The pain law Washington State drug registry opened two days ago. All of the pharmacies have to register all opiate prescriptions in a central registry. I haven't done quite the right things to get access yet. But I had a new patient yesterday who was changing his story as we spoke to try to get methadone from me. Initially he said that his knees had been injured one day ago, but as the visit progressed, he changed it to four days. I called one pharmacy, which said he had enough methadone until Jan 9, and I called his doc's office. He'd said she was out of town all week, but she had put a note in the chart the day before that he'd gotten oxycodone from multiple providers, presumably from the registry. Ouch. 40mg methadone is a lot. He stomped out as soon as he realized that I was not giving him a prescription. I sent him a letter saying I am not accepting him as a new patient at this time. I did tell him that withdrawal does not fully hit until 10-14 days.

So that may be the first of many folks swirling around in horrible opiate withdrawal. I may get MORE suboxone patients because the law has hit. And any doc dumb enough to not check the state opiate registry is going to get flooded with opiate dependent drug seeking patients. Hope the rehab centers have hired extra help for the next few months. Your best investment in Washington state right now is probably a methadone clinic or a heroin operation.

It was a difficult clinic visit. I feel very sad when I have someone in the grip of addiction, telling me a story. I know what I will find even before I check. I check the story with the other clinic and pharmacy, calling while I am in the room with the person. At last he said, "Someone is telling lies about me." Yes, that is true. Unfortunately it is the addiction, making him lie to himself and everyone else. And he's not down far enough yet to face it.

WA drug registry
WA state guidelines for opioids
Tool kit to help drug dependent patients

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