[I love my cat!]

Very interesting article:
Million in Pain

Excerpt:
One characteristic that pain doesn't seem to distinguish is gender: according to Krueger and Stone's study, men and women were nearly equally likely to find themselves in pain.

I found the above very interesting!

A 2005 study in Michigan showed that minorities and the poor have less access to such drugs than wealthier Americans because local pharmacies don't stock enough pain medications such as oxycodone or morphine. "Those [pharmacies] in white ZIP codes were more than 13 times more likely to have sufficient supplies," says lead researcher Dr. Carmen Green, an anesthesiology professor at the University of Michigan. "I have patients who have to drive 30 miles or more just to get their pain medications."

Is that disgusting or what!
I can't believe that this would even be allowed to happen. Honestly, I think or society has become so preoccupied with addiction and the regulation of drugs that we've forgotten who really needs these drugs and why!
I seem to be reading more and more articles about pain and inadequate pain relief. Very sad, scary and discouraging.

[RN1989]

Originally Posted by I love my cat!

A 2005 study in Michigan showed that minorities and the poor have less access to such drugs than wealthier Americans because local pharmacies don't stock enough pain medications such as oxycodone or morphine. "Those [pharmacies] in white ZIP codes were more than 13 times more likely to have sufficient supplies," says lead researcher Dr. Carmen Green, an anesthesiology professor at the University of Michigan. "I have patients who have to drive 30 miles or more just to get their pain medications."

Pharmacies in "minority" and low income areas are not being discriminatory like you might think. Unfortunately these areas are high crime, including buying/selling/using drugs and the pharmacies that stock such pain meds have often had multiple robberies with these narcs being the target. The damage done to the building is only one of the costs of such robberies. Other costs can include being unable to get liability as well as structural insurance due to too many breakins. Some places have been told that they must get rid of the narcs or be without the insurance, in which case they would have to close completely. There is also risk of employee/patron injury and death in a robbery.

I do believe that there are people who have true pain that is not controlled. I also know that being overweight, being depressed, engaging in risky activity, and thinking that you can do anything to your body because there is always a pill to fix it, also contributes to people's perception of pain. These are cultural issues and personal choices that people make.

Pain is a good thing because it can tell us when something is wrong. It tells people that sticking your hand in a fire is not something you want to do. Our ancestors had pain but the majority did not let it rule their lives. They knew they had certain tasks to perform in order to stay alive so they sucked it up and worked through the pain if the doc couldn't figure out what was wrong with them. Now, people want to neglect and abuse their bodies and minds and be cured. They want to sit on their butts and complain about their pain instead of getting up and going to work. Sometimes actually going to work can help relieve pain because you are not dwelling on your pain when you have a task to accomplish. I find that many people who have started getting disability checks for intractable pain are much whinier about their pain because they dwell on it all the time and think about "oh poor me. I'm disabled and can't work. I 'm useless and can't do anything. And I hurt all the time."

I believe that this epidemic of uncontrolled pain is part of a cultural problem, just like minority areas in a city are usually high crime areas. Until we do something about the underlying problems in our culture, we will never cure everyone's pain, hunger, depression, etc.

[Michigan RN]

I have one particular patient that is on frequent dilaudid at home. She's got a neurological disorder that confines her to a wheelchair and it causes ulcers in the g.i. tract. She's also on a pretty heavy antibiotic regimen that she's received for ten years and she goes every other day for infusions. She's been on dilaudid for 10 years. Yeah, maybe she is addicted or just tolerant but I hate when she comes in and my co-workers are acting like she is drug-seeking which she's not.

[VivaLasViejas]

I've had chronic pain (back mostly; now it's also my left knee, both ankles and my neck and shoulders) for much of my life. Maybe I have a high pain threshold, because I've rarely taken narcotics for my pain and indeed have never developed much of a tolerance for them.

Today, however, I've been wishing I still had some Percocet left over from my last surgery.......I worked in the garden and yard for FIVE SOLID HOURS yesterday. And I'm not talking about a little weeding, either---I dug up and transplanted six rosebushes, made raised beds for my strawberries, chopped weeds, shoveled, raked, hoed, AND pulled weeds. It didn't occur to me until I was on the last of the strawberry plants that I was asking an awful lot of my fifty-year-old, three-hundred-pound body, and so today I feel like one enormous ache. I hurt in places I'd forgotten even existed. And this is exactly the sort of experience that makes me grateful that I don't feel like this every day of my life---yes, I have some chronic pain, but nothing that incapacitates me or forces me to eat handfuls of narcs as if they were peanuts.

JYep, as long as the ibuprofen and the ES Tylenol supplies hold out, I can probably go on for another ten years............as long as I don't lose track of time working in the garden and ruin myself!!

[traumahawk99]

so we are learning that the u.s. is unique in chronic pain? what about the rest of the world? are they all laying around hurting too? does all humanity need to pop pills, or else they are hapless victims?

ibuprofen is a wonderful drug. to suggest that millions need to have narcotics 24/7 is just irresponsible. at some point, narcotics create more problems than they solve. i've seen several actually beat their narcotic habit and use ibuprofen to manage chronic pain. sure, some are in pain, and there is a place for narcotics. however, they aren't candy.

[Toquay]

I think what makes this subject so touchy is the many who do abuse the system. Are there people with legitimate pain? Yes, of course there are. Are there people that know how to work the system and just want drugs? Yes, again. We are all taught that pain is to be taken at face value. Its subjective to the individual and who are we as "healthcare" people to question anyone that states they have pain?

I have seen patients that if they are awake they have pain, even when you have to shake them awake. Medicate to pre-sedation being the only appropriate pain control it seems. Who decides when its abuse? Who is responsible for the increasing perscription drug abuse? The overdoses? The compliancy of medications used with other drugs or washed down with alcohol? There really is no reason to get illegal drugs because going to any ER and c/o pain can get you a script of some sort.

We are a society that wants what we want when we want it. Anytime somone abuses a system, it hurts the ones ones truly in need.

Toq

[I love my cat!]

Originally Posted by traumahawk99

ibuprofen is a wonderful drug. to suggest that millions need to have narcotics 24/7 is just irresponsible. at some point, narcotics create more problems than they solve. i've seen several actually beat their narcotic habit and use ibuprofen to manage chronic pain. sure, some are in pain, and there is a place for narcotics. however, they aren't candy.

Ibuprofen is a good drug for certain pain. I personally do not think it is good for severe, chronic pain. It is horrible drug for individuals with ulcers and stomach ailments and life threatening for those with an allergy to it.
Nothing in the article said is saying Opioids are "candy". Nobody said that people "need to have" Opioids 24/7.
The article is stating that millions are suffering in pain that do not have to.
Trust me, most people in a lot of pain have already been down that "ice/heat/ massage/ibuprofen/meditation/aromathrapy..even the Scientologists "Touch Assists' route".........if it is helping their pain, I think that is fabulous, but I feel that it is unfair to assume that all people in pain are going to have relief from this. Many do not.
I really don't feel that people should have to suffer. I feel that it shouldn't matter what a person needs/has to take-if it works-keep doing it!!


QUOTE from RN1989:
"Some places have been told that they must get rid of the narcs or be without the insurance"

WOW! I never know that. The things I learn on Allnurses...I love it!

"Our ancestors had pain but the majority did not let it rule their lives"

Well, we really don't know that. I've read a lot of History and from what I have gathered, there was a lot of pain and suffering.
Have you read the history of Opioids? It is fascinating. In the past, there were narcotics in every "tincture" and "cure". It was used much more than it is now. Heck, door-to-door salesmen use to peddle it!
Also, the life span of our ancestors was much shorter than it is today. They dealt with pain and were dead by 40. They didn't live to be 80-100 years old.

[morte]

Originally Posted by I love my cat!

Ibuprofen is a good drug for certain pain. I personally do not think it is good for severe, chronic pain. It is horrible drug for individuals with ulcers and stomach ailments and life threatening for those with an allergy to it.
Nothing in the article said is saying Opioids are "candy". Nobody said that people "need to have" Opioids 24/7.
The article is stating that millions are suffering in pain that do not have to.
Trust me, most people in a lot of pain have already been down that "ice/heat/ massage/ibuprofen/meditation/aromathrapy..even the Scientologists "Touch Assists' route".........if it is helping their pain, I think that is fabulous, but I feel that it is unfair to assume that all people in pain are going to have relief from this. Many do not.
I really don't feel that people should have to suffer. I feel that it shouldn't matter what a person needs/has to take-if it works-keep doing it!!


QUOTE from RN1989:
"Some places have been told that they must get rid of the narcs or be without the insurance"

WOW! I never know that. The things I learn on Allnurses...I love it!

"Our ancestors had pain but the majority did not let it rule their lives"

Well, we really don't know that. I've read a lot of History and from what I have gathered, there was a lot of pain and suffering.
Have you read the history of Opioids? It is fascinating. In the past, there were narcotics in every "tincture" and "cure". It was used much more than it is now. Heck, door-to-door salesmen use to peddle it!
Also, the life span of our ancestors was much shorter than it is today. They dealt with pain and were dead by 40. They didn't live to be 80-100 years old.

nor did they have the survival of severe accidents:long term pain issue,
industrialization, high speed auto accidents, and better trauma rx.....,
do you really want someone in mod/sev pain working on ANY product that is going to affect your safety?..pain alters judgement....

[SillyStudent]

There are people who nearly kill their livers with OTC drugs to manage their pain.and have to be forced to go on narcotics to control it. These people will take 3500 mg of motrin a day to be able to even remotely function. The same people are worried about becoming addicted to narcotics and the stigma of being on pain medication.

Like me. Or rather, like I used to be before I gave in and let my physician and pharmacist help manage my condition.

I always assume that someone is in pain until they make it crystal clear that they are drug seeking. I think that is a pretty good rule of thumb. I remember the day I finally went to the ER ...because I was in the fetal position on my living room floor with tears rolling down my face.

A nurse in triage rolled her eyes at me when she got the answer to 'how long have you been in pain?'. The answer was: "Twelve years". I did try to make her understand that this was the first time I couldn't function at all. I was very lucky to meet a different ER nurse that day with the same condition, and got some good advice and immediate temporary pain relief.

People live longer now, we have different stressors, different kinds of jobs and different injuries with the advent of new technology. Let's be open minded about pain. To see me, you would never believe that I function at a pain level of about 5/10 every (good) day of my life. It is almost impossible to explain to a person who does not have a chronic pain disorder how exhausting and frustrating it is.

[quezen]

'SillyStudent', what is the 'crystal clear' test/rule/behavior that shows a patient is drug seaking? Like 'Toquay', above, I take care of at least one or two patients every time I go to work who are 'in pain', as long as they are awake. Only sedation qualifies a 'no pain' for these patients.