.kavitapmd: The first time a patient threatened to kill me, I was a third-year medical student on a trauma surgery rotation in Texas. After I wouldn't prescribe him more opioids, he asked me how I wanted to die: by knife or gun, or both?
had reported misusing opioid prescriptions in the past year, underscoring that while there are valid uses for such medications, the United States simply had too many opioid pills in medicine cabinets. If that sounds familiar, think of the debate we’re having about guns in this country right now.
The nation labeled and then grappled with reversing these trends by introducing incredible scrutiny and regulation in the form of prescription drug monitoring programs, limits on the quantities that can be prescribed and state medical boards investigating high volume prescribers. These efforts have started to yield results, but something else started happening: Millions of addicted patients began to resort toto self-medicate when the generous supply of prescription drugs started to dwindle.
The worst outcome of our nation’s inability to manage double epidemics of opioids and guns is the complete breakdown of the relationship between doctor and patient. Preventive measures to deal with violence such as security and panic buttons can create an immediate assumption that the patient waiting in their room or on the gurney is guilty until proven otherwise.