I call bullshit on that top story. Any medical worker worth anything at all knows how to triage a person in pain over a known drug seeker. Whoever wrote that is basically admitting, in print, to malpractice. Even if they hospital-hop, the hospitals have access to the other hospitals records on you.

Plus, ER's have standing orders for pain meds for things like broken bones, they don't even have to see a Dr first if there's no reason to suspect head injury.

You've convinced me on legalizing many drugs, over the years, but this particular article is crappy support for it.

My neighbor disappeared in Nov. She texted me asking if I could grab her kid from school along with mine because she was running late, then she wasn't heard from again until the cops found her in a drug den a week later. She told them she left of her own accord and wasn't coming home. Her hubby just got the divorce and custody finalized this week. She lost her parental rights. She just walked out on 3 kids (one in his 20s and out in the world, but still). Being able to buy legally would not have stopped that tragedy, but it being illegal didn't either.

My cousin in TN is dying, horrifically, from metastasized cancer. I have a friend in CO who would ship him pot, but he won't accept the offer because he works for a gov't-contracted company with random pee checks, and if someone reported him, even though he's "on leave" he's lose his job, medical insurance, disability insuramce that he's living on right now, life insurance, everything. It's unreal and cruel, that it isn't legal nationwide.

I find it amazing that someone would try to claim that the horrific costs of addiction would just go away if they could buy their drugs at 7-11 instead of from some guy on the corner.

After all, if they could buy raw milk from that guy, everything would just be fine and dandy, because, hey, the customer knows what they're doing. There's no need for standards in commercial drug trade.

M4 beat me to it... I'm in favor of legalization, but this is not a rational argument in favor of it. If the ER is incapable (or not permitted by their management) of applying basic principles of triage, drug legalization isn't going to fix that. That's another problem. And no, identifying the drug seekers isn't hard -- hell, I can stand in the ER and do it. The drug seeker is the guy who walks in the door, plops his ass down in an unattended wheelchair, rolls up to the desk, and tells the attendant "I got back spasms! You need to get me some Lortabs!" (Yes, I have seen this exact thing. And the ER played it right -- they shunted him off to the side while they took care of more urgent cases, including my stepson's head injury, which is why I was there. I assume he got his drugs eventually.)

Similarly, legalization in itself will not solve the problem of crime committed by hard-core addicts. The problem with salons and dispensaries is that they want money in exchange for the goods, and the hard-core addicts don't make any money because their only goal in life is to get high and stay that way. And there is a subset of them that use drugs because it's transgressive, and they aren't about to take a legitimate job for the same reason -- working for a living is "selling out", while crime is "sticking it to the man".

Really, there's a cynical part of me that thinks we ought to just deliver heroin by the pound to the addict's door, every day. Let them kill themselves -- they're going to do it anyway; this is just speeding up the process.

@"I find it amazing that someone would try to claim that the horrific costs of addiction would just go away"

There are two different types of 'horrific costs of addiction' - those costs that are intrinsic to addiction and mostly beyond our control to improve (e.g. the economic loss of a potentially productive person losing him/herself to addiction for months/years), and those costs that are artificially created and that we can very much do something about (e.g. paying for SWAT teams to raid homes for pot, paying prisons to house and feed people who could otherwise be economically productive just for possessing a bit of pot, paying cops to spend their valuable and limited time investigating people for minor things like growing some plant for medicinal or harmless recreational purposes, paying judges, lawyers and everyone else involved in prosecuting minor drug offenders, as well as costs like Amy mentions in this article - this most certainly falls under 'costs we can do something about'.)

Yea, I call BS on the story too.

Any healthcare provider that uses the excuse that junkies are preventing them from helping other, seriously ill, patients should not be in the healthcare profession.

Momof4 used the right word: malpractice.

@"Really, there's a cynical part of me that thinks we ought to just deliver heroin by the pound to the addict's door, every day"

And there's a part of me that says we should be kind and try help these people, and give them copies of Stanton Peele's "Recover" instead. The evidence and research on addiction suggest these are mostly just normal people struggling to cope with difficult circumstances.

Countries that have largely decriminalized drug use (e.g. Portugal), and instead treated it as a health problem, allowing addicts to seek help, have seen their addiction rates plummet.

While I have no doubt that drug addicts are a severe strain on resources at an ER, count me among the people that find the above story a wee too convenient to be true.

I work in a pharmacy. My state recently introduced a database to track all narcotic rxs making it much harder for people to go to multiple pharmacies for narcotics. The end result is narcotics rxs are down and illegal heroin is up in my state. And god forbid you actually have chronic intractable pain. Those people are just screwed.

I don't blame Richard. Under drug prohibition, he has two places to get his fix: medical outlets like emergency rooms, or the streets.

And Richard would still choose medical outlets because there, he can get them for free.

(Or are we expected to believe that Richard, with his once-every-two-day visits to ER, has medical insurance?)

Having worked in the ER and urgent care, I call BS as well. Drug seekers are very easy to pick out and were always pushed aside for real patients with real problems. That's what triage is for. They weren't give drugs either. They got prescriptions for ibuprofen 800 mg if anything. Often this meant having violent, angry people making threats and trashing the place, involving security, calling the police, etc. I don't see how legalization is going to fix all the problems associated with addiction. Those will always be there.

I work in a pharmacy. My state recently introduced a database to track all narcotic rxs making it much harder for people to go to multiple pharmacies for narcotics. The end result is narcotics rxs are down and illegal heroin is up in my state. And god forbid you actually have chronic intractable pain. Those people are just screwed.

I'm confused, on the one hand you claim its BS that people in ERs have a harder time getting drugs becuase or the feds and drug laws, but at the same time you claim to see it personally at your pharmancy?

My thinking the hospital story is BS doesn't have much to do with working in a retail pharmacy. What it did do is make me think about the new database my state introduced to track narcotic prescriptions. Before the database an enterprising addict could doctor shop and get multiple rxs from different doctors and go to multiple pharmacies to get them filled. As long as the person was paying cash and not using insurance it would be very hard for the pharmacy to know that the patient was doing this. Now each narcotic rx is entered into a central database that the state runs. This has curbed that particular practice but now illegal heroin use has increased in my state.
Another consequence is that people that have legitimate chronic intractable pain have a much harder time getting narcotic rxs. Physicians have been arrested for running narcotic rx "mills" and are much more careful about giving out rxs. Like I said the people I feel bad for are the people in pain. I wish I knew the answer because people that are in pain do become addicts and there will always be addicts taking advantage of the situation. It can quite sad actually.

My thinking the hospital story is BS doesn't have much to do with working in a retail pharmacy. What it did do is make me think about the new database my state introduced to track narcotic prescriptions. Before the database an enterprising addict could doctor shop and get multiple rxs from different doctors and go to multiple pharmacies to get them filled. As long as the person was paying cash and not using insurance it would be very hard for the pharmacy to know that the patient was doing this. Now each narcotic rx is entered into a central database that the state runs. This has curbed that particular practice but now illegal heroin use has increased in my state.
Another consequence is that people that have legitimate chronic intractable pain have a much harder time getting narcotic rxs. Physicians have been arrested for running narcotic rx "mills" and are much more careful about giving out rxs. Like I said the people I feel bad for are the people in pain. I wish I knew the answer because people that are in pain do become addicts and there will always be addicts taking advantage of the situation. It can quite sad actually.

Sorry for the double post.

I call bullshit on the people calling bullshit.

Jeez, if only all those naive, ignorant doctors and nurses who've been working in ERs and urgent care centers and dealing with all those drug seekers for years, even decades, were only as clever and observant as you imagine yourself to be, drug seeking would be a futile endeavor. It would've never, ever been a problem. But alas, it is a problem. Is that for lack of doctors and nurses as smart and observant as you?

You, like anyone else, could probably sit in an ER waiting room and pick out the most conspicuous, least experienced drug seekers, maybe even almost as well as the triage nurse can.

Sometimes, no matter how clever you imagine yourself to be, you just won't be able to tell the difference between someone who is ER shopping for drugs and someone who really is in pain. Because many of those ER shopping drug seekers really do have serious chronic pain - which is why they're addicted to narcotics and going from ER to ER shopping for drugs.

Sometimes people who are not addicted to narcotics, and really are in pain, come to the ER looking and acting like someone who is drug seeking. You would probably direct them off to the side to wait for hours, or maybe you'd just run them off.

Sometimes people who are addicted to narcotics and aren't in pain, but are drug seeking, look and act like people who are really in pain. Sometimes they even injure themselves to be more convincing. They might use a nail or piece of wire to cause their gums to be swollen and inflamed, and claim to have an excruciating tooth ache. They might roll down a flight of stairs, creating bruising and swelling, and claim they fell down a flight of stairs. One young woman in the detox center where I worked slammed her hand in a car door causing fractures and bruising; and another time she intentionally crashed her car - with her 4-year-old child inside - so she could claim to have pain from injuries. Each time she was treated with sympathy and given narcotics (she admitted this to me when she came to my detox unit seeking treatment for her addiction)

Those conspicuous, inexperienced drug seekers who are so easy to spot in the waiting room and get directed off to the side, will sit there for hours observing the patients who don't get directed off to the side. Eventually they'll learn how to be more convincing and look and act like someone in pain. In the meantime they'll continue to go from ER to ER, and sit and wait. In every ER they go to, they eventually must be seen; the ER can't just turn them away. Time and resources will be spent. Practice makes perfect. Eventually they'll get very good at it, and won't have to wait so long. But they'll probably use up more resources, because the more convincing they are, the more effort all those naive doctors and nurses will make to evaluate and treat their "pain".

Busy ERs get a steady flow of people complaining of severe headaches, tooth aches, back pain, abdominal pain, shoulder pain... you name it. The obvious drug seekers are treated with care and offered treatments other than narcotics. The rest, real or fake, are treated as though their complaints are genuine and usually score a few pain pills. Real pain, fake pain, or obvious drug seekers, they take time, and they cost a lot of money.

So all of you with the paranormal ability to accurately and consistently tell just by looking who is a legitimate patient and who is just a lying, drug seeking addict should head on down to a busy ER and demonstrate your abilities to the administrators. Then offer your services for a mere million bucks a year. The hospital will snatch you up in an instant and consider it the best investment they ever made.

Ken, a Dr or RN or any other medical professional that would allow a child to sit in pain, with a broken bone, for hours, for ANY reason short of mass-casualty trauma, has no business in the business. The "drug-seeker" angle was really not even needed. There's almost nothing one could insert into that story that doesn't make it malpractice.

I've done plenty of time working EDs. And state psych wards. And the huge county indigent-and-level-1-trauma hospital.

Honestly, to save money, every ED should have a walk-up "narcotics" window where they will just hand out a couple pills if the person prefers that to seeing the Dr. It'd cost less, if one could truly eliminate their right to sue over regretting their choice. Nebver happen, but it'd clear up the ER for real problems.

@"Sometimes, no matter how clever you imagine yourself to be, you just won't be able to tell the difference between someone who is ER shopping for drugs and someone who really is in pain"

Yup, this. I don't care how clever you are at picking the most obvious drug users ... you're not always going to detect the more subtle ones. Worse, you're also going to falsely accuse innocent people of being drug seekers*.

Statistically, even the best judges of character are going to have BOTH false positives, and false negatives. So it's an inescapable mathematical fact that you're going to have a so-called 'baseline rate' of both false positives and false negatives. These need to be dealt with, and it's a simple consequence of the laws of physics that dealing with these these raises costs.

Nobody can escape the laws of physics.

@BunnyGirl "Often this meant having violent, angry people making threats and trashing the place, involving security, calling the police, etc."

You 'call BS', but you admit this 'often meant' angry violent people making threats and having to call the police? This is a contradiction - often having to cell the police etc. will EXPLICITLY both raise costs, and make it harder for legitimate patients to seek help. You're confirming the original point, not contradicting it. It's physically impossible to go through what you describe without it impacting legitimate patients. It sounds like it would be so much easier if you just gave them the pills they're looking for.

I also have a suspicion at least some of those were angry because they were being falsely accused and were just trying to get medication.

* The false accusation thing actually *almost* happened to me once when I was trying to get medication completely legitimately. I'd been programming for a few days for work deadlines, I'd had almost no sleep for days because of a crying baby in the house, I hadn't shaved or showered in a few days, and I was dressed 'sloppy engineering student' style ... out of the blue they started with some very accusatory-sounding questions and I was treated like a speck of dirt. I realized I wasn't looking my best though, but I really got angry, I doubled down, said I'm not some drug user, that I'm just trying to get medication, said they can they phone the damn doctor on the script, and that I don't like being treated this way - fortunately they backed off.

@"Honestly, to save money, every ED should have a walk-up "narcotics" window where they will just hand out a couple pills if the person prefers that to seeing the Dr. It'd cost less, if one could truly eliminate their right to sue over regretting their choice."

^ Yes, this.

"Honestly, to save money, every ED should have a walk-up "narcotics" window where they will just hand out a couple pills if the person prefers that to seeing the Dr. It'd cost less, if one could truly eliminate their right to sue over regretting their choice. Nebver happen, but it'd clear up the ER for real problems.

Posted by: momof4 at January 22, 2016 7:37 PM+"

That would last about a week, before the DEA arrested everyone involved as "drug traffickers".

Yes, the addicts would be a small and manageable problem. It's the drug warriors that are the big problem. People saw that with Prohibition - but unlike alcohol, few middle-class people had experience with opiates, cocaine, or marijuana, so they could be panicked into supporting bans by racist propaganda.