The patient needed a refill on his narcotics--in fact, several months' worth, because he was leaving in a few days for a long trip. I pointed out that, per our records, his last prescription had been filled recently. The patient's adult son, who cohabitates with his father, chimed in. "The pills get mailed to us," he said, "and they keep getting stolen right out of our mailbox. Big problem in our neighborhood. I have to take Norco for my elbow, and the damn thieves take my pain pills, too."
I relayed the story to the doctor, pointing out that it contained numerous red flags. The doctor mused that his patients use the same excuses to explain they need an early refill on their narcotics. Stolen from the mailbox is a favorite. Another classic is that the dog ate the bottle.
"Tell me, [Reflex Hammer]," he said, "how many times has a patient told you that they need a refill on their blood pressure medication, because the dog ate it?" He paused. "It's remarkable how dogs have such discriminating taste in pills."
