On an otherwise
unremarkable grey and cold January afternoon two years ago in the Washington,
DC area, my mother and I were returning to her apartment in time for lunch.
Excitedly, my mom offered a variety of dining options, focused mostly on her
proud inventory of fresh breads, cold cuts, and cheeses. She wanted to put the
meal together, but I assured her that I was fully capable of assembling my own
sandwich, especially in her present condition. You see just 24 hours earlier,
almost exactly to the minute, a surgeon had tied off the final stiches to my
mother’s hip replacement. That wild look in my mom’s eyes and frantic speech
was the Oxy taking over her body.
This all came to mind
last week with the news that a group of pharmaceutical companies, distributers,
and litigating states had reached a settlement concerning abusive selling and
distributing tactics of Oxy. By now we are familiar with the story of Oxy, the
miracle drug that, unlike other powerful medicines, would save patients from
excruciating pain with barely a chance of addiction. Society (and a fair chunk
of the medical industry) all took a bite from this apple of pharma Eden and,
just like Adam and Eve, were cast out from paradise. While nobody will publicly
take any of the blame, now there’s $26 billion to start repairing some of the
damage.
I would be more hopeful
if some of the money would do some good, but the signs are not promising. While
not allowed to fill state budget gaps, the money can go treatment centers
(nice, but kind of after the fact), pill and needle disposal education (which
doesn’t address using too many pills or shooting up drugs), or providing funds
for first responders (and while paying for more NarCon sticks is great, it
would be better if folks didn’t need it in the first place). So while the
landmark tobacco settlement at least tried to promote better behavior
from the tobacco companies (no more billboards, super-slick marketing, or Joe
Camel cartoons), after the Oxy agreement we are still left with an extremely
powerful narcotic, legally manufactured and distributed, and freely prescribed
by medical professionals. Isn’t this how we got here in the first place?
After getting my mom
comfortable in her bed and dulling her mind with daytime TV, I went about a
week’s worth of playing a combination of loving son (OK, I am a loving
son) and Nurse Ratched (I couldn’t let her fall because she forgot to use her
walker or accidently let her start in on her 6:00 PM wine). One important role was
to keep track of her medications, and part of that meant a bottle of 40 Oxy
pills—one every six hours. The first few days required full Oxy dosage, but after
that we had a good rapport of me offering pills at the allotted time and she
would figure out if she needed them. Once in a while she would ask for one
unprompted, and I was happy to oblige. It may have been amateur pain
management, but I think we made a good team and kept her from suffering
unnecessarily. In the end she went through about half of the bottle, with 20 or
so pills still left. Had mom wanted, she could have shilled those extras on the
street for $20 a pop, and traded up her Two Buck Chuck for some excellent
Trader Joe’s Reserve wines.
And while some states now
have requirements for electronic prescription submission and ID requirements to
pick up meds such as Oxy, is it right to prescribe that many pills in the first
place? I’m sure the medical literature from all the studies indicate that ten
days of four Oxy pills may be safe and, technically, not addictive, but would
you want to wake up from no pain or responsibility? No doctor, or their
office, wants to have patients ask for more pain killers, much less having them
go through the hassle of traveling to the drug store and picking them up while
still hurting. But shouldn’t we start with the bare minimum prescription and
then work our way up? While medicine is so advanced that you can replace a hip
and send the patient home the next day, has the medical community abdicated
their responsibility to monitor care, especially from powerful pills, in the
name of convenience?
I ask these uncomfortable
questions because nine months after mom’s hip surgery she had a knee replaced
(she couldn’t do both at the same time because they were on opposite legs). In
a déjà vu moment, the kind orderly wheeled my mom to the hospital pharmacy
where she would pick up her discharge medications. Befitting the fact Halloween
was only weeks away, we trick ‘o treated a grab bag of post-surgery meds and
headed to her apartment for another week of recovery. There were 40 more Oxy
pills.
© 2021 Alexander W.
Stephens, All Rights Reserved.
