prescription drug addiction

Nurses General Nursing

Published

Noticed a Facebook "trending topic" this evening (early morning?) about neonatal abstinence syndrome and it talked about prescription drug abuse. Thought it was an interesting article.

Researchers say the increase coincides with the increase in opioid use in rural communities and rising prescription pill overdose rates.

Honestly, I would be happy if I never had to give IV dilaudid.

I have told all my docs and nurse friends, if I end up in the hospital, NO IV NARCS. I had auditory hallucinations when I had PO oxycodone after a knee surgery. I can only imagine that dilaudid would probably kill me.

Specializes in Med Surg/ICU/Psych/Emergency/CEN/retired.
I still face a complicated surgery to put my insides back together....where they belong. Being so sick and septic my teeth are ruined and I am in the process of removable teeth...something which I dread but cannot avoid. The abdominal surgery will be extensive and include a mesh (which I am terrified of) so I need to minimize danger of infection....the saga continues.

Esme,

I don't like hearing this, but you have explained that it is necessary. I can only imagine the ordeal you have been through. You have kept this site informed and up to date about your travails. I recall some posters asking about you in the past and someone posting when you were too ill to do so yourself. It's nice to read all the supportive comments from posters here, most perfect strangers.

I wonder if you've ever considered writing a book about what has happened to you. Maybe not now but later. Just a thought...

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Specializes in Geriatrics, Home Health.

Where I live, in the heart of New England's opioid crisis, many PCPs no longer prescribe them. Chronic pain patients are referred to the (only) pain clinic, with long waits and higher "specialist" copays. Once you get in you have to agree to a pain contract, with random pill counts, random pee tests, and refills through one, and only one, pharmacy. No mail-order pharmacies, no early refills. Going out of town? Too bad.

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Where I live, in the heart of New England's opioid crisis, many PCPs no longer prescribe them. Chronic pain patients are referred to the (only) pain clinic, with long waits and higher "specialist" copays. Once you get in you have to agree to a pain contract, with random pill counts, random pee tests, and refills through one, and only one, pharmacy. No mail-order pharmacies, no early refills. Going out of town? Too bad.

Yup, sounds like my outpatient clinic. An incredible inconvenience for folks who take their medications appropriately..... But I can see why these stringent rules are in place- especially when it seems to be the same patients that consistently report their medications lost/stolen/flushed down the toilet/dog at them... then proceed to provide cold urine samples. The monkey business can be incredulous.They also seem to be the same patients that can't be bothered to show up to their PCP appointments, PT sessions, imaging, referrals, etc.... Patients have to be held to some level of accountability.

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Specializes in Psych, Addictions, SOL (Student of Life).
It fascinates me how some nurses are able to look into their crystal balls and personal bias to try to reduce the pain meds I was on even though my pain docs at the academic facility prescribed them.

I am with you on this. Having been through something similar though not nearly as serious as your experience I remember hearing nurses discussing "My Pain". My doctor finally told the nurses that were reluctant to " just give her the ******* medication I ordered" As far as I am concerned if you are awake and oriented and it's time I'll give you your meds and you bet I'm going to pre-medicate you for PT and dressing changes.

I hope you are healing and that you find a pain management specialist who get give you some comfort. You have earned it after all you have been through.

Peace and Namaste

Hppy

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I'm so sorry Esme.

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Specializes in Hospital medicine; NP precepting; staff education.

God bless you, Esme. You are a valued member of this forum and our profession. I cried at your story, not only because you are so loving and lovely, but to treat ANYONE like that (addict or not) is abhorrent.

And here I am after a much less severe surgery and I barely take my narcotics and the doctor wanted to write me for more in a week after the procedure. I told him I barely took any, I have plenty. Meanwhile, my husband, who is a clinical counselor to substance users, is worried about me getting hooked. I simply don't take it unless I need to. The other day I cleaned out a purse and found a 3 or 4 year old bottle that still had some in there.

Despite my dad's alcoholism, the only thing I really depend on is caffeine. I don't like the taste of alcohol, and I hate how narcs make me feel so I have such a deterrent to their use unless absolutely warranted, despite chronic pain, that I do not get addicted. My switch was never flipped. Maybe I'm lucky or that gene is dormant or nonexistent in me.

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Specializes in SNF, Home Health & Hospice, L&D, Peds.

What I find hard to understand is why in this day and age anyone has to live in pain...period! Not to mention haven't we as health care providers been mandated to assess patient pain and treat pain as if it was the worst offense if we did not treat the patients pain as they said their pain was? Now all of the sudden they say, now too many people are on opioids and we must do something to combat this!? What a bunch of bs! I believe in managing a patients pain. I have seen so many patients with under treated pain in my career and I for one was so happy to see the tide turn in favor of prescribing more freely. I am just so disgusted with the about face and the act as if they have no idea how this all happened!

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Specializes in SNF, Home Health & Hospice, L&D, Peds.
I always feel conflicted when I have a new patient in LTAC who gets Dilaudid maybe once on my shift, then the next day maybe twice, then by day 3 they are setting their phones for the Q4 and they are around the clock from then on.

Ugghh! Of course people want to have pain relief for crying out loud. I am so sick of nurses who decide they are the police of morality or whatever their opinion is about patients giving pain meds. I have seen nurses delay or refuse to give patients their PRESCRIBED pain medication because of their own, misguided beliefs! I had all 4 of my wisdom teeth out at once. I was prescribed Tyl#3. for pain however, when I got home I went straight to bed. I was in so much pain but was able to go to sleep...yes patients can actually sleep whilest in pain, sometimes it is the only relief they get. WHile I was sleeping the oral surgeon's office called and spoke with my sister. My sister came and woke me up and gave me my pain medicine because the oral surgeon's office told her if I didnt take it now the pain would be unbearable soon. I took the medication and I was really shocked how much relief I had received from the medication. For the most part people want to have pain releif period. Sometimes until you are out of pain you don't realize how much pain you were in.

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hppy, thanks for the link to the article. katfish67lpn, I will tell you why people are in pain in this day and age. Per the article hppy linked to, my horse stepped on my lower leg about 17 years ago (I fell,) and basically blew all the meat out of the top of my calf. The ER doc gave me 6 vicodin and told me to take 2 every 4 to 6 hours. I thought about it, and as I am medication sensitive, I took 1/2 vicodin and hallucinated for 2 hours. I went to 2 ibuprofen every 6 hours with relief. Fast-forward, I had a severe back injury at work a couple of years later, 10 out of 10 (childbirth only rates a 9), and I live in 5 to 6 out of 10 every day of my life because I don't react well to meds. If I hit 7 or 8 (if I overdo at work) I take an ibuprofen with an acetaminophen 500mg. I do not choose to go through life sedated, and I need to know if I am overdoing it, which I would not know if I am constantly medicated.

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Specializes in SNF, Home Health & Hospice, L&D, Peds.
hppy, thanks for the link to the article. katfish67lpn, I will tell you why people are in pain in this day and age. Per the article hppy linked to, my horse stepped on my lower leg about 17 years ago (I fell,) and basically blew all the meat out of the top of my calf. The ER doc gave me 6 vicodin and told me to take 2 every 4 to 6 hours. I thought about it, and as I am medication sensitive, I took 1/2 vicodin and hallucinated for 2 hours. I went to 2 ibuprofen every 6 hours with relief. Fast-forward, I had a severe back injury at work a couple of years later, 10 out of 10 (childbirth only rates a 9), and I live in 5 to 6 out of 10 every day of my life because I don't react well to meds. If I hit 7 or 8 (if I overdo at work) I take an ibuprofen with an acetaminophen 500mg. I do not choose to go through life sedated, and I need to know if I am overdoing it, which I would not know if I am constantly medicated.

Just because one takes opioids does not mean they are "going through life sedated"

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I was not speaking for everyone if you read my reply, I was speaking about MY reaction to opioids. You said NO ONE needs to go through life in any pain, I was simply saying why someone might choose to. When my other horse dislocated my thumb last year, I told the ER PA to tear up the Rx for Percocet, I would not accept it due to my previous reaction. She could not believe I would not take the Rx.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Esme's story is one of my worst nightmares. Being in pain, not being believed, not being treated, not being helped...usually by people who have no idea what excruciating, debilitating pain even feels like. It's the smug attitude that burns me the most. That's when I find myself being very uncharitable and hoping for that thing called Karma.
YOu betcha and I want to change my name to Karma.
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