Epidemic of Parents trying to get younger kids on narcotics

[DrCommonSense]

In the last year, I have seen a decent number of patients from the 18-25 year age range with literally zero objective pathology that appear to be unable to tolerate any non narcotic medications for their "pain" state.

Of course, I immediately drug test them and send them to our psychiatrist while telling them narcotic medications are NOT a good solution for this problem (zero of them have gotten ANY scripts from me for any pain meds).

Most of these patients UDS's are positive for Methadone, Benzos, THC, etc with zero prescriptions.

The funny thing is the PARENT is always very angry looking while seemingly DEMANDING me place these patients on narcotic medications.

Even after dirty UDS findings, the parents seem to have a hostile attitude towards me when I suggest PT, psychiatry and non narcotic methods of treatment (almost never injections either).

These interactions never seem to be long term pleasant with most of these patients just discharging themselves from my practice (presumably shopping around for other docs).

What is up with the parents? You would think they would demand NON narcotic methods of treating these patients but I usually see the opposite.

Incidentally, these same parents will go on TV and blame the bullied/foolish doc that gave these kids a narcotic medication if they get a sucker to do it and say the doc got the kid "addicted" to the narcotic medication and that is why he/she overdoses despite their clear history of misuse of medications (mostly illegal).

I think we have to be honest that alot of the parents are playing part of this game with the narcotics either in an attempt to sell them, abuse them with the kid, etc. I can't think of any other reason I see these parents who are so gung ho on getting narcs for a perfectly healthy younger person.

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[Tapspatellas]

In the last year, I have seen a decent number of patients from the 18-25 year age range with literally zero objective pathology that appear to be unable to tolerate any non narcotic medications for their "pain" state.

Of course, I immediately drug test them and send them to Behavorial while telling them narcotic medications are NOT a good solution for this problem (zero of them have gotten ANY scripts from me for any pain meds).

Most of these patients UDS's are positive for Methadone, Benzos, THC, etc with zero prescriptions.

The funny thing is the PARENT is always very angry looking while seemingly DEMANDING me place these patients on narcotic medications.

Even after dirty UDS findings, the parents seem to have a hostile attitude towards me when I suggest PT, Behavorial and non narcotic methods of treatment (almost never injections either).

These interactions never seem to be long term pleasant with most of these patients just discharging themselves from my practice (presumably shopping around for other docs).

What is up with the parents? You would think they would demand NON narcotic methods of treating these patients but I usually see the opposite.

Incidentally, these same parents will go on TV and blame the bullied/foolish doc that gave these kids a narcotic medication if they get a sucker to do it and say the doc got the kid "addicted" to the narcotic medication and that is why he/she overdoses despite their clear history of misuse of medications (mostly illegal).

I think we have to be honest that alot of the parents are playing part of this game with the narcotics either in an attempt to sell them, abuse them with the kid, etc. I can't think of any other reason I see these parents who are so gung ho on getting narcs for a perfectly healthy younger person.

I see pushing for opioids with spouses, and children for their older parents as well. I like to think it is them trying to advocate for their loved one who they feel is suffering. But I must admit that my radar goes off with any aggressive push for these substances by a non-patient. I rarely comply. Exception for me can be an elderly patient who has limited options, and I may trial them on a very low dose of hydrocodone.

I had a 19 yo patient a couple years ago who's parents were pushing for "something stronger" due to failure of non-narcotic treatment. No definite pathology that I was able to identify. Big no for me. Turned out several months later the kid was on heroin. The parents didn't know and were truly just advocating due to their perception of his suffering, I believe.

 

[DrCommonSense]

I see pushing for opioids with spouses, and children for their older parents as well. I like to think it is them trying to advocate for their loved one who they feel is suffering. But I must admit that my radar goes off with any aggressive push for these substances by a non-patient. I rarely comply. Exception for me can be an elderly patient who has limited options, and I may trial them on a very low dose of hydrocodone.

I had a 19 yo patient a couple years ago who's parents were pushing for "something stronger" due to failure of non-narcotic treatment. No definite pathology that I was able to identify. Big no for me. Turned out several months later the kid was on heroin. The parents didn't know and were truly just advocating due to their perception of his suffering, I believe.

See thats the thing.

If you gave the kid any Norco, they would immediately have blamed you for making the kid into a heroin addict and claim he was a "good kid" that was turned into an addict by the doctor when he would naturally get on heroin anyway.

From my experience, 99.99% of these people have been abusing some type of illegal substances already and just want to get a legal prescription because they perceive it as easier to obtain and possibly concerned with potency/tainted substances.

Almost anytime I do a UDS on one of these patient's there is something illegal in the urine. The parents always claim they "didn't know" but don't appear surprised or swayed against narcotics even with these results.

That is why I think alot of the parents aren't exactly innocent here either. Plus they would be the first to claim you "made their kid into an addict" if they OD on heroin, cocaine, etc.

 

[willabeast]

The relationships between parents and their kids can be so complex that unless the pain doc has some sort of genius emotional IQ it is best to get help from (preferably) someone in addiction medicine whose specialty is young adults. Does not have to be a psychologist - just someone with experience who understands both parties. I once had a parent who told me he was sure his son was using cocaine because there was a pool of ink staining his son's bed sheet. I asked what that had to do with cocaine he said his son used the pen to snort the drug. I asked him how he knew that, the parent responded he used to do the same thing when he was addicted to cocaine. In retrospect i should have known.

 

[Aether2000]

I have started only two patients on chronic opioids in the past 18 months- one had cancer with metastatic lesions and the other severe renal osteopathy. The answers to kids wanting opioids is simply no.

 

[hyperalgesia]

Had a Thai med student rotating with me last week. He said in Thailand people don't get opioids unless they're in hospice or it's an acute situation. Makes me wonder about Americans...

 

[Tapspatellas]

See thats the thing.

If you gave the kid any Norco, they would immediately have blamed you for making the kid into a heroin addict and claim he was a "good kid" that was turned into an addict by the doctor when he would naturally get on heroin anyway.

From my experience, 99.99% of these people have been abusing some type of illegal substances already and just want to get a legal prescription because they perceive it as easier to obtain and possibly concerned with potency/tainted substances.

Almost anytime I do a UDS on one of these patient's there is something illegal in the urine. The parents always claim they "didn't know" but don't appear surprised or swayed against narcotics even with these results.

That is why I think alot of the parents aren't exactly innocent here either. Plus they would be the first to claim you "made their kid into an addict" if they OD on heroin, cocaine, etc.

Agree completely. I kept thinking how glad I was that he didn't get anything controlled from me, because I saw that blame coming.

 

[drpainfree]

I have started only two patients on chronic opioids in the past 18 months- one had cancer with metastatic lesions and the other severe renal osteopathy. The answers to kids wanting opioids is simply no.

don't mean to brag about it, just say in last 2 years I have not start a single patient on opioids...every low dose opioid patients I have now (just a few of my practice) were started by someone else who referred me over and I initiated tight monitoring schedule and were open to weaning down or in the process of weaning down. Magically, they are all doing fine or better after I get them down gradually...

 

[drpainfree]

Had a Thai med student rotating with me last week. He said in Thailand people don't get opioids unless they're in hospice or it's an acute situation. Makes me wonder about Americans...

1.5 billion Chinese, not aware opioids ever prescribed for outpatient...think about that percentage...

 

[painfree23]

I have started only two patients on chronic opioids in the past 18 months- one had cancer with metastatic lesions and the other severe renal osteopathy. The answers to kids wanting opioids is simply no.

What does ur referral base say??

 

[waterbottle10]

1.5 billion Chinese, not aware opioids ever prescribed for outpatient...think about that percentage...

That's why most of the opioids in the world are used in the us

 

[Aether2000]

My referral physicians are trained to understand we are not in the opioid business, but are in the business of diagnosing and treating chronic pain. Those that are on opioids and are expected to be continued on opioids by the pain physician are sent to the pill mills by the PCPs.

 

[wjs010]

Would it be unethical to be straight with the parent and say "no I cannot prescribe this to your kid because you will come back at me with a suit if/when your kid becomes an addict" ?


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[Ducttape]

It is not unethical to state that the most common time frame that people develop addictions is in their teenage years, and because of that fact, I cannot recommend CoT....


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[Crybaby]

How about the parents of teens who come in requesting opiates and their UDS shows up with illicits? They act as if nothing is wrong. I just do not understand.

 

[Ducttape]

those teens are using weed with their parents...

 

[Michael_Scott]

In the last year, I have seen a decent number of patients from the 18-25 year age range with literally zero objective pathology that appear to be unable to tolerate any non narcotic medications for their "pain" state.

Of course, I immediately drug test them and send them to our psychiatrist while telling them narcotic medications are NOT a good solution for this problem (zero of them have gotten ANY scripts from me for any pain meds).

Most of these patients UDS's are positive for Methadone, Benzos, THC, etc with zero prescriptions.

The funny thing is the PARENT is always very angry looking while seemingly DEMANDING me place these patients on narcotic medications.

Even after dirty UDS findings, the parents seem to have a hostile attitude towards me when I suggest PT, psychiatry and non narcotic methods of treatment (almost never injections either).

These interactions never seem to be long term pleasant with most of these patients just discharging themselves from my practice (presumably shopping around for other docs).

What is up with the parents? You would think they would demand NON narcotic methods of treating these patients but I usually see the opposite.

Incidentally, these same parents will go on TV and blame the bullied/foolish doc that gave these kids a narcotic medication if they get a sucker to do it and say the doc got the kid "addicted" to the narcotic medication and that is why he/she overdoses despite their clear history of misuse of medications (mostly illegal).

I think we have to be honest that alot of the parents are playing part of this game with the narcotics either in an attempt to sell them, abuse them with the kid, etc. I can't think of any other reason I see these parents who are so gung ho on getting narcs for a perfectly healthy younger person.

sad. Also tells how bad the state of parenting is that they need to medicate kids instead of taking "care" of the child and finding proper ways to solve the issue. Also on the other hand, I feel like these parents are either junkies themselves or just looking to go and sell.