A patient arrives drunk at 3 a.m. with a chief complaint of back pain, toothache, headache, or toe pain. He is allergic to ibuprofen, all non-narcotic medicine, employment, and accountability. He is out of his insulin, inhalers, and hydrochlorothiazide, but he really wants his Vicodin refilled. He normally gets extra-strength Vicodin, 2,000 tablets with 20 refills, but darn-it-all, he just lost his prescription.
Explore This IssueACEP News: Vol 31 – No 09 – September 2012
You know this man; you have seen this man. He is easy to treat the wrong way and hard to treat the right way.
Now, do not get me wrong. Vicodin is a great medication that is prescribed all the time. However, prescription drug abuse is at an all-time high.
Almost a third of those who use drugs illegally start by taking prescription drugs for nonmedical reasons. Since they are prescribed, these medications have an illusion of safety that leads to accidental overdoses.
I cared for a patient who returned to the ED after her prescription for Vicodin ran out. She also “ran out” of medicine for her UTI. She stated she had only enough money for the Vicodin, not the antibiotics. However, we have many pharmacies where that antibiotic is free! Some patients refuse to take their prescription for high blood pressure or high cholesterol or their diabetes medication – but they always fill their Vicodin.
We have a noncompliance epidemic.
Perhaps considering the logical extreme could work. We could just embrace the narcotics and put them in everything.
Now I hear you wailing in agony like a rabid Chihuahua yipping violently at the vacuum. Just hear me out.
The medication is half hydrocodone, half … anything. Patients know the name Vicodin, so just add that to the name and see how we do.
Vicocillen will have amoxicillin (and hydrocodone) in it. Vicodolololol will be for your high blood pressure. Vicodistatin will treat your high cholesterol. Vicoformin is for your diabetes.
Trying to get someone to take a daily vitamin? It never works – they always forget about it. But they always remember their daily Vicomin.
Some of you might be a bit worried about constipation. Vicofiber! Simply put a heaping spoonful of Vicolax in your morning orange juice, and you are good to go.
OK, maybe that’s the worst idea of all time; but I am sure people would be compliant. Extremely compliant. But there are other medications that can cause scary results as well.