Thursday, October 16, 2008

Poetic Justice

The other day at work we were talking about the security arrangements at the clinic. We have security cameras, an alarm system, and a series of interior lock-ups for the drugs, which require either a key, a combination, or both, plus the knowledge of where to look for the stash. This is a good thing, since certain veterinary drugs have become popular street drugs and as a result vet clinics are not-infrequent targets of those wishing to sell illicit drugs, or those wishing to use them themselves. (This has created any number of headaches for the FDA and subsequently for us as well, since drug logging has become a huge chore and a lot of heretofore unscheduled drugs are headed for the "controlled substance" lists.)

The alarm system has been updated here and there as the need has arisen. One of the first upgrades was after we were broken into (this was several years ago, before my advent here). We have lots of windows, and in the doctors' office there are large upper windows which are fixed and unopenable, but there used to be lower windows (like, a foot off the ground) that you can crank open when it's hot to get good ventilation (and yes, by "hot" I mean over 70 degrees, and we should just get a grip and not whine about it. Stupid Alaskans.) These lower windows are maybe 18 inches high and 30 inches wide, and don't open all the way - they're the type that has the little hand crank inside, so that the pane rises like an awning but never gets as high as parallel to the ground. Not a great big entry point, but where there's a will... Anyway, initially these windows were not on the alarm system, since no one thought that anyone would weasel through them, but someone did. (Subsequently they were on the alarm system AND had bars inside, but since that still did not keep people from breaking them out - although how they thought they'd get through the bars, I don't know - those windows were built over a few years ago, to the ventilatory detriment of the clinic.)

Our story takes place in the days before the multiple lockups for the in-use drugs, and before the motion sensors inside the clinic, although (fortunately) not before the policy of keeping only about one day's usage worth of drugs in the (then unsecured) cabinets, and the rest in a separate lockup. So once our thieves made it through the window, they got away with a small amount of drugs, but no cash and none of the big stores of goodies.

Naturally they grabbed what they could as fast as possible and scarpered with the loot. However, they were apprehended not much later that night - before they'd even made it home, in fact - and the next day the officer who made the collar came in to the clinic on followup. She was talking to our office manager SS about it, and told her that the only reason she pulled them over was that they were driving erratically. She had no inkling that they were our drug thieves until she got out of her cruiser and went to the pulled-over car. Why were they driving erratically, you ask? Had they intoxicated themselves by taking some of the drugs they stole from us?

Well, almost.

They had stolen (and evidently immediately ingested, perhaps in an attempt to dispose of evidence, or maybe just because they were really jonesing for a high) our apomorphine. Apomorphine IS expensive and therefore of monetary value to us, but of little street value. Why? Because it is used to induce vomiting.

Apparently reading the "morphine" part of "apomorphine", our heroes thought it was a nice opioid narcotic, suitable for a good recreational high. While it IS a morphine derivative, apomorpine is used IV to induce immediate vomiting. We suspend it in saline and use it as an eye drop for the same purpose (mind you, we generally use one pill to a cc of saline and give one or two drops, not the entire tablet). Evidently it's pretty effective as an oral drug as well, because it wasn't long after ingestion (they WERE still driving home, after all) before our heroes were given an opportunity to see The Error Of Their Ways. All over their laps. And the front seat. And each other. I have no idea how many pills they each took, but I'm pretty sure this was the cause of the erratic driving. After all, if you are simultaneously puking your guts out and dodging vomit from your partner in crime, I'd kind of expect that your driving skills might suffer.

Naturally SS thought this was hilarious. I admit I have to agree. No word on what the cop thought (I'm wondering: Now, did she have to transport them in the back of her squad car in that state....?)

Guess it's an example of "what goes around comes around" (or up, in this case) - sometimes sooner than others.


Bill Fosher said...

How does the profession deal with drug abuse by staff? I ask because one of the best vets I have ever known became addicted to ketamine, broke up his marriage, ruined his practice, and ended up killing himself.

Somehow no one noticed that this solo practitioner was ordering enough Special K to keep a five-vet practice stocked.

MaskedMan said...

Hmmm. Original comment lost somehow...

I'd be startled to learn that the Veterenary medicine world was any more organized in its response to addicted doctors than the MD world is. But, I'd be equally startled to learn that it was much less organized, either.

I've a friend, for instance, who is an emergency medicine MD, who is also a recovering addict. She's in a state-run sobriety program, a kind of "second chance" program, which allows her to continue to practice, so long as she abides by the rather stringent rules, including some pretty invasive testing and surveilance programs.

It's a pretty good concept - It keeps skilled doctors practicing, while protecting the public from an intoxicated practicioner, and in her case has the side benefit of placing an addiction-savvy doc in the emergency room - surely an asset in a place where addicts are no doubt frequently encountered.

AKDD said...

It's self-policing (first), FDA oversight, AAHA and AVMA regs and individual hospital policies. The only time I worked with an impaired vet (to the best of my knowledge, anyway), the hospital group for which we worked made a policy decision about testing and monitoring. There are also the State liscencing and review boards.

I don't know about ER docs, but I don't in general think there are tons of addicted vets out there, even though the opportunity exists. Most of us take our ethics pretty seriously, which makes sure a lot of people never go there to start with. I will say that suicidal behavior isn't as common as you'd expect, what with the long hours, high stress, and relatively low pay. Plus death is our constant companion, since dogs and cats don't live as long as people do, so perhaps we think of it more easily than MDs do. Certainly we are at least somewhat inclined to regard it as an opportunity to relieve suffering (since we do sometimes euthanise our patients.)

I need orange said...

Your thieves ... talk about a punishment fitting a crime. Can't ask for better..... Too bad there isn't always an immediate and unforgettable consequence to bad behavior!