Posted by: HAT | January 24, 2011

Just Do What You’re Told

a persistent representation of the drug seeker

Here’s what I’ve deduced about the rules that govern asking for pain medicine:

Patients (normal, good) are instructed to ask for pain medication so that they will keep their pain at a less bothersome level, like a “4” or “5” out of 10. Good patients will ask for what they need when they need it. (Corollary, patients don’t need to know what they have been prescribed to know what they need when they need it.)

Drug seekers (deviant, bad) want to take the maximum amount of pain medication they can. Therefore, drug seekers ask to know how much they are allowed to take, and when it is due, and drug seekers ask for what they are allowed to take shortly around the time it is due.

    A patient who asks to know her dose is acting like a drug seeker; a patient who asks for the maximum amount of pain medication she is allowed to take shortly around the time it is due, is acting like a drug seeker.

Patients are encouraged to ask for what they NEED. The orders have presumably been written to make it possible for a normal person to keep from experiencing acute pain — which is sort of undesirable — so asking for what you are allowed to take around the time you are allowed to take it is probably what will prevent your pain from escalating (e.g., it might keep it at around a “4” out of 10).

Drug seekers ask for more pain medication than they actually NEED. They ask for what they can get (e.g., a big dose of narcotic right around the time they can get it) just because they know they can get it, not because they NEED it (i.e., even if they are not having pain greater than around “4” out of 10 – or who knows, maybe even less than that, really).

    Someone who asks for the maximum amount she can take of a narcotic when her pain is at about a “4” out of 10 is acting like a drug seeker, because she is asking for the pain medication she knows she can get, instead of asking for the pain medication that she feels she NEEDS.

So what I have learned at hip replacement camp is that my choice is between being indistinguishable from a drug seeker and maybe having less pain, or being distinguishable from a drug seeker by actually experiencing more acute pain before asking for more pain medication.

I officially take back what I told my daughter. Sometimes it IS a bad thing to be smart.

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