b'She was diagnosed with Bipolar and Oppo- supply of two others. Shes not really sure sitional Defiant Disorder during herwhat those other pills are for, but hey, maybe rebellious adolescent years. In truth, sheshe can sell some of them on the street and was full of rage over the relentless abusespare herself a couple of dates, so shes not from her uncle. She is now 22 and regularlygoing to decline whatever they want to give consumes whatever illegal drug she can get.her. So she accepts the three bottles, rips off She doesnt want to feel what she feels.the labels, and a few days later, shes in When she cannot get the street drugs sheanother city and back to work. None of her prefers, she will misuse her medications, sohistory goes with her, and there is no one its important to her that she keep those pre- with medical oversight for all those plastic scriptions going. She now just had a badbottles of pills in the bottom of her purse.date, fraught with physical violence. Shes wounded, shes in pain, and she just wantsScenarios like this are all too common, so we out of the Life, at any cost. She presents infound it indispensable to put two measures in an emergency room and is carrying onplace. For one, we forged a close relationship about how shes bipolar and wants to harmwith a qualified pharmacist with whom we could herself. Shes not going to tell them aboutconfer. At intake we would list all the medication the dude in the car outside, her substancenames and dosages, along with pertinent but use history, or what other meds she maynonidentifiable information, for example: 22-have stockpiled. The overworked psychia- year-old female, 110 pounds. Sometimes there trist in the E.R. has only minutes with eachwould be no label on the bottle, so we learned to patient, and that brief encounter results inphotograph the pills as well. The pharmacist a refill of one prescription and a 30-daywould then review what we sent, simply on the 38 WWW.CITYGATENETWORK.ORG JANUARY/FEBRUARY 2024'