Where do folks get the medications that they over-use and abuse?
Some get them from prescription “mills”, i.e. doctors who prescribe without examining the patients or only cursorily. They are more than willing to write for meds requested for a fee. Doctors like we saw in a recent case who was more than happy to write for Fentanyl, Oxycontin, morphine, and benzodiazepines for an individual. This doctor had been asked to leave his previous group practice because of this practice and had lost staff because of this practice. He was famous (infamous) locally because of the practice. [We are reporting him to the DEA and state licensing folks.]
Some get them from doctors in a hurry or want to send the patient home with “something” because “they expect it” or feel that it is the right thing to do to throw a med at everything and every symptom. I know an individual who I had seen (I do some volunteer work) and we discussed my opinion that he didn’t need meds, but needed to deal with what was going on. After our discussion the individual agreed. A short while later he saw another physician, mentioning the same symptoms he had discussed with me, who promptly wrote him 3 prescriptions and sent him on his way. (The individual filled the prescriptions, but felt 2 of them made things worse or made him feel worse. He takes the other intermittently, although I don’t think he needs it and he continues to agree with me it might be best to go without meds)
Some get them from doctors who just can’t imagine that their patients would over-use or abuse anything. Some from doctors that are not really aware of the possibility of non-medical use of prescription meds. Some from doctors that are not as familiar as they ought to be with the meds they a prescribing.
And then there are folks that “borrow” them or obtain them with various surreptitious means.
So many possibilities and quite frankly most of them are not really related to wrong doing. But it is a significant problem that not enough folks, including doctors, are aware of. We will work to get the word out.