My name is Ed, and I am addicted to the A&E television series Intervention. For those of you unfamiliar with the show, it cynically exploits people at their lowest point – drunk, addicted to meth, often homeless or sponging off family, etc. – under the guise of a "documentary" about addiction and recovery. Since each episode devotes about 2 minutes to recovery and treatment, it's pretty clear that the show exists to let us all gawk at train wreck addicts at their lowest point.
Like everyone who watches it, I watch Intervention to feel better about myself.
To discuss every messed up aspect of this show (not to mention its popularity or mere existence) would take too long, but one thing really blows my mind regularly. Many of the addicted people have bathrooms full of prescription pill bottles the size of pop cans filled with opiates, stimulants, and other varieties of addictive narcotics. Yes, obviously some of the pills a drug addict consumes are going to be obtained illegally. But that doesn't account for all of it. Some of the show's subjects reveal how they get legitimate prescriptions for insane quantities of Oxycontin, Xanax, and so on. And my question is, who are these doctors writing out 30-day scrips for 150 maximum strength Oxycontin?
I've talked before about how American medicine is basically a big vending machine of prescription drugs. It goes without saying that the idea of actual patient care and accurate, thorough diagnosis is foreign to the American for-profit model of medicine. Doctors have every incentive to get patients out of the office as quickly as possible and with as few (expensive!) diagnostic tests as possible, and the easiest way to send the average patient on his or her way happily is with a prescription or five. I did assume, though, that if for no reason other than self interest, doctors wouldn't prescribe narcotics quite so casually. One would imagine, for example, that oversight by the DEA and state licensing authorities would make a doctor think twice and act conservatively when controlled substances are involved.
Is that hopelessly naive? I can't say I've ever tried it, but…is it really as easy as semi-reality TV makes it seem to walk into a doctor's office reeking of the symptoms of drug abuse and walk out with a Keith Richards sized allotment of mind altering drugs? My confusion on this point goes beyond reality TV. For instance, I regularly hear students telling tales of getting large prescriptions for Adderall and other stimulants at the slightest mention to a doctor of having "a hard time concentrating."
As a kid I remember our family pediatrician offering candy to patients who completed a visit without crying. This encouraged me to be brave, but in reality the good doctor was pretty liberal with the candy policy. In fact, no matter how I comported myself in her office I don't recall ever leaving without having been given candy. This seems like a good policy in hindsight; the kids would probably cry even more if they were denied candy in addition to being poked and prodded. This worked because the doctor figured that there is no real harm in one piece of candy, especially if it meant getting a child out of the office calmly and expediently. This same policy seems dubious when applied to addictive drugs, however. Is our system of assembly line, bottom line focused medicine really so broken that we're willing to hand out prescriptions for whatever the patient wants just to keep things moving along?
I think I already know the answer to that question, unfortunately.