- 26 Nov 2015 03:30
#14624420
We already do. Doctors prescribe drugs like Methadone to Opium addicts and long acting benzodiazepines to those addicted to short acting benzodiazepines for the purpose of eventually weaning them from drugs that are potentially harmful to the patient. And that is the rub.
"First do no harm to your patient". This is one of the guiding principles to which virtually every doctor subscribes. What you are asking about is the possibility that doctors should be in the business of prescribing recreational drugs. And in doing so potentially do harm to their patient and put his family, friends, and neighbors at additional risk. I know few doctors who are willing to do such an unethical thing.
Along with the white coat and stethoscope comes massive credibility. People expect (and have every right to expect) physicians to act only in the best interests of the patient. I can't imagine any circumstance where prescribing heroin would be in the best interests of the patient.
There is this notion among those who do not study the epidemiology of heroin use that the only harm is to the patient him/herself. This is, of course, not true. Do we really want strung out folks driving high? Of course not. Is there a justification for getting someone who does not have an anxiety disorder strung out on alprazolam? So from the standpoint of a physician or public heath person the argument for legalization under the supervision of a doctor takes on a whole new perspective. I get that the patient may think he/she wants to calm down every night after work. I get that they enjoyed the feeling they got from the Vicodin prescription they had when they got there tooth pulled. But are they wise enough to know what a doctor knows about Vicodin? Nope. Do they know that this drug (which is used frequently in the US) can be deadly if used even a little wrong? Do they know that the acetaminophen (Paracetamol for our UK friends) is a serious liver toxin? Doctors do. So what happens when the doctor says no? What if he says, "you see Susan, you have liver problems and Vicodin could be deadly for you not just because of the danger of opioids but also because acetaminophen is a liver toxin." So off she goes doctor shopping until she finds a doctor who does not care about her history and general health and gives her what she wants.
But, you say....what about the guy who is already addicted? Well. If as a doctor I am sworn to try and heal my patient, rather than prescribe for them a drug that I know may well eventually kill them, I should do everything in my power to try and get them into rehab. And if there is a drug that is called for it is methadone, not heroin, and in diminishing doses over time.
I am not arguing for or against the decriminalization of drugs. But I am saying that having doctors prescribe these drugs is a very poor idea. It goes against everything that it means to call oneself a physician.
Addiction is an illness. Alcoholism is a disease. A physicians role is to cure that disease not make it easier to catch and keep. Lexington's brave post shows this exactly. He is receiving the correct treatment from his physician. What a downright shame it would be if his doctor gave him opiates and a handshake instead.
Did you see my earlier post about prescribing drugs to addicts?
Do you think it's workable?
We already do. Doctors prescribe drugs like Methadone to Opium addicts and long acting benzodiazepines to those addicted to short acting benzodiazepines for the purpose of eventually weaning them from drugs that are potentially harmful to the patient. And that is the rub.
"First do no harm to your patient". This is one of the guiding principles to which virtually every doctor subscribes. What you are asking about is the possibility that doctors should be in the business of prescribing recreational drugs. And in doing so potentially do harm to their patient and put his family, friends, and neighbors at additional risk. I know few doctors who are willing to do such an unethical thing.
Along with the white coat and stethoscope comes massive credibility. People expect (and have every right to expect) physicians to act only in the best interests of the patient. I can't imagine any circumstance where prescribing heroin would be in the best interests of the patient.
There is this notion among those who do not study the epidemiology of heroin use that the only harm is to the patient him/herself. This is, of course, not true. Do we really want strung out folks driving high? Of course not. Is there a justification for getting someone who does not have an anxiety disorder strung out on alprazolam? So from the standpoint of a physician or public heath person the argument for legalization under the supervision of a doctor takes on a whole new perspective. I get that the patient may think he/she wants to calm down every night after work. I get that they enjoyed the feeling they got from the Vicodin prescription they had when they got there tooth pulled. But are they wise enough to know what a doctor knows about Vicodin? Nope. Do they know that this drug (which is used frequently in the US) can be deadly if used even a little wrong? Do they know that the acetaminophen (Paracetamol for our UK friends) is a serious liver toxin? Doctors do. So what happens when the doctor says no? What if he says, "you see Susan, you have liver problems and Vicodin could be deadly for you not just because of the danger of opioids but also because acetaminophen is a liver toxin." So off she goes doctor shopping until she finds a doctor who does not care about her history and general health and gives her what she wants.
But, you say....what about the guy who is already addicted? Well. If as a doctor I am sworn to try and heal my patient, rather than prescribe for them a drug that I know may well eventually kill them, I should do everything in my power to try and get them into rehab. And if there is a drug that is called for it is methadone, not heroin, and in diminishing doses over time.
I am not arguing for or against the decriminalization of drugs. But I am saying that having doctors prescribe these drugs is a very poor idea. It goes against everything that it means to call oneself a physician.
Addiction is an illness. Alcoholism is a disease. A physicians role is to cure that disease not make it easier to catch and keep. Lexington's brave post shows this exactly. He is receiving the correct treatment from his physician. What a downright shame it would be if his doctor gave him opiates and a handshake instead.
To believe in God is impossible not to believe in Him is absurd.
Voltaire
God is a comedian playing to an audience that is afraid to laugh.
Voltaire
Voltaire
God is a comedian playing to an audience that is afraid to laugh.
Voltaire