I guess this is sorta on-topic, sorta off-topic. And if I've posted it before, please forgive the repeat.
I get very upset when I hear about addicts or criminals who illegally obtain prescription pain-killers because I feel like each time that happens, that's one more reason that legislators will make access harder for people who really need them. I know Oxycontin abuse has made many drs reluctant to prescribe it and that the possibility of legal repercussions has made it even worse. So I take it very personally when these crimes happen because I feel that when I need a stronger pain-killer in the future, it might not be available due to people like these.
The reason I bring this up today is that hubby and I ended up in a fight this morning. He was ranting about how people could possibly still buy Martha Stewart merchandise knowing that she broke the law and got off easy. I asked him how that was any different than him wanting to go see Rob Grill in concert (he's a singer with the Grass Roots in the 60's) when Rob was arrested this past spring for doctor-shopping for oxycontin. Now I don't know Rob Grill personally, and I've not walked a mile in his shoes, but....
Hubby tried to tell me that Rob Grill has terrible problems with his hip and he needed the meds for pain. I argue that if he's in that much pain, he shouldn't be working, much less touring the country and performing on stage. I read this morning that he obtained 490 doses of oxycodone in a 60-day period. If he in fact took all that medicine during that time, that would be 8.2 doses of oxy a day, every day. What was even more astounding to me is that Rob is now supposedly on only aspirin. If he really had such a strong medical need for that level of pain killers, how can he be only on aspirin and still touring?
Rob had earlier said something to the effect that this was like "stealing a few apples when your family is starving". Except it was him not his family, he doesn't appear to have been "starving", and it isn't illegal to eat bushels of apples.
If he really did have a need for that much pain relief and wasn't getting the meds he needed, I would feel very badly for him, but that doesn't seem to be the case from what I can see.
Thoughts, anyone?
This whole anti-opiate fervor (brainwashing, really) causes real suffering. My stepmother is dying of cancer. She won't take opiates; she doesn't want to get "high" or get addicted. She was offered synthetic THC (Marinol?) for nausea and vomiting from chemotherapy; she refused that too, saying it was immoral. So, she sits dying on the couch, suffering from intense pain and nausea.So I am no expert in any area about this story, but couldn't a doc have prescribed him something? And that does sound like a lot, 8.2 doses of oxycodone in a day?
JasmineRain - sorry to hear about your stepmother. That must be hard to see happen.
I've seen families resort to giving opiates to their elderly parents under the guise of vitamins or another med. It's really sad to see this anti opiate mentality, especially among the elderly who can be made so much more comfortable in the final stages by a few pills a day.
Until recently physicians have helped promote this mentality. I've seen doctors refuse to write scripts for opiates and their deriviates even though the person was in pain and already dying. Then you have the legal system, the FDA, and the pill cops all trying to crack down on illiegall use of opiates and it has turned into a pill circus.
I think with the coming of the baby boomers that there will be some changes made. The upcoming boomers want it all and that includes the latest and greatest medical treatment and the use of narcotics for pain control. The boomers are going to have high rates of arthritis related diseases due to their early jock years and are going to demand pain control in their later years. This boomer generation is the largest one in history and will be changing the face of medical treatment and care for the better. It's already started with newer style clinics, holistic care available to the masses, more pallative care available for the end stage of life, hospitals paying for students to attend nursing school, and many other changes.
This to shall pass; I see the political pundit's fat fingers stirring the pill pot. Soon they'll tire of this and go onto something else. Lindy
And another thing... I love the fools who say they wish they had RA so they could have a constant supply of Vicodin. Morons. My "constant" supply of Vicodin is a 60-tablet script every three or four months. Hardly enough to satisfy the cravings of an addict.
That is so true Jasmine I really liked that thanks for the laugh
since our bodies take on this intense pain over time. If anyone could
feel the full affects of a flare for 10 minutes they would never say
such a stupid thing again. Hope everybody has painfree day.
Well, I'm on my way to a pain-free day; three days of bedrest have left me with a strained neck (I tend to roam around the bed and twist up like a pretzel when I sleep). I just popped a couple of Vicodin, and when it kicks in I'm going to tackle the mess left behind by three days of boys running wild in the house with no rules. I am the enforcer... my oldest one says that MOM stands for "Mean Old Mom".Jasmine, so sorry about your stepmother. I think you're right to call it brainwashing. It's bad enough when we are suffering, but to watch those we love suffer, I think is worse.
I think is Lindy is right about the changes to come, but then again, recent studies showing the explosion of prescription pain killer abuse is fueling fire on the other side. I'm really afraid. I know that even if I find the best treatments for all my conditions, it is still very likely I will have some level of pain for the rest of my life, and I want to be sure I can get some relief for that.
[QUOTE=InnerGlow]Jasmine, so sorry about your stepmother. I think you're right to call it brainwashing. It's bad enough when we are suffering, but to watch those we love suffer, I think is worse.
I think is Lindy is right about the changes to come, but then again, recent studies showing the explosion of prescription pain killer abuse is fueling fire on the other side. I'm really afraid. I know that even if I find the best treatments for all my conditions, it is still very likely I will have some level of pain for the rest of my life, and I want to be sure I can get some relief for that.
[/QUOTE]Jasmine, I have a stash also. I take Tramadol on the days that I'm not so bad and it cuts the number of Lortab that I need. I usually try and wait 24 hours between the Lortab and Tramadol - make sure I'm not overloading myself with 2 different pain killers. I've been off Lortab for as much as 3 days and have had no signs of dependency. Neither one of my doctors have a problem with prescribing because they know that I don't abuse the drugs. When I have to take more than the prescribed dose I make an appt. to see my primary care and let him know what's going on and why I've had to increase the dose. He notes it and I've never had a problem with a refill.
Lortabs make me a little more hyper and talkative and Tramadol makes me dull and dizzy. Can't take Tylenol but Lyrica has really helped with the pain levels and I've had to use much less pain medication since starting Lyrica. Lindy
I guess I just do not understand what all the fuss is about people needingSociety in general and the pill cops are the ones causing more problems than the pill seeking addicts.
Lori, like you said I think they cause more problems for the hospitals, nursing staff, and doctors. I personally don't care if they seek medication.
When I was nursing I never expected to make a difference in a pill seeking addict's life. To them, I just stood between them and their next pill. Like you, I didn't want them to die on my shift.
I've seen the same patient over and over in the hospital and the cost is astronomical for these visits to the ER. They come in complaining of severe back pain, migraine, etc. The ERs run tests to determine if there are problems. They need to cover their butts. These tests are all unnecessary and are expensive. Many times there's no insurance or the insurance won't pay for this visit and tests because it isn't life threatening. This is the 2nd tier problem with pill addicts seeking meds, charges that are never paid.
That being said we're back to the basic problem that was discussed earlier. The pill seeking addict garners all the publicity either by being a famous addict or by a research study that's manipulated to show what the pill cops want it to show. That in turn fuels the pill cops and the FDA to make laws that are unreasonable and can affect all of us on this forum, and every other person who has pain and needs pain medication to function in society.
I don't expect the laws to be tightened up, if anything I think they'll become less restrictive because of the influx of the baby boomers demanding treatment and pain control.
This latest study is going to fuel the fires but I don't expect any fallout from it. I'd like to see the study broken down by age, gender, economics, geography, and diagnoses I think that would give you a more honest study result . Lindy
Thanks, Lori. I should say too though, that my doctor has never made me feel like that. It's in my own head.Linda, please don't feel guilty when you ask for pain meds. If you need them ask for them.
Any RD should prescribe pain meds to his patients or refer you to a pain management specialist.
I guess I've been lucky, because both my RD and primary care prescribe pain meds for me. If one is out of town, etc. the other prescibes. They've never left me without pain control. Even when I had my TKR the surgeon prescribed 50 pain pills and I talked to my primary about it. He said that if I needed additional pain control that he would prescribe because surgeons are known to undermedicate pain. Fortunately, I didn't need more and still have half of them left.
Don't be afraid to ask and give them a complete description of why you need pain. When they ask you what your pain number is - tell them the number when the pain is at it's worst, not the present pain level, unless that's the worst. Lindy
I would be interested to hear how other countries around the worldLori~ I was under the impression that street drugs like meth, crack, and cocaine were the most sought after drugs for the abusers. How can they be so addicted to drugs like morphine, fentanyl, oxycontin, and other prescription drugs? Where did this addiction start? From a dr or on the streets? Can you even get these drugs on the street?
I understand your frustration, someone like that is taking up a bed and precious time that a critical care patient has to wait for.
I know a guy who's addicted to pain meds. He started taking Oxycontin several years ago after a bad car accident. He suffered severe head trauma among other things, docs didn't expect him to survive. Anyway, the guy lies about everything, steals from his friends, has back stabbed just about everyone he knows and he's becoming increasingly violent. A couple of weeks ago he decked a women and put a chair through my sisters window. It's hard to say how much of his personality is due to his drug/alcohol addiction or his brain injury. His whole family except one brother is pretty crazy too, so maybe it's just in him to be this way. He didn't use to be though.
See and my hubby being a drug and alcohol couns. does monitor my pain meds, but he talked to the doctor and tried to insist that I have a sleeping pill when it is the pain that keeps me awake. I am so glad he had the conversation with the doctor, b/c in that conversation he asked...so when are you going to stop perscribing pain pills to my wife. The doctor replied...I have patients that because of the pain level need pain pills for the rest of their lives...I am hoping to get the arthritis under control, so your wife doesn't need them as much...but I cannot guarentee that she will ever be off pain meds.
I still write down what I take each day. That also makes it easier to track inflamation, and flares. I am also in a quandry(which hubby just got) I cannot take asprin or NSAIDS or I will end up in the hospital. So, occasionally I will take Tylenol during the day, but that is my only option. Thank God I have a very high pain tolerence, 'cause I sure could take a vicodin every six hours and feel like a normal person, but I never do. Even after knee surgery...I tried to slow them down as quickly as I could.
Rheumatologists dispense pain medication? I thought they just did the DMARDS, steroids, biologics part, not pain medication. I thought that the steroids were to control the pain through reducing inflammation until a DMARDS or a biologic kicked in. Perhaps I misunderstood what the rheumatogist is allowed to treat, as I never knew they dispensed pain medication. My Rheumatologist prescribes pain meds...Cathy, a Rheumatologist is a board certified Internist who has had an additional fellowship training of 2-4 years in Rheumatology. Once they pass the Rheumy boards they can be board certified in Rheumatology. They treat over one hundred arthritis conditions, the assorted diseases caused by the arthritic conditions, and also treat other diseases of the muscle and joints.
All M.D.'s can write RXs for pain medications. Also some PA's can write RXs for pain medications, depends on their training.
Hi,
Someone asked about how it works in the UK? Well I'm not actually sure what vicodin is (it's probably called something different here...) so I can't really comment... What I can say is that I have never had any problem getting pain killers apart from the fact that some of them don't agre with me so I had to try loads to find the right combination... SOme of the meds are given with strict monitoring - eg a short prescription and then you have to go back to see the Dr for more rather than getting a repeat. I have Etoricoxib (anti-inflammatory, cox-2 inhibitor) on repeat plus co-dydramol and tramadol (50mg ordinary as well as the modified release ones) on repeat. Repeat means I can take the slip in to the Dr surgery and leave it, go backin a couple of days and pick up my prescrition without having to see the Dr. I tried so many painkillers and never felt like I was being denied them, when I ended up in hosp one time the first thing they did was give me a pethidine shot so that they could examine me properly, then I had anti-inflammatories pa (via your anus) so I could have biger doses without stomach damage and they gave me df118's (which I know are sought by drug seekers) with no problems... I think maybe they look at your records and make a judgement?
Someone asked about why addicts want these drugs - if you're a heroin addict any form of opiate is going to help you to some extent, people addicted to cocain or amphetamines etc often use opiates to counter the effects. Many people get addicted to opiate meds by accident which is why Dr's are a bit careful about prescribing them - eg if you go in every other week saying you lost your prescription and need another or if you're always going to different Dr's or hospitals to get prescriptions etc.
KT
My RD is also certified in pain management. He believes in treating the whole person. I feel very lucky to have found him.
I have never had any trouble with my doctors prescribing pain meds. After my right TKR I had a pilonidal abscess and they couldn't figure out where the pain was coming from. My gp prescribed sustained release morphine, tramadol and tylenol with codiene to take in a pattern for the pain. I did that for about 2 weeks as I had my knee replacement and the surgery for the pilonidal abscess about 10 days apart. I couldn't sit or lay down or stand comfortably, talk about a pain in the A$$
My pain these days is usually controlled by 2 tylenol with 30 of codiene once or twice a day. I dont need any of the big guns yet. My gp calls and gets an 'authority' from the govt and then prescribes 180 tylenol with codiene with 5 repeats. I can only get a repeat every 30 days but never need it that often. I don't need to go back to the gp until the repeats are all used up, I just take it to the chemist and pick it up later in the day. They can only prescribe 20 at a time without getting an authority.
Certain chemist's (drug stores) are issued special licenses to dispense methadone. Addicts have to get a script (with an authority) from their doctor every 2 weeks (they have to be seen not just prescribed over the phone) and they take it to the chemist and get their daily dose for the 2 weeks until their next visit to the doctor. They have to show up at the chemist at a certain time every day to get their dose. The govt keeps a sharp eye on doctor shoppers because benzos and opiates all have to be authorized before they can be prescribed. That means that the govt has a record of each time those drugs are prescribed and issued. When an addict shops and the govt body realises that the scripts are a bit overdone, each of the doctors that has been prescribing gets a letter notifying them that the patient has been shopping and they are not to be given any more scripts.
To prescribe opiates, the doctor has to apply for permission to prescribe the dose for the specific patient and justify the need for it. Only one doctor can have that permission at any given time. If you change doctors the old doctor has to sign off permission and the new doctor has to apply.
Most prescriptions that are regular and have to be filled monthly can only be filled once in 30 days (unless say, you are going away and need to get a month in advance.)
I know there are those that abuse the system but they seem to be quite regulated here in Aus. I don't worry so much about getting my 180 pills every 5-6 weeks, I'm more conscious of showing up with a script for ANOTHER new med every few months. I have a really wonderful chemist and she knows me well. She has AS and we can chat about all the RA drugs and how we are going. She loooves her enbrel.
Thanks for your information. It is nice to learn how other countries handleall ER visits are recorded because hospitals are run by the govt. They can give a dose but they don't give you much in the way of meds to take with you, they tell you to visit your GP the next day for any further treatment. Then they fax or mail all treatment and med details to your GP. It still all has to be registered through medicare so its all in the system.
Here in Illinois, pseudoephedrine ("Sudafed", a decongestant) is tightly controlled because it's commonly used to make methamphetamine. You have to show your ID and sign a log book at the pharmacy to get some, and you're only allowed a small amount (I think it ends up being enough for one person for a week). So imagine if you and your family are all sick with a cold. Mom and dad need the adult stuff; the kids need the kid stuff. You will end up running to the pharmacy almost every day! While we do have phenylephrine in over-the-counter cold preparations now, many people do not find it to be as effective as pseudoephedrine. It's great for raising blood pressure and making you jittery, but for me anyway, it does not clear a snotty nose.Wow, sorry to start the thread and then disappear (a couple of bad pain days and busy days), but all the responses have been very interesting.
Just to be clear, my original post wasn't intended to address treating addictions and what the laws should be (prison doesn't solve addiction!). And there is definitely plenty of blame to go to the politicians, and to the doctors. But with the laws and the political climate what they are, I do feel like those who break the law to feed their addiction are creating a problem for those of us who have need of these medications.
Anyway, I have been fortunate that (so far) my rheumy has prescribed my pain meds, and although he hasn't always prescribed what I would have liked, he has tried to manage my pain as best he can. When I visit my other doctors (PCP, ortho, etc), I always tell them what I am on and they leave all my pain meds to my rheumy to manage.
I have been amazed that the pharmacy will give all sorts of my meds to my husband without asking who he is. Occasionally they ask our address or phone number (which anyone could find out), but he clearly doesn't look like a Suzanne.
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