A Debate On Pain Medication Delivery

[oldfart]

I remember once we were in the hospital for some treatments for my son and we requested some Tylenol because he has some discomfort. The nurse went to go talk to the doc to see if we could get some and returned letting us know that the doc did not want him to take Tylenol because it might mask a fever. They were willing to give him some morphine though in its place.

Naturally I asked how we made the jump from Tylenol to morphine. There should be something a little less extreme. After leaving and coming back she had another solution – oxycodone. At that point we said we would just deal with it. He was uncomfortable, not in severe or even moderate pain and with the amounts of opiates and other very nasty drugs he has already been on there was little reason to pump him with some more without cause.

Unfortunately I don't think there is a non-opiod that is not an NSAID that would mask fever. For example, Fiorecet and Fiorinal work well on moderate pain containing butalbital, caffeine, and either aspirin or acetominaphen. But the last two are NSAIDs.

Maybe someone with a better grasp of pharmacology could help us here, but I can't think of one.

The care of the youth from birth to young adulthood is a field all of its own. I totally sympathize with the responsibility of those that as well as having to keep their own health issues in check must also supervise the handling of their offspring.

This is a thread concerning health issues of those of us that have not fallen in front of buses or taken chances ending our time here leaving us to fend off issues not from bad judgement but from the ravages of having outlived many that did not make all the right descisons along the way.

Stories about babies breath and his or her first asprin are cute as a bugs ear but seriously??? I would train my offspring to keep their eyes out for drunk drivers and point them out along the way at every opportunity if you want your kid to have a reasonable chance to make it to adulthood.

You formatted this post as a reply to mine, but I see absolutely no connection. Are you confusing posters or am I missing something?

FA_Q2 posted about an experience with his son, where an explanation was given that NSAIDs were not being used because they would mask fever, and an opiod was offered. My comment was that I was unaware of a pain medication that was not an opiod or NSAID, with an example. I asked if anyone knew of another class of drug that would be available in that situation. How this got to your last paragraph of hysterical diatribe totally escapes me.

 

[oldfart]

Fascinating stuff for sure.. With no pain medication I cannot reach to put on socks on my left foot. With 30 mg of morphine sulfate in my system I can just barely reach and put on socks.

Yoga and other similar exercises prescribed in the myriad of physical therapy assisted and un assisted is a futile "excercise" in torture for me. I don't know how many times I must say that my condition IS NOT GOING TO HEAL. Crushed and bulging discs do not miraculously repair themselves. Arthritically degenerated spinal sections do not magically regenerate bone tissue. Openings in the pelvic bone closing with calcium deposit do not etherically open wide for nerve passage.

Please stop attempting to insult my intelligence and make light of mine and others pain. Maybe a harsh criticism but after having gone through the whole gambit and having been a student and private practicioneer of meditation ..student of several martial arts schools including Kung Foo..Tai Chi ..Karate .. by some of the best sensais available since I was 17 I REALLY don't believe your suggestion has been overlooked. I am expert in beathing technique using color visualization to aid in decending to sleep. I could and have taught the subject.

You do not know how much time and discomfort I have invested in the above sort of prescription by some of the so called best physicians working in one of the best university medical staffs in the world.

I cannot function without EXTREME discomfort without the aid of pain killer. I can BARELY function with pain killer but the difference is HUGE in my life as it affects my sense of well being and mood. With grinding pain 24/7 I am not a happy camper. I am very angry all of the time and hate living that way. When I can aquire enough pain medication to "take the edge off" of the hell I normally endure my mood brightens up significantly and just the ability to put on a pair of socks is an uplifting experience.

Describing pain medication as "happy pills" is condecending and frankly highly insulting to the words I am putting out here about mine and others conditions.

Many of my friends are dealing with similar problems involving chronic pain.

As for your prescription..been there done that..please pass the pain medication ...thank you.

Thanks for stating so well what has to be said. I also deal with chronic pain issues as well as a few acute pain episodes. Thankfully I achieve reasonable pain control with diet, exercise, meditation, acetaminophen, a bunch of medication for stuff other than pain control, and occasional use of butalbital. There have been years when this was not sufficient, and I expect there will be times in the future when it will not be sufficient.

The sanctimonious attitude of many who have been deprecating you goes away when they have a loved one with intractable pain screaming for help in ending a pain-filled existence. It happens a lot. There is a reason ER workers have last friend understandings. They wouldn't be necessary except for the elitists who think that they have the right to make these decisions for the lesser folk who have to be protected from themselves. When the time comes for their spouse or child, I hope they remember the sanctimonious manure they dished out on this topic.

 

[HUGGY]

Unfortunately I don't think there is a non-opiod that is not an NSAID that would mask fever. For example, Fiorecet and Fiorinal work well on moderate pain containing butalbital, caffeine, and either aspirin or acetominaphen. But the last two are NSAIDs.

Maybe someone with a better grasp of pharmacology could help us here, but I can't think of one.

The care of the youth from birth to young adulthood is a field all of its own. I totally sympathize with the responsibility of those that as well as having to keep their own health issues in check must also supervise the handling of their offspring.

This is a thread concerning health issues of those of us that have not fallen in front of buses or taken chances ending our time here leaving us to fend off issues not from bad judgement but from the ravages of having outlived many that did not make all the right descisons along the way.

Stories about babies breath and his or her first asprin are cute as a bugs ear but seriously??? I would train my offspring to keep their eyes out for drunk drivers and point them out along the way at every opportunity if you want your kid to have a reasonable chance to make it to adulthood.

You formatted this post as a reply to mine, but I see absolutely no connection. Are you confusing posters or am I missing something?

FA_Q2 posted about an experience with his son, where an explanation was given that NSAIDs were not being used because they would mask fever, and an opiod was offered. My comment was that I was unaware of a pain medication that was not an opiod or NSAID, with an example. I asked if anyone knew of another class of drug that would be available in that situation. How this got to your last paragraph of hysterical diatribe totally escapes me.

Both...probably more his than yours.

 

[HUGGY]

Fascinating stuff for sure.. With no pain medication I cannot reach to put on socks on my left foot. With 30 mg of morphine sulfate in my system I can just barely reach and put on socks.

Yoga and other similar exercises prescribed in the myriad of physical therapy assisted and un assisted is a futile "excercise" in torture for me. I don't know how many times I must say that my condition IS NOT GOING TO HEAL. Crushed and bulging discs do not miraculously repair themselves. Arthritically degenerated spinal sections do not magically regenerate bone tissue. Openings in the pelvic bone closing with calcium deposit do not etherically open wide for nerve passage.

Please stop attempting to insult my intelligence and make light of mine and others pain. Maybe a harsh criticism but after having gone through the whole gambit and having been a student and private practicioneer of meditation ..student of several martial arts schools including Kung Foo..Tai Chi ..Karate .. by some of the best sensais available since I was 17 I REALLY don't believe your suggestion has been overlooked. I am expert in beathing technique using color visualization to aid in decending to sleep. I could and have taught the subject.

You do not know how much time and discomfort I have invested in the above sort of prescription by some of the so called best physicians working in one of the best university medical staffs in the world.

I cannot function without EXTREME discomfort without the aid of pain killer. I can BARELY function with pain killer but the difference is HUGE in my life as it affects my sense of well being and mood. With grinding pain 24/7 I am not a happy camper. I am very angry all of the time and hate living that way. When I can aquire enough pain medication to "take the edge off" of the hell I normally endure my mood brightens up significantly and just the ability to put on a pair of socks is an uplifting experience.

Describing pain medication as "happy pills" is condecending and frankly highly insulting to the words I am putting out here about mine and others conditions.

Many of my friends are dealing with similar problems involving chronic pain.

As for your prescription..been there done that..please pass the pain medication ...thank you.

Thanks for stating so well what has to be said. I also deal with chronic pain issues as well as a few acute pain episodes. Thankfully I achieve reasonable pain control with diet, exercise, meditation, acetaminophen, a bunch of medication for stuff other than pain control, and occasional use of butalbital. There have been years when this was not sufficient, and I expect there will be times in the future when it will not be sufficient.

The sanctimonious attitude of many who have been deprecating you goes away when they have a loved one with intractable pain screaming for help in ending a pain-filled existence. It happens a lot. There is a reason ER workers have last friend understandings. They wouldn't be necessary except for the elitists who think that they have the right to make these decisions for the lesser folk who have to be protected from themselves. When the time comes for their spouse or child, I hope they remember the sanctimonious manure they dished out on this topic.

I'm not going away any time soon..

I just don't want the next twenty or so years to be uneccesarily unbearable. There is still much I would like to accomplish. Frozen with pain there is no way I can do much at all. It may take a while to turn back the tide to a more reasonable mindset from within the medical comunity and some Congressional push back towards the Nazis at the DEA but that is all I have ..so be it.

All this talk of secret pacts is spooky !!!

 

[HUGGY]

Unfortunately I don't think there is a non-opiod that is not an NSAID that would mask fever. For example, Fiorecet and Fiorinal work well on moderate pain containing butalbital, caffeine, and either aspirin or acetominaphen. But the last two are NSAIDs.

Maybe someone with a better grasp of pharmacology could help us here, but I can't think of one.

The care of the youth from birth to young adulthood is a field all of its own. I totally sympathize with the responsibility of those that as well as having to keep their own health issues in check must also supervise the handling of their offspring.

This is a thread concerning health issues of those of us that have not fallen in front of buses or taken chances ending our time here leaving us to fend off issues not from bad judgement but from the ravages of having outlived many that did not make all the right descisons along the way.

Stories about babies breath and his or her first asprin are cute as a bugs ear but seriously??? I would train my offspring to keep their eyes out for drunk drivers and point them out along the way at every opportunity if you want your kid to have a reasonable chance to make it to adulthood.

Except my story was not of babies first aspirin nor is it cute. It is fucking tragic. It was about struggles that we have had with leukemia and the related years of treatments that he went through.

Do you really think that the doctor was offering morphine because of a bruise? Think Huggy - being old is not the sole cause of serious pain.

It is clear that there will be some rubbing fur the wrong way with a subject that encompasses so much mental as well as physical anguish.

I have no intention or desire to make light of anyone's or their childs pain. I hope you can see as a sort of moderator(unnofficial) of this thread attempting to reach a specific goal of enlightenment that somehow transforms to action that I have to steer the topic towards my goals which I hope will help all who feel that there are problems with the delivery of pain medication in our country.

 

[HUGGY]

"
FDA Action on Vicodin May Mean More Pain, Not Less Addiction or Overdose

Stricter rules for prescribing opioids may not be the only answer to curbing addiction to painkillers"

FDA Action on Vicodin May Mean More Pain, Not Less Addiction or Overdose | TIME.com

 

[Tresha91203]

My mother has chronic pain. She has been given more diagnosis than I can count and all of them have been best guesses. All they know for sure is that her spinal column contracts, pinching the nerves running through it. She requires surgeries to put stints in to try to keep it open. There have been 3 of those over a dozen years. Currently, we are trying to avoid the next one, as it should be in the neck, requiring 2 stages, front and back. The chance of paralysis is alarming.

She's tried everything: physical therapy (helps to keep as much range of motion as possible), accupuncture (no effect), meditation (no effect), prolotherapy (very painful procedures every 6 weeks with moderate success for a few weeks after, until that doctor said that was all he could do), a spinal implant that makes her vibrate to distract the mind from the pain (she is very happy with that, as she was able to reduce her pain med dosage by half), and now some weird doc that is teaching her to "chase the pain" to one central place (so far, so good, some success and she is optimistic).

Before the stimulator implant, she was on a patch med (phentanyl duragisic sp?) and still needed "breakthrough" oral meds daily. She is thrilled to be off that, as she could not even read on that stuff. Even after all that, even with the successful non narcotic stimulator implant, she is on a main pain med and breakthrough meds. She gets so excited during the good periods when she can reduce, and gets so depressed when the column gets too tight (indicating it is time for another surgery) and she has to go up on the meds. She will never be off those meds. All her doctors tell her that. There is no cure. It is not fatal, just chronic. Addiction is not even an issue, as there is zero chance of any quality of life without those meds.

Her pain is very real. Her movement is limited, but she can function well enough if the pain is managed. She's been through emotional hell, and I had to put her on a 72 hour hold 20 years ago when she found out this was permanent and progressive. Thankfully, she stayed 30 days and got the help she needed to process that. Still, she has to go on antidepressants every so often when it gets too overwhelming. After finding her on the bathroom floor in the fetal position and discovering she had been there about 36 hours, we've moved her into a cottage behind our house. At times her life is good and she enjoys her grandchild. At times, her life is hell and she has to wait it out ... days to months. I don't know how she does it, honestly. I know I couldn't.

Fortunately, she has great doctors, including her pain management doc. I thank God for her team, and I thank God for Avinza and Roxycodone. Without them, she would have stroked out or suicided long before her grandchild was born.

 

[FA_Q2]

The care of the youth from birth to young adulthood is a field all of its own. I totally sympathize with the responsibility of those that as well as having to keep their own health issues in check must also supervise the handling of their offspring.

This is a thread concerning health issues of those of us that have not fallen in front of buses or taken chances ending our time here leaving us to fend off issues not from bad judgement but from the ravages of having outlived many that did not make all the right descisons along the way.

Stories about babies breath and his or her first asprin are cute as a bugs ear but seriously??? I would train my offspring to keep their eyes out for drunk drivers and point them out along the way at every opportunity if you want your kid to have a reasonable chance to make it to adulthood.

Except my story was not of babies first aspirin nor is it cute. It is fucking tragic. It was about struggles that we have had with leukemia and the related years of treatments that he went through.

Do you really think that the doctor was offering morphine because of a bruise? Think Huggy - being old is not the sole cause of serious pain.

It is clear that there will be some rubbing fur the wrong way with a subject that encompasses so much mental as well as physical anguish.

I have no intention or desire to make light of anyone's or their childs pain. I hope you can see as a sort of moderator(unnofficial) of this thread attempting to reach a specific goal of enlightenment that somehow transforms to action that I have to steer the topic towards my goals which I hope will help all who feel that there are problems with the delivery of pain medication in our country.

And my comments were on that topic. You seemed to be dismissing the points because they were about a child and not someone that was old. You can steer as you wish but I am going to call you out if I think your statements are dismissing others pain just because they are happening to the young as well.

Pain medication for chronic illness is NOT a problem confined to your situation nor is that type of pain. It affects everyone. Your last statements certainly seemed as if you were making that connection.

 

[HUGGY]

Except my story was not of babies first aspirin nor is it cute. It is fucking tragic. It was about struggles that we have had with leukemia and the related years of treatments that he went through.

Do you really think that the doctor was offering morphine because of a bruise? Think Huggy - being old is not the sole cause of serious pain.

It is clear that there will be some rubbing fur the wrong way with a subject that encompasses so much mental as well as physical anguish.

I have no intention or desire to make light of anyone's or their childs pain. I hope you can see as a sort of moderator(unnofficial) of this thread attempting to reach a specific goal of enlightenment that somehow transforms to action that I have to steer the topic towards my goals which I hope will help all who feel that there are problems with the delivery of pain medication in our country.

And my comments were on that topic. You seemed to be dismissing the points because they were about a child and not someone that was old. You can steer as you wish but I am going to call you out if I think your statements are dismissing others pain just because they are happening to the young as well.

Pain medication for chronic illness is NOT a problem confined to your situation nor is that type of pain. It affects everyone. Your last statements certainly seemed as if you were making that connection.

The title of the thread is pretty clear as to the direction I hope the debate and interest travels. For me and those closest to me that share the same lack of care from the mecical community when it comes to chronic pain the focus is what we know is wrong and what needs corrected.

That doesn't EXCLUDE young people but it is somewhat different in that the child or teen has the parents or parent or SOMEBODY interveining on their behalf. The addition of an advocate changes the dynamics somewhat. My experience with my primary care giver is somewhat different than what a child with parent gets. My doctor acts friendly but looks at my chart and tells me that I am not a "good" candidate for opiods. I ask why and reluctantly he confides that there are several red flags in my history that suggest I would fail as a patient. One flag is that I smoke.. Another is that due to my lack of money to go to a dentist my teeth are in bad shape...several are missing.... drug addicts typically have bad teeth...I live and work in an area that is heavely populated by people that abuse drugs and themselves. There are others he wouldn't talk about but upon pressing..The head doctor at the U of W pain mnagement clinic tried physical therapy..cortezone injections in my hip..several mood altering drugs.. After 6 months told me that they don't prescribe opiates to anyone that isn't dying from cancer or AIDS. The State board had decided to highly restrict those prescriptions and she wasn't going to risk her liscence with helping me in that way. That is a huge red flag in that she had made a determination that very few doctors would or could change. The next attempt at a managed pain clinic was at the Swedish Hospital and I was 5 minutes late for my first appointment and sent away ..second appointment the doctor looked at my history and told me within two minutes that if I expected to get any pain pills don't bother us. I wasn't even examined or questioned.

That was over a year ago and discovered several friends treated in a similar manner.

SO.. if you or your child has suffered with bad to horrible pain medication delivery bring it on. I don't want to vent to anyone about my personal pain. I really don't want to hear about the pain at all. It is extremely depressing. But I will if it leads to stories that include poor medical delivery of pain medication. What I do want to hear about is stories of how the system has failed so I can eventually contact some elected officials and let then know what needs changed.

 

[HUGGY]

Why are patients shut out of the debate over prescription pain medicine?


Why are patients shut out of the debate over prescription pain medicine?

 

[Boatswain2PA]

Unfortunately I don't think there is a non-opiod that is not an NSAID that would mask fever. For example, Fiorecet and Fiorinal work well on moderate pain containing butalbital, caffeine, and either aspirin or acetominaphen. But the last two are NSAIDs.

Maybe someone with a better grasp of pharmacology could help us here, but I can't think of one.

The care of the youth from birth to young adulthood is a field all of its own. I totally sympathize with the responsibility of those that as well as having to keep their own health issues in check must also supervise the handling of their offspring.

This is a thread concerning health issues of those of us that have not fallen in front of buses or taken chances ending our time here leaving us to fend off issues not from bad judgement but from the ravages of having outlived many that did not make all the right descisons along the way.

Stories about babies breath and his or her first asprin are cute as a bugs ear but seriously??? I would train my offspring to keep their eyes out for drunk drivers and point them out along the way at every opportunity if you want your kid to have a reasonable chance to make it to adulthood.

You formatted this post as a reply to mine, but I see absolutely no connection. Are you confusing posters or am I missing something?

FA_Q2 posted about an experience with his son, where an explanation was given that NSAIDs were not being used because they would mask fever, and an opiod was offered. My comment was that I was unaware of a pain medication that was not an opiod or NSAID, with an example. I asked if anyone knew of another class of drug that would be available in that situation. How this got to your last paragraph of hysterical diatribe totally escapes me.

It appears FA Q2's son has leukemia. I don't know what kind, but I can certainly see a situation where his physician would want to know ASAP if he developed a fever (an indication of a systemic infection), and would not want that masked by acetaminophen or an NSAID.

 

[Boatswain2PA]

I practice emergency medicine, which is likely on the "front lines" of the four-way battle between the "drug seekers" (ie: those abusing narcotics), the chronic pain patients, the acute pain patients, and the providers. Add in the government, and their pursuit of providers and patients, and you have a five-way battle.

Lots of good points made here. Chronic pain sucks. I had a patient a few months ago with the chronic regional pain syndrome and it was almost as bad for me as it was for her (no, not really...but it was bad for me) because there was virtually nothing I could do for her other than just sedating her.

Here is my advice for those who suffer from chronic pain: Find a PRIMARY PROVIDER to manager ALL of your pain medications. There is nothing like using an opioid (Dilaudid, morphine, oxy, hydro, etc) to trigger the mu-receptors in your body to dull pain. It's the best we have. But unfortunately it causes dependency. Every chronic pain patient needs to have ONE primary provider to manage ALL of their pain medicines, sign that pain contract with them that allows that provider to give you a LOT of opioids in exchange for ensuring you do not get other opioids from another provider.

If you have a pain contract, and you come into my ED with a broken bone (or other acute injury), tell me you have a pain contract, and I give you extra opioids... then your primary provider will understand. Better yet, I will understand that I have to give you a lot MORE opioids to treat your acute (on chronic) pain. However, if you come into my ED with a toothache, headache, back pain, or excacerbation of your chronic pain and you receive opioids, then you will be in a world of trouble because you have voided your pain contract and you will be dropped by that provider.

Bottom line: Work with your Doc or PA to find a way to meet your needs. If you are concerned about addiction, talk to them. If you are not getting enough pain relief, then talk to them.

 

[specklebang]

I suffer from severe arthritis, particularly in my hands. The pain is blinding, I am in so much agony that I can't focus on anything else.

I could probably resolve this with surgery. The problem is that I'll only have one hand to function with for 10 weeks post-surgery.

So, I decided to go on pain medication. I'm thoroughly dependent, I go into detox if I don't take enough. I'm currently taking 8 mg. of dilaudid daily. I expect to be on these medications for the rest of my life.

So, this would be a frightening decision if I were not 70 years old. What if I were 20? I really don't know what I would do.

I follow the rules, I take my 8 mg. or slightly less, never more. I learned the hard way to be sure to save at least .5 mg. to take near bed-time. I tried cutting myself off at 6 PM but I would wake up sick, and literally stagger to the medicine cabinet. So, at around 11 PM I take that last little dose even if my pain level is low and I wake up feeling OK.

Unfortunately, there is no ER version of Dilaudid and even if there was, it costs 10 times as much for ER versions. I can buy 30 mg. Oxycodone for less than $1 but the ER version, Oxycontin, is $11.

Since I don't get "high" or dysfunctional from these medications, I don't understand why there is so much negative press and DEA meddling.

 

[Tresha91203]

I suffer from severe arthritis, particularly in my hands. The pain is blinding, I am in so much agony that I can't focus on anything else.

I could probably resolve this with surgery. The problem is that I'll only have one hand to function with for 10 weeks post-surgery.

So, I decided to go on pain medication. I'm thoroughly dependent, I go into detox if I don't take enough. I'm currently taking 8 mg. of dilaudid daily. I expect to be on these medications for the rest of my life.

So, this would be a frightening decision if I were not 70 years old. What if I were 20? I really don't know what I would do.

I follow the rules, I take my 8 mg. or slightly less, never more. I learned the hard way to be sure to save at least .5 mg. to take near bed-time. I tried cutting myself off at 6 PM but I would wake up sick, and literally stagger to the medicine cabinet. So, at around 11 PM I take that last little dose even if my pain level is low and I wake up feeling OK.

Unfortunately, there is no ER version of Dilaudid and even if there was, it costs 10 times as much for ER versions. I can buy 30 mg. Oxycodone for less than $1 but the ER version, Oxycontin, is $11.

Since I don't get "high" or dysfunctional from these medications, I don't understand why there is so much negative press and DEA meddling.

~hugs~ Many people don't understand until it is their loved one. Quality of life is paramount, IMO. Much better to do as you do than to wait for the pain to be too great, then you have to take twice as much to conquer it once it takes hold.

 

[RosieS]

I practice emergency medicine, which is likely on the "front lines" of the four-way battle between the "drug seekers" (ie: those abusing narcotics), the chronic pain patients, the acute pain patients, and the providers. Add in the government, and their pursuit of providers and patients, and you have a five-way battle.

Lots of good points made here. Chronic pain sucks. I had a patient a few months ago with the chronic regional pain syndrome and it was almost as bad for me as it was for her (no, not really...but it was bad for me) because there was virtually nothing I could do for her other than just sedating her.

Here is my advice for those who suffer from chronic pain: Find a PRIMARY PROVIDER to manager ALL of your pain medications. There is nothing like using an opioid (Dilaudid, morphine, oxy, hydro, etc) to trigger the mu-receptors in your body to dull pain. It's the best we have. But unfortunately it causes dependency. Every chronic pain patient needs to have ONE primary provider to manage ALL of their pain medicines, sign that pain contract with them that allows that provider to give you a LOT of opioids in exchange for ensuring you do not get other opioids from another provider.

If you have a pain contract, and you come into my ED with a broken bone (or other acute injury), tell me you have a pain contract, and I give you extra opioids... then your primary provider will understand. Better yet, I will understand that I have to give you a lot MORE opioids to treat your acute (on chronic) pain. However, if you come into my ED with a toothache, headache, back pain, or excacerbation of your chronic pain and you receive opioids, then you will be in a world of trouble because you have voided your pain contract and you will be dropped by that provider.

Bottom line: Work with your Doc or PA to find a way to meet your needs. If you are concerned about addiction, talk to them. If you are not getting enough pain relief, then talk to them.

There is a difference that is major. Hospitals MUST adequately treat pain or their accreditation is at risk.

Primary care providers can do whatever they want.

Pain contracts are for the benefit of the doctor. If a chronic pain patient of theirs is not being drug seeking or otherwise a pain in the neck, primary care providers do whatever they should no matter what the contract says.

I have been on opioid medicine for 17 years. My doctors that treat pain treat my pain meds the same as my GERD med and my cholesterol med, etc. I get as much as I need when I need it.

The problem comes when moving. Who knew a rheumatologist would not prescribe pain meds. Are you kidding? So my primary writes it, no contract, in exchange for a monthly appointment.

It is all about doing the right thing - by all parties involved.

Regards from Rosie

 

[HUGGY]

I suffer from severe arthritis, particularly in my hands. The pain is blinding, I am in so much agony that I can't focus on anything else.

I could probably resolve this with surgery. The problem is that I'll only have one hand to function with for 10 weeks post-surgery.

So, I decided to go on pain medication. I'm thoroughly dependent, I go into detox if I don't take enough. I'm currently taking 8 mg. of dilaudid daily. I expect to be on these medications for the rest of my life.

So, this would be a frightening decision if I were not 70 years old. What if I were 20? I really don't know what I would do.

I follow the rules, I take my 8 mg. or slightly less, never more. I learned the hard way to be sure to save at least .5 mg. to take near bed-time. I tried cutting myself off at 6 PM but I would wake up sick, and literally stagger to the medicine cabinet. So, at around 11 PM I take that last little dose even if my pain level is low and I wake up feeling OK.

Unfortunately, there is no ER version of Dilaudid and even if there was, it costs 10 times as much for ER versions. I can buy 30 mg. Oxycodone for less than $1 but the ER version, Oxycontin, is $11.

Since I don't get "high" or dysfunctional from these medications, I don't understand why there is so much negative press and DEA meddling.

I find it interesting how different pain medication effects are in any two patients.. I wouldn't even feel the effects of an 8 mg delaudid. When I am fortunate enough to run accross pain meds from friends that take pity on my condition I have taken recently 30 mg morphine sulfate extended release. I have to take two of those in a 4 hr time frame before I can walk upright and not have to hang on to something like a chair with wheels to keep balance. One might think reading your post that I would be "stoned" out of my mind. Not so. I think clearly. Even after 60 mg of the morphine I STILL have a lot of pain and maybe that is what keeps my brain functioning at a high level. From what you described a dose that doesn't even take away half my pain would probably be fatal to someone like yourself. Therein lies the most recent EXCUSE coming from the DEA..and that is that far too many children and young adults steal pain meds from thier parents and relatives and end up ODing and dying.

 

[Katzndogz]

Drug addicts have abused necessary medications so much that the ones most hurt are non drug addicts. If addicts can't get their fix no one will get medication they really need.

 

[FA_Q2]

Well, as this thread has been revived, a neighbor of mine just ran into this problem as well. He is a war vet and has been ‘blown up’ in his convoy over a dozen times. Quite obviously this has caused some permanent and painful side effects that require a rather constant dose of pain meds to control. The really sad part is that he had to switch providers and that led to a gap in his treatment cycle where he was off medication entirely. Normal people would not see this as a problem – just get more meds when he can but when he went to the doctor he was outright refused. The reason, because there WERE NO DRUGS IN HIS SYSTEM when they administered the urine test. Because HE WAS CLEAN! If that is not the most asinine statement that I have ever heard.

The supposition was that he might be selling the pills. The gap in treatment was documented and the reason known but yet the doc did not care. He wasn’t shy about it either – he came right out and told him that he was not going to risk his medical license to help him. NOT. GOING. TO. RISK. HIS. LICENSE!

As though that should ever even be in question. It is bad when the instance and cause is well documented and it STILL leads to a doctor running scared from his job. The government is getting out of hand.

Now, he did have a medical pain contract and I am not sure why this didn’t play a factor – possibly because the risk was selling and not seeking to abuse. He is currently demanding a new doctor through the VA and using the doctor’s statements as a claim of no faith in the ability and intent of the doctor to actually treat his conditions. I am not so sure that this will work though. While I am NOT getting into the ACA or anything like that here I can attest to one of the drawbacks to a socialized medical system like the military has with us – appealing a decision is sometimes completely pointless because they have ultimate power to say no and discard you completely. It has happened many times to me and others I know caught up in the terrible system that is our primary means of care. I only hope that he ends up with a reasonable person that has compassion for his circumstances in this case or he might not get any of the medication that he sacrificed body parts to get.

 

[HUGGY]

Well, as this thread has been revived, a neighbor of mine just ran into this problem as well. He is a war vet and has been ‘blown up’ in his convoy over a dozen times. Quite obviously this has caused some permanent and painful side effects that require a rather constant dose of pain meds to control. The really sad part is that he had to switch providers and that led to a gap in his treatment cycle where he was off medication entirely. Normal people would not see this as a problem – just get more meds when he can but when he went to the doctor he was outright refused. The reason, because there WERE NO DRUGS IN HIS SYSTEM when they administered the urine test. Because HE WAS CLEAN! If that is not the most asinine statement that I have ever heard.

The supposition was that he might be selling the pills. The gap in treatment was documented and the reason known but yet the doc did not care. He wasn’t shy about it either – he came right out and told him that he was not going to risk his medical license to help him. NOT. GOING. TO. RISK. HIS. LICENSE!

As though that should ever even be in question. It is bad when the instance and cause is well documented and it STILL leads to a doctor running scared from his job. The government is getting out of hand.

Now, he did have a medical pain contract and I am not sure why this didn’t play a factor – possibly because the risk was selling and not seeking to abuse. He is currently demanding a new doctor through the VA and using the doctor’s statements as a claim of no faith in the ability and intent of the doctor to actually treat his conditions. I am not so sure that this will work though. While I am NOT getting into the ACA or anything like that here I can attest to one of the drawbacks to a socialized medical system like the military has with us – appealing a decision is sometimes completely pointless because they have ultimate power to say no and discard you completely. It has happened many times to me and others I know caught up in the terrible system that is our primary means of care. I only hope that he ends up with a reasonable person that has compassion for his circumstances in this case or he might not get any of the medication that he sacrificed body parts to get.

I'm no expert on the subject but it seems to me the above described patient should engage an attourney and sue or threaten to sue through the lawyer the doctor and the facility in question for dereliction of duty and for causing or prolonging the patients pain.

The reason I would sue is that no one illegally selling the pills would do that just so they could make 5-10 dollars a pill. Selling a hundred pills for $5 each would certainly not be enough to make it worth it to sue anyone.

It COULD be possible to sell enough pills to make enough money to make the risk worth it...but that would mean selling THOUSANDS of dollars worth every month. One would need to sell several hundred pills a month to make a living at it. If the patient had legitimate pain that would leave precious few pills to sell. No one is going to risk losing their pain prescription source to make just a few hundred dollars a month...and be ass out controlling their own pain.

I would sue their asses off.

 

[FA_Q2]

Well, as this thread has been revived, a neighbor of mine just ran into this problem as well. He is a war vet and has been ‘blown up’ in his convoy over a dozen times. Quite obviously this has caused some permanent and painful side effects that require a rather constant dose of pain meds to control. The really sad part is that he had to switch providers and that led to a gap in his treatment cycle where he was off medication entirely. Normal people would not see this as a problem – just get more meds when he can but when he went to the doctor he was outright refused. The reason, because there WERE NO DRUGS IN HIS SYSTEM when they administered the urine test. Because HE WAS CLEAN! If that is not the most asinine statement that I have ever heard.

The supposition was that he might be selling the pills. The gap in treatment was documented and the reason known but yet the doc did not care. He wasn’t shy about it either – he came right out and told him that he was not going to risk his medical license to help him. NOT. GOING. TO. RISK. HIS. LICENSE!

As though that should ever even be in question. It is bad when the instance and cause is well documented and it STILL leads to a doctor running scared from his job. The government is getting out of hand.

Now, he did have a medical pain contract and I am not sure why this didn’t play a factor – possibly because the risk was selling and not seeking to abuse. He is currently demanding a new doctor through the VA and using the doctor’s statements as a claim of no faith in the ability and intent of the doctor to actually treat his conditions. I am not so sure that this will work though. While I am NOT getting into the ACA or anything like that here I can attest to one of the drawbacks to a socialized medical system like the military has with us – appealing a decision is sometimes completely pointless because they have ultimate power to say no and discard you completely. It has happened many times to me and others I know caught up in the terrible system that is our primary means of care. I only hope that he ends up with a reasonable person that has compassion for his circumstances in this case or he might not get any of the medication that he sacrificed body parts to get.

I'm no expert on the subject but it seems to me the above described patient should engage an attourney and sue or threaten to sue through the lawyer the doctor and the facility in question for dereliction of duty and for causing or prolonging the patients pain.

The reason I would sue is that no one illegally selling the pills would do that just so they could make 5-10 dollars a pill. Selling a hundred pills for $5 each would certainly not be enough to make it worth it to sue anyone.

It COULD be possible to sell enough pills to make enough money to make the risk worth it...but that would mean selling THOUSANDS of dollars worth every month. One would need to sell several hundred pills a month to make a living at it. If the patient had legitimate pain that would leave precious few pills to sell. No one is going to risk losing their pain prescription source to make just a few hundred dollars a month...and be ass out controlling their own pain.

I would sue their asses off.

In most instances, you cant. That socialized medicine again. This might be a little different dealing with the VA but in general, a uniformed or retired member cannot sue the government for anything related to duty or those executing it under that banner. It is a side effect of having the government administer the care. Everything is virtually free but your recourse when you are not pleased with services are diminished.

Further, this sounds very similar to the stories that you have been putting up as well - the doc fears governmental reprisal for actually helping the patient. that makes me believe that there is something from the regulators that he is falling back on. It is pathetic and sad. The government does not belong in between you and your doctor to combat drug abuse. The very idea is silly.