Today you told me my operation is scheduled for tomorrow. I am not looking
forward to this experience, I am not dreading it much either, because I have
faith in you and your pledge to do your best for me.
I told you that I am an alcoholic. You said that you know about my sensitivity to mood-changing drugs and that you would be extremely cautious in prescribing dangerous medication for me after surgery.
But are you sure you know what medication is dangerous?
When I was a patient in Willingway, they told me there is often a misconception about the meaning of dangerous medication. They said that Doctors think of "hard drugs" like morphine, Dilaudid®, Pantopon®, and Demerol® as being dangerous and "mild" drugs like tranquilizers as being safe. In a way, the staff said, this is backwards. The hard narcotics given for a short time to relieve pain are pretty safe, except in rare cases, while the milder drugs given by prescription over a longer period, are what's dangerous. According to them you can give just about any alcoholic or addict a hard drug in the same doses you give your non-alcoholic and non-addictive patients after surgery without fear of serious consequences if you stop it in three or four days.
They said that the trouble comes from changes in attitude caused by the effect of the chemical on the brain. My sobriety depends upon a clear head. The few days I get the narcotic when I am still recovering from the anesthetic probably won't bother me very much, but the longer usage of the prescription drug can cause a drastic change in my attitude toward everything. I will explain what I mean.
Several days after surgery when I am feeling better I might tell you that I don't need any more strong shots and I might try to persuade you to let me go home with a prescription for a mild pain reliever that I can take if I really need it. My argument could be convincing, as I am a pretty good con artist. I might talk about how you need the hospital bed. You might decide that maybe that's a fine idea and then give me a prescription for some capsules with a little codeine or maybe some Valium® for nervousness and perhaps a downer for sleep and send me home.
All the time you might be feeling good that I have really not given you any big mouth about needing more medication.
Wait! Think it through!
When I get a prescription, I become my own doctor. If the directions say to take one pill four times a day, I might decide that it would be the same if I just waited until night and then took four at one time. In a few days, I will probably want a refill. If you are out of town, I will call another doctor. I might claim than medicine you gave me had been lost through "calamities". I can say that the dog got it, or the car ran over it, or it was flushed down the toilet. Remember, I am operating under a compulsion and I just might get more of that drug somewhere regardless of what it takes. You see, by then my sanity is gone and I am in a chemical fantasyland. I may not yet be drunk but it is probably just a matter of time.
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