How Resonsible Are Doctors?

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A tragic case like Michael Jackson's reinforces the recurring story of addicted celebrities and their enabling doctors. Being a celebrity does not change the simple fact that the user is a drug addict. And having an M.D. after your name does not change the fact that if you supply the addict you're still a drug pusher. But to be famous and addicted does make treatment much more difficult.

Whether or not Michael Jackson's sudden death was directly caused by prescription drugs, this tragedy highlights the need to crackdown on M.D.s who become enablers of addiction. It's no exaggeration to say that they are basically drug pushers or at least suppliers. Their role although perhaps well meaning can become genuinely sinister, for it's not just a matter of joining a star's entourage by virtue of a prescription pad. Physicians are quite aware of the potential for addiction with opiate/opioid pain medication. The same narcotics like Demerol and OxyContin that became a regular part of Michael's life also lead to high addiction rates among physicians themselves. In the celebrity culture, some doctors become co-dependent and enmeshed with the stars to whom they hitch themselves, creating a mix of compulsions for fame, approval, power, and self-indulgence. As with other enablers in their entourage, the doctor is unable to set limits, frustrate and confront the celebrity lest the physician be banished and another eager medical provider step in. But the bottom line is always the same: the standard of care has not been maintained; pain and potentially treatable conditions are overlooked. And their oaths as physicians have been violated. These doctors are doing harm.

Without a doubt, enabling M.D.s are hard to control, since they can hide behind any number of excuses, the favorite one being that the celebrity himself (or herself) deceived them. "I had no idea he was that strung out, and anyway, he had a dozen other doctors he was fooling." A familiar rationale and a credible one -- addicts who aren't celebrities devise contorted ways of getting drugs. Celebrities are better at it and can dismiss anyone who doesn't agree to play along with their addictive lifestyle. Merely because a drug is prescribed or even taken as directed does not mean the patient is not addicted. The community of physicians needs to show more vigilance when dealing with these difficult patients.

Serious medical issues must be faced, among them:

-- Celebrities are known to have higher rates of trauma in their childhood, whether physical, sexual, or emotional. Behind the glitter of fame they feel real pain and suffer from conditions that need serious medical and psychiatric treatment.

-- The narcissism of celebrities looks glamorous -- who wouldn't want to be the center of attention? -- but in fact it is actually a symptom of psychological damage. There's a frightened refusal to look at their problems and an inability to see how much they themselves are contributing to the turmoil that uproots everyday existence. (To make matters worse, the enabling doctors have their own narcissistic issues, which may be gratified by basking in the glow of celebrity. Doctors, too, may be defensive and manifest the same refusal to take responsibility.)

-- The use of short-acting painkillers isn't innocuous. These can cause changes in the brain that impair thinking and perception. After a certain point, the addicted brain sends the message that getting off drugs will be like committing suicide. Under heavy use, painkillers are in fact the cause of pain, a condition known as hyperalgesia. But reckless doctors keep supplying pills and injections because "my patient is in pain." This ignores the simple fact that pain can be managed in many ways. Even if narcotics are called for, that's not the same as saying they are called for at addictive or dangerous levels.

-- Opiates suppress respiration, but often this effect isn't noticed until suddenly the addict stops breathing completely. Subjectively they may not feel sedated even as larger and larger doses are given over time (known medically as drug tolerance or tachyphylaxis). A drug can stop producing the desired effect after only one dose. The addict wants subjective relief, but as larger doses continue to have no greater effect, the addict fails to notice that his body is suffering from serious side effects. This is one of the covert causes of sudden death.

The list of risks extends much farther, but the overall point is that trained physicians know of these dangers. Therefore, participating in an escalating daily regimen of opiates for any patient with probable addiction, much less a celebrity is indefensible. Ignorance is no defense if you have a medical license.

What can be done?

The public's attention span is short, but widespread awareness is the first step. The real target audience are the local licensing boards and peer review committees who handle medical practice. The culture of "just say yes" when a celebrity shows up in a doctor's office needs to be condemned. This condemnation needs to be followed up with serious consequences for enabling physicians. If they recklessly addict a patient, severe repercussions should follow. If they themselves are addicted, complete abstinence must be achieved before they are allowed to return to medical practice, and random drug testing should be required by all states. Computerized medical histories should be instituted, so that we know precisely how many prescriptions are being written by each doctor and filled by each patient. With a centralized database, celebrities won't be able to pull off the trick of fooling dozens doctors and pharmacists all over town. And we need to do a better job educating physicians about the nuances and difficulties of treating patients such as these.

These steps are a beginning. Realistically, celebrities will always be first in line in gaining easy access to drugs. They have the means, the excuses, the money, and the opportunity. But at the very least the culture of enabling physicians must be branded as shameful. The same image that fools the public has eroded medical ethics. The abuse of prescription medication is becoming an alarming problem in this country, It's not fun to take drugs, it is serious business as is our charge to care for patients, celebrity or not. Doctors that enable celebrities must be brought to justice or else we will continue to witness shattered lives and sudden death.

Read Dr. Drew Pinsky on Huffington Post and at dr.drew.com

I guess I could never find the right doctors. Either that or I'm just not rich enough or famous enough.

I know one thing. If I were a celebrity with an almost unlimited supply, I'd be dead by now too. Without a doubt.
Really.I saw a clip yesterday on CNN of a dude who just went through the yellow pages of dentist complaining of an impacted tooth or some other painful condition.When they couldn't schedule him until a week later,he would then ask for some pain meds until he could get in.Most accomodated him because it meant future money.

I know when I doctor shopped,I would go to a part of town that has multiple mini-clinics and would usually score.I had a few who called me out but if they think you can be a potential client,I didn't have much problems.

Some of them now will do a urine test to see if you have opiates in your system.That seems to stop a lot of it.
Interesting Tim, thanks for posting this.

If and I say if; only because it is all 'hear say" until the reports come back, although I tend to believe those that were thrown out of Mikes circle because they tried to help him, over those who hung around. I tend to believe his sister Janet who says she tried to intervene.

The bottom line is this. Michael is the only one responsible here. No one else. Yes I think the Doctors have a responsibility to a degree, but they were in it for the simple fact it was Michael Jackson, or if other names were used, then the doctors more than likely didn't have a clue it was for MJ. Those that enabled for money should be ashamed.

Those that tried to help him should be applauded. Note, those folks are no longer around. He fired them.

I do not buy the murder theory his family is alleging, it was another Anna N Smith story, and Elvis story, etc etc, many people die daily of an OD. Who is to blame?
MJ knew he had a problem, he chose not to get help, after his first stint in rehab. I must say if he was strung out on drugs, his rehearsal dance sure didn't yield any signs.

He was a brilliant performer, period. Far from ignorant or stupid, he knew what he was doing. Didn't we all?

I do not feel sorry for people for the most part, but him I do. He had no childhood, (his father wasn't anymore abusive than our parents were back then)
If it weren't for Joe, there would be no MJ.

I get that once you are that famous you cant just go to walmart. Sad life to live in my opinion, but that is the price of fame. His lack of having a childhood could be the ramification's of his actions through adulthood.

People that really cared were turned away, the addict way of thinking. Those that he allowed to take advantage of him, they the greedy ones, including some doctors, should be ashamed, but my guess is, they are scrambling trying to figure out a way on how to cover their asses.

I guess the report will tell all, unless it says, inconclusive.

I do think Doctors are responsible to a point, as I have said before, even had my pain management doc said, listen' this is the way it is', i.e. you will become dependant/addicted and here are the WD symptoms, 'are you sure you want to move ahead with this'?

I would have most likely said yes, (never taken much in the way of pain meds prior to that). Due to the pain I was in and I needed to function.

Their responsibilty is to make sure the patient isn't overdoing it. And that is where mine fell short.

I only speak for myself but anybody who blames anybody else for there problems instead of looking forward and taking action to improve life today-tommorow.

Regarding Past? My Doc feel good warned me and maybe I am a bit different as I have a lot of chronic pain and legit need something or ? find a way without the opiates.

I have learned to just take it one day at a time.

Brooke you write

Their responsibility is to make sure the patient isn't overdoing it. And that is where mine fell short.

You lost me there? If your doctor gave you a 30 day supply for your pain how is he/she going to check on you? You obviously got addicted? I know basically nothing about your story so if you can explain what your doctor did to you and what you feel he/she could have done to monitor you?

I had a doc feel good who killed my friend the person who introduced me to him. My doctor cut em off.He flipped out as he was caught doctor shopping.

???

Jeff
I totally agree with you Brooke.In the end we are the responsible parties for own addictions.I admit that I had one unscrupulous doctor who had to know I was an addict because of the amounts being prescribed as a trade off for work at her house.There is no ethical way a Dr. would be prescribing me 120OxyContin,120 Oxy Ir,valium and even Oxyfast for some minor back problem.In fact the guy who turned me on to her had loaned her some money and he was getting 100's of vials of demerol.
She would prescribe another 120 Oxycontin two weeks later and tell me what pharmacy to get it filled at so it wouldn't show up on the radar.

When I went in and told her I was an addict,a year later she still prescribed me Percocet.I did ask for it but legally she could have been in hot water because she knew I was an addict.

When I got clean,I changed doctors.I take full responsibility for my actions because I knew she was nothing but a drug pusher.It's how she got work done on her house.

Some of those Drs. of MJ's are sweating right now,especially that cardiolgist? from Houston.He's all lawyered up and is hiding.Giving someone Deprivan for a good night's sleep is ludicrous.That drug is not even a scheduled drug and is only used in the ER.It literally puts you in a coma which requires oxygen and an anesthesiologist monitoring it.What I think happend is the good doc fell asleep during the procedure and the rest is history.

MJ didn't want help.I think his pain was so intrinsic from his upbringing,narcotics were his only relief.It's really sad.
I had one of those doctors. In reality, he was a drug pusher but didn't hold a gun to my head. He's still my doctor, hard to let go of him. He was my husband's doctor when he was a child and delivered all three of my boys. There's a history there. I suppose when he retires...well. I don't know.

At what point are we responsible?
Jeff I am not blaming my doctors 100%, i do to a point, once I became non ignorant of pain pills, and addiction, and liver toxicity etc etc, that is when I knew I was in big big trouble. I am saying they should take some responsibility.

Where my doctor fell short was not monitoring me as well as a pm should have, as I got my tolerance level up higher and higher, meaning he/she would say, 'this is normal, here take more'. I was like, 'but i want to stop taking so much'. Once it reached a point to where I went to detox, the doctors still didn't see a problem. I mean a tall woman weighing in at 103-107 is not normal, normally 120-125, .
One of the doctors said, ' you are looking good', the next week I put myself into detox. NO I wasn't looking good, I looked like I had not eaten in a year.

I didn't get from the streets, I didn't steal, didnt need to, they gave me all that I wanted, and would run short, as my tolerance grew, I would go in, here take xyz per day.

In their defense, they wanted to put me on a longer acting drug, I refused, not wanting to go on morphine or oxycontin, or anything like that. I did agree to the fentanyl patch and sucker type things, they had a pink top to them, yeah like that isn't a strong drug. lol I didnt realize at the time, but I remember it was the most god awesome drug i had ever been on. I had two full grocery paper bags full of this crap, and took them back to her office sat them in front of her and said, NO way will I ever try this again. I asked her to get rid of them. I didnt know what to do with all of the patches I had. Back then they didnt give just 30 days of drugs, i had like 6 months worth, or it seemed like it, they were less regulated. I took these maybe 3-4 days, couldn't tolerate them at all.

I blame myself for not doing my homework when instead of 'taking' their word for it. But as I said, I dont think it would have much mattered, I just wanted out of pain. The pm was after years and years of going to a neurologist.
Hey Lisa, got your message, will talk tomorrow.

No they didnt hold a gun to our heads, but what they did do is take an oath.

But if they are going to be in the circle of the pain medication with a patient, then it should be full circle.

Not just cut someone off without some type of help, especially when a person is on some heavy duty drugs. Or when a patient comes in, like I did and says/ I am addicted please help me get off of these. And the doctor says your not an addict, just dependant.
I told him/her didnt care what she called me, just help me.

I get that people do not follow the rules, hence why docs drop them, so not condoning that, but at least help them with the WD, the very same drugs the doctor put the patient on.

I am thankful this didnt happen to me, but i do know folks that it did happen to, yes they f***ed up, the doctor should expect high doses of drugs they give with their knowledge of pm, will cause problems down the road. Somehow they need to come up with a protocol different than the one that was in place a few years ago. And maybe due to the DEA riding their butts, things have changed.

The DEA monitoring system is way overdue, but I am so glad that the pharmacist can now cross reference a person doctor shopping.
Brooke good afternoon.

I have read almost all your posts. I know you take responsibility for your actions

And yes your correct there are many that should be held accountable But life goes on sheet happens.

I mean if your me in 1998 they mis diagnosis and scope my knee--3 weeks later I am walking.on one leg and they properly diagnose me with bone on bone and boom Hip Replacement you have no clue what it takes for me to get cleared for a prostate examination. Its sad what happened. It led to the end of my second business which led to my divorce. Was I angry you bet. Anyone here who really knows my story knows I fight Mood swings and have severe anger issues but man I am doing much better these past yrs even with all the new 'STUFF" I deal with.lately.

Tim Over the years I have been prescribed many opiates heck recently ritalin by my shrink. he knows my whole story. Asthmatics should not take any opiates it goes on and on. And many doctors good ones have prescribed me opiates knowing I am an addict. Hey were all different. I am sad when I read another dead kid like heath ledger? the actor/

What bothers me is all these so called "friends of M.J where were they 10-15 yrs ago. The guy started going whacko and yet all these people were surprised he died of a drug overdose? Come on.

Thank god for Walter Cronkite sad he passed but at least it took the media back to covering a real story IMHO



For me I have always known the drugs I was taking mostly to manipulate my doctors to prescribe me a cocktail of barbs benzos opiates of course I did not drink

Brooke its the lack of the use of technology that could prevent so many deaths.

Education--my 10 yr old knows what a bong is. Some parents are mortified. Me I rather have an educated kid then someone who follows the leader and wakes up well you all know how it leads--and its younger and younger.


I meant to ask Anybody this question. We are addicts for whatever reason genes? upbringing I do not know much about addiction except its a killer disease.

Why does our government just educate the next generation. Cigs are going down Do not want to start a political rant here but legalize certain drugs/indoor exercising?

But to many afraid--Just an idea

Jeff

Later--Jeff
you no,,,its so strange about us addicts,,we want to blame dr ,,its not there fault,,its us addicts,,I no some people ,,my spouse for one ,,that has never abused pills,,,so some dr are not so good alot are,,stop blaming others for our pill addiction,,we are the ones that want to escape from our cruel world,,,we make life what it is ,,,drs do not make us take the pills,,,we take them,,,thats my opionen...thank you,,,,poopie
I think that doctors should have to be more accountable when prescribing more than a 10 day supply. They should have to take classes, at the very least, educate thier patients on the danger of addiction. If mine had paid more attention...he probably would have stopped prescribing but I just would have found another avenue.
I believe a lot of the problems startes with all the HMO's.Doctors do not want to spend the time with patients to explain the reprucussions of continued opiate use or don't have the option.It's get in as many patients in and out in one day to meet your quota.Pain is subjective and I guess some feel it's easier to just write the script and get them out of there.

The old fashioned family doctors are a rarity these days.They would monitor and ask more questions.

I don't believe real pain sufferers should be deprived either so there has to be a balance.Ultimately,you still are responsible for your addiction.I think everyone knows when they've crossed that line.Then it's your responsibility to either get help from your doctor or find it from someone else.
The old fashioned family doctors are a rarity these days.They would monitor and ask more questions.

Wrong. That's who got me started on valium and fiorinal. There is absolutely no way on earth I could possibly blame my doctors for my addiction. I am the one that went to them looking for more pills. They thought they were helping me. I lied and cheated. They did their jobs. Yes, I found a couple that were in it only for the money and prescribed what I wanted without question but I also watched them on the news on their way to jail. Never did a doctor force a pill on me. I took each and every one with a song in my heart and a smile on my face.
My Dr is one of those old fashion docs., He does spend time with me, more than any other doctor but still over prescribed. He just was one of those docs who didn't want his patients in pain? Maybe we were too close.


I took each and every one with a song in my heart and a smile on my face. .....I'm sure you did.
The point I was trying to make was the amount of time doctors spend with patients,not that they still didn't over-prescribe but like offering some holistic alternatives to treat pain.That takes a bit more time than a drive by clinic but if you're an addict that's the last thing you want to hear.


I have a question.Since I don't have health insurance one of my old doctors has started this business with a few other doctors that you pay a flat fee of 1500.00 a year and you can go see them as much as you need to for minor stuff like infections,flu shots,extensive blood work,prostrate examinations and in-depth physical.examinations,sprains,anything but something major like cancer.There is no co-pay and you even get a discount on any prescriptions.They also cap the amount of patients they have so you're not rushed in and out & they let you pay quarterly so if you feel it's not something you will use you can cancel.

That sounds like a good deal to me since I haven't had health insurance in about 10 years but I don't have any health problems.The last quote I got was about 4 years ago and it was about 600.00 a month.It's not going to get any cheaper either since I'm aging.

Any thoughts? Also,the guy knows I'm an addict.I wrote him a letter years ago not to give me any pain meds.He goes to my gym and was telling me that it might be a good option for me.
How much do you usually spend a year? If you spend more than 1500 then go for it. I don't have health insurance either but I only go to the doc once a year for the past 3 or 4 so I'm good but if I get sick I am just going to die because I can't afford to do anything else.
This is common in the life of all celebrities. The busy lifestyle, schedules, appearances, performances, etc. do take their toll and in MJ's case injuries play a big roll. The artist is definitely responsible for his own well being as are any of us, but trust is often given passage of our responsibilities. In this case there would appear to be greedy opportunists seeking their own fame and reward at the misfortunes of the artist. This is a recurring theme and not likely to go away just because the king of pop is dead....
I agree David.

Kat-That's the deal.My last visit was a couple of months ago for that testicle thing,but Cipro cleared that up and the Dr.visit was only $80.Before that,it was like two years ago when I tore the ligament so no I don't spend near that amount but I also don't get physicals,intensive examinations or yearly prostrate screenings.I heard some of those intensive physicals can cost 5 0r 600.00,especially when they do a lot of blood work.

I don't know what to do.I'm 54 and getting nervous about being uninsured.I feel healthy but who knows? I will give it some thought.It could be a con because the dude knows I'm healthy and that's exactly who they want to sign up.

They also do eye and ear work and I need to get my ears cleaned.All that gulf water....God knows what's growing up in there.
Tim can you afford to insure yourself? If the answer is yes You gotta be nuts not to.

Assuming your in good health you still may be looking at 5-6000 for a sheet policy but god forbid you get sick once?

Jeff