Washington, DC – In a split 5-4 decision in the case of ‘These Two Dudes’ vs Purdue Pharmaceuticals, the US Supreme Court surprisingly overturned a lower court ruling and declared unconstitutional the administration, manufacture, and transport of hydromorphone, a.k.a Dilaudid. Experts had previously predicted that the court would uphold the lower court ruling. Writing for the majority, the suspected swing voting justice, Sonia Sotomayor, declared that “the constitution clearly states that potent IV narcotics such as hydromorphone should be given only in cases of severe cancer pain. Prevailing trends in medicine and patient satisfaction have made it such that pretty much anyone can get this drug for almost any pain condition. For the good of the country, this drug must be outlawed and other non-Dilaudid modalities of treating pain should be considered.”
In a minority dissenting opinion, Justice Antonin Scalia wrote, “Americans should have the freedom to receive any medication that doctors have felt to be indicated. Like for chronic back pain. I mean, who could imagine the practice of Medicine without Dilaudid? That sweet, sweet Dilaudid. I must go to the ED and get some right now! Wait, why am I writing this”?
The American College of Emergency Physicians (ACEP) has come out in opposition to this ruling stating that non-medically trained judges should not have the power to make medical treatment decisions by limiting physician’s therapeutic options. A spokesman commented off the record that ACEP’s view is that this ruling also impinges on the freedom of Emergency Physicians to get drug-seeking patients out of their ED quickly.
Furthermore, EDs everywhere have been force to scramble their resources and find some way to supply alternatives to Dilaudid. Some physicians are fearful that losing the ability to administer Dilaudid could make it exceptionally difficult to treat those who have extensive medication allergies, much of the time to “everything except Dilaudid.”
One emergency physician, who asked for anonymity, was concerned that when patients ask for “that medicine that starts with a ‘D’…..you know….Duh….Duh…..” that they would be unable to provide that medication. In turn, he was concerned that this could affect patient satisfaction and Press-Ganey scores. He went on to postulate that we should considering bringing back Demerol. “It would sort of answer that question. It’s not really ‘Duh-mer-ol’ but if you kind of slur the way you say it, it could work. Alternatively, while it might be fraudulent, you could sort of complete the phrase with ‘Duh-lahn-tin,’ ‘Duh-ksee-sahye-kleen,’ or ‘Duh-kso-roo-bih-suhn’ and give them that instead.”