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Painkiller addiction

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Flipping through the style section of the Sunday Times thismonth, I came across an article about addiction to prescription drugs such aspainkillers. Several celebrities have been linked to this issue, infamously arethe deaths of Whitney Housten, and Michael Jackson .Others, such as Nicole Ritchiehave been treated for addiction to painkillers.A recent silent witness episode also saw characters pop oxycodone tablets. However addiction to prescriptiondrugs is not only evident in the celebrity world but increasingly common inours.

Pain killers may be used short term in many situations suchas post-operatively. However for some people this period continues past thepain resolving and they end up dependent. Others , need these drugs for chronicpain associated with medical conditions such as neuralgia  their pain medication is prescribed by specialists.It can sometimes be hard to divide a line between the need for painkillers and anabuse of them since pain is a person’s perception. Perhaps one sign is peopleusing painkillers in doses that are above those prescribed. Many patients in hospitalhave dehabilitating chronic pain issues that require masses amount of opiatedrugs to improve their quality of life. However a small minority of patients mayrequire lots of PRN (when necessary) morphine despite having no clear source ofpain or claim to be on higher doses than what is prescribed. It may be up to usas pharmacist to raise concern and limit supply of these drugs on discharge,this decision needs to be balanced against the need for these drugs due to thepatient’s presenting complaints.

In community ,we are often told to keep an eye for thatperson that is frequently popping in for a hundred box of  soluble Solpadeine. How do we know he/she  is not popping round the corner for anotherbox? . It can be difficult issue for us to deal with. What if the person isn’t addictedand just has chronic pain issues that needed to be addressed, what if thepatient is addicted but fails to admit it ?. I think we have to be tactful inour approach to how we deal with these situations. We can certainly not judgeor assume, however we can advise and refer if necessary and it is within ourright to refuse supply .

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