As I sit here today with my good friend Butch and his daughter Paige, I am reminded that life is very short. Paige has melanoma in her brain and it has been progressing in recent weeks. We do not know what to expect next and that is the scariest thing. While I sit here I am contemplating why things happen the way they do. Why, after all the shit I pulled am I healthy and strong, and 22 year old Paige is so sick. Paige has a 16 month old daughter to take care of too. It isn’t fair. She is on all kinds of pain medication, fentanyl patches, Dilaudid, morphine, meds she needs to keep the headaches at bay. I know that she is using those meds because she needs them. While we sit here at the hospital I worry about people stealing the meds she so desperately needs.
Since I know that about 10-15% of healthcare workers are addicted, and working, I know that at some point she will be cared for by one of them. Will they take her drugs and leave her to suffer? Will they ‘share’ them with her, not giving her the intended dose? Why do I worry about it? I worry because I know it is a real problem. These drugs are so addictive and strong. Those who take them are sneaky and you may never know they are doing it. That is how it was with me. Nobody I worked with knew I was stealing and using until they caught me. I was careful to use only a little at work. I was a manipulator and very good at it. I was well liked by my coworkers and supervisors, I had never had any disciplinary issues, ever. When drugs started going missing, it took them a few months to figure out it was me. Once they did and the news got around the hospital, people were shocked. They had no idea it was me. They had no clue I had been stealing and using right under their noses. They felt stunned, hurt, angry. I hope that it opened their eyes.
That was 11 years ago and I am now sober. My goal is to increase awareness so that people know this problem exists, it is growing and we aren’t doing enough to stop it. If someone had drug tested me during or after one of my shifts, they would have caught me. Maybe I would have gotten help earlier. It would have stopped me from putting my patients at risk. Maybe if I had known the possibility existed that I would be drug tested, I would not have started. Who knows? I don’t know, but I do know we have to do something. I think performing random urine drug screens on healthcare workers with access to narcotics is a good place to start.
The National Institute of Health (NIH) names the most commonly abused classes of prescription drugs as opioids (for pain), central nervous system (CNS) depressants (for anxiety and sleep disorders), and stimulants (for ADHD and narcolepsy). http://www.drugabuse.gov/drugs-abuse/prescription-drugs-cold-medicines
Common Opioids include:
- Fentanyl (Duragesic®)
- Hydrocodone (Vicodin®)
- Oxycodone (OxyContin®)
- Hydromorphone (Dilaudid®)
- Meperidine (Demerol®)
Common central nervous system depressants include:
- Pentobarbital sodium (Nembutal®)
- Diazepam (Valium®)
- Alprazolam (Xanax®)
Common stimulants include:
- Methylphenidate (Ritalin® and Concerta®)
- Amphetamines (Adderall®)
If you work at all with narcotics you are probably familiar with most of the above. If you abuse narcotics you are probably familiar with most of the above. If you work with and abuse drugs you are probably intimately familiar with many of them. Some are more addictive than others and all of them are abused. Doctors prescribe them too often for minor aches and pains. Why does anyone get Oxy for tooth pain? I know tooth pain is bad, but not THAT bad. Drugs like fentanyl and Oxy is so very addictive and should only be used for the very worst pain. Unrelenting severe pain. It should be given to those that failed treatment with more minor drugs and therapies. But patients don’t want to hear that, they want the ‘good stuff’. They don’t realize that the ‘good stuff’ is really very bad. If prone to addiction, all it takes is one time and they can become one of the many many people that become addicted. Pain like what Paige has. The headaches are so bad that she can’t sit up without vomiting. She has been on the gamut of narcotics and now needs the strongest of them to keep the pain at bay. This journey has been a reminder to me, a reminder that we need to be vigilant and take care to make sure our loved ones are cared for and not taken advantage of.
Would I leave Paige alone here to fend for herself? No I would not. I want to be here to make sure they don’t take advantage of her pain…and pain meds. Am I worried about using? No. I work my 12 step program and take very good care of my sobriety. But not everyone does. Would I mind if someone asked me to take a drug test? No I would not. Should you mind? No you should not. We have to work together to keep our patients and loved ones safe. We can’t rely on others anymore. You can’t get offended if your place of employment decides to do random drug screens on healthcare workers who have access to narcotics. Well, you CAN be offended, but you shouldn’t be. It is the way things are these days. It is what we need to do in the world we live in. Accept it. It is what it is.