Why Doctors Can't Deal With Addicted Patients - Page 3

By Ruth Fowler 05/09/11

Just because your physician took a Hippocratic oath doesn’t guarantee that he’ll be able to confront you about hitting the bottle. (Or that he’ll treat you like a human being.)

Some doctors simply push pills on patients who have substance problems.

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Every doctor I spoke to also said they’d recommend a 12-step group to an addicted patient but most emphasized that they can only strongly make this suggestion—meaning, they can’t require it. Bienefeld suggests though, that the process of detoxing, going to an addiction specialist, and working on underlying issues can sometimes help patients realize the breadth of their problems, which in turn makes them find the idea of attending a 12-step meeting more acceptable.

“As an addiction specialist, you realize that lying, shame, and perceived judgment are part of the addiction and recovery slip cycle,” says Dr. Greg Dillon, another New York based addiction specialist. “A patient needs to work through that. I do prescribe medication in the service of treating some forms of underlying anxiety, depression and cravings—but extremely sparingly.” Bienenfeld notes that it’s important for the addiction specialist to try to identify co-occurring problems—many of which a therapist or primary care physician simply does not have the expertise to adequately treat—such as depression, phobias, mood disorders and actual physical pain.

The short answer to how doctors should treat their addicted patients is that if the patient has demonstrated a clear addiction, it’s the physician’s responsibility to help get them off it. Repeat prescriptions for Vicodin without any other question than “Where’s my check?” may make you think you have a great, understanding doctor—but this isn’t the case. Sometimes, of course, people get addicted to pain medication they need—a particularly complex episode of Intervention focused on Brooke, a 20-something former cheerleader whose painful rheumatoid arthritis demanded a degree of pain control and a doctor who could help her manage pain without descending into addiction.

But ultimately, once a doctor has confronted a patient’s addiction, the responsibility for recovery lies entirely with the patient. That’s when, as every doctor will surely testify, other people in recovery—meaning the non-medical professionals—are the greatest help. Knowing this, Naqvi, Bienenfeld and Dillon believe that medical professionals who specialize in substance abuse, addiction and recovery have a responsibility to get out into the community at a grassroots level—attending NA, AA and other 12-step meetings to speak to recovering addicts and alcoholics so that when they recommend patients go there, they know what and why they’re recommending it. Which means that if you landed on this article because your doctor suggested you hit up a 12-step meeting, before you blow up at them, perhaps consider hightailing it along to your local community center or church basement.

And maybe take an MD along with you.

British-born author, screenwriter and journalist Ruth Fowler lives in Venice, California and has written for The Village Voice, The Guardian, The Huffington Post, The New York Post and The Observer. Her memoir, No Man's Land, which documented her pre-sobriety experiences as a stripper in Manhattan, was published by Viking in 2008. She also wrote about nursing your way back to health.

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