[Culture]
[culture] Again with the meds
You know the old problem of why hot dogs are ten to a pack but buns are eight to a pack? One thing I’ve noticed in medicine is a tendency to do that sort of thing with prescription drugs.
I had port implant surgery yesterday. I was given two Vicodin in the hospital during recovery. I was also given a Vicodin prescription for pain management at home. Since returning to Nuevo Rancho Lake from the hospital, I have taken exactly two more Vicodin. I am highly unlikely to take any further pills, and if I do, it will be one or two at the most.
My prescription is for fifty pills.
What the hell do I need fifty Vicodin for? Even if I were dreadfully pain-sensitive and tanking up on the damned things at every conceivable opportunity, that’s a significant oversupply. Given my pain tolerance and my aversion to opiates, this is a multi-year ration of pills.
I don’t really care. I just find it weird. And this kind of oversupply must be a contributing factor to healthcare cost overruns, however small it might be. So what is up with giving me fifty of these things?
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Posted: 4:26 am Sat September 15 2012 |
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We might be cruel, but at my institution we only give a 1 day supply of pain medications after an interventional procedure like port placement – if a patient’s pain persists at a level necessitating narcotics we want them to come back and see us about it… Some physicians might oversupply just to avoid the inevitable call from people who are highly pain intolerant, though.
Had a similar issue with post-operative Percoset this summer. Been there, done that. I said I don’t like to use it after the first week, and even then, only at night. I cut the pills down during the week so I get less each day. Still got a prescription for 20 pills, threw most of them away.
Interesting. When I was a PA at an abortion clinic, we gave prescriptions for Vicodin — ten pills, no more. The assumption was that if the pain was worse than that, you needed to come back in right away. Only had a few people come back in, and they were all legitimate issues. Can’t really imagine 50 for a port placement. You might mention that to your doc when you return.
I think they were trying to provide you with a little extra income. You could probably make a bundle by selling them on the street!
It could be a number of things. Like JD stated above, not everyone has the same pain tolerance level and giving you as much as most people (or the outliers) this reduces your need to return to the doctor and paying another prescription copay. It could also be that 50 pills is part of your doctor’s signature. This way the pharmacies that most often handle their prescriptions know that someone isn’t forging the doctor’s prescriptions. In pharm tech class the instructor told us about one doctor who always put 99 refills on their prescriptions, even though by law prescriptions are only good for one year from the day they’re written, and you can’t prescribe refills on Class II narcotics. This way, not only to the pharmacies know his handwriting they also know his prescriptions weren’t being forged. If course for all C II drugs they had to call him to clarify.
I’ve had the same problem but their shelf-life is very long. I put the left overs in the freezer once but flushed them when I thought to use them for minor pains. Then I heard medicine ends up in the drinking water somehow. So the last time I was prescribed 50 some odd pills for diverticular pain of which I used about nine over 3 days I just stuck the left overs in my sock drawer. Three years later my doc prescribed me antibiotics to get rid of the flora in my instestines but the drug store was closed by the time I got my scrip and the doc said I could use the left-over hydrocodone if I couldn’t get to the drugstore. The pain was that bad and the antibiotics didn’t even touch the pain. I ended up using almost every last one of those pills for nine days, 2 or 3 a day. Just because I ate one little damn onion. So, just save them. That way they don’t go to waste
German doctors are notoriously stingy with their painkiller prescriptions and they’d never prescribe a fifty pack for a fairly minor surgery.
When I had a pretty nasty tooth extraction a few years ago, I was prescribed a package of 10 codeine tablets. I was pretty lucky – last year my Dad only got Ibuprofen for oral surgery that was worse than mine. You’d have to be dying to get prescribed 50 Vicodin tablets. And even then, they’d only prescribe you twenty and then they would check if you’d died yet or needed more.
Oh yes, and don’t throw leftover meds in the trash or flush them down the toilet. The proper procedure is to take them back to the pharmacy, so they can be properly disposed of.
It was explained to me once, by a doctor if I recall, that it has to do with insurance. Because you have to pay the same co-pay regardless of a prescription, it was easier to over-prescribe rather than forcing a patient to pay a co-pay again for just a handful of pills.
Our doctor here in Seattle listens to us. My husband gets vicodin for migraines, but has been weaning himself off of it and using other pain-reduction methods. This last time he asked for only 15 pills (the usual has been 30), and that’s what his doctor wrote it for. Our “copay” consists of the difference between what the insurance covers and the cost (which is discounted by the pharmacy) of the meds.