Drug seeking- something to ponder

  1. I have been a nurse for over 20 years and I have seen nursing change over the last 20 years for sure. I obviously am very aware of the rampant drug problem that we are facing.
    I too have been concerned about if I am a glorified drug pusher until I had a huge reality check. I went from being the nurse to the patient and what a change that is.
    I was diagnosed with CRPS or RSD, to my left arm that eventually spread to my left knee ( due to a fall at work) and I also have fibromyalgia. CRPS has been around since the civil war and now servicemen and women coming home from war are also suffering from this terrible disease.
    I look normal sitting in a bed.
    The McGill pain index shows that (CRPS) Chronic Regional Pain Syndrome is the most painful condition on the planet, worse then natural childbirth ( and I can attest to that). I know that when my med list is reviewed, I can see the change in a nurse or doctors attitude. Questions about why I take this, who orders that. All of which I understand.
    I like many chronic pain patients have a very regimented schedule and going into the hospital changes the times to all my medications. I can't shower in the hospital due to my cold intolerance. Sometimes I can only wear the one thing I brought due to the sensitivity to material, seems and even lung sounds on the left cause me intense pain. My limbs are different temperatures, and sometimes my left leg will swell and my toes get red. But a majority of they one my disease is invisible. I have been treated so badly by nurses and doctors. When I try to explain my medication schedule or when I ask for meds and I say my pain is an 8 or 9, I have been asked "really, you look fine to me" I have even had nurses not give me tylenlol with my maintence med because they didn't feel comfortable giving them together??? I have heard "we go for the lower med first and if it doesn't work..," which is fine for a post op day 2 hip, but I have chronic pain for 12 years. I follow all the rules. Never accept any narcotics from another doctor, urine tests, go to a pain clinic, have had over 50 procedures including a spinal cord stimulator.
    When I attempt to explain my situation and my meds and why I take them or arrange my day in the way I do, like eating or showering, " I'm anxious, pushy, or the PIA patient" all of which I have heard. Then people find out I'm a nurse and I never have anyone help me with my bed, or rarely come in my room. The worst part is I can count on one hand the number of nurses who have read about CRPS and asked me questions or tried to understand. Patients can eat, watch tv and talk on the phone in pain. I hate to ring the buzzer asking for meds and ask for water or juice and get directed to the kitchen.
    Pain is subjective, and if patients like myself get off our schedule it is very difficult to get relief. A 5 is a good day for me. I only post this to ask that despite you feeling like a patient can't be in pain or that we call because we are drug seeking, just take a minute and image your mother, sister, brother or best friend in that bed. Suffering.
    I CRPS makes your affected area feel like it's on fire. The. The fibro ( yes it's real) makes you ache everywhere else. Pain in my legs so bad, I use a wheelchair for long distances. Migraines, stomach issues, chest pain ( with negative markers) because CRPS can affect your organs. We would much rather be at home. If you knew the things that we miss out on, Holidays or dates because we are mentally and physically exhausted from pain. Imagine having the worst migraine and toothache ever, the sounds make you nauseous and all you want is a quiet dark room. I put a pillow on my head because I am extremely sensitive to sound and light. Imagine that toothache and migraine last for 10 years. They never go away- ever.
    Please think about how humiliating and difficult it is to ask for everything you need. The uncertainty of asking for meds by name and amounts to assist the nurse in making more then one trip vs sounding like a "seeker". We know what everyone thinks. We feel it. It's just one more worry that we deal with.
    Please take the time to understand the condition your medicating for, or why this patient is non compliant. Go out of your way and change the times on a patients meds to accommodate their schedule, it validates me and may cut down on my prn meds. Understand that I have had a change in my condition and stress increases my pain and anxiety, along with no sleep.
    Its easy to get frustrated and assume, I've done it before. I lost a lot due to my illnesses. I am a shell of a person that I was. I cringe just knowing I have to go to the ER to be picked apart and judged. I waited 7 hours for an ekg. Don't judge what you can't see. I'm not asking for any special anything, just try to understand.
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  2. 20 Comments

  3. by   nursewall-e
    Did some research on fibromyalgia a few weeks ago and found out NIH.gov doesn't even have a medical diagnosis page for it. Just a mini-page. Even Google spellcheck doesn't know the word! (now added to my dictionary) so maybe I would call it something else in order to be taken seriously.

    As for pain, it is always what the patient says it is. As for judgment, I leave mine in the car before I walk into work.
  4. by   Nsg is an art
    "so maybe I would call it something else in order to be taken seriously."

    That alone sounds judgmental- I wrote this post as an awareness. I read a post from some time ago that was closed and I really think it's an important topic and maybe my story could help someone. life is hard enough without having to defend your broken body.


    I applaud you for researching fibromyalgia- I would invite you to also look up Chronic Regional Pain Syndrome. (CRPS) or RSD

    Complex Regional Pain Syndrome Fact Sheet: National Institute of Neurological Disorders and Stroke (NINDS)

    Scientists estimate that fibromyalgia affects 5 million Americans age 18 or older.

    Questions and Answers About Fibromyalgia

    5 million people Is quite a significant number "to be taken seriously"
  5. by   rnrg
    I too am a RN who suffers from chronic pain. Thank you for taking the time to post here. If u could ask one favor from you it would be to keep advocating for us, the chronic pain sufferers. The daily battle of pain, the lost quality of life, the fear of losing the right to pain mgmt because of physicians who have egos, the judgemental looks, the stress it puts on your loved ones, the cost of lost work or loosing the ability to work period. Please continue to be our voice. Post frequently. I have yet to come across ONE compassionate dr. Nurse or physician staff who treats me like I am a real patient. They all treat pain sufferes the same. It's awful.
  6. by   Nsg is an art
    Thank you. It is a unique experience when you can identify with the patient and the nurse. Its not anything I asked for, this disease has robbed me of over a decade of life and part of my soul. Chronic pain changes you as a human being. Thank you " rnrg " for validating what I was feeling, I was beginning to become angry at myself for putting myself out there. I don't want to preach or tell others what to do. But chronic pain suffers are everywhere and I can totally relate to you rnrg that so much gets taken away. I have been and currently am in the spotlight again. It's not a good place to be.
    We didn't ask for these illnesses. I would rather a nurse who feels strongly about not caring for me give me to someone else or talk to me about why I am askin for medication when I am watching tv. That my words and nonverbal language seem at odds. That would be a relieve.
    Thank you for understanding my plight and I certainly agree 100%, no one will understand what is taken from us chronic pain sufferers on a daily basis.
  7. by   emtb2rn
    This post explains exactly why i get annoyed by the actual drug seekers. That minority of pts who try to scam the system have wound up casting a pall over those who do have chronic day to day pain. I get that those who live with pain day in & day out may not "look" like they're suffering because severe pain is their baseline.

    OP, good luck to you.
  8. by   toomuchbaloney
    Quote from emtb2rn
    This post explains exactly why i get annoyed by the actual drug seekers. That minority of pts who try to scam the system have wound up casting a pall over those who do have chronic day to day pain. I get that those who live with pain day in & day out may not "look" like they're suffering because severe pain is their baseline.

    OP, good luck to you.
    So why do health professionals CHOOSE to treat all persons exactly as if they are abusing drugs when we KNOW that many, many people are actually experiencing pain on a chronic basis with unbearable acute exacerbations?

    Why?

    Why must we develop and then protect those ugly and judgemental tendencies and behaviors? Why do we pass them on to the new professionals who join our ranks?

    Bah

    We are so worried about the minority of people who might be abusing the pharmaceuticals that we actively punish the majority of people who are attempting to gain a measure of comfort, function, and dignity in their pain wracked lives.
  9. by   Mavrick
    I work in PACU and don't mind giving people, even obvious substance abusers, pain medication. It takes what it takes. I am not going to attempt rehab on anyone in the first hour and a half after surgery.

    What I do mind is the drama, the show, the performance. Just tell me you need medication and I can titrate to apnea. The instant change from "fine" to "I'm in terrible pain" when family show up makes me look like the evil nurse that hasn't done anything to alleviate the suffering of this poor neglected patient. I do not like being part of that family dynamic.
  10. by   bluebirdflyx
    Quote from Mavrick
    I work in PACU and don't mind giving people, even obvious substance abusers, pain medication. It takes what it takes. I am not going to attempt rehab on anyone in the first hour and a half after surgery.

    What I do mind is the drama, the show, the performance. Just tell me you need medication and I can titrate to apnea. The instant change from "fine" to "I'm in terrible pain" when family show up makes me look like the evil nurse that hasn't done anything to alleviate the suffering of this poor neglected patient. I do not like being part of that family dynamic.
    This is exactly how I feel. I will gladly give prescribed pain medication without judgement or argument. I even get along really well with patients (even the known abusers) because they see that I try hard to keep them on schedule. It doesn't matter to me why you need the medication, I understand that you need it. But when it becomes status dramaticus - you've lost me.
  11. by   BeckyESRN
    I was injured in karate class when I was 16. I required nerve decompression surgery on my left foot. Then I broke my left ankle as soon as they removed my cast; first day in PT to be exact! Over the next few years, I had 4 more surgeries. Nothing ever got better, but my symptoms were getting much worse. A resident at my hospital asked why I had my foot propped up, I told him my symptoms and he told me RDS and gave me the name of a doctor. I had seen 10 different specialist prior to that and they had just scheduled what would have been my 6th surgery.
    My doctor was amazing and I finally found someone who understood my symptoms. My leg would turn bright red if my shower was too hot or blue if it was too cold. Winter was awful, once cold, my foot, toes, and leg would stay cold for hours. Muscle spasms and charlie horses woke me up from sleep several times every night and made walking difficult. I had foot drop transiently, I would fall/trip all the time. I cried constantly. We tried all kinds of treatments, but nothing help. Eventually we settled on a regime on medications that brought my base pain level down to 4-5 on good days.
    I dread seeing a new provider. I hate going to urgent care when I'm sick. I hate calling for refills. I hated the looks when I was admitted to the hospital. There are subtle changes that happen once you give out your med. list. I had my severe abd. pain disregarded as drug-seeking on one trip to the ER, only to see my provider the next day and be rushed into surgery for appendicitis. My provider later told me that the ER note said "Pain 10/10 already on pain medication, does not require treatment"

    I've only had one NP ask me about my history and try to understand why, even though I take a medication daily for muscle spasms, this was not enough to cover my acute back injury.
    I know I've been guilty of assuming that certain people are over selling their pain level. (the lady with her fentanyl patches on her nipples, for example). But, I would never withhold medications the way I've seen other nurses do. I would never talk about patients the way some nurses do. I've been there. I've been judged by doctors, nurses, friends, family. I've been told "it's all in your head", "if you exercised more, it would go away", "you're probably addicted now, so you only think you need those meds.".

    The new regulations on narcotics and the rash of ODs has made everyone a drug addict. Those of us on chronic pain medication are now the same as those selling prescription drugs. Over prescribing is a problem, but under prescribing is not an answer. Not everyone is "seeking" more meds, some of us need them to function at a basic level. I have not been pain free for 13 years. I cope with my chronic pain differently than I can cope with acute pain. My chronic meds are for my chronic pain; they do not treat anything acute, please stop assuming because I've taken something today, my pain should be gone or is made up.

    OP, thank you for this. I truly understand what you're trying to convey with this post.
  12. by   No Stars In My Eyes
    Hubby has had chronic knee pain, pre and post-surgery (TKR). Has been on routine maintenance dose of a 'popular' opiate for 8 years. It doesn't make the pain go away, although in some people's opinion (remember the "everyone has one" saying about opinions?) at the dose he takes, it certainly should. But it does keep the pain at a livable level. It DOESN"T make him "high" in the least.

    If I see his reddened and sweating face, that's my clue he's in pain. He seldom even talks about it, though.

    But , if others were to only notice his joking and laughing, they wouldn't think he was in pain. What they don't see is the man in the privacy of his own home, sitting for long periods of time resting his head on his hand, eyes closed, quiet for hours at a time. He looks, but is NOT "relaxed", because using his bonhomie to rise above the pain is as tiring as the pain is exhausting. But if there are others around he will make the effort and act sociably, trying to make people laugh. So what you 'see' is not necessarily what he's got!

    His primary recently retired .

    The new doc says her new office policy is that anybody prescribed any kind of pain med has to have a pee-test before any prescriptions are written. Maybe the next 'thing' in this War On Drugs via your primary doctor's office will be Lie Detector Tests? And they can call it what they want to, but it's a War On Prescriptions and Patients who Require Drugs. Guilty until proven innocent, possibly innocent between this pee-test and the next...who knows? But we are ever alert, thinking the patient is hanging around that dreaded "Gateway To Other Drugs", and any minute they may put one foot over that threshold and become a total JUNKIE!

    Do you know that Heroin is so much easier to get, and is cheaper, than jumping through hoops at your doctor's office?

    Could the War On Drugs BECOME the actual 'Gateway' itself? Tune in next time....
  13. by   One-X
    I had a three month long fight to get Adderall that I need to function. Yes, ADHD is a real thing, and before the Adderall, I was a much worse student and CNA; I even had a harder time driving safely.

    I eventually had to pay $400 for testing. My insurance doesn't cover testing, and they wanted me to go directly to a psychiatrist, but almost every single psychiatrist I called thought I was a drug seeker. Yes, I understand that a lot of people abuse Adderall, but some of the regulations are ridiculous. A friend of mine went a whole semester without Ritalin despite having a diagnosis since she was seven, because our college doesn't prescribe without test results (her psychiatrist was a 2.5 hour drive from school). I should mention I was also very lucky to be able to drive an hour to get cheaper and quicker testing, because the testing at my college has a seven month waiting period (they're really booked out) and costs $1500.
  14. by   toomuchbaloney
    Quote from No Stars In My Eyes
    Hubby has had chronic knee pain, pre and post-surgery (TKR). Has been on routine maintenance dose of a 'popular' opiate for 8 years. It doesn't make the pain go away, although in some people's opinion (remember the "everyone has one" saying about opinions?) at the dose he takes, it certainly should. But it does keep the pain at a livable level. It DOESN"T make him "high" in the least.

    If I see his reddened and sweating face, that's my clue he's in pain. He seldom even talks about it, though.

    But , if others were to only notice his joking and laughing, they wouldn't think he was in pain. What they don't see is the man in the privacy of his own home, sitting for long periods of time resting his head on his hand, eyes closed, quiet for hours at a time. He looks, but is NOT "relaxed", because using his bonhomie to rise above the pain is as tiring as the pain is exhausting. But if there are others around he will make the effort and act sociably, trying to make people laugh. So what you 'see' is not necessarily what he's got!

    His primary recently retired .

    The new doc says her new office policy is that anybody prescribed any kind of pain med has to have a pee-test before any prescriptions are written. Maybe the next 'thing' in this War On Drugs via your primary doctor's office will be Lie Detector Tests? And they can call it what they want to, but it's a War On Prescriptions and Patients who Require Drugs. Guilty until proven innocent, possibly innocent between this pee-test and the next...who knows? But we are ever alert, thinking the patient is hanging around that dreaded "Gateway To Other Drugs", and any minute they may put one foot over that threshold and become a total JUNKIE!

    Do you know that Heroin is so much easier to get, and is cheaper, than jumping through hoops at your doctor's office?

    Could the War On Drugs BECOME the actual 'Gateway' itself? Tune in next time....
    you win

    I believe that pharmaceutical companies ought to have to finance opiate addictions and treatment.
    I despise the notion that chronic pain patients are presumed to be drug seekers and abusers as if they sought out the pain and then sought out the most addictive treatment themselves at the start of their health journeys.

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