I am your Doctor, not your Mother

The Directions are on the Bottle

I had a patient in the office that I see frequently for chronic pain.  One of her prescriptions has to be written every month.  There are many medications like this.  It is a controlled substance.  It is dangerous to take too much of this medicine.  

You get 30 days of pills and it needs to last 30 days.   This patient had filled her prescription 20 days ago and had ½ pill left.   Here we go again.  I sighed. 

“Have you been taking more of the medication than what you were supposed to?” I guessed (hoping that she had not been selling her pills).

“I’m having pain in the middle of the night, so I get up and take more of the stronger pills.”   She has a prescription for other medication for pain, but is almost out of that, also.   She didn’t call the office to report problems. 

This patient and I had this problem before.  Her insurance will not pay for more pills.  She cannot afford the ten days of medication.  It costs as much as a house payment. 

I felt like I was reprimanding a three year old child.  “This is the last time we can have this conversation.  If you can’t follow the rules, you’ll have to find another doctor.”

Basically, I can’t be your Mommy.  You need to grow up and follow the directions.  Can you spell W-I-T-H-D-R-A-W-L?