The fuzzy line between medication use and abuse

Opioid painkillers, such as Vicodin (hydrocodone) and OxyContin (oxycodone), are crucial medical tools that are addictive and widely abused. Tranquilizers and sleeping pills of the benzodiazepine class, like Xanax (alprazolam), Ativan (lorazepam) and Klonopin (clonazepam), are safe and effective in limited, short-term use, but are often taken too freely, leading to drug tolerance and withdrawal risks. Stimulants such as Ritalin (methylphenidate) and Adderall (amphetamine) ease the burden of ADHD but are also widely used as college study aids as well as recreationally. All of these medications are available only by prescription. This means prescribers serve as gatekeepers, permitting access for medical needs and denying it otherwise. This gatekeeping can be difficult. Doctors are imperfect lie detectors and can be fooled with a plausible story. Pain, anxiety, insomnia and inattention are mostly invisible. The internet offers quick lessons in how to fake a medical history. Beyond the initial assessment, every physician has patients who repeatedly “lose” bottles of painkillers or tranquilizers and request more. Secretly seeing multiple doctors to obtain the same drug remains fairly easy. While a few doctors run illegal “pill mills” and flout the gatekeeper role, many more are simply too overworked to be vigilant with every patient. None of us became physicians to fight the war on drugs. On the contrary, most of us are uncomfortable doubting our patients’ honesty. It...
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Meds Patients Source Type: blogs