By Rodrigo Garcia, APN, MSN, CRNA, MBA
I remember it well. A late added surgical case was taking longer than expected and melancholic tones from the ECG machine were working in this cooled room to facilitate a new kind of anxiety.
This day my thoughts would be different from the norm and from the coming moment on I would never be the same.
The last few weeks had been spent trying to “ween” off the prescription medication I received after my shattered ankle repair three months prior. Doing “the math” as a part of my pain treatment has become a new norm. My life was now being planned around my dosing cycle which was being directed by the ability to secure yet another prescription. At the time, opioid prescriptions were being written more generously and with less regulatory oversight. “As needed” became a new mantra and my growing physical dependency, free flowing supply and false sense of security equated “as needed” to “always needed.”
I was educated and far from oblivious to the dangers of addiction and the impaired provider. I was not getting enjoyment out of taking the medication. I was productive and well respected at work.
It was a legal prescription from my physician. I had a great family and many friends. And, I ONLY took the medication because I needed them to feel normal. I knew what an addict looked like and that was not me.
This particular day I had already done the math several times and was aware that I would soon be out without any “plan” to quell the impending withdrawal. The physical pain had subsided to tolerable levels quite some time ago, but without the prescription medication I felt miserable, actually it was debilitating on every front (physical, emotional, mental, psychological). My calculations were correct. I had run out of medication and would soon feel the paralyzing effects.
The physical effects were tolerable, at least initially. However, the anxiety, anticipation and mind racing was immediately unbearable. It was near the end of the case and I could feel the writhing discomfort and self-loathing begin to take its hold as the withdraw settled in and self-shame took over. Maybe it was self-preservation, perhaps desperation. It may have even been maladaptive rationalization. It was likely all.
Whether over or under thinking, I began contemplating options to solve my growing angst. As I became consumed by pain, discomfort and fear, I looked around my work environment and realized the “solution” was always surrounding me. It was apparent that the “waste medication” could be used to ward off the evils of withdrawal. Moving forward, it would be used to bring strength to my failing body and comfort to my troubled mind. From this moment on, I would never see my work world the same way again. Someday, this experience and growing knowledge would become an incredible asset, but not before going through a tumultuous personal and professional hell.
As I continued to move through the next several days, my observations would lead me to ask myself, “Has it always been this way?” I noticed anesthesia carts unlocked, unattended powerful medication, automated dispensing machines logged open, questionable waste medication witnessing, improper controlled substance disposal, loose pharmacy parameters, blind trust, and poorly written or implemented policies pertaining to the impaired provider. What was clearly apparent was that while the outside world was talking about, and feverishly tightening, prescribing and dispensing regulations to address the opioid epidemic, hospitals across the country had become unwitting participants in the largest drug heists on record, to the tune of 300 billion dollars a year.
My fall from that point was not a unique story. The arduous climb back up to health and success, however, required support and assistance from many people. Thanks to the involvement of hospital administrators, skilled treatment providers, regulatory agencies and family my story has a positive outcome.
Today, my wife, business partner, highly skilled practitioners and staff have come together to form a professionals-only addiction treatment center called Parkdale Center for Professionals. Those combined talents, along with some additional forces, have given way to using our new-found experience and knowledge to address the growing epidemic of hospital diversion and the impaired provider. Parkdale Solutions is forging new ground with a cutting-edge program called Healthcare Experts in Loss Prevention (H.E.L.P.).
Change the name and the location and this story is repeated in hospitals many times and every day across the country. Some providers will end up in the legal system, some will be fortunate to receive treatment, but many will lose their lives. However, there is hope. By experiencing this epidemic from the inside, we at Parkdale are better equipped to help those that need it most. By sharing our story with you today, we hope to join with you and your team to do the same.