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Physicians, Patients, and Pills (Part II)
Learn about a medication’s potential interactions with alcohol, prescription medicines, and over-the-counter medicines. You never want to add something new to your body until you know whether its ying will knock your yang out of flow and off balance. In the second part of my two-part series on physicians, patients, and pills I cover five specific tasks patients should engage in with their doctor regarding prescription drugs. Tweet this to your friends and discuss these points with your doctor at your next visit.
1. You can and should ask your doctor about any new non-prescription remedy. Over-the-counter medications, herbs and supplements are particularly misleading because we think of them as less harmful than their prescription counterparts. Yet ever year patients have to undergo emergency organ transplants due to haphazard combinations of seemingly harmless herbals. Only your doctor can tell you which combinations are hazardous or even lethal before it’s too late.
2. Tell your your doctor about any history of substance abuse. It isn’t your doctor’s job to judge you. It IS your doctor’s job to make sure your medications don’t put you in danger, and your doctor can’t do that if you withhold information about your medical history. This necessarily includes your substance abuse history, past or present. If you have a history of substance abuse, you don’t need to worry that you will be left to agonize without pain medication. Telling your doctor your full and complete medical picture only lets her do her job, customizing your pain therapy to your needs.
3. Never, never and let me say it again…. never share prescription medications. By now you know that it can pose unexpected risks. Furthermore, it’s actually illegal! And it can create legal liability if an adverse reaction happens. If you share your prescription, you expose yourself to charges of engaging in the practice of medicine without a license. If someone you care about needs a pill or a prescription, do the responsible thing for them—tell them to see their own physician, not raid your drug cabinet. Please do not pretend to be a pharmacist. You could kill someone.
4. Don’t doctor shop or fill prescriptions at multiple pharmacies. Doctor shopping is the practice of going to multiple doctors simultaneously to scam prescriptions. It is illegal, and prosecutors are cracking down. Filling prescriptions at multiple pharmacies is a red flag— to your physician, to state drug authorities who monitor your prescription filling actives, and to your insurance carrier. In instances when you have a legitimate need to fill medication at more than one pharmacy, simply discuss this with your physician in advance. If he or she knows why you need to break routine, they can incorporate the appropriate documentation into your chart. Keeping your doctor in the loop by planning your pharmacy changes ahead of time helps him to trust you just as you trust him.
5. Be willing to submit a urine or blood sample or information needed to monitor your use of painkillers. Don’t be insulted when you’re asked to pee in a cup. If you want to continue to receive easily misused drugs, it’s in your best interest. Doctors are constantly faced with patients who are addicts, either through using illicit drugs or doctor shopping. When a doctor asks for a urine sample, she wants assurance that there is no potentially lethal misinformation that could affect his or her prescription strategy for you.
By complying with requests for fluid samples, you are making life easier on yourself in another way. You’re helping your doctor to weed out abusers from his/her practice so that he or she can focus on practicing medicine with their bona fide patients.
Moshe Lewis MD, MPH, MBA is currently on the Volunteer Clinical Faculty of UCSF. Dr. Lewis also serves as the Chief Medical Officer for Blackwomenshealth.com and is a Medical Contributor for healthyblackmen.org.