doctor liability in prescribing opioids

[enabler]

What is the name of your state (only U.S. law)? vermont
my husband was in a car accident several years ago and suffered permanent nerve damage to his back. while visiting him in the hospital with my daughter and mother his nurse was going over his meds with him. When she said he would be prescribed oxycodone I said I wanted another non-narcotic pain med because he had been on opioids before and had a problem with abusing/ misusing them as well as a history of depression and abuse of alcohol and recreational drugs. The nurse brushed off my concerns and said he should have no problem with these meds. 4 years later he is increasingly dependent-his dosage continues to go up and he is able to function less. His quality of life is non-existent- he can't hold a job, complete basic household chores, pay bills and often runs out of meds between scripts and then resorts to drinking or searching for drugs to replace his script. My question is did the hospital have liability in prescribing opioids after learning of his medical history? His current doctor continues to prescribe oxycodone and schedules regular visits but he is aware of my husbands history with depression and drug/alcohol abuse.

 

[lealea1005]

What is the name of your state (only U.S. law)? vermont
my husband was in a car accident several years ago and suffered permanent nerve damage to his back. while visiting him in the hospital with my daughter and mother his nurse was going over his meds with him. When she said he would be prescribed oxycodone I said I wanted another non-narcotic pain med because he had been on opioids before and had a problem with abusing/ misusing them as well as a history of depression and abuse of alcohol and recreational drugs. The nurse brushed off my concerns and said he should have no problem with these meds. 4 years later he is increasingly dependent-his dosage continues to go up and he is able to function less. His quality of life is non-existent- he can't hold a job, complete basic household chores, pay bills and often runs out of meds between scripts and then resorts to drinking or searching for drugs to replace his script. My question is did the hospital have liability in prescribing opioids after learning of his medical history? His current doctor continues to prescribe oxycodone and schedules regular visits but he is aware of my husbands history with depression and drug/alcohol abuse.

If the Physician prescribes reasonable dosage, combined with required regularly scheduled office visits for evaluation/management/documentation, then s/he is within the standard of care for pain management.

 

[lealea1005]

I understand that aspect but guidelines for pain management require special attention to those patients at risk for medication misuse, abuse or diversion including extra care, monitoring, documentation and/or consultation with an expert in the management of those patients at risk (which has not occurred to my knowledge). Additionally, guidelines discourage prescribing of narcotic pain meds to those who are at risk of misuse/abuse or diversion. who is responsible for ensuring these guidelines are followed and not just completed through routine paperwork?

So, if your husband is not satisfied with his care, ask for a referral to a Boarded Pain Management specialist or inpatient treatment. However, you should know that, technically, any Board Certified Physician with a DEA# and schedule II clearance is legally permitted to prescribe your husband's medication.

The documentation of patient compliance keeping regularly scheduled appointments, taking medications only as prescribed, evaluation of the patient's pain, etc. must support the medication and amount prescribed.

 

[ecmst12]

How much of his lack of functioning is due to the drugs and how much is due to the pain and/or injury itself?

Non-legally, I would suggest you do some research on intrathecal pain pumps...medication delivered into the spinal column. Most of the drugs used are still narcotics, but I'm told with that delivery methods, the patient experiences pain relief with less or no euphoria or dopey feelings.

 

[xylene]

4 years later...

4 years is a long time

 

[gasgirl]

To blame the current scenario on a single prescription for narcotics 4 years ago is reaching...the nurse gave your husband the prescriptions and discharge instructions...you had every right to tear up the prescription and take IBUPROFEN or TYLENOL or, if that was ineffective, to call the doctor for some other non-narcotic medication or referral to another specialist.

It's a chicken and egg deal with regards to chronic pain/narcotic dependence/Alcohol Abuse/Depression. They all potentiate each other and exaggerate each other.

If the cause of your husband's pain is not amenable to surgical correction, then you better get with a Pain Specialist who uses a multidisciplinary approach to treatment and buckle up, cuz it's gonna be a long ride....

 

[ecmst12]

No, OP did NOT have the right to destroy her HUSBAND'S prescription.