I am trying so hard not to explode here. I am equally aggravated by colleagues, including those in the ER, who refuse to take the time to either read a note I have sent them, call me and talk about a patient or to check a patient's pharmacy history. I have a patient that I have spent untold amounts of time with trying to keep her off nightly Ambien and increasing doses of Alprazolam. She really is not your typical drug seeker but she just seems to always be needing more and more. "Oh doctor if I don't take an Ambien every night I wake up at 5 AM and cannot go back to sleep (goes to bed at 9)". I have consented to give her only 10 Ambien a month and a fixed number of alprazolam with explicit instructions that that is all she gets. She will have to use these prn rather than routinely. She then goes to her neurologist, gives him her sob story and he writes for 30 Ambien with 6 refills!!! The week before I had sent him my office note describing how I had spent 30 minutes with this patient explaining my concerns over her increasing use of these medications and explaining the "deal" I made with her. It is like having a child play one parent against the other.
