Knowing the whole story

One of my regular substance misuse (buprenorphine) patients went to the GP the other day and got a prescription for co-codamol 30/500 x 224 for his painful knee...a bit unusual you may think - and quite an extraordinary quantity, especially for an addict.
 
I intervened in the supply.
 
My patient, who appeared to be unaware of the fact that the painkillers prescribed contained 30mg of codeine per tablet, agreed that it wasprobably unwise to take the prescription until he had spoken to his buprenorphine prescriber!
 
Following a telephone conversation, the buprenorphine prescriber agreed that there was a need to speak to the patient prior to me completing the supply of the high strength co-codamol - an appointment was arranged to see the patient the very next day and he agreed to manage on paracetamol until then. Further, the prescriber agreed to speak to the GP...
 
The main issue here appears to be the fact that the 2 prescribers, who have the best interests of the patient at heart, don't have the full story - good job the patient always comes to the same pharmacy - because we did in this case and we intervened.
 
(For completeness, I would like to report that he ended up on paracetamol and is managing really well)

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