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Thread: An open letter from an ER doc to drug seekers-

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    Default An open letter from an ER doc to drug seekers-

    Found on CraigsList: Read:

    Date: 2007-03-27, 9:56AM PDT


    OK, I am not going to lecture you about the dangers of narcotic pain medicines. We both know how addictive they are: you because you know how it feels when you don't have your vicodin, me because I've seen many many many people just like you. However, there are a few things I can tell you that would make us both much happier. By following a few simple rules our little clinical transaction can go more smoothly and we'll both be happier because you get out of the ER quicker.

    The first rule is be nice to the nurses. They are underpaid, overworked, and have a lot more influence over your stay in the ER than you think. When you are tempted to treat them like shit because they are not the ones who write the rx, remember: I might write for you to get a shot of 2mg of dilaudid, but your behavior toward the nurses determines what percent of that dilaudid is squirted onto the floor before you get your shot.

    The second rule is pick a simple, non-dangerous, (non-verifiable) painful condition which doesn't require me to do a four thousand dollar work-up in order to get you out of the ER. If you tell me that you headache started suddenly and is the 'worst headache of your life' you will either end up with a spinal tap or signing out against medical advice without an rx for pain medicine. The parts of the story that you think make you sound pitiful and worthy of extra narcotics make me worry that you have a bleeding aneurysm. And while I am 99% sure its not, I'm not willing to lay my license and my families future on the line for your ass. I also don't want to miss the poor bastard who really has a bleed, so everyone with that history gets a needle in the back. Just stick to a history of your 'typical pain that is totally the same as I usually get' and we will both be much happier.

    The third rule (related to #2) is never rate your pain a 10/10. 10/10 means the worst pain you could possibly imagine. I've seen people in a 10/10 pain and you sitting there playing tetris on your cell phone are not in 10/10 pain. 10/10 pain is an open fracture dangling in the wind, a 50% body surface deep partial thickness burn, or the pain of a real cerebral aneurysm. Even when I passed a kidney stone, the worst pain I had was probably a 7. And that was when I was projectile vomiting and crying for my mother. So stick with a nice 7 or even an 8. That means to me you are hurting by you might not be lying. (See below.)

    The fourth rule is never ever ever lie to me about who you are or your history. If you come to the ER and give us a fake name so we can't get your old records I will assume you are a worse douchetard than you really are. More importantly though it will really really piss me the fuck off. Pissing off the guy who writes the rx you want does not work to your advantage.

    The fifth rule is don't assume I am an idiot. I went to medical school. That is certainly no guarantee that I am a rocket scientist I know (hell, I went to school with a few people who were a couple of french fries short of a happy meal.) However, I also got an ER residency spot which means I was in the top quarter or so of my class. This means it is a fair guess I am a reasonably smart guy. So if I read your triage note and 1) you list allergies to every non-narcotic pain medicine ever made, 2) you have a history of migraines, fibromyalgia, and lumbar disk disease, and 3) your doctor is on vacation, only has clinic on alternate Tuesdays, or is dead, I am smart enough to read that as: you are scamming for some vicodin. That in and of itself won't necessarily mean you don't get any pain medicine. Hell, the fucktards who list and allergy to tylenol but who can take vicodin (which contains tylenol) are at least good for a few laughs at the nurses station. However, if you give that history everyone in the ER from me to the guy who mops the floor will know you are a lying douchetard who is scamming for vicodin. (See rule # 4 about lying.)

    The sixth and final rule is wait your fucking turn. If the nurse triages you to the waiting room but brings patients who arrived after you back to be treated first, that is because this is an EMERGENCY room and they are sicker than you are. You getting a fix of vicodin is not more important than the 6 year old with a severe asthma attack. Telling the nurse at triage that now your migraine is giving you chest pain since you have been sitting a half hour in the waiting area to try to force her into taking you back sooner is a recipe for making all of us hate you. Even if you end up coming back immediately, I will make it my mission that night to torment you. You will not get the pain medicine you want under any circumstances. And I firmly believe that if you manipulate your way to the back and make a 19 year old young woman with an ectopic pregnancy that might kill her in a few hours wait even a moment longer to be seen, I should be able to piss in a glass and make you drink it before you leave the ER.

    So if you keep these few simple rules in mind, our interaction will go much more smoothly. I don't really give a shit if I give 20 vicodins to a drug-seeker. Before I was burnt out in the ER I was a hippy and I would honestly rather give that to ten of you guys than make one person in real pain (unrelated to withdrawal) suffer. However, if you insist on waving a flourescent orange flag that says 'I am a drug seeker' and pissing me and the nurses off with your behavior, I am less likely to give you that rx. You don't want that. I don't want that. So lets keep this simple, easy, and we'll all be much happier.

    Sincerely,
    Your friendly neighborhood ER doctor
    hello.

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    Default Re: An open letter from an ER doc to drug seekers-

    I think someone posted this before. But thanks, it's an interesting read.

    GOR

    I need a signature!



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    Default Re: An open letter from an ER doc to drug seekers-

    Tonight I experienced a patient who reminded me there are limits to drug seeking behavior in the Emergency Department. Having been on the receiving end of this, I’d like to pass on some words of wisdom.

    Basic rules: don’t put
    • “allergic to hydrocodone 5’s, but not the 7.5’s”
    • I’m just here for a pain shot
      • and I need “Demerol”
    • “yes, I have some hydrocodone, but need more”
    on your triage list.

    Advanced rules: don’t
    • start screaming for another doctor 30 seconds after being told ‘no pain shot’
    • ask the nurse “is taking 7 darvocet like one hydrocodone 7.5?”
    • ask for refills of Soma, Duragesic and Oxycodone at 2 AM, on a weekend, without being able to supply name doctors at hospitals that have previously treated you.
    • think “the only drug that works for me starts with a D…” isn’t going to make us less wary…
    • ask “is doctor ‘X’ on duty?” (knowing the names of the EM docs is never a good sign)
    • And, True, the clothes make the man, but they often give away the drug seeker
    And the most basic rule: and ED nurse can smell BS at 20 paces, and can point out ‘not right’ in about 3 seconds. Never, ever, screw with an ED nurse.
    Oh, and ticking off the ED doc isn’t good, either.

    another one
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    Default Re: An open letter from an ER doc to drug seekers-

    Wow, that advice pretty much follows exactly what myself and a few others recommended on a thread here last week. Its good advice.....though I have my doubts that was written by an ER doc.
    Morphine. It's whats for dinner!

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    Default Re: An open letter from an ER doc to drug seekers-

    I would honestly rather give that to ten of you guys than make one person in real pain (unrelated to withdrawal) suffer
    Wish all I doc were like this.
    :confused:

    "How much pain one feels is not something the government should be deciding"
    Smoke weed everyday!

    1 year+ clean on methadone.

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    Default Re: An open letter from an ER doc to drug seekers-

    Oops, I've done the "hmm, i think it starts with a 'D'" ROTFL. Oh well it worked for me but it probable sent a red flag up. I think i only used that method 2 or 3 times and after that i just flat out told them what works when they asked me, I'd just say "Huh, yea, Dilaudid seems to work the best"

    GOR

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    Default Re: An open letter from an ER doc to drug seekers-

    I know plenty of people who I can imagine would probably act like this in the ER (meaning like the jurk 'ol doc was saying not to be), but in all honesty I pretty much already follow al his rules. I try to be nice to them all on any visit to the doc or ER because at my old doctor's office in Fla the nurse had a lot of pull and I think she knew what I wanted. Most of the time she wrote out the scripts and the doc just signed 'em. Either way, she was cool b/c I called a few times for refills on perc 10/325 and the nurse would sometimes up the sript from 60 pills to 90 pills for me...

    I think it does work in most cases just to be nice to everyone and have a decent story...

    Also does a lot of people use stories about headaches b/c it seems to work better if you got a bad back or something. I mean think about it, you can have hurniated disks in your back and the ER is just going to give you a script but in a headache situation they might think you have a tumor in your head or something... I don't know, just seems easier to me...
    [SIGPIC]

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    Default Re: An open letter from an ER doc to drug seekers-

    My wife is a nurse and I used to be an X-Ray tech. She has worked in EC(ER) and I did portables in the EC - many of them in the green room(worst-most emergent patients) I've also had the displeasure of being an EC patient. The letter from the 'ER doc' is a good common sense letter but there are a few things that don't quite add up. I have my doubts it came from a real MD.

    Any nurse that gets caught wasting any bit of medication that should go to a patient would be written-up in a heartbeat. Maybe not fired but certainly given a few unpaid days off. Then there would be an incident report and all kinds of other stuff those outside of the medical community have no clue about. Now the rn may discuss with the doc how they feel about a particular patient and they may walk very slowly to get a patients meds, fill the order and bring it back. Want your catheter to be tugged hard a few times by accident - call your nurse a bitch or dick. But when a doc gives a written or verbal order, no rn in their right mind is going to waste part of a patients meds. I asked my wife about this and she laughed and said she's never heard of such a thing. She said if something went wrong and the patient had some sort of problem from being under-medicated via GROSS NEGLIGENCE (at the least) it's lawsuit time and time to look for a new job.

    Let's talk about how you're dressed when you come to the EC. Most real emergencies really don't have the time to put on their Sunday-go-to-meeting clothes before entering the EC. They are dressed in everything from bathing suits to tuxedos. The triage nurse will see how your dressed but the experienced ones know Shit from Shinola. Oh yes and lets not forget that by the time you get back to your little exam room you've been asked to take off everything but the socks and put on the open-backed robe. Kind of a great equalizer.

    How you act. Pain is a subjective thing. That's why the docs and nurses will ask you to rate your pain. Then they will use a method called SOAP. (Subjective Objective Assessment Plan) to further assess your pain and treatment. There are actually some physiological signs of pain. But they aren't written in stone. Elevated blood pressure is one sign of excruciating pain. But - not always. Go figure.

    My wife and I have both seen people come in complaining of migraines who get medicated with CII narcotics without having a CT. You see it's not so often what they give you while you're there - it's what they give or don't give you to walk out with. When people come to the EC with REAL pain the objectives are to find out the etiology of the pain and then to manage the pain. BTW - If an EC doc ordered a CT for every patient he/she examined who complained of a headache the chief resident would be breathing fire down their necks about keeping costs to a minimum - needless tests and, 'Where in the hell did you learn your evaluation skills from - the funny papers' I actually heard a resident getting reamed with that particular statement one night.

    There are some very good common sense tips in the letter. Don't be rude to the people taking care of you. Don't exaggerate, but if you're really in pain and you feel it's a 8 or 9 you'd better say so because it could make a huge difference in how you are treated. Oh - if you think you're having a heart attack PLEASE don't take the time to put on nice clothes before going to the EC(ER).

    Now if you're walking into the EC to scam them try to keep this in mind - They've seen it all before. There is nothing new under the sun. They do keep files on 'frequent fliers' - so if you've been there to restock your stash chances are it's not going to happen. This is not to say that people don't get lucky now and then. But, the odds are stacked way against you if you're trying to scam the EC. But - most of us already knew that.

    Honestly some of that stuff is poppy-cock and some of it's just good common sense. And some of the examples of what not to do would only be done by an extreme idiot. But - I've seen that as well.

    PAX
    Last edited by Uncle Wiggly; 01-24-2008 at 01:15 AM. Reason: 8ui895*(*(YU--\][
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    Fifteen cents for the old morphine, now carry me away from here."
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    Default Re: An open letter from an ER doc to drug seekers-

    Wiggly the only thing i disagree with is the frequency of nurses diverting medicine. IMO a lot of that goes on. A lot of nurses are drug seekers themselves, and if they see someone who "won't really even notice", they'll have a bottle on them and either just take some of the morphine right away, or save it for later and only give you half of the bottle it comes in. Sure they SHOULD be written up (I wouldn't say fired, i mean losing your livelihood over a mistake is a bit harsh), but they probably don't most of the time. I mean they could do it when they're alone with a patient and the patient usually wouldn't even know what's going on.

    I STRONGLY believe this happened to me one time. I was in withdrawal and went to the ER for a headache (which was real, but not that bad, mostly just w/d's), and after the toradol and everything else they FINALLY decided to try morphine, but i didn't really feel ANY better. And i didn't really have much tolerance back then so that doesn't explain it, and it was IV morphine so i should have felt something. She said "i'm just gonna give you half to start and see if you throw up". So she gave me half and then PULLED THE NEEDLE OUT. Then she just left and i never saw her again. The doctor was next to see me.
    "Live on coffee and flowers"

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    Default Re: An open letter from an ER doc to drug seekers-

    I think you're just being shorted from the start. You should've been able to feel half a shot to some degree or else the second half probably wouldn't do much either. And if it didn't help you I doubt it'd help the thief/nurse much unless she saves several half-full hypos from all her patients.

    You were probably just under-medicated and you know how busy those nurses can be she probably just got sidetracked. You could be right but I think most nurses I've met are compassionate enough not to steal half shots from people in pain.

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    Re: An open letter from an ER doc to drug seekers-

    Quote Originally Posted by GoddessofRATs View Post
    I think someone posted this before. But thanks, it's an interesting read.

    GOR
    Yeah, wasn't there a video on CraigsList too? Remember the guy who said to pretend like you were lifting a piano and something slipped and now your back is out of whack! Don't say your chest hurts or it will get you no painkillers and they'll just do a couple hours of wasted tests on you just to discharge you with nada. That video was pretty good.

    I know I've bitched about my failed attempts at ERs and what I've FINALLY, finally figured out... after talking to you guys and friends... it seems ONCE you KNOW what's wrong with your back they treat you a lot differently.

    Scenario I:

    LE goes to the local ER in pain. They do all the usual stuff but I've been there a few times. I tell them how I have CP but how it fluctuates between levels I can deal with and levels I can't. Have I had an MRI, yes? Have I been to a specialist, yes? My doctor isn't available for a few days (although it's true it sounds shitty).

    NO PILLS OR THE SHITTIEST ONES THEY CAN GET ME OUT THE DOOR WITH.

    Scenario II:

    LE goes to an ER he's only been to once or twice (there are some I've been saving up that I've hardly ever been to but only a couple that are close enough not to be questioned why I'm going "so far" out of my way).

    LE goes in and complains of back pain; let's only assume I'm going to bother going because it's real. If I want to get high I'll just find another way; believe you me, it's NOT worth putting on an X hour song and dance for 10 vicodin or some crappy Ty-3's.

    Instead of saying that it's chronic or that I have a specialist—say just what really happened but if it's not plausable (cause believe it or not some of the things that render me in pain don't sound like they would). By just doing that—playing naive to medications—not using any fancy medical terms—in the past I used to score 12-15 percs no problem. I think it's ONLY when I started making it known that I've had a whole history of problems for a while and this and that—right there I'm setting off the "drug seeker" alarm. If I play like I'm just a first timer dumb-dumb (which is easy to do at a location I haven't burned) perhaps I'll fair better.

    LE should at least walk away with 10-15 percs or maybe 10-20 vics. If God is really smiling down upon me maybe even a morphine or a dilly shot (doubtful nowadays: the only thing they gave me dilly for was the appendix—and I still can't get that shit out of my mind).

    So does Scenario II sound like an improvement and more likely to work? As I've said, I'm going to try this PM thing out and see what the deal is. I'll try all their magic tricks and this and that. But, let's say when all else fails, hypothetically what do you guys think? Have I finally found the qualities that are "red flagging" my ass? Agent Orange? GoR? Anyone care to comment?
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  12. #12
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    Default Re: An open letter from an ER doc to drug seekers-

    Any junkie thats needs a hospital to score, my advice is "give it up man"..Nurses work for shit wages, more of a vocation than occupation and why bother them when gear is only a phonecall away?
    Nurses saved my life, have a lot of respect for them.If ya need the ER to score,the games over.Go back to college and normal life, they are to busy savin lives to be some college/high school kids dope dealer......

  13. #13
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    Default Re: An open letter from an ER doc to drug seekers-

    Quote Originally Posted by Indy View Post
    Wiggly the only thing i disagree with is the frequency of nurses diverting medicine. IMO a lot of that goes on. A lot of nurses are drug seekers themselves, and if they see someone who "won't really even notice", they'll have a bottle on them and either just take some of the morphine right away, or save it for later and only give you half of the bottle it comes in. Sure they SHOULD be written up (I wouldn't say fired, i mean losing your livelihood over a mistake is a bit harsh), but they probably don't most of the time. I mean they could do it when they're alone with a patient and the patient usually wouldn't even know what's going on.

    I STRONGLY believe this happened to me one time. I was in withdrawal and went to the ER for a headache (which was real, but not that bad, mostly just w/d's), and after the toradol and everything else they FINALLY decided to try morphine, but i didn't really feel ANY better. And i didn't really have much tolerance back then so that doesn't explain it, and it was IV morphine so i should have felt something. She said "i'm just gonna give you half to start and see if you throw up". So she gave me half and then PULLED THE NEEDLE OUT. Then she just left and i never saw her again. The doctor was next to see me.
    Yes you're right about the DIVERSION of drugs. I was talking about an RN deliberately wasting a patients meds because she/he didn't like them. (no other reason than spite) Now we all know when some one has a jones - all bets are off. The medical field is the top of the pile when it comes to drug addiction amongst professionals. But it's getting a lot tougher for meds to be diverted in the EC and other high-volume areas. Even in the hospital - period. That's why a lot of diversion is being done in the private sector of medicine now.

    There was a nurse who was giving Toradol to the patients she was supposed to be giving CIIs to. That was because Toradol wasn't locked up at this particular hospital. Well it seemed that too many of her patients were complaining of 'not feeling' their pain shots. So they started following her around. It wasn't long until they caught her in a bathroom-stall banging what should have gone to a person in pain. Now many hospitals are locking up their injectable NSAIDs along with the CIIs. There was a big to-do last year when one of the top surgeons was found passed out in the bathroom with a half-full shot of Numorphan still in his arm.

    They don't usually fire people the first time they get popped. They don't even call the cops. They do give them the choice of going to rehab and keeping their jobs when they get out or getting let go and 'black-listed'. There's a lot of understanding toward a person with an addiction but there wouldn't be much slack given to some one who was just wasting meds to cause misery in a patient. It's very different.

    A lot of hospitals are now requiring all personnel to take random drug tests. Believe it or not that wasn't the case in most hospitals only 20 years ago. There are also cameras everywhere now. It's very difficult for medical people to divert drugs these days. I'm not saying it doesn't happen. There's always somebody who figures out a way to beat the system. The thing is the drugs that docs and nurses get a hold of are very powerful so it isn't long until their tolerance is going through the roof and they're taking bigger chances to score. Then their co-workers start getting suspicious...

    The thing is - hospitals weren't always tight when it came to security involving meds. For example it used to be if a nurse on one a unit forgot to give the drug keys to the next shift before going home, they'd just call and ask them to bring them back. Not any more. If the drug keys leave the hospital the first thing that happens is security changes the lock. There's a full count done on all the controlled substances on the unit (even if one had just been dome a few minutes before). If it comes up short the shit hits the fan and they launch an internal investigation. Those used to be kind of a joke in years past but not any more.

    So anyway, yeah you're right about that part. I was just saying an RN isn't going to waste meds because a patient rubs them the wrong way. Especially after a doc has ordered those meds to go to that patient. That letter reads to me like it was written by somebody who has watched too many episodes of ER - not an MD. Plus there are things you're used to hearing from EC docs that this person never mentions in the letter. The person keeps using the term, 'douchetards'. It makes me think they might still be in high school. Now if they would have used GOMER it would have sounded a little more authentic.

    Raz - I couldn't have said it better.

    PAX
    Last edited by Uncle Wiggly; 01-24-2008 at 06:12 AM. Reason: RAZ - &*&*$&V)&%(^$U
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  14. #14
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    Re: An open letter from an ER doc to drug seekers-

    Quote Originally Posted by Raz View Post
    Any junkie thats needs a hospital to score, my advice is "give it up man"..Nurses work for shit wages, more of a vocation than occupation and why bother them when gear is only a phonecall away?
    Nurses saved my life, have a lot of respect for them.If ya need the ER to score,the games over.Go back to college and normal life, they are to busy savin lives to be some college/high school kids dope dealer......
    ERs serve their purpose, especially for those who w/o medical attention they could get complications and potentially die. As far as me and my pain, fuck that—they've proven they're worthless to me. I just have a thorn in my side about the whole issue because whenever I've needed the help the most they've never been there for me. The one or two times I friggin' scored good C-II meds were the times I probably could have squeaked by with C-III meds. Oh well, I'm not trying to hijack the thread—it's useful info. to have and be aware of.

    My word to the wise: try to avoid going to the ER just cause you're in w/d (unless it's really, really bad) or you're just plain old jonsing. You're likely to fuck it up for when you are in a situation where you really are in acute pain and nobody cares to take you seriously. This is spoken from someone who has been there. Case closed.
    Last edited by limitless_euphoria; 01-24-2008 at 06:13 AM. Reason: spelling and grammar
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    Default Re: An open letter from an ER doc to drug seekers-

    ^^^^I wasnt diggin anyone out.Just amazes me that some guys go through the hoops etc to score C11 meds when the easiest route is,"Make a call".....Mates of mine have taken flights to score rather than do that ER shit.
    My own personal experience with nurses, DR's etc is they saved my life,when i got shot,and without them payin me the care they did i wouldnt typin this..Common sense kinda indicates its a million times easier to score on the street,than the ER.....Nurses work for shit, when they should be on a million quid a week....
    Just my 2cents,take on things.Nothin personal bro.Be cool.....Raz

  16. #16
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    Default Re: An open letter from an ER doc to drug seekers-

    Quote Originally Posted by Raz View Post
    Any junkie thats needs a hospital to score, my advice is "give it up man"..Nurses work for shit wages, more of a vocation than occupation and why bother them when gear is only a phonecall away?
    Nurses saved my life, have a lot of respect for them.If ya need the ER to score,the games over.Go back to college and normal life, they are to busy savin lives to be some college/high school kids dope dealer......
    Truer words were never spoken! The time most will spend waiting at the ER to run the pain game (assuming its fake of course, or ridiculously exaggerated, not talking about legit pain problems) is easily enough time to for a decent junkie to pull together enough scratch to score some shit that's as good or better than their highest IV dose of dilaudid. And lets face it, it is true that one could be occupying their time while someone's kid is having some unknown meltdown with a huge fever and diarrhea and vomiting and no one knows what the hell is wrong, or someone's family member is ripped in half in a wicked bad accident...

    Just remember people, time IS money, yours and theirs! This is at best a gamble with your money (time), one that is probably of similar odds as wearing a pair of dockers and an izod shirt down to "the hood" in a volvo, and asking if you could kindly be directed to the "reliable neighborhood heroin distributor". I mean I get that different people have different comfort levels and different experiences, but if you are a true junky (as in pretty high tolerance, IV, and require it to function) this is a huge waste of time compared to the 10 bucks a stamp/point bag or 40 bucks for a half gram, depending on where you are, will get you. And it won't piss off/interfere with the health care workers. Note I said "true junkie" meaning already IV'ing, goes looking for the IV morphine or dilaudid, etc, I'm not saying the person who's mildly physically addicted to vicodin and needs maybe 5 to 10 5/500's a day should start shootin' dope, but the heavy opiate user really is wasting their time.

    The exception of course would be those who have a well documented CP condition, one that the docs pretty much universally accept, and its a given (from experience) that you will get what you expect/need. This is meant more for the "malingerers/drug seekers".

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    Re: An open letter from an ER doc to drug seekers-



    When I was 19-20 I worked graveyard shift in an ER. We used to put the people who came in for

    painkillers all the time on the " best dressed list " I don't have any idea why they called it that.

    But the thing we really hated was when these ding bat babes would come in and just want felt up.

    They would come in at like 20 am every friday nite and say OHH I have this pain right here see,

    no down a little OHHH that s GOO- OHHthat hurts! OH and I think I also have some verry little

    lumps in my breast right by the nipple there. Those were the days when they use to pack your nose

    FULL of pharmacutical grade coke if you broke it. ( I always took the left overs ) And quite a few

    bottles of Demerol got droped and ( "BROKEN" ) back then. AHH the good old days. I missm. .:jumping-s
    All you need is LOVE and a 134 D Mini - Gun.

    ** Bring back the 6O's Raise some Hell.**

  18. #18
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    Default Re: An open letter from an ER doc to drug seekers-

    LOL!!! I knew some of us had tried this, the minute I read it. I remember going to my GP who treated my pain for over six years and asking for dilaudid. I acted all stupid.. told him that my next door neighbor was a pain patient (true) and his doctor gave him something that started with a "D" for breakthrough pain. This patient recommended me trying it... umm... something like di-lau-da-phine/? does that make sense? LOL

    Funny thing is, it worked. He gave me 60 2mg tablets for a couple of months. The third month, I had to see the Nurse Practitioner, because my doctor was at a conference. She said she wasn't comfortable using them outside an ER setting, because of the abuse and diversion potential. I argued with her, telling her that if they suspected me of doing either, then they shouldn't be writing me for anything. All the medicines they had scripted me over six years were all CII's with abuse and diversion potential. She ended up giving me another 2 weeks worth and wanted me to come back to see my regular doctor.

    By the time I got back, I had finally figured out that Dilaudid was worthless in any ROA except IV. I could easily take the whole bottle in less than 2 days and not even be close to comfortable, pain wise. Worthless shit, orally, imo.

    Great information, AO. Thanks for posting!



    Quote Originally Posted by GoddessofRATs View Post
    Oops, I've done the "hmm, i think it starts with a 'D'" ROTFL. Oh well it worked for me but it probable sent a red flag up. I think i only used that method 2 or 3 times and after that i just flat out told them what works when they asked me, I'd just say "Huh, yea, Dilaudid seems to work the best"

    GOR

    "He who fights too long against dragons becomes a dragon himself; and if you gaze too long into the abyss, the abyss will gaze into you." - Friedrich Nietzsche










  19. #19
    Never Looked Back Uncle Wiggly has conned a lot of people to get this much rep Uncle Wiggly has conned a lot of people to get this much rep Uncle Wiggly has conned a lot of people to get this much rep Uncle Wiggly has conned a lot of people to get this much rep Uncle Wiggly has conned a lot of people to get this much rep Uncle Wiggly has conned a lot of people to get this much rep Uncle Wiggly has conned a lot of people to get this much rep Uncle Wiggly has conned a lot of people to get this much rep Uncle Wiggly has conned a lot of people to get this much rep Uncle Wiggly has conned a lot of people to get this much rep Uncle Wiggly has conned a lot of people to get this much rep Uncle Wiggly's Avatar
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    Default Re: An open letter from an ER doc to drug seekers-

    One more thing. Yesterday I read this letter and I thought is was bogus but I was only an X-Ray tech and my wife has been an RN - MSNfor over twenty years - 8+ years spent in the EC(ER). So I printed the letter and gave it to her to read. I did not give any indication as to where it came from or what my opinion of the letter was.

    After a very short amount of time she started laughing. The laughing turned to sighing. The sighing turned to cursing. When she was finished she walked up to me and said,"Tell me this is a joke and no one is taking this seriously." Then she started tearing the letter apart and showing me where it's medical-logic fell short. She even went so far as to take a hi-liter to certain sentences/paragraphs and explaining why she thought they were written by a medical voyeur - not a REAL MD.

    Then we started talking about it and I told her where my doubts entered into the picture. We both felt the same way and I only know a fraction of what she knows about emergency medicine. Raz put it very well in his post. It makes me sad to know that some one reading this 'letter' is going to use it as an EC Patient's Drug Seeking Manual.

    Most of the 'letter' is just common sense stuff that most moderately intelligent people know in the first place and relatively harmless. But the scary part about this 'letter' is it may motivate some one who is experiencing a genuine medical emergency to understate their symptoms to the doctors and nurses at the EC because they took the advice of some one who shouldn't be handing out anything but hall passes.

    PAX
    "Fifteen cents for the morphine, and twenty-five cents for the beer.
    Fifteen cents for the old morphine, now carry me away from here."
    "Soldier's Joy"
    (Traditional Scottish fiddle reel with lyrics added during the American Civil War)

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    Default Re: An open letter from an ER doc to drug seekers-

    It didnt take rocket scientist to see a real MD didnt write that. I said that in my first post. How do I know? Because that letter could in no way make a doctor any money, and thats thier number one motivating factor to do ANYTHING.

    ANd the whole, it starts with a D shit, could land you with a bottle of useless pink Darvocets! LOL!
    Morphine. It's whats for dinner!

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    Default Re: An open letter from an ER doc to drug seekers-

    a headache will get you a shot of fioracet, shitty butilbital. My first ever experience with oppies was 2 summers ago at 2 am, fucking blister on my ear drum, it was, and still is the worst experience i've ever had. Got me 25 percs too i was suprised, now here i am literally just finished shooting up OC, that damn blister delivered me into evil!

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    Default Re: An open letter from an ER doc to drug seekers-

    Quote Originally Posted by CIIORNOTHING View Post
    It didnt take rocket scientist to see a real MD didnt write that. I said that in my first post. How do I know? Because that letter could in no way make a doctor any money, and thats thier number one motivating factor to do ANYTHING.

    ANd the whole, it starts with a D shit, could land you with a bottle of useless pink Darvocets! LOL!
    Exactly! Since when does an EC resident have the time to sit down and write out a detailed letter about how TO score in the EC. Arrgh!!!

    There are a lot of docs who do it because they genuinely want to help people. That's why the bad ones hurt all of them. You wouldn't believe the debt most docs are in after they're out on their own. Medical school costs lots of money. It takes them a long time before they see the bigger bucks.

    And the "starts with a D" line is straight from the television show - ER! Season 1 - I have it on DVD
    "Fifteen cents for the morphine, and twenty-five cents for the beer.
    Fifteen cents for the old morphine, now carry me away from here."
    "Soldier's Joy"
    (Traditional Scottish fiddle reel with lyrics added during the American Civil War)

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    Default Re: An open letter from an ER doc to drug seekers-

    Quote Originally Posted by Uncle Wiggly View Post
    Exactly! Since when does an EC resident have the time to sit down and write out a detailed letter about how TO score in the EC. Arrgh!!!

    There are a lot of docs who do it because they genuinely want to help people. That's why the bad ones hurt all of them. You wouldn't believe the debt most docs are in after they're out on their own. Medical school costs lots of money. It takes them a long time before they see the bigger bucks

    Yes I would. I was pre-med and my best freind went on to be OB/GYN well I dropped out and settled being a Paramedic. I also worked as a Paramedic in the ED on my off days. Residents work thier asses off, long crazy hours, 100s of thousands in debt. But I still have hard time feeling sorry for them
    Morphine. It's whats for dinner!

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    Default Re: An open letter from an ER doc to drug seekers-

    regardless of if its authentic or not (I told you I found it on craigslist), point is the same: its decent basic advice (be polite, dont fake chest pain to go to the front of the line) and it got me interested in the topic, last night I read a bunch of stuff written by ER doctors on HOW TO spot drug seekers- and those how-to-spot guides can just as easily be how-to-score guides. Best strategy at the ER so far seems to be: get sickle cell. Other than that, go to your neighborhood dope man.
    hello.

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    Default Re: An open letter from an ER doc to drug seekers-

    Quote Originally Posted by CIIORNOTHING View Post
    Yes I would. I was pre-med and my best freind went on to be OB/GYN well I dropped out and settled being a Paramedic. I also worked as a Paramedic in the ED on my off days. Residents work thier asses off, long crazy hours, 100s of thousands in debt. But I still have hard time feeling sorry for them
    Don't sell yourself short. I wouldn't look at it as settling to be a Paramedic. Most of us in the field (or used to be in the field ) have nothing but respect for you all. You're the first line of defense for most people who are crashing.

    "Best strategy at the ER so far seems to be: get sickle cell. Other than that, go to your neighborhood dope man."

    That's what Raz has been saying since the beginning of this thread.



    PAX
    Last edited by Uncle Wiggly; 01-24-2008 at 08:29 AM. Reason: &*%*&HGHV)(L
    "Fifteen cents for the morphine, and twenty-five cents for the beer.
    Fifteen cents for the old morphine, now carry me away from here."
    "Soldier's Joy"
    (Traditional Scottish fiddle reel with lyrics added during the American Civil War)

  26. #26
    OpioNoMo Raz is one bad motherfucker Raz is one bad motherfucker Raz is one bad motherfucker Raz is one bad motherfucker Raz is one bad motherfucker Raz is one bad motherfucker Raz is one bad motherfucker Raz is one bad motherfucker Raz is one bad motherfucker Raz is one bad motherfucker Raz is one bad motherfucker Raz's Avatar
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    Default Re: An open letter from an ER doc to drug seekers-

    Goin to the ER is probably a cry for help more than a cry for dope?

  27. #27
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    Default Re: An open letter from an ER doc to drug seekers-

    Hey thanks Wiggle. My folks would disagree and did nothing but bitch at me for dropping out of school. Anway, I appreciate that. I miss that work. Im in sales now , totally different. Much better money but boring as hell.

    And hey Raz, I hear you bro, and agree to some extent. Most times I went to the ER it was a cry for help alright, "help me stop thse fucking WD's". And for me, Ive never had a solid source for pills and I havent done the H road yet.....trying not to.
    Morphine. It's whats for dinner!

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    Default Re: An open letter from an ER doc to drug seekers-

    Quote Originally Posted by CIIORNOTHING View Post
    Hey thanks Wiggle. My folks would disagree and did nothing but bitch at me for dropping out of school. Anway, I appreciate that. I miss that work. Im in sales now , totally different. Much better money but boring as hell.

    And hey Raz, I hear you bro, and agree to some extent. Most times I went to the ER it was a cry for help alright, "help me stop thse fucking WD's". And for me, Ive never had a solid source for pills and I havent done the H road yet.....trying not to.
    I had to leave the med field as well. Besides having Stones and Crohn's I've got Torticollis (too bad the 3rd disease didn't rhyme with Stones- and Crohn's- like maybe Broken Bones. I'll have to try for another illness that rhymes with the first two) ANYWAY -- I had to quit because I couldn't lift people up on the table any longer etc... I'm sure you get the idea.

    However - Now I can get anything I want drug-wise. I could walk into any EC and get scripted. Fuck - I look like Quasimodo on a bad hair day. But that would be wrong. You've got to look at the big picture. It just messes it up for the folks who really need to be there. I get enough
    meds from my PM doc for all my needs -- most of the time. There have been times I've had to go and even if you get triaged straight into treatment there's still people either more emergent or playing games with the system in front of or next to you. I've been there enough times that my wife and I have it worked out to where she drops me off and I call her to pick me up when it's over. Hell - why should she have to sit there while I'm waiting to be seen and treated.


    Once I had went in for renal colic and I was sitting on the gurney waiting to be seen. The lady who's
    on the gurney to my right is talking to her BF about where they're going to eat after they get out of there. I'm still giving them the benefit-of-the-doubt until I hear the curtain slide open and the doc walk in. Then she starts saying how much it hurts and she's sick to her stomach from the pain. I just kept my lips zipped. As fucked-up as I think it is to scam the the EC - I think it's even more fucked-up to drop a dime on any one.


    The moral of this story. As I was being discharged so was the couple who were next to me. I made it a point to walk out the door just behind them. When we got outside I started walking toward where my wife was waiting and I said, "Have a nice dinner." They knew I was talking to them because they both turned to look at me. I just smiled and got in the car and left.

    I'm not really knocking any of you who have had to use the EC for getting well/high. I know we all have to do what we have to do - OK. Sorry about the ramble. I happen to be dealing with a stone as I write this but not to worry. I'm well medicated. Thanks you and good day.

    PAX
    Last edited by Uncle Wiggly; 01-24-2008 at 10:48 AM. Reason: yuv &%)(*&89+1816
    "Fifteen cents for the morphine, and twenty-five cents for the beer.
    Fifteen cents for the old morphine, now carry me away from here."
    "Soldier's Joy"
    (Traditional Scottish fiddle reel with lyrics added during the American Civil War)

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    Default Re: An open letter from an ER doc to drug seekers-

    Quote Originally Posted by Uncle Wiggly View Post
    I had to leave the med field as well. Besides having Stones and Crohn's I've got Torticollis (too bad the 3rd disease didn't rhyme with Stones- and Crohn's- like maybe Broken Bones. I'll have to try for another illness that rhymes with the first two) ANYWAY -- I had to quit because I couldn't lift people up on the table any longer etc... I'm sure you get the idea.

    However - Now I can get anything I want drug-wise. I could walk into any EC and get scripted. Fuck - I look like Quasimodo on a bad hair day. But that would be wrong. You've got to look at the big picture. It just messes it up for the folks who really need to be there. I get enough meds from my PM doc for all my needs -- most of the time. There have been times I've had to go and even if you get triaged straight into treatment there's still people either more emergent or playing games with the system in front of or next to you. I've been there enough times that my wife and I have it worked out to where she drops me off and I call her to pick me up when it's over. Hell - why should she have to sit there while I'm waiting to be seen and treated.


    Once I had went in for renal colic and I was sitting on the gurney waiting to be seen. The lady who's on the gurney to my right is talking to her BF about where they're going to eat after they get out of there. I'm still giving them the benefit-of-the-doubt until I hear the curtain slide open and the doc walk in. Then she starts saying how much it hurts and she's sick to her stomach from the pain. I just kept my lips zipped. As fucked-up as I think it is to scam the the EC - I think it's even more fucked-up to drop a dime on any one.


    The moral of this story. As I was being discharged so was the couple who were next to me. I made it a point to walk out the door just behind them. When we got outside I started walking toward where my wife was waiting and I said, "Have a nice dinner." They knew I was talking to them because they both turned to look at me. I just smiled and got in the car and left.

    I'm not really knocking any of you who have had to use the EC for getting well/high. I know we all have to do what we have to do - OK. Sorry about the ramble. I happen to be dealing with a stone as I write this but not to worry. I'm well medicated. Thanks you and good day.

    PAX
    Good post man. And I hear you. Im lucky that today I dont have to do the ER scam thing because I have a very generous pain doc and not so lucky to have two slipped disks L4-L5-S1. Also my wife works in a vet practice and lets just say they dont keep tight controls on the inventory at all.

    I agree about the ER thing, but hey, sometimes when youre hurting bad enough, you will try anything. Bad WDs will make you lose every ounce of shame you even dreamed about having
    Morphine. It's whats for dinner!

  30. #30
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    Default Re: An open letter from an ER doc to drug seekers-

    Meh, scamming ER's work for me.... Yeah, I've been given Ultram too on a few occasions, but I've also walked out with OCs, so it's not like it's impossible to get good meds there. I usually walk out with percocets or sometimes vicodin, so it's not like it's impossible by any means...

    And as for those who have a real ailment, and don't get anything, I'm sorry for ya. I really am, and if I could do something about it, I would... But it's not my fault.

    It's not like there's a limited amount of narcotics out there, and if I get some, the dude with a broken leg doesn't get any. Blame the shitty doc, who doesn't give you a script, but don't blame me or other scammers.

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