Patients seeking refills for chronic pain prescriptions are finding that those requests are being rejected more and more often by emergency departments. Due to the increasing incidence of drug diversion and doctor shopping, many hospitals are developing policies that limit or even prohibit prescription of controlled substances for chronic medical problems.
But every time that people build a better mousetrap, Mother Nature builds a better mouse.
Patients know that they won’t get prescriptions for chronic pain, so they often come in complaining of acute injuries. Lots of falls down stairs with acute back injuries, lots of twisted ankles, some neck spasms after non-reported car accidents. So not only do the patients get their medications, they often get additional x-rays … which drives up the cost of their medical care.
One regular patient was reportedly pretty creative with her acute injury. She came in with significant pain in her thigh after suffering a stab wound. In fact, when she rolled in the doors on the ambulance stretcher, she still had a paring knife sticking out of her leg. Police weren’t called though. The injury was self-inflicted.
Turns out that the patient was using a paring knife to make herself a baloney sandwich. While she was standing in the kitchen spreading mayonnaise on the bread, her leg kept twitching. In fact, the twitching got so bad that she had trouble standing upright. So in the spur of the moment, she stabbed herself in the leg to make her leg stop twitching.
Of course, now her pain was “at least a twelve” on a 1-10 scale. And her allergy list included all NSAIDS, codeine, and Tramadol.
She got cleansed, sewn up, and discharged with Tylenol – fortunately she wasn’t allergic to that. She also got to follow up with the neurologist to address the case of the incessantly twitching leg.
The knife got confiscated and thrown into a sharps bin.
And everyone kept wondering what she was going to do with her baloney after that incident …
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