Last week I learned that if you have a script for more than 120 oxycodone tablets, it must say "for chronic, intractable pain." I'm sure most of the junkies have figured this out, but good try, DEA. This week, I learned that you can teach a course on "law and ethics" and fail miserably at teaching the ethics portion. You can teach a person what it means to be ethical, but you can't teach him to be ethical. And that sometimes, what is lawful is not always ethical.

During my first week of rotations, we dispensed thousands of oxycodones. On one day, there must have been at least 10 oxycodone patients that arrived within 5 minutes of each other. For the most part, the prescriptions were "legitimate." That is, they were written by a licensed doctor, with the proper strength, sig, etc. On a strictly legal basis, it was perfectly okay for us to fill those prescriptions. But it can be said with 95% confidence that most or all of those patients were opioid addicts. It was legal to dispense the medication, but it just didn't seem ethical. After all, it is now a well known fact that some doctors are abusing their power to prescribe. And many of the ones that aren't corrupt are over-prescribing narcotics, for fear that a patient will not be satisfied with a prescription for a higher strength NSAID.

What really makes me sick, though, is not just the fact that we fill those prescriptions. It's that afterward my preceptor turns to me and says with a crooked smile, "Didn't I tell you we fill a lot of narcotics?" (And then cackles maniacally). After the first day of rotations, I told a friend that my preceptor was pretty nice. By the end of the week, he didn't seem so nice and I said I really don't like it, but hate is too strong a word. I'm now nearing the end of my third week and hate is no longer too strong a word.


"Better a poor man who walks in his integrity than a rich man who is crooked in his ways." - Proverb 28:6