Senate Investigates JACHO Big Pharma Pain Link - page 2
Read article below first. I always thought something was fishy the way hospitals were mandated by JACHO to make pain a priority. My Admission assessment have an entire tedious section devoted to... Read More
May 13, '12Time we did something about prescription narcotics. Healthcare providers get annoyed when people come in looking for narcs, but we've done this to many of them. We're pushers in many cases. I want to scream at many ED doctors I work with "If you hate the drug seekers so much, stop enabling them for Pete's sake!!".
May 13, '12Another one who advocates for narcs. I toss 'em out like peanuts when I can get 'em prescribed. A lot of people hurt all of the time. There's no need for it aside from puritanical attitudes. And Phamra, as has been said, makes next to nothing on the opioids.
May 13, '12I worked home care for a spell...it broke my heart to work with the scores of people who suffer daily in pain, especially the elderly.
It seems in healthcare we are more afraid of the "drug seekers" than we are concerned about those who are suffering.
May 13, '12My father and my uncle died of Colon Cancer. I sat next to both of them through the battle. I also lived with and cared for a dear friend has she died from Breast Cancer. I have not suffered it myself, but advocated as much as any loved one could to be sure they were never in pain...physically anyway.
The scenario of a burn unit patient or cancer patient has nothing to do with someone who gets caught on the street with a pain prescription bottle of 120 Oxycontins and caught running from the police after selling it on the corner to your kid. The prescription is his, with his name and he has been selling individual pills to anyone with $20. He goes to the ER regularly claiming back pain or to a doc who takes a cut. Do you think this doesn't happen and how does this situation have anything to do with me wanting someone to bite on a rag?
Yes, I do feel lucky I didn't need as much pain medication, but quite frankly my doctor wouldn't have prescribed much more anyway and that was okay with me, because she had my best interest in mind.
For the people that NEED pain medication it should totally tick you off that there are doctors, drug dealers and people who are content to vegetate on their couch for no reason or drive around and hit you head on driving down the street that make a mockery of the only thing available to help you with your discomfort. No one, especially me is criticizing your use of pain meds if you need it...IF YOU NEED IT.
May 13, '12Usually, and that is usually, hospitalized people do need pain meds for various reasons. MY big concern is the regular PCP who is doling out these pain meds, esp to pregnant women! You would not believe the number of prescription drug withdrawl kids we are seeing. It just seems that no one thinks about it and hands them out like candy...without a thought to what can happen.
May 13, '12Everybody can't take NSAIDS (I can't.) Tylenol doesn't help much for many types of pain. If the doctor orders it, and the patient's vitals are ok, then I give the pain med as ordered. I have gotten chewed out by administration for not giving IV dilaudid to someone who was obviously just seeking, with a bogus complaint. Since the almighty patient satisfaction scores are all that matter now, I just go ahead and give them the IV narcotics as ordered by the doctor, unless there is a valid reason not to. If they are a seeker, or addicted, they will simply get it on the street, regardless of what I think. I really don't care what they claim their pain level is, because it almost always is 8 to 10 (so they say.) I have seen too many nurses hold off on pain meds for people with cancer, etc., so if the doctor has ordered it, I give it.
May 13, '12I This finding appeals to me on so many levels. Granted I am no longer a young scared nurse that fears JACHO, I love it when they come. The hospital tries to do things that make sense so if you have any good suggestions, just hold them until JACHO is coming. For instance, we have been keeping new oxygen tanks in our dirty utility room and used ones in our equipment room. I have been saying this is gross for years and finally a mock surveyor said it. It is like magic or Christmastime. You get the supplies you have wanted all year. They make time for people to clean and organize and on the day they come you will have a floater to give you lunch. That said, I truly feel they make up some arbritrary crap that just does not work in the real world. That is why I love the idea that they have someone sniffing around behind them forcing them to do ridiculous things and examine theirself for conflict of interest.
On a completely different level the pain obsession is part of the arbritrary crap they come up with. Pain is a symptom not a disease. How many times have I heard "Is it time for my pain medicine yet?" Reply "It's not schedualed, are you hurting?" Give them that stupid scale. "Oh it's an 11!" This will be the same patient that cries when I swab their arm with alcohal prior to starting their IV. "Do you have to rub that hard? Oh that hurts!"
Their pain was an 11, when they were talking on the phone eating a sandwich and asking me if it was time yet though. I have back pain. I have missed work because of it before, but I just don't get the point of narcs. I cannot really do anything productive if I am high on Lortab, so why take it. How will it enrich my life? Just take a Motrin or a Tylenol and find a more comfortable position. I have had migraines with pain that leaves me vomiting. If that's a 10 then I can see wanting to take something if you are in the hospital and can just lay around anyway. However, some people are in 10/10 pain but they are also worried about whatever channel they can't find on the hospital TV. I have also seen people shaking in pain and denying it. Pain is NOT whatever the person says it is!
May 13, '12The Joint Commission being investigated by the Senate.....Kind of like having the fox watch the hen house.
May 13, '12If I am ever hospitalized again with cellulitis from have no lymph nodes, I certainly hope my nurse takes my complaints and rating of pain seriously. People who are in pain shouldn't be judged and denied pain meds because there are people who abuse medication.
May 13, '12We're talking apples and oranges, I think. Nobody's going to hold a pain med on a burn victim, major surgery patient, ortho repair or someone with trauma. But when you see the same teenagers and twenty year olds every single week in the ER for earpain...back pain...belly pain...foot pain...headache...back to ears, and they've been MRI'd, CT'd, and there's never anything wrong, they can't remember if the pain's on the left or the right on this visit, and they're always positive for illegal drugs? We are not making them better. We are making them want to do anything to us, our kids, or any other complete stranger to stay high.
I had major ovarian cysts -- I went to the ER because I thought I'd had a ruptured appendix or gallbladder going bad. They wanted to give me methadone when they saw I had masses in my abdomen. I actually asked the doc, "are you nuts? I may have masses in my abdomen, but you're not turning me into a junkie on top of things." Hurt like crazy, but I got by on Advil.
Had to have a BSO/TAH, stage IV endometriosis where they scrapped the tissue off of my intestines and cut loose adhesions. I took 8mg of Dilaudid, total, most via a PCA pump I had them pull the morning after surgery. By my second day home, back to Advil. It was another month before I could turn over in bed without belly pain. But a year later, I'm not hooked on vicodin, either.
I also have chronic back pain -- compressed disks, my pinky and 4th finger will go numb, and my back feels like it's on fire. That few days was the only time my neck/back hasn't hurt since I was a teenager. I've had docs offer all kinds of narcotics, and to put me on disability. I hurt. All the time. There are days where I look like a broken scarecrow trying to get up out of bed and start moving. But I'm not going to do a swan dive into a bowl of Vicodin just because I could get a script, either.
There's no way or legit reason we take 99% of the pain medicine in the WORLD unless it's being overprescribed. We're not the only people with back pain, arthritis, and chronic pain, but other countries and their citizens get thru life just fine. In other countries, physicians are only allowed to prescribe narcotics per week (not 300 at a time like I routinely see), unless the patient is on hospice. Practices have their script analyzed for "appropriate for specialty" and if you have a dermatologist where 70% of the scripts are for narcotics, they get fined and investigated. We're turning out a who generation of unproductive prescription junkies, and if you don't think so, go spend a weekend in the ER. You'll see them in droves.
May 13, '12It's a huge moral and ethical dilemna. How do you balance treating the people who truly need the pain meds against the people who criminally steal and/or misuse them. Unfortunately in the end it is going to come down to people will have to just learn to live with the pain because the drugs are most likely going to go away.
They will be regulated right into a pill prohibition and then we will have a worse situation on our hands.
I don't know the answer. I was disabled in an accident many years ago. Chose to rehab to the best of my ability and now work full time. I live with almost constant pain, but learned to ignore it for the most part. Motrin is as strong as I go. But I see how dibilitating chronic pain can be. I quess I could say Pride and Vanity rehabbed me cause w/c don't go with any of my outfits.
I've been an ER nurse for 8 years and I have seen drug junkies who come in every other day with back pain, and get loaded up with meds. And I have seen kids who have broken bones set with almost no pain meds because the doc/nurse doesn't believe in them.
I see the number of "self medicating" alcohol users going way up.
May 13, '12i hear all this about pain, and i am completely with you and have always advocated for adequate relief no matter what it takes. i know-- and preach often-- the difference between addiction, habituation and tolerance. so forgive me if i don't want to follow you guys down that path in this thread. that's not what it's all about.
the idea that big pharma "doesn't make much money on opioids" so they don't have any incentive to push a lot of them makes no sense. one, have you priced the most recent additions to the pharmacopaeia lately? the fentanyl products, the oral and transmucosal morphines, the transdermal stuff, not to mention the non-opioids for neuropathic and other pains. not cheap. not cheap at all. two, even if that were true and all we had were the old traditional opioids, basic economics says that if you make only a small profit on a unit of product, what you need to do is sell a lot of it.
doesn't anybody feel as shocked as i was to read that article? that joint commission and big pharma have made it possible for more and more people to have opioids pressed on them, with a financial relationship with the apf? i found that astonishing. here's the link again....
american pain foundation shuts down as senators launch investigation of prescription narcotics - propublica
May 13, '12Everyone has a different tolerance for pain. Mine is quite high but I don't use it as a gauge of anyone else's pain. I've worked in facilities where there were many drug seeking residents. I've worked in facilities with people who are in chronic pain and refuse to take pain medicine because they fear they will become addicted. If drugs that are legal are goi g to be taken off the market because some people abuse them, I suggest we start with nicotine which has no positive benefit to anyone and kills more people than drugs do.