Reilly
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Will try to make this as short as possible..
I'm an MA...mandatory reporter...
This situation is somewhat colored because I'm personally involved and therein lies the dilemma...
Without a lot of background, daughter is "with" a complete idiot. He is a chronic pill abuser (Percocet, Oxycontin, etc)He is also a thief, liar and physical abuser. He will be further referred to as the "idiot boyfriend"
I have a patient come into my office yesterday and asks me if "[censored] is your son"....Yes..he is..This is in reference to SS17...Seems that Idiot boyfriend now has SS17 soliciting pain meds from people...this person brought it to me because the person SS contacted for Percocets was HER daughter. SS17 didn't realize that the number he was texting was someone else's number...not the guy he knew...(it disturbs me that SS knows who to get pills from, but that's another story)
Anyway...Idiot boyfriend does have a condition..he has testicular cancer and is currently receiving chemo...prognosis is good and he has his last treatment next week. He had surgery about 3 months ago to remove one of his testes... He is receiving Perc 10 from his oncologist at the rate of about 90 every 2 weeks...his last treatment was last week, so this means he has gone thru all 90 in less than a week...Selling? Probably...but he is actively using a minor to solicit pain meds...
Here's the dilemma...Am I obligated to call his oncologist and report the drug seeking behavior? Since this involved a patient of ours and was brought to us...are we ethically required to report it?
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Ever notice how 'What the hell' is always the right answer?~Marilyn Monroe
Edited by Reilly (12/07/11 07:51 AM)
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Reilly
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Just to add...DH and BM and I have addressed the behavior with SS17 AND idiot boyfriend. I had patient text me the actual text messages so there is NO doubt what transpired...On a personal level, we are addressing the situation...it isn't at issue...
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Ever notice how 'What the hell' is always the right answer?~Marilyn Monroe
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gr8Dad
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The ONLY consideration I could offer would be that Perc's are one of those meds that the body builds up a tolerance for at a pretty fast rate, and what took ONE pill a week ago, might take two or three now. He MAY be using them all, and is still in pain.
Other than that, I would approach SS17 directly, tell him what you know, tell him what your OBLIGATION is, and explain that unless he has a satifactory answer, you OBLIGATION, not only as a medical professional, but as a step parent, is to report this.
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Why give a "senior" discount, they have had plenty of time to raise the money...
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BeachBabeRN
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You are NOT a mandated reporter for an adult that is abusing pain meds -- believe me, his doctor will find out at some point that he is abusing them, whether by hospitals contacting him when he goes there for more narcotics or by running him through the prescription database that's maintained by every state. Sometimes those are fascinating reading.
This situation was not brought to you as a patient concern, it was brought to you on a personal level that pertains to your stepson. I'd pull out all the stops regarding his involvement **that might involve him not leaving the house until he's 30 or so**
Obviously the person with the medical condition is aware that he can only get so much within a certain period of time but if he's got Oxycontin and Percocet? He's either selling them or abusing them. His oncologist will find out eventually.
Your obligation is to extricate your SS from this issue. There is no obligation to report drug abuse on the aprt of an adult to anyone. Now if you choose to go to the POLICE about the issue of using a minor to attempt to obtain narcotics illegally? That's a whole other issue and one that would be a matter of personal choice for you.
What he's doing in having your SS solicit drugs for him is completely illegal -- and is chargeable, I believe. If you have a friend that's a cop, you might run it by him, without using names and see what the charges would be for the adult -- without a name, an officer can't do anything either. I have one very trusted friend that's a cop that helped me out with my son regarding the various alternatives, etc. at the time that his behavior became chargeable felonies.
If the actual PATIENT was 17 and doing this, then absolutely, you're a mandated reporter and should report it to the proper authorities, i.e. CPS, police department. However, in the situation you describe, you have nothing that you are mandated to report. Adults can choose addiction if they want to -- not the best choice in the world, but it's their life. They can choose to deal drugs, they can choose to solicit them for themselves -- but there's nothing to report there.
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spinnerdegrassi
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Depends if you want to get the SS in trouble. He's also committing a crime here by extricating narcotics he doesn't have an Rx for.
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Reilly
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"Your obligation is to extricate your SS from this issue. There is no obligation to report drug abuse on the aprt of an adult to anyone. Now if you choose to go to the POLICE about the issue of using a minor to attempt to obtain narcotics illegally? That's a whole other issue and one that would be a matter of personal choice for you."
Right...idiot boyfriend is NOT a patient..the mother and daughter in question, as well as SS IS a patient of my doctor.
It is important to note that idiot boyfriend has a long history of perc abuse...long before the dx of cancer...They gave percocet to someone who already abuses it...unknown to them, I know...but nevertheless.
So...? NO obligation to contact the doctor and report the drug seeking behavior...right?
Just want to make sure I CYA...
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Ever notice how 'What the hell' is always the right answer?~Marilyn Monroe
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Reilly
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[quote]Depends if you want to get the SS in trouble. He's also committing a crime here by extricating narcotics he doesn't have an Rx for. [/quote]
Absolutely...and my desire to "bust" idiot boyfriend is VERY strong...VERY Strong...in doing so, I implicate SS...who was dumb enough to follow thru with the request...
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Ever notice how 'What the hell' is always the right answer?~Marilyn Monroe
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Reilly
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[quote]The ONLY consideration I could offer would be that Perc's are one of those meds that the body builds up a tolerance for at a pretty fast rate, and what took ONE pill a week ago, might take two or three now. He MAY be using them all, and is still in pain.
Other than that, I would approach SS17 directly, tell him what you know, tell him what your OBLIGATION is, and explain that unless he has a satifactory answer, you OBLIGATION, not only as a medical professional, but as a step parent, is to report this. [/quote]
My only concern is any obligation I may have to any other medical professional regarding the information.
Pain medication abuse is at insane levels in this area.. Idiot Boyfriend has been a Perc abuser for some time.. even prior to diagnosis with cancer.
As a matter of fact, his dx of testicular cancer is most likely directly related to the fact that his equally idiotic parents put him on steroids at age 14, because they were just positive he was going to be the next Nolan Ryan...
Really..can't make this stuff up...LOL..
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Ever notice how 'What the hell' is always the right answer?~Marilyn Monroe
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BeachBabeRN
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I don't know what I'd do quite frankly Reilly. Is this the first time your SS has been involved in something like this? What was he getting out of it? He had to be getting paid something somehow in order to convince him to do it -- he's 17, he knows the difference between right and wrong -- must have been a powerful persuasive argument for him to even do it.
However, your actual question as it pertains to any other medical professional about this? Unfortunately zero. While narc abuse is at an all time high, technically it's not illegal. Obtaining it on the street IS illegal --
I mean, consider this -- some pain management patients that come into my ER all the time are technically breaking their pain contract -- they're obtaining narcotics from other than their pain management doctors. Are they abusing drugs? Certainly. Is it illegal????? No. Especially when the p^ssy doctors I have won't stand f irm and say **no** It's easier for them to cave than have to deal with the then escalating issue of the patient making a scene. Are they calling the pain doctors each and every time the patient is in the ER? No. THAT would be the most effective way to stop it -- to a point. Anyone can doctor shop, get their prescriptions, etc. and fly under the radar for a LONG time.
So. You have to deal with your SS, first and foremost. THEN your daughter's mentality on staying with said idiot boyfriend. Those are your priorities.
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Reilly
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Our ER docs don't NOT give pain meds..but they alert us to it...I can't tell you the things we've had to implement in the last year to combat pain medication abuse...urine drug screens, OARRS reports...our state is very aggressive, our governor is making it very hard on doctors right now..
As to the rest..we asked the same questions...what in the world was he thinking? After all that IB has done, why in the WORLD would he even consider helping him find pain meds...still blows my mind and we didn't get a real answer out of him...
There had to be some motivation on his part..even if it was just to keep IB from stealing from him again and selling his stuff to get money for pills...he's lost new shoes, video games and cash to IB all in the name of pain meds...The real brain bender in this is that SS's mother allows the idiot into the house at all...but again, another dynamic there with the grandchildren...Therefore, SD and IB end up making the rules..because BM is afraid to stand up for the rest of the people in her household...afraid she won't see her grandchildren if SD leaves...
Its idiotic...at best...
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Ever notice how 'What the hell' is always the right answer?~Marilyn Monroe
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Reilly
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So. You have to deal with your SS, first and foremost. THEN your daughter's mentality on staying with said idiot boyfriend. Those are your priorities.
~~~~Completely agree...just wanted to make sure I wasn't foregoing something else...I knew there wasn't much chance I was in violation...but wanted to make sure...
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Ever notice how 'What the hell' is always the right answer?~Marilyn Monroe
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Gecko
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1. You and your husband NEED to have a very serious 'come to Jesus' talk with his son about the moral and legal responsibilities of soliciting pain meds from people.
2. You and Dad (and maybe your husband) NEED to have a very serious talk with your daughter about her 'idiot boyfriend' addiction to pain meds AND that he has now involved SS17 AND the potential legal consequences of her involvement.
3. You, hubby, and Dad or combination thereof NEED to contact 'idiot boyfriend' and let him now that the cat is out of the bag.
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If you air your dirty linen in public, expect people to comment on the skid marks!
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BeachBabeRN
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What she said.....^^^^^^^
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Reilly
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Already been done...thanks...
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Ever notice how 'What the hell' is always the right answer?~Marilyn Monroe
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