Wednesday, June 25, 2008

detoxing from what? and/or what doctors should talk to their patients

We run a "non medical" chemical detox unit. This means we don't have any medical professionals on staff. Before a clients comes in to detox they have to get medically cleared by a physician (or nurse practitioner) and have their medications listed on their medical clearance form. When they come to book their intake appointment they have to have all the meds on the form and enough to last them 10 days.

I am continually amazed at how many medications my detoxing clients are on. And yet really, it makes sense. Long term substance use creates medical problems. These require medication. Psychiatric problems and substance use goes hand in hand, these require medications. And many nice doctors will prescribe a benzodiazapine to help with the detox process. Again, pretty normal. But it still surprises me.

What makes me mad however is the number of clients who have no idea what they're taking or why their taking it. We dispense client medication as per their prescriptions, and I can never get over how many clients are clueless about their meds. Many of them only take their meds on a regular basis when they're in detox, but still, it bothers me (and reminds me of another subject which is the starting and stopping of psych meds).

A couple days ago a young woman and her mother came in to get the girl into detox. She had a prescription (not yet filled) for olanzipine. Olanzipine is a fairly heavy duty antipsychotic. From what I know and have observed, it's generally not prescribed first...especially when the patient is not psychotic. But whatever, I'm not a doctor and have no medical training. What bugged me, is that this girl and her mom had NO idea what the medication was. None at all. Her mom thought it "might be like valium". And that was it. I can't imagine going to the doctor, getting a prescription and then taking a medication without knowing what it was supposed to do! And with all the potential side effect of olanzipine, starting it while detoxing has got to be hard. The two asked me if I knew what it was, and i started to explain, but realized I shouldn't be explaining this, I'm not a doctor, I'm not a pharmacist, they need to be talking to someone who knows.

Bah. I have so many clients like that. We have this program where I live called "It's safe to ask", which is supposed to encourage doctors and patients to talk to each other; in particular about medications. I guess it didn't work in this case!

ps. just cause someone uses crack doesn't mean they're psychotic when they're not on it!

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