Pain control

Far too often, inmates who say that OTC pain meds are "not working" are hoping to get narcotics, which we don't use except for fresh post-ops in the infirmary. We also had a near rebellion when we found out that gabapentin (Neurontin) was being traded on the yard, and we discontinued its use for pain control. We had numerous kites and grievances insisting that it was "the only thing that works". All of these guys somehow survived not having it.

In your instance, I don't understand the discontinuation of OTC pain meds, especially naproxen, which has less risk than the others. In a correctional medical seminar I attended a couple of years ago, naproxen was cited as the only OTC pain reliever that doesn't potentially create cardiac issues with long term use.

We limit use of OTC pain relievers to 90 days, at which point the inmate has to be seen by a medical provider to determine the need for continuing therapy.

We had people on naproxen and ibuprofen 600mg for 365 days a year. The problem is, they say, that there are risks associated with long term use of these meds, mainly kidney issues. They were not reassessed at 90 days and when they were reassessed, they still had the same chronic pain issues...... arthritis, chronic back pain etc. What do you do for these folks? How do you manage their pain? The other issue we are having right now is everyone, and I mean everyone insisting they need allergy meds and ppi, like protonix, both of which are also being extremely limited now. They say with the protonox that it was not meant to be a long term med and to use it as such is dangerous. But again, our previous doc was writing them 365 days worth of protonix. Now that they don't have it, they are putting in sick call after sick call to get it back. I just don't know what to say to them because even when you explain the risks, they still insist they need it!! It gets very frustrating sometimes.

Gabapentin was one of the most abused drugs in prison. They snort it and shoot it. It should have been removed long ago. Many drug addict inmates will say and do anything for narcotics, even break their own fingers. There are far too many narcotics in the prison system and they result in a great amount of violence when drug debts aren't paid on time.

We had people on naproxen and ibuprofen 600mg for 365 days a year. The problem is, they say, that there are risks associated with long term use of these meds, mainly kidney issues. They were not reassessed at 90 days and when they were reassessed, they still had the same chronic pain issues...... arthritis, chronic back pain etc. What do you do for these folks? How do you manage their pain?

According to a study cited at a correctional medical conference that I attended, long term ibuprofen and acetaminophen use can also carry the risk of cardiac issues (naproxen does not).

If an inmate continues to insist on a medication that is not supposed to be for long term use, often there is an evaluation by x-ray and sometimes other tests. If none of the testing reveals anything that would cause the symptoms that the inmate is claiming, he gets nothing.