The Legal Trade in Illegal Drugs
                                               by The Scalpel

I never intended to become a drug dealer. In fact, even now, I don’t want to be a drug dealer. But a man has got to
earn a living; put food on the table, and make sure the kids have shoes on their feet. I could not do this without
dealing drugs. Besides, dealing drugs makes me a lot of friends. In addition to some of my patients;hospitals,
pharmacies, drug companies, and the government at all levels encourage me to deal drugs. Doing so makes them all
my friends, and they all receive a cut of the profits.      

You can come to me for narcotics, tranquilizers, speed, sometimes even marijuana.  The best part of all this, is that if
you buy from me, it is completely legal and I am obligated by law to take care of you even if you never intend to pay.
My place of business is your local Emergency Department. I am your legal drug dealer. I am your physician. Here is
how it works:   

Plausible deniability – it’s not just for Presidents any more. Plausible deniability is the key that unlocks the
narcotics cabinet.    

You don’t want drugs for the fun of it. You are ill, very ill. You wish you didn't have to take drugs. You would do
anything you could to get off the pills, but without them, you would suffer terribly.  You need to complain of SEVERE
pain. You don’t need to actually have pain. That would be inconvenient. You are fortunate in the sense that other
people do actually have severe pain and no one can tell for sure if you are one of those people or not.  So just say
you have TERRIBLE pain.  Besides, doesn’t the fact that you really need narcotics, but don’t have them cause you a
great deal of “pain”?  No one, especially a doctor, wants to see you suffer.   

To ensure quick service, and to drive home the point that you are in EXCRUCIATING pain, call an ambulance to take
you to the hospital. Medicaid, Medicare or your private insurance will pay for it. Even if you have no insurance and no
way to pay, the ambulance will not refuse to take you. Others will pick up the tab for you. When you arrive at the
Emergency Department by ambulance, there is a good chance you will receive immediate care – no boring waste of
time in the waiting room. Those other sick people can wait. What else are they going to do anyway? They are sick.
You, on the other hand,have things to do and people to see - after you get your drugs, that is.

In the past few years, the government has become very involved in making sure that people complaining of pain are
satisfied. Hospitals that do not satisfy your complaint of pain can lose their government accreditation. That would
cause these hospitals to hemorrhage money. That is absolutely the worst type of hemorrhage that can happen in a
hospital. You can take full advantage of this situation. You have the RIGHT to have your complaint of pain fully

Of course you will need a reason for this pain. The best type of severe pain to say you have is a type that cannot be
disproved by any test. Migraine headaches, toothaches, and back pain are popular choices. Back pain is an
especially good choice because, if you complain about it enough, you can file for disability and quit working
while collecting narcotics and money for your complaint of pain. If you want, you can even use the money you collect
to buy more drugs!

If money is what you need, you can sell the drugs for more money. It works both ways! To hit the back pain trifecta,
claim that you injured your back at work.  Then you can collect Worker’s Compensation as well. (The downside to this
option, of course, is that you must have actually performed some real work at some time in the past.)  

It may worry you that you are costing society billions of dollars for unnecessary ambulance rides, medical tests,
hospital and doctor’s fees, and medications. It may worry you that this contribute significantly to the cost of health
insurance premiums. If all of this does worry you, you are in luck. You can use that anxiety to justify your request for
more drugs!  Xanax is a popular choice for anxiety. Valium, Ativan and Klonopin are also good.  

If these medications don’t relieve your anxiety about wasting society’s resources, you can rest assured that some
folks are making money from your “work”. Every ambulance ride and every patient visit,including visits by those who
are trying to score drugs, are a source of revenue for ambulance companies, doctors and hospitals. Every
prescription written for drugs is a source of revenue for drug companies and pharmacies. Doctors, hospitals,
pharmacies, and ambulance companies know that many people use complaints of pain as I have described above,
but as long as they are making money,your plausible deniability works for them too!   

“Dealing” with difficult physicians   

Many times, your doctor will give you whatever you want. Doing so makes their job easier and improves their patient
satisfaction scores. Such a course of action costs your doctor no money, and will probably make them more of it. On
some unfortunate occasions; however, you may encounter a doctor who knows the score. You may encounter some
unreasonable idealist who finds it important to him or herself to know that he/she is not facilitating your drug abuse
and possible addiction. Maybe, like me, they are just ornery and mean. Below are some useful techniques to use
when dealing with these“difficult physicians.”   

No alternatives   

Remember, you want the good stuff. Tell the doctors and nurses that you are allergic to Tylenol because of your liver
and all anti-inflammatory drugs because of your stomach. If they still try to give you something that is non-narcotic
“remember” that you are allergic to that too. At this point, many doctors will grow frustrated and ask you what it is that
you are not allergic to, or what you have had in the past that works. If this happens, avoid sounding like you are too
familiar with narcotics. You are just an innocent victim of INTOLERABLE pain.   

In such a situation, there is a fun and useful game you can play with your doctor. Let’s say you want a shot of
Demerol and a prescription for Dilaudid. Be coy, and say uh, um, it’s a D..something…... dimma,dumma, demma…Try
to see if the doctor will complete the sentence for you.  You “score” if he says Demerol or Dilaudid.  In a sort of end-
zone ritual, you exclaim in a jubilant, yet still painful manner, “Yes, that’s it! That always works!”   

Your ER doctor may ask you why your private doctor is not treating your painful condition.  You might reply that your
private doctor is treating you, but that your prescription was lost, or better yet, stolen.(The stolen option might elicit a
good sympathy Rx.)  Your private doctor can’t get you in for an appointment for another week or two,and won’t write
another prescription without an appointment.  

Ask the kind physician if he would just write a prescription for enough Dilaudid to cover you – enough to take two pills
every four hours for the next 2 weeks.  Another angle on the sympathy theme is to say that your private doctor was
treating you, but he no longer takes your insurance, or your insurance was cancelled, or you can’t afford insurance
because you lost your job, and can’t afford to pay cash. That’s why you came to the Emergency Department –
because you didn’t have to pay. If you want to keep it simple, just say that you are new in town, or from out of town,
or don’t have a private doctor.   


The middle of the night is the best time to go to the ER for drugs. Chances are, at that time of day, the ER doctor will
not be able to verify anything regarding your private doctor if you said you have one.  Weekends and holidays are
also good in this regard.  Another advantage of going to the ER in the middle of the night is that your doctor will be
tired and more likely to give you anything you want just to get you on your way.    

Patient satisfaction   

Public relations and patient satisfaction are exceedingly important to Emergency Departments. Hospitals hire Quality
Assurance Specialists and other patient advocates whose main function is to make sure your needs are satisfied.
Every patient who complains is a liability to the hospital and the insurance industry. Dissatisfied patients are more
likely to sue, and will complain to their insurance companies, medical boards and politicians.  If your “needs” for pain
medication are not satisfied, your hospital might find itself in violation of various public statutes and regulations
regarding patient’s rights with respect to pain management.  Even patients who cannot or do not pay are a liability if
their complaints generate bad publicity for the hospital.   

For the above reasons hospitals, insurance companies, and governments aggressively investigate patient
complaints. Medical personnel, including ER doctors, who are the subject of complaints,must defend their actions. If it
is necessary for the sake of public relations and patient satisfaction, medical personnel may, and often do, lose their

So insist that you get something for your pain. Tell them you need pills, but that won’t be enough right now. You want
a shot too.   

The nuclear option   

If the doctor continues to resist giving you what you want, state that you are refusing to leave the Emergency
Department until your “pain” is treated “appropriately, and then in a manner sweet as pie,ask to see someone from

The bottom line is that your insurance company or the government,or both, will pay your hospital when your doctor
gives you the drugs you want - even if you have no verifiable medical condition that requires you to take them. Truth
be told, no one but you can be absolutely certain about whether or not you have pain. This allows you to take full
advantage of the fact that many others suffer from real pain that very much needs care.     

While you are waiting to complain to administration, you might consider other legal sources of drugs:

Doctor’s offices: These are almost always pay to play and are rarely open nights and weekends. Your chances of
“scoring” all come down to the style of practice of the individual physician involved. Some will play, some won’t. The
upside is that if you can convince a private doctor of your “needs,” then you can get much lager prescriptions than
are typical for an ER visit, and get them on a recurring basis.

Urgent Care Centers , Walk-in Clinics, etc: Like doctor’s offices,these are typically pay to play, but they are more
likely to be open evenings and weekends, and less likely to say no if you can't afford to pay.

Pain clinics: Private pain clinics, while pay to play, can be a virtual Nirvana for those who can afford them. Once in,
you are likely to get large prescriptions for the strongest narcotics on a recurring basis –as long as your insurance
holds out anyway. While you are thinking of it, ask your ER doctor to refer you to a pain clinic. He is not likely to
refuse because he is hoping that it will keep you from returning to his ER.  Don’t let on that you do fully intend to
return to his ER. On the downside, a few pain clinics may try to force you to endure injections of non-narcotic
medicines or try non-narcotic pills. You may be required to attend boring classes on pain management or
participate in undesirable physical therapy which can, ironically, be painful in an exercise sort of way.

Public pain clinics usually limit themselves to Methadone.  They dispense only a few days worth of medicine at a time,
so frequent, time-consuming visits are necessary. The good news is that public pain clinics are inexpensive or free
and are very easy to get into. One only needs to state that they need the drugs.

Returning to your situation in the ER, you will be pleased to find that, by this time, nearly all of the “difficult”
physicians will have capitulated and initiated negotiations for peace. Now you will get the narcotics you came for.  

If you are unlucky enough to have encountered one of the few mean and ornery ER doctors, like me, who is still
holding out, you can always expand your "nuclear options."   

Ask the doctor why he is being so “rude” to you.  It was nothing he actually said, but his facial expressions and the
tone of his voice made you feel as if you were some sort of drug addict or something. Tell your doctor in a convincing
way that your cousin is a lawyer, and then tell him that in addition to complaining right now, you intend to, with your
cousin’s help, write a letter to the CEO of the hospital. To heighten the drama, ask your doctor to supply you with pen
and paper and then start writing the letter while he is in your room!    

At this point, even I would probably raise the white flag of surrender. There is plenty of hypocrisy in the “War on
Drugs” - some of it undoubtedly my own. If any ER doctors meaner than me exist, and are still holding out on you,
then they must be some sort of mutant species. Not to worry, though, the Hospital Administrator will soon arrive to
straighten them out.   

Congratulations! You have just scored your first legal hit. The advice above applies to narcotic pain medicine, which
is our most requested drug, but if your desire is for a different type of mind altering controlled substance, the same
techniques can be applied.

You need only to modify your complaint to fit the drug you intend to obtain. I have paired up other desirable drugs
with suggested complaints below:   

Other drugs

Amphetamines (AKA crank, speed):  You want to lose weight. You or your child (whose medicine you might
“share”) has Attention Deficit Disorder. You are a military pilot.

Benzodiazepines (AKA Xanax, Librium, Valium, etc): You have panic attacks. You have muscle spasms. You are
having a seizure (shake it up baby!). You can’t sleep. You have anxiety. You want to stop drinking and fear

Marijuana: This one only applies in certain states. You have glaucoma. You have severe nausea. You have pain
that responds to nothing else.

Barbiturates (tranquilizers): You have muscle spasms, or seizures, or alcohol withdrawal.

Cocaine: Sorry, no legal excuse for this one yet. Caught you looking though, didn’t  I?  Same goes for LSD and

Let me make a couple last suggestions. On the slim chance that you encountered a mean and ornery doctor during
your visit to the ER, try to note the make and model of his car in the ER doctor’s parking spot as you leave. Most
Emergency Departments are staffed by five or more physicians. You can greatly simplify future drug runs by avoiding
the ER when the ornery doctor’s car is parked there. And finally, hold onto your pill bottles. If you should somehow
come across some pills in a let’s say, less than legal manner, simply place them in your empty pill bottle of the same
type, (be careful not to exceed the number on the bottle,) and they instantly become “legal.”

Well, now that I have "spilled the beans" so to speak, its time for me to get back to work. No need to thank me. Thank
the patients who taught me all of this. In fact, if you are looking for drugs in the ED, I'd bet I didn't tell you anything
you don't already know. And if you decide to put this knowledge to work, look for my car in the ER doctor's parking
lot. If you see it, I'd advise you to go somewhere else. Remember, I'm one of the mean ornery ones.


Footnotes - for those lacking functioning satire detectors. (gawd I hate to have to do this)

1. The people I am referring to in this essay are not actually in pain, etc. That is the whole point.
2. This essay is a lament about a system that actually enables and in some way encourages this type of activity. It describes things that
are actually done every day in Emergency Departments across the country. It is an attempt to fight back against that.
3. not contact me and harangue me about how I don't care for people in pain or have written a how-to manual on how to illicitly
obtain drugs
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