prescription drug addiction

nurseinthezoo · Dec 29, 2016

To the patient with a kidney stone or pancreatitis, for example, that dilaudid works pretty well.

David40836 · Dec 29, 2016

... commenting on something you have no clue about. Your opinion is not appreciated. I have had 6 back surgeries with L2 through S1 fused. 8 knee surgeries, 1 ankle and 1 hip. All over the course of 12 years. Before people like all of you started giving your opinions, i was able to live somewhat normally. Then you all had to talk about whats best, how you **** know escapes me, and now my pcp refuses to treat me out of fear of the DEA, FDA, med boards etc. Pain management clinics only will do so much before telling you to * ***. Point is yes there are and always will be people trying to get free highs or whatever but to stop the few you have all *** the many. We now no longer can receive the help we need. Fear in doctors is death in patients. All of you took the oath to treat patients as THEY not you need yet you bow to government control. How can you look at me and say i am lying? How can you tell me you wont help me? How can you sleep at night? I am 39 and prior to Oct 2013 i had a wonderful life. I was properly treated, i could work, i could take care of my family. Now i am unable to work, my family barely survives all because people like you allow government politicians to dictate care. If you want to call me an addict, go ahead because i am. Anyone would be if the choice was a pill or a death worse then death. I would eat dog **** if it had the chance of helping. I have been through every procedure imaginable with no results. This was my only help. This WAS my only way to normal life. Excuse me for the above but when i see people openly stating things such as listed in here, it ****** me off. Until you can measure pain, measure quality of life **** and listen to your patients. If you are doing your job and spending time with them then you can pick out the seekers. You all supposedly took this career to help people, not make life better not to immidiatly doubt and question everything they say. You all make me sick. Dont speak of pain management from having a knee surgery. Imagine waking up every day looking at 3 options. 1: take a pain pill and live. 2: take nothing and suffer. 3: take a pistol and end it. You all have taken away option 1 for most of us.

There is more then one form of death.

Rocknurse, MSN, APRN, NP · Dec 29, 2016

.commenting on something you have no clue about. Your opinion is not appreciated. I have had 6 back surgeries with L2 through S1 fused. 8 knee surgeries, 1 ankle and 1 hip. All over the course of 12 years. Before people like all of you started giving your opinions, i was able to live somewhat normally. Then you all had to talk about whats best, how you **** know escapes me, and now my pcp refuses to treat me out of fear of the DEA, FDA, med boards etc. Pain management clinics only will do so much before telling you to * ***. Point is yes there are and always will be people trying to get free highs or whatever but to stop the few you have all *** the many. We now no longer can receive the help we need. Fear in doctors is death in patients. All of you took the oath to treat patients as THEY not you need yet you bow to government control. How can you look at me and say i am lying? How can you tell me you wont help me? How can you sleep at night? I am 39 and prior to Oct 2013 i had a wonderful life. I was properly treated, i could work, i could take care of my family. Now i am unable to work, my family barely survives all because people like you allow government politicians to dictate care. If you want to call me an addict, go ahead because i am. Anyone would be if the choice was a pill or a death worse then death. I would eat dog **** if it had the chance of helping. I have been through every procedure imaginable with no results. This was my only help. This WAS my only way to normal life. Excuse me for the above but when i see people openly stating things such as listed in here, it ****** me off. Until you can measure pain, measure quality of life **** and listen to your patients. If you are doing your job and spending time with them then you can pick out the seekers. You all supposedly took this career to help people, not make life better not to immidiatly doubt and question everything they say. You all make me sick. Dont speak of pain management from having a knee surgery. Imagine waking up every day looking at 3 options. 1: take a pain pill and live. 2: take nothing and suffer. 3: take a pistol and end it. You all have taken away option 1 for most of us.
There is more then one form of death.

I totally agree with you. I get so angry when I read some of the nonsense and misinformation about opioids. I've been taking them for a long time for intractable stage 4 endometriosis and adenomyosis pain. My diseases are incurable. They aren't going to go away nor will they improve. I've had three surgeries and I have chronic pelvic and back pain. Sometimes my entire body hurts from my knees to my chest. Sometimes the pain is so bad I am rolling around crying. I have tried many kinds of pain meds...even fentanyl. I tried all of the NSAIDs but was either allergic or they gave me other side effects. One of the NSAIDs gave me the worst GI pain every time I had a BM that I would cry. My doc was wonderful and worked through each med with me and eventually settled on dilaudid. I don't take it every day- I am not addicted nor dependent on it unless I am in pain. I am responsible and careful with it. I understand the pharmacokinetics and the implications of taking it all the time. It doesn't affect me in any other way than relieving pain. I would struggle to function if I did not have it. If my doc told me tomorrow that I could no longer have a prescription I just don't know what I would do. I live in fear of that every single time I have to call for a new prescription. So much bs judgment and fear mongering. Some people will abuse no matter what. Don't let innocent people suffer because of maybes. Absolutely prescribe sensibly and appropriately, but denying people in pain their relief is unethical and cruel.

heron, ASN, RN · Dec 29, 2016

@ David and Rocknurse: perhaps you could point out where anyone advocated withholding pain meds from people who need them?

Rocknurse, MSN, APRN, NP · Dec 29, 2016

@ David and Rocknurse: perhaps you could point out where anyone advocated withholding pain meds from people who need them?

Well that's the thing isn't it? You don't know who "needs" them but many judgments have been made on this thread (and many others) about who is perceived as worthy and who is perceived as drug seeking. As it can't really be known for sure, isn't it wise to just give the patient in question their prescribed meds without some silent moral judging? The general undercurrent is that most people are addicted and drug seeking and that only a few are genuinely "worthy". As it's impossible for anyone to know who's genuinely "worthy" I suggest just giving meds as ordered and not worry too much about the reasons that brought the patient to having to take the meds in the first place. I've experienced that judgment and false moralism myself as a patient in the ED and it outraged me. I hate this discussion because I've been on both sides. It's so easy for people who have never experienced chronic pain to make sweeping statements but reality is so much uglier and multi-faceted.

David40836 · Dec 29, 2016

It isn't as cut and dry as that. It has to do with all the federal prescribing laws which hit in 2013 and beyond. It is the hyper focus of media, government and police agencies. Its the doctors who are all backed by lobbyist against opiate prescribing. The stats the US consumes 80-90% of the worlds opiates. The news of **** doctors busted for pill mills. Combine all of that into a nice cookie and nearly 100% of medical staff are now so leery of DEA/FDA interventions or patient abuse, selling, overdosing that no one will treat the people who truly need it the most. Yes all the above are problems, yes people sell their prescriptions, yes people over use them but to stop the issue the fix was to pretty much make opiates a taboo subject. It is an issue being treated with fear and hostility.

But I will tell ya what....it has done nothing. The numbers of prescriptions hasn't fallen, overdoses hasn't changed, people selling prescriptions hasn't changed nor the price of them or quantities. The only thing that has, is people with real problems are being left in the void or have gone to use illegal drugs. We do not aggressively ask for opiates, shop for that "golden" doctor. When I go to Walgreens to fill my prescriptions I receive the most abysmal looks, I have had pharmacists tell me they wont fill my prescription because they do not support drug addicts and I need to go somewhere else. The opinions spread by media and people are viral, poisonous and have pushed patients into the same world as heroin addicts. Yes I have reported all my issues to the proper people but then I appear as they have stated, an addict. Its a double edged sword, no matter what you do your going to be hurt.

I live in Memphis Tn. and have been to nearly every pain management center within 400 miles and always end up in 1 of 2 boats. Boat 1 is the only treatment they will provide is nerve blocks which have never worked and if I do not want them then I need to leave. Boat 2 is prescribe a medication which I took for over 10 years but do not consider the length of time I have been on it, frequency or strength. Prior to 10/2013, I was give 20mg hydrocodone every 6-8 hours. Was on that for 3-4 years. It didn't work 100% but was enough and every month I would turn down increasing or changing to something stronger. Since 10/2013 no matter what, its 10mg every 8 hours only of hydrocodone even though I tell them every month it is 100% ineffective and actually refused it this month. Don't see the purpose of taking a medication with 0 benefits. LOL and my reward? Kicked out of pain management for refusing treatment. Last place was Comprehensive Pain Management. It was the last one in this area left for me to try. They had no issues billing me every month for coming in only to give me a prescription through a window and a drug test without being seen by anyone. Midsouth Pain Treatment Center was the center that would only do nerve blocks at 400 a pop....literally every 2 weeks I went in they told me I needed another one and if I said no I needed to leave...so I left with a finger in the air trailing. I have begged on hands and knees for knee surgery, knee replacements anything to fix it and I get jerked around. I am far more valuable to keep coming back then to refer. 4/18/2016 was when I begged for a referral to an ortho and on 12/15/2016 I was still being told they are working on it which is when I refused the scripts. I'm no doctor but I know my body and my problems. I am (was) an electrical engineer prior to 10-2013, now I am unable to work. Treat the patient, treat the disease, give me an identity as an individual and not as a group.

heron, ASN, RN · Dec 29, 2016

But it's addiction that's under discussion, here - not pain management. Are you proposing that prescription drug abuse doesn't exist? If not, how would you approach the problem?

Ruby Vee, BSN · Dec 29, 2016

.commenting on something you have no clue about. Your opinion is not appreciated. I have had 6 back surgeries with L2 through S1 fused. 8 knee surgeries, 1 ankle and 1 hip. All over the course of 12 years. Before people like all of you started giving your opinions, i was able to live somewhat normally. Then you all had to talk about whats best, how you **** know escapes me, and now my pcp refuses to treat me out of fear of the DEA, FDA, med boards etc. Pain management clinics only will do so much before telling you to * ***. Point is yes there are and always will be people trying to get free highs or whatever but to stop the few you have all *** the many. We now no longer can receive the help we need. Fear in doctors is death in patients. All of you took the oath to treat patients as THEY not you need yet you bow to government control. How can you look at me and say i am lying? How can you tell me you wont help me? How can you sleep at night? I am 39 and prior to Oct 2013 i had a wonderful life. I was properly treated, i could work, i could take care of my family. Now i am unable to work, my family barely survives all because people like you allow government politicians to dictate care. If you want to call me an addict, go ahead because i am. Anyone would be if the choice was a pill or a death worse then death. I would eat dog **** if it had the chance of helping. I have been through every procedure imaginable with no results. This was my only help. This WAS my only way to normal life. Excuse me for the above but when i see people openly stating things such as listed in here, it ****** me off. Until you can measure pain, measure quality of life **** and listen to your patients. If you are doing your job and spending time with them then you can pick out the seekers. You all supposedly took this career to help people, not make life better not to immidiatly doubt and question everything they say. You all make me sick. Dont speak of pain management from having a knee surgery. Imagine waking up every day looking at 3 options. 1: take a pain pill and live. 2: take nothing and suffer. 3: take a pistol and end it. You all have taken away option 1 for most of us.
There is more then one form of death.

Whoa there! I understand that you're frustrated, but this post is abusive.

Have you looked into a pain management clinic? Have you tried non-narcotic pain medications? Physical therapy? Or is it a case of "give me my narcotics and leave me alone?"

I've spoken both as a registered nurse giving pain medication to patients who may (or may not) be in excruciating pain and as a former patient of many orthopedic surgeries, some more successful than others. There was a time when I needed Dilaudid to function -- but with time, hard work and some very good physical therapists, I've managed to strengthen my muscles, increase my flexibility and get through most days with no pain medication. I'm able to work in the ICU. I've not walked in your particular shoes, but I am entitled to an opinion on the topic.

As a nurse, and as a patient sitting in the waiting rooms of various orthopedic clinics and physical therapy practices, I've seen some (many) patients who are all about the pain medication. I've seen people who won't do their prescribed PT because "it's stupid" or "it doesn't work" or "it hurts." (Of course it hurts -- that's why they recommend you premeditated with pain medication before you start your exercises.). I've seen people who don't want to do anything to help themselves except take more narcotics. And they get addicted.

I don't think this thread is about failing to treat legitimate pain, it's about addiction to prescription pain medication. You're addicted, by your own admission. You don't seem interested in any constructive solutions to the problem; it seems you just wish to be abusive to nurses. OK. Rant heard.

David40836 · Dec 29, 2016

Well you can call it what you will but pain management is drug addiction. For me an addiction is anything needed to maintain a specific function as in my case life. The addictions caused by the over prescribing during late 90's into early 2000's has lead to the pain management practices which are now interlaced with true patients and drug seekers. Is there a difference in addiction between them? No not at all except the seekers want the high and the patients want the relief. They are intertwined and should not and can not be separated (management and addiction). You run topics on addiction and users etc but when you leave out the patients, you lose a large part of the picture. So we get what we have now. Regulations and views attacking a drug without the needed separation. Like I said, we are now bumped all up into the same levels of junkies, pill poppers, name it. When media, medical, police, etc speak of the epidemic do they ever make any separation between us? NO. So in the view of the majority I am no better then a doc shopping pill popping junkie.

I'll tell ya what...If I could go back to the day when that drunk rear ended my car at 85 I would but I cant and I am now left with the results. So what now.....we attack the issue as always with prejudice, hate, spin and political correctness. We attack an epidemic by making it impossible for the 99% to receive help to stop the 1%. We didn't help the problem, we created an even larger problem. We sent all the true patients to the heroin dealers, to the streets when the doctors got scared. Yeah sit back in good health and say "what idiots", "their problem" but do you really think a middle class person with a good job and family would naturally roll down to the hood looking for a heroin dealer? No, they do it because a DOCTOR got them hooked on something and then when the heat and incentives of prescribing dried up cut them off. Remember in these discussions, we can not prescribe ourselves so our first drug dealer was our doctor. I was lucky I never followed the docs requests to increase and increase over the years as I am more then sure I would of ended up down a road like that. Now I just suffer.

When it comes down to it, addiction is a natural effect of the treatment for pain. There are no other solutions right now. Its the same with any drug whether taken for recreation or for treatment of problems. No problems these days getting 10 year olds to pop Adderall like skittles yet its not an issue right when they cant get it anymore and run down the road for crystal meth? Its just opiate is the word of the day these days. All these discussions are so hypocritical its not funny.

So my idea to fix it? YOU CANT. There isn't a law, or a policy or anything to fix this. Look at any drug policy...they have all failed. You can however educate, identify and treat. You take this crap long enough your brain physically changes and you can not undo that with a law or fear. If there is any fix it is to stay out of doctor/patient business and let the sticks fall where they may. People who want to abuse will abuse whether its pain pills, designer drugs, experimental, illegal you name it. You can not stop that and its sad to see people still in 2016 believing there is a "fix" for something like this. We all know well enough smoking kills yet how big is BIG TOBACCO even in 2016?

You only have 1 of 3 choices.....

1: You mind your own business and let people get the help they need without fear

2: You screw over all the legit patients in a bid to stop the idiots who will just move on to the next big, easy and cheap drug once the honey pot dries up.

3: Eliminate all the drugs whether good or bad from the face of the planet and move us back to the dark ages.

No matter what you do, what you say, what you write, it will not stop people from doing what they want with what they want.

The real question is, as doctors and nurses do you honor your oath to treat humans to the BEST of your ability using all available resources or do you lump us all into the pile of addicts who are laughed at, scorned, rejected and under treated? I say this because there has yet to be a difference made in the discussions of this topic and just simply stated as how to stop addicts.

heron, ASN, RN · Dec 29, 2016

No, the real question is how to treat pain effectively without causing or contributing to the life-limiting disease of addiction?

David40836 · Dec 29, 2016

I have tried literally every method possible and was my 1st choices each and every time. I hate narcotics. I hate being on something I have to take. If you gave me a stick and said naw on this daily and your problems are gone I would naw till my gums bled.

I have been through PT for months and months. I have had more nerve blocks and ablations then I can count. I have had the spinal stimulator installed into my gut. Acupuncture. This year alone I have had over 30k in medical bills due to other options tried. MRI's, nerve blocks, PT you name it...year after year. I ASK for these things not drugs first. So what now? Most my spine is titanium, my knees no longer have cartilage/ligaments/function. My hips are worn out. Each issue plays into or is caused by another. Sooooo backs are better from exercise yet my knees cant handle it. I walk messed up due to knees which places pressure on my back and hips. A constant negative feedback all at 39 because I didn't go seeking drugs, I didn't go looking for help, I waited until I couldn't stand it.

Sorry for the content of my posts but as you stated "did you just ask for narcotics". Its an automatic assumption that I did and there in lies the issue with discussions like this. An automatic assumption that I/we are liars simply because I have tried everything and that is the only option. A no win situation.

Do you not ever ask "What will happen to the real patients?" What effect will all this have on them because in all the pro papers I have read on this issue none ever do. Its celebrated as a victory against X people who do X. Pats on backs etc yet the streets are still flooded with it and the only ones without are the patients. I would love to take the docs and nurses around the city to show them how effective all this has been. I wanted to state the view of someone who was negatively effected by this hyper focus. Someone who's life was destroyed not by the use of the drugs in question but by the extreme prejudice now exhibited in the prescribing of the drugs in question. You attack only one side of the issue. It is short sided and tunnel vision and only wrecks the lives of more then it truly saves. We the true patients never have a voice in these matters and if we do its viewed as an addict mad at a lost source.

Do not get me wrong, I have no issues with doctors or nurses and believe they do try their best but I do have issues with the doctors or nurses who speak of what I or someone else needs without knowing first hand how it feels or based off simple assumptions or stereotyping of people. I have been dealing with this issue now for 3 years. It isn't one place or another but everywhere. Automatic assumption of "he's here to get free drugs" even though my med recs say otherwise. I/we now do not just have to find a doctor but also go in under the pretense we are guilty by simple association until we can prove otherwise if at all ever.

heron, ASN, RN · Dec 29, 2016

No one disagrees with that, David. But you still haven't addressed the subject of the thread.

Ineffective and prejudiced pain management is a real thing precisely because practitioners get confused about whether they're treating pain or addiction or both.

You have every right to be angry, but you are ranting at the wrong people in the wrong context.