pain meds while working?

[TattedRN]

A long time ago I had a nursing teacher advise me to take narcotics for pain while in school, I told her no as I assumed this was illegal (I had meningitis and was still getting terrible headaches).

Fast forward 8 years. I started having back pain after having my first son, it was usually tolerable as long as I didn't perform certain motions so I brushed it off. After the birth of my second son I could no longer brush it off. It became excruciating especially when sitting and I started losing feeling in my right leg. I assumed it was nerve pain so my PCP prescribed me gabapentin and oxycodone 5mg TID PRN. The pain meds took the edge off and gabapentin did nothing (I never took the pain meds during work). The pain kept getting worse as well as the tingling so I finally got an MRI and saw a spine specialist. He found a lesion growing from my hip into my first sacral vertebrae. They now have me on 10mg oxycodone q4-6 PRN (I'm allowed to take up to 60mgs daily but the max I've ever taken is 40mgs). I still have never taken it while at work and am very responsible with my meds. I never feel "high" or impaired. I feel very impaired when I'm in pain. I start to forget things during work, I'm very distracted and I shake from the pain. I triple check my work constantly because I'm so afraid to make an error.

Surgery has been discussed but I'm very young and want to try everything else first (obviously). When I told my pain management doctor I was a nurse the only thing he said was then I need to be the only doctor that prescribes you narcotics which is exactly what my spine doctor suggested.

A week ago I had dye injected at my S1 and a steroid as well. I had high hopes for some relief only to find I'm in even more pain.

My husband is so tired of seeing me in pain and I'm usually in tears by the time I get home from work. He happened to bring up a good point so I'm asking for help on here as well.

He said to me if a person has ADHD would it be illegal for them to take their ritalin (sp?) at work? It's legal speed. What about an antidepressant, it can cause lots of bad side effects? He doesn't understand why I'm forced to work in severe pain that makes me so afraid to make a mistake. Then I thought about my teacher advising me to take pain meds during school. The only thing I can find on the AZ BON website is that it's illegal to misuse narcotics while working as an RN (it's illegal period right) or to put a patients safety at risk. No where does it specifically say an RN cannot work while taking narcotics.

Keep in mind I've now been on pain meds for about a year, I'm under the care of a pain specialist and I'm very responsible with my medications.

Is it honestly true that it's illegal to work while being treated for chronic pain? I cannot find the answer anywhere. I think all of us assume it is simply because it's a narcotic and has side effects but my husband had a good point, what medication doesn't. Some meds have severe side effects or are legal street drugs but are not illegal to use while working as an RN.

Please do not respond with judgmental rudeness, it took me 3 years to finally give in and treat my pain. I barely had a life, I was depressed and my kids missed their mom.

Thanks in advance.

[elkpark]

A few people have posted here over the years that, in their state (I believe FL is one), the BON has specific regulations that you cannot work while taking opioids or other potentially altering drugs, period. In most states, there is no specific rule/law against it as long as, as you note, the medications are legitimately rx'd for you.

However, you can assume that, if anything goes seriously wrong at work, you will be drug tested by your employer and my concern would be that, if something did go significantly wrong and I had opioids in my system at the time, even legitimately rx'd, it would be difficult to prove that you weren't altered at the time and the medication didn't play a role in whatever Bad Thing occurred.

There are lots of people who post here who feel entirely differently, and have been working regularly for years on rx opioids. I'm sure someone in that position will be along shortly.

[popmode77]

Hi tattedRN, have you thought about contacting the BON either by phone or going in person for answers? They would be the ones to give you accurate answers. Good luck!

[greenerpastures]

THIS IS NOT MEDICAL ADVICE - just a thought - but what about asking the pain specialist about a long acting nerve block or something else that might provide more long term relief? The technology for pain these days is endless. I just heard of someone having something similar to a TENS unit put in to help with pain.

I'd definitely call your state BON directly to ask for specifics about narc use in your state. GOOD LUCK! Chronic pain is A PAIN!

[Ruby Vee, BSN]

I understand the reluctance to get back surgery, but if you're having numbness and tingling in your leg, that's a sign of nerve damage. Consider getting the surgery before it becomes permanent.