Drug-seeking voice mail of the day

As I checked my voice mail yesterday, there was the following message:

"Hi, I just got out of the hospital and I really need something for anxiety. They gave me something good there, you can check my records if you like. It's called lorazepam. L-o-r-a-z-e-p-a-m. So if you could get Dr. Analytic to prescribe it for me, that would be great." [click]

Buddy, it's great that you took the time and effort to think about what drug you wanted the doc to give you, and even spelled out its name for us. While it's pretty unlikely that he'd prescribe one of the most-abused medications to you without seeing you himself in an office visit, at least you gave it a good shot. But since you didn't give us your name and phone number, it's not going to do you any good!

Do I look like I give out drugs for fun?

Mr. Methhead is one of our "regulars." People tell me that when he's sober and stable on his medications, he's a pretty cool guy. Since I've never had the pleasure of encountering him in either of those states, I'll take their word for it.
Monday, I got to field the following telephone call from him, several hours after I'd given him his regularly scheduled antispychotic injection:
Mr. Methhead: "Hey, I've got the worst headache today! Do you think it could be from that shot you gave me this morning?"
Me: "Maybe, but I wouldn't bet on it. Skipping caffeine can cause bad headaches, though. Did you have your coffee this morning?"
MM: "No, but I had some black tar heroin over the weekend. Would that do it?"
Me: "Yes it would. Heroin withdrawl will really make you feel like crap. How's the diarrhea and vomiting today?"
MM: "I'm not puking, but the @%#s are bad. Do you have any heroin?"
Me, very thankful it's a phone conversation so I don't have to try so hard to keep a professional facial expression: "No, sir, I do not have any heroin."
MM: "Oh, then do you think the doc would prescribe me some OxyContin?"
After the usual reminders to him that we're a mental health office and DON'T prescribe pain medication (We don't do this under any circumstances. Your arm could fall off in our waiting room, and we still wouldn't. We firmly believe in "not feeding the bears.") , drink lots of clear fluids, call 911 if you can't breathe, etc, I managed to somehow gracefully disengage from the phone conversation only to look over and see the interns gathered at my door with their best nonchalant expressions plastered on their faces. You know, the ones that say "No, I haven't been eavesdropping even though my eyes are the size of saucers."
"What's up?" I asked, trying to keep a straight face.
One of the braver ones spoke up. "Our supervisor told us you'd give us tetanus shots as part of the new hire process..."

A drug is a drug is a drug?

Mr. Methhead is one of our long-term patients. He's been with RCMH for ages. While our chart numbering system is currently at six digits and growing, his medical ID number only has four! Due to his bad decisions on how to finance his drug habit, he takes a break from us regularly to spend quality time with the nice folks at the Random County jail, but he always comes back.

He's out again, and that means he's on my list of clients who come in for regularly scheduled injections of long-acting antipsychotic medication. As I gave him his injection last week, he said "Wow, I got such a rush from that!"
At a loss for words, I just stared at him before finally stammering out "You know, Mr. Methhead, that may be the nicest thing anyone's ever had to say about Prolixin!"

Drug-seeking fun

As with any medical doctor’s office, there are the occasional patients who come to us hoping that we’ll support their addiction to prescription medications. We generally refer to them (outside their hearing, as insulting them to their faces would be "unprofessional") as "seekers," short for "drug-seekers." We don’t prescribe narcotics, but we do regularly prescribe Valium, Xanax, and Ativan to patients who have legitimate anxiety problems.

Life happens, and people do lose their medications for strange reasons. (My brother used to have a disturbed German Shepherd that liked to snack on bottles of Percocet.) Our clinic's policy is pretty simple: The first mishap is a "freebie," but if you seem to be especially accident-prone, we will start to grow concerned.

This past week was especially noteworthy for lost meds. It seemed like three or four people called each day wanting us to authorize another prescription. After yet another patient telephoned to complain that someone had stolen her Valium (for the second time that month,) SuperNP got annoyed.

“My God, does no one ever steal these people’s blood pressure medication? Why don’t their antibiotics get flushed down the toilet accidentally? Do their dogs just not like to eat cholesterol pills? Why is it that only the entertaining drugs that get lost and need replaced?”