.

"Oops: How Casual Drug Use Leads to Addiction"

I realize that this flies in the face of the notion that drug addiction boils down to a serious character flaw -- that those addicted to drugs are just too weak-willed to quit drug use on their own. But the moral weakness notion itself flies in the face of all scientific evidence, and so it should be discarded.

BOTH FROM US GOVERNMENT WEBSITES


Your view is more conservative than the DEA. Get a clue.

 

[Hypostatize]

Addiction is an illness, caused by a character fault, just like obesity can be...

Hey! I'm an obese drug addict!

Okay, not really. But seriously, addiction isn't a character flaw, it's a part of the human condition. 100% of us are addicted to something - Be it chemical or not, be it good for us or not. It's all a matter of what your addiction is and how people view it. Can we "choose" our addictions? Perhaps to some extent, but the fact remains that we're all addicted to something (Maybe even someONE).

 

[oceandreams]

[/QUOTE]
Now that is bullshit. Addiction is an illness, caused by a character fault, just like obesity can be. You do a stupid thing, you end up hurting yourself. That's what it is. Anyone who doesn't know that certain drugs can be addicting, is patently retarded.[QUOTE/]

Well Dr. BilZ0r if as simple as a character fault maybe you have the answer to fix fix my fucking character fault. Because trust me when I tell you I don't choose to be an addict.

[/QUOTE] Anyone who doesn't know that certain drugs can be addicting, is patently retarded.[QUOTE/]

When Dr.s put me on Tylox at 12 for a back injury I did not know they were addicting so I take offense to your generalization.