can doc or hospitals give you a fake dose?

[opiobsessed]

I dont know if this is b.s. or true but I heard it through the grapevine that its a common thing for doctors or the hospital or the doctor to order the pharmacy to give you basically a placebo type of pill. For example you get your normal looking 8mg suboxone from the pharmacy and they look the same as the real pill but have been specially compounded so there is only like 4mg of bupe in there instead of the real 8mg, same with vicodin etc or being in the hospital on the morphine pump and you look in the pump and the iv bag is printed 2mg hydromorphone, when you are really getting a higher dose or lower dose than what you think. I think who I heard this from has to be bullshitting, I mean how much worse can they treat us junkies and get away with it? Sorry if I put this in the wrong section, I figured it would fit in here because swim was recently out of surgery and couldn't believe his eyes when he looked into the morphine pump and it showed only 2mg on the little bag in there. Even the nurse said "man this hospital does definately under medicate pain patients, even 1mg dilaudid. It just makes me want to get a bunch of people together, we must all do something about this country literally trying to kill our only hope. When the only medication that works best for swim is opiates and then hears the crap he hears lately. He just thinks its all about the war going on and wishes peace and many fields of poppies growing freely, with prohibition history soon before swim turns 50 at least.

[candy]

As a nurse myself and fellow opiate addict, I would of never made a comment like that in front of a patient regardless of how I felt. I myself feel that it can be healthcare workers themselves who needlessly put fear into patients with there inappropriate comments. They forget they have a patient sitting there hanging onto every word. Nurses are generally the first caregiver a patient sees and the nurses behavior and his/her verbal comments can make a huge difference in patient care and the outcome of the patient.

In regards to placebo's, I myself have never knowingly administered a placebo. Placebos, I believe don't contain any medication and are given to monitor the patients response to pain. Legally, I am not sure how that works.
In the event of say research, patients are given a placebo or the actual med, but they sign consents knowing they may receive one or the other.

In the case of drugs administered in a different dosage than the patient normally gets, I would imagine it may be a call the docs make. With your experience after surgery, the bag may have said 2mg of Morphine, but your IV pump may have been set to administer the dose ordered. So let's say the bag is labeled 2mg per 10cc or 10ml and your dose is 4 mg of Morphine every hour. The pump can be set to administer 4mg of Morphine every hour. (I have not used my nursing math in a while, so for anyone trying to figure that one out, it may not be accurate, but it should make it's point)
With IV pumps you can administer any med in any dose at any interval of time.

My point to all of this, Don't always believe anything you hear. It is true that their is discrimination in treatment to those with opiate addiction. Especially among those who inject. I myself experienced it first hand as a nurse and as a patient.

My advice to anyone with opiate addiction and dealing with healthcare is to be prepared:

Have your medical records ready to go if you do need healthcare. Whether it is a visit to the doctor's office or your going to the ER. Bring your records with you to show your history and the meds you take. This way, no one can question your need for care or the drugs you take by prescription, especially if they are narcotics.

Bring along a family member or friend as your patient advocate and don't be afraid to let the staff know you have this person their as an advocate. Get the names of those who do treat you unkindly and ask for the nursing supervisor is you do get lousy care or are treated unfairly. Although all nursing staff should have badges, they are not always visible and the first name may be the only name easily read.

Don't offer information unless you feel it will directly affect your care. If you are only seeing the doc for pain or are in the ER after an accident or illness and need pain meds, chances are you will get a lower dose if you tell them you have had a problem in the past with opiates. And believe me this happens, especially with those who are clean. They admit they have had an addiction to opiates and don't want strong pain meds....Well, be careful what you ask for, cause you will get just that....mild pain meds.

And the last thing...Do your research! Find out about your doc or hospital before you go. Call and ask what services they provide and check out your doc's past. Don't limit your options.

[Paregoric Kid]

if it were true it sounds like medical malpractice/negligence. stepping on prescription medication is illegal.

[caesee]

that reminds me of some vets from desert storm that brought a lawsuit against the VA. They were getting scripts for "obecalp" and is wasnt working. They were either told or figured out it was placebo backwards.....

[longing]

[quote=opiobsessed] its a common thing for doctors or the hospital or the doctor to order the pharmacy to give you basically a placebo type of pill. For example you get your normal looking 8mg suboxone from the pharmacy and they look the same as the real pill but have been specially compounded so there is only like 4mg of bupe in there instead of the real 8mg, same with vicodin etc or being in the hospital on the morphine pump and you look in the pump and the iv bag is printed 2mg hydromorphone, when you are really getting a higher dose or lower dose than what you think. [unquote]

no - what an exhausting rigmarole for a group of medical and allied health people to conceive of, meet about, agree upon, draw up guidelines to, manufacture, distribute, and prescribe (with a wink to each other).

doctors arent averse to denying people treatment. they will confidently deny anyone anything, if they feel they should. conspiracies arent necesary. only supreme arrogance and creamy, above-it-all smugness.

[skeletontea]

that reminds me of some vets from desert storm that brought a lawsuit against the VA. They were getting scripts for "obecalp" and is wasnt working. They were either told or figured out it was placebo backwards.....

You'd think the creator's of the "drug" would be clever enough to not use some grade school cipher to disguise their placebo. Were they merely testing "military intelligence"? Essentially saying, not only are we screwing you over, but also we're mocking you about it right to your face? It seems at times we treat our veterans worse than the people our government claim to be our enemies. :mad:

[SirDonkeyPunch]

I dont know if this is b.s. or true but I heard it through the grapevine that its a common thing for doctors or the hospital or the doctor to order the pharmacy to give you basically a placebo type of pill. For example you get your normal looking 8mg suboxone from the pharmacy and they look the same as the real pill but have been specially compounded so there is only like 4mg of bupe in there instead of the real 8mg, same with vicodin etc or being in the hospital on the morphine pump and you look in the pump and the iv bag is printed 2mg hydromorphone, when you are really getting a higher dose or lower dose than what you think. I think who I heard this from has to be bullshitting, I mean how much worse can they treat us junkies and get away with it? Sorry if I put this in the wrong section, I figured it would fit in here because swim was recently out of surgery and couldn't believe his eyes when he looked into the morphine pump and it showed only 2mg on the little bag in there. Even the nurse said "man this hospital does definately under medicate pain patients, even 1mg dilaudid. It just makes me want to get a bunch of people together, we must all do something about this country literally trying to kill our only hope. When the only medication that works best for swim is opiates and then hears the crap he hears lately. He just thinks its all about the war going on and wishes peace and many fields of poppies growing freely, with prohibition history soon before swim turns 50 at least.

I was just reading an old DEA MicroGram Bulletin and i found something interesting i thought may fit well in this thread


- INTELLIGENCE BRIEF -
PLACEBO OXYCONTIN TABLETS IN BREVARD COUNTY, FLORIDA The Florida Department of Law Enforcement Daytona Beach Crime Laboratory (Daytona Beach, Florida) recently received a large shipment (total net mass 31.6 grams, not counted) of apparent 40 milligram dosage Purdue Oxycontin tablets (photo not taken). The exhibit was submitted by the Brevard County Sheriff's Office (Brevard County is located to the immediate south of Daytona Beach). Analysis of a methanolic extract of two tablets by GC/MS, however, indicated no controlled substances. Subsequent discussions with Purdue confirmed that they produce placebo Oxycontin tablets. This was the first submission of such tablets to the laboratory.

--------------- ------------------------ -----------------------------



So it looks like they make "fake" pills, i dont know what circumstances that they would give them out though.

[insanesteveo]

I was just reading an old DEA MicroGram Bulletin and i found something interesting i thought may fit well in this thread


- INTELLIGENCE BRIEF -
PLACEBO OXYCONTIN TABLETS IN BREVARD COUNTY, FLORIDA The Florida Department of Law Enforcement Daytona Beach Crime Laboratory (Daytona Beach, Florida) recently received a large shipment (total net mass 31.6 grams, not counted) of apparent 40 milligram dosage Purdue Oxycontin tablets (photo not taken). The exhibit was submitted by the Brevard County Sheriff's Office (Brevard County is located to the immediate south of Daytona Beach). Analysis of a methanolic extract of two tablets by GC/MS, however, indicated no controlled substances. Subsequent discussions with Purdue confirmed that they produce placebo Oxycontin tablets. This was the first submission of such tablets to the laboratory.

--------------- ------------------------ -----------------------------



So it looks like they make "fake" pills, i dont know what circumstances that they would give them out though.



wow, now thats fucked up. for the pharmaceutical company to admit that they make fake pills is horrible. you would think they would want that info kept secret, or ya know, THEY SHOULDNT DO IT TO BEGIN WITH!

[exitwound]

that's insane! totally insane!

[Zoop]

Dude! I am never going to see a doctor or go to a hospital again as long as I live!

I knew it! I knew it! I knew ! It's that fucking asshole president of ours isn't it? The orders probably came down straight from the Oval Office. Naw, he's too stupid to think of that. Hmmmm. Who could come up with a diabolical plan like that? Karl Rove, that's it! And Rush Limbaugh, that junky scumbag!

/sarcasm off/

No. They don't do shit like that. BUT, and it's a big but, I remember in pharmacy school, we had this old dude who was like old as dirt, used to be a pharmacist for like 20 or 30 years (this would have been back in the 50's + 60's), and then went to law school so he could be a lawyer.

He ended up as the dean of the Medical College of Virginia School of Pharmacy. Well, this cat was tellin' us during a lecture one time about that drug called "obecalp" which was popular with people stricken by various mental conditions back a long time ago.

The shrink would write an Rx of "obecalp, disp. #60, take one every day" or some shit like that and the patient would come back to the doc a week later and swear he or she was good to go.

These days, though, with all the freakin lawsuits flyin around like it's going out of style, NO WAY would that happen!

Candy made a good point about the thing with injection solutions, tho' It could say like "morphine 10mg/ml" on it, but that little pump is only giving you like 0.1ml every six minutes, well, you ain't gettin' no 10mg of morph every six minutes!

[Paregoric Kid]

they could be pills required for double blind studies that require a placebo group.

[WarmCyanide]

Candy made a good point about the thing with injection solutions, tho' It could say like "morphine 10mg/ml" on it, but that little pump is only giving you like 0.1ml every six minutes, well, you ain't gettin' no 10mg of morph every six minutes!

your correct it would be (0.1ml of 10mg/mL) Morphine 1.0mg every 6 mins. not 10.

[candy]

Just to hit up on what was last posted regarding injectable medication.

What I have found, especially when it came to medicating patients is that they often misread or did not understand the label printed on the bag or bottle.

For example, if the bag containing Morphine read 2mg/ml and the patient was supposed to receive say 4mg and hour, we would set the pump to give 2ml over 60mins with a bolus of a 1/2 mg every 10mins. What seemed difficult for patients to understand was that they were getting 4mg of Morphine every hour and the bolus along with it. But because the bag was labeled 2mg/1ml, they were convinced they were only getting 2mg of morphine and the doctor was purposely trying to make them suffer.
Maybe it was their pain causing the confusion or maybe they just really had difficultly understanding how we could administer 4mg of Morphine to them through the pump when the bag contained 2mg/ml.
Believe me, you want to cause them pain after trying to convince them that they are getting the meds that they were told they would receive.

OK, did I even make a point!!! :o

I have given many patients an aspirin when they thought they were getting something else, but these folks usually had some severe mental illnesses and if calming them down meant giving them an aspirin, then we did. Of course the patient thought it was something else, but when they felt that their meds were being poisoned, giving them an aspirin or something harmless calmed them enough to evaluate them medically. But, we did this to protect their well-being and keep them from hurting others. They often came to the ER after being picked up or walked in on their own claiming their meds were contaminated or when asked where their meds were, they threw them away because they tasted funny and thought they contained poison. When you have a violent schizophrenic in your ER, sometimes you have to become creative in order to protect them and the staff. Did I feel bad about doing this, not very often. But, I wouldn't have done it to a patient who honestly was suffering pain and needed to be medicated.
Placebos are used in research, but those patients know that they may receive them.
Other than those experiences, I have not given a patient a placebo knowingly. I have seen docs give the patient another drug than what the patient asks for or decrease the dosage.
I really have been on both sides of the issue. I have experienced patients who manipulate the docs to get meds and patients who really need the meds, but the doctor doesn't believe the patient really needs the drug.
In both cases, I try to advocate for the patient. Obviously in both cases, something is going on and because pain is so subjective, who can really say if a patient is or isn't experiencing pain.

There is so much to be said on the issue of pain management and what I can honestly say is that doctors, nurses, etc. need more education on pain management and how to treat patients effectively who are dealing with chronic pain.