[rehab nurse]

Originally Posted by bethin

If the rate is so low for addiction (1%) I wonder why we as a society and as healthcare professionals talk about it so much as if it happens to 95% of pts who take narcotics.

I take Vicodin PRN for Crohn's. I can't eat a meal without experiencing pain. Sometimes excrutiating pain where I curl up in a ball and pray to God to kill me then I won't feel anything. I worry that I will become addicted but after reading all this info that everyone has provided my fear has lessened - a little. I receive my meds from one dr, I don't steal narcotics from pts and I don't seek outside sources for my meds. My dr has asked me numerous times if my pain med is strong enough (sometimes it isn't) and he says he can prescribe something stronger but that fear creaps up and I refuse. It's as if society has brainwashed me into thinking if I take a narcotic for longer than a week I'll become addicted.

I have went off the Vicodin to see how I do. I wanted to test myself to see if I'm addicted. It's misery so back on it I go. I don't take it every 4 hours as it says on the bottle, I don't take it to escape. I take it for pain. And anyone who says that Crohn's AND Ulcerative Colitis isn't painful is full of it. The other pts that I've talked to have equated it with giving childbirth.
You think asking for an epidural will work? Since it numbs from the waist down then I wouldn't feel my LUQ and RUQ pain.

Sorry for the rant.

Rant away.

I, for one, understand what you are feeling. I took PRN meds for pain for about 2 years. felt terrible, like i was this person who was evil thinking about my back pain all the time. felt horrible when i had to ask my doc for pain meds (darvocet at that time). i finally got a discogram and several MRI's and a decent surgeon finally told me what was wrong with me. that i deserve to have my pain managed properly. so i went to see a PM specialist (which is where i heard about this low rate...that's why i said not to quote me as i don't have the link for a study/studies) and i have had to since leave nursing due to the meds i take and the demands on my body being too much. i have recently faced a cancer battle as well, and i've been off work for a few months. i couldn't do it anymore.

i don't know why, now as just a patient, if i present to a different doc or to ER for a totally different reason, and i give mymed list to them why i have to get the eye rolling, sighing healthcare people who treat me like a low life. i have been a nurse 11 years. i don't work anymore. i am trying to get disability for now. i hate life right now. i truly feel for anyone who has to deal with pain, especially those with chronic pain. it is miserable. even when treated, my pain is usually hovering about a 4. if i get OOB, it shoots up. my quality of life is very poor right now. but i get up, cause i have two little kids who need me.

i hope you find relief. i truly do. i don't know why pain patients have to fight to get treatment and fight to "prove" ourselves time and time again. i don't know. not all nurses are like that. i have met very many kind and caring (and competent) nurses and other HCP who help.

[bethin]

Originally Posted by rehab nurse

Rant away.

i don't know why, now as just a patient, if i present to a different doc or to ER for a totally different reason, and i give mymed list to them why i have to get the eye rolling, sighing healthcare people who treat me like a low life. i have been a nurse 11 years. i don't work anymore. i am trying to get disability for now. i hate life right now. i truly feel for anyone who has to deal with pain, especially those with chronic pain. it is miserable. even when treated, my pain is usually hovering about a 4. if i get OOB, it shoots up. my quality of life is very poor right now. but i get up, cause i have two little kids who need me.

i hope you find relief. i truly do. i don't know why pain patients have to fight to get treatment and fight to "prove" ourselves time and time again. i don't know. not all nurses are like that. i have met very many kind and caring (and competent) nurses and other HCP who help.

Do you think that others are jealous? Do you think that they think we enjoy taking our pain meds so we can get high and they want to join in the fun? It's crossed my mind. It's the only reason I can account for the eye rolling. What's it to them it to administer the medication? You don't see eye rolling when nurses have to give insulin shots.

If it is jealousy, they need help more than we do. Personally, I hate taking pain medication. I hate the loopy feeling and sometimes I get headaches. Who would choose to get a headache? When I take my pain meds, I go to bed because I'm so tired I can't do anything else. I don't want to live my life in bed.

[narcoticjunkie]

This is an e-learning program based on the Assessment and Management of Pain guideline.

http://www.rnao.org/Pain_e-learning/index.html

[Gompers]

Oh this just burns me up!!!

Nurses not giving pain meds because they assume the patient will become addicted - even if the patient is in obvious pain - are just plain cruel!!! That is one of my pet peeves - nurses who don't give pain meds when they are necessary. Why not give them? I know if I was a patient I'd want my nurse to give me whatever she could to make me more comfortable!!!

My other pet peeve (totally unrelated) is when a nurse or anesthesiologist won't give pain meds to a patient in pain or during surgery simply because the patient is hypotensive. They fear that giving the narcotics will further drop the BP. Hello!!! Two totally separate issues! Give the pain meds if they're needed and do something else to increase the BP if it drops. A patient can be in excruciating pain and hypotensive at the same time.

There is a big difference between physical and psychological addiction. Yes, after a few days on narcotics the body does start to get addicted to the meds. But you can always wean them off by cutting back on the dose and frequency AFTER the pain starts to resolve. Psychological addiction is a totally separate issue - yes it involves physical addiction as well, but there is more to it than that. The main issue, to me, though, is that if a patient is hospitalized an in pain, then thoughts of addiction should be put on the back burner and the patient's comfort should be the top priority.

[Patient]

Hear hear! From a chronic pain patient on the 50 mcg fentanyl patch with norco 10/325 for breakthrough pain, I can speak from personal experience. Am I physically addicted to narcotics? You bet! I take these meds exactly as prescribed and very responsibly, but still get dirty looks and snide remarks from doctors, nurses, and pharm techs. If I need yet another procedure, I make sure all doctors and nurses involved are aware of what I am taking. Inevitably, someone will make a comment like, "We sure had to use a lot of medication on you" accompanied with a gimlet-eyed stare. Sheesh! I'm sick of it, but some people refuse to be educated and I've finally learned to let it go and not engage the ignorant.

[NurseyBaby'05]

The other thing is, if someone is drug seeking, you're not going to cure them in a day. That's for pain service and the pt's PCP to resolve. Do I give them their PRN IV Dilaudid round the clock? No. If they ask, yes. (And are still awake to receive it when I get back to the room.) If the pt is gorked out of his mind and it's taking a lot of effort to arouse him, no way am I giving it. But if he's awake, appropriately responsive, and in pain, I'm going to give it. I'm not there to treat his addiction. We can make referrals to pain service and detox for that.