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How would you go about reporting this? (long, of course)
Someone I know recently confided to me that she has a problem with taking pills. It started small, but now it is close to out of control and she doesn't know what to do.
Here is the major, huge, can't believe this can even happen problem: the doctor that prescribes them hasn't even seen her in over a year. She clicks a button and voila! He approves 5 more refills of 150(!!!) pills. She went in for a minor problem years ago, and really has no reason at all to be taking these pills, ever.
She has tried to stop. She will get a week or 2 in, then will have a bad day or something will set her off, and she knows a click of the mouse and a short drive to Walgreens is all it takes. If she had to actually make an appointment to go in and see a doctor to make sure she really needs to be taking these pills (and then faking her reason), she wouldn't go there.
Who can I report this to?? It is obvious that this doctor must be doing this for other patients. She said something crazy like he has prescribed over 8000 pills to her in the last 2 years or something (she doesn't take them all). I want to help her, not sure how other than to make sure this a-hole doctor doesn't keep blindly approving refills! She actually told me that the last time the pharmacist got wide eyed and was like "um, I need to get your doctor to sign off that he has tested your liver. You are filling this every 9 days!". And the doctor signed off on it!!!
Anyway, this sucks. Any clues where to find info on how to report something like this?
Re: How would you go about reporting this? (long, of course)
Really I think reporting the doctor isn't easy or simple. However, I think just getting a doctor reported won't solve your friend's problem - she'll have another bad day and head off to find a doctor who believes her pain issues. She's addicted and if you take away the source, I bet she'll try for another 2 weeks or so, but without support, she'll find a way to get more.
I read in a mommy magazine that women aged 25-35 are the fastest growing group of people addicted to pain pills/narcotics. I guess I would talk to her and tell her that she needs help - not from you or the doctor, but Narcotics Anonymous or something like that. Do you know if her husband/family is concerned or are you close enough to find out?
Are you united with the CCOKCs?
I agree that reporting the dr probably won't solve your friend's problems, BUT if he's letting her have these many pills, he's probably letting others have just as many and he does need to be reported.
Maybe start with the state medical board? Or call a pharmacist and ask them if they know where you can call?
Her husband is part of the problem. She shares them with him. They had both agreed to stop and not ask for another refill, and she did anyway behind his back and told him there was one refill left. She knows she has a problem, but is probably not at the point of really getting help for herself (like calling Narcotics Anonymous or something). She did mention finding a few websites with message boards with people going through the same thing. I guess that is a start.
Trying to stop multiple times and not being able to and lying to her husband, who also has some issues with not wanting to stop pill use is VERY typical addiction activities.
Even if she isn't to that point yet of realizing her full problem, I think it's wise to be very tough-love about it. My advice and you can take it or leave it is the following: don't condone, don't congratulate for "finding a website," don't enable by telling her the doctor is in the wrong (he is, but someone without an addiction would never know b/c they would have filled their Rx, used it and never asked for more), don't ever let her get in a car when you know she's had several pills, don't hide this from her family/friends if they ask.
It's great to file a complaint on the doctor, but honestly, you aren't a direct patient, so I wonder how quickly that will be resolved or investigated. But also thank your friend for sharing with you, try to be supportive and tough telling her that only support from REAL people face-to-face who have gone through this helps, support her when she has to acknowlege that she has a problem, and try your darnedest to encourage her to go to an addiction counselor or NA meeting. Just b/c she stops using pills doesn't mean she isn't an addict.
Just a tidbit, but someone I know (and really like and think is a great person) hit and almost ran over their own 3 yr old after just taking "a couple pain pills" that slowed her reactions just a little. That 3 yr old baby is now 7 and can't play sports or run without pain and that mom has to live with that every day of her life. The problem with an addiction is that you have to hit a bottom to realize that you're really hurting yourself and others. As her friend you might have to let her do that on her own while you're watching...and that's a hard spot to be a friend.
Are you united with the CCOKCs?
As a pharmacist, I'd probably recommend the following:
First, it sounds like your friend definitely has a problem. Doesn't sound like her husband gets that or feels compelled to do anything about it. Do you know any other friends or family you could rally to approach her about seeking treatment? If she's been abusing as long as it sounds, she may really need inpatient treatment. Minimally, attendance at Narcotics Anonymous and finding a sponsor would be a good start.
Second, I would be cautious about reporting the doc to the state. Bear with me here - I'm not saying he may not be committing poor practices. However, my experience with physician colleagues is that CO DORA has a highly punitive track record. Even the act of filing a claim can create huge issues for a practitioner. And your info about his practices, frankly, are coming from an addict. It's possible this doc doesn't even know what's going on; many physician offices rely on nursing staff to approve prescription renewals with little input from the MD. A good practice? No. But is it possible the MD has no idea his office is complicit in feeding an addiction? Absolutely. Obviously, you have to do what you think is right. But, be aware that filing a complaint with the state may lead to significant legal and professional ramifications for a doctor you don't know, are not a patient of, and whose practices you only know about second-hand. I, myself, recently found out my old OB, who I haven't seen in two years, had been approving my mail order pharmacy's requests for my Synthroid. It was a clerical error as I had told the pharmacy to contact my current doc, but these things happen routinely.
Third, her pharmacy may be wise to what's going on. They have a responsibility to contact practitioners regarding and even refuse to fill narcotic prescriptions they feel may be fraudulent. Obviously, this requires knowing your patients pretty well and tracking their refill habits. I don't work in retail, but I can tell you that refills every 9 days for narcotics would get my attention, especially if the patient doesn't have a severe, chronic, or terminal condition.
Personally, I would start with her family and friends and work on an intervention. If that doesn't work, you could go to the pharmacy manager at her Walgreens. HIPPAA regulations preclude them from sharing her info with you, but you could certainly contact them, explain your concerns, and they could do with that info what they please. Believe me, pharmacies do NOT want to be involved in this kind of dispensing, so this might be a place to bring your concerns. Lastly, you could contact the physician directly. I would ask for the office manager and explain your concerns. They could tell you to buzz off, but at least they'd have the info.
Good luck and I hope your friend gets help soon.
I have had many patients who were addicted to pain meds. Some of those we were informed by the family that they had substance abuse problems. In that case we directed the family to call the pharmacy and inform them.
I would call the Dr.'s office and the pharmacy to let them know. If anything is will cause a glance at a chart. You really won't be able to do much. Does she have a parent or sibling you could contact? You may have better chances of getting her help through them but I wouldn't get your hopes up. My mother and sister both have bad substance abuse problems and I have learned you can't help someone that doesn't want to help themselves. I really hope your friend wakes up and gets some help.
Sending you a pm...