What do you think? My mother is told she is a drug addict by her primary care physician

[BeenThere2012, ASN, RN]

My mother has a number of drug allergies/intolerance unfortunately including all of the NSAIDs. This didn't use to be a problem for her to get prescription pain meds in small doses to keep around the house for her to use for headaches, etc., but in recent years it hasn't been possible. Now she just doesn't have pain control as an option other than nonpharmacologic methods or topicals at home.

She went in to the ER after a fall and demanded pain killers for the severe pain in her wrist. It turned out it was broken, but they almost turned her away for "drug seeking behavior" because she was asking for specific medicines. She just knows because she has so many allergies what she can and cannot take. In the fight to make sure they didn't give my "druggie" mom anything for her pain, they almost completely missed that she had broken bones.

So sorry your mom went through that. Unfortunately, this is another example of how the pendulum has swung too far in the opposite direction of giving powerful pain meds for "whatever the patient says it is".

[mmc51264, BSN, MSN, RN]

I had a doctor that would not let me keep my tramadol. ?????? Sent me to the pain clinic. B/c I take tramadol for chronic OA pain. I LOVE the doctor there and now I see the PA. They laughed at me, in a good way-told me I was the easiest pt. No heroin, methadone, no___ contin.

I think the increase in pain specialists is a good thing though not commonplace yet. I wish your mom could find a decent pain clinic.

[BeenThere2012, ASN, RN]

I had a doctor that would not let me keep my tramadol. ?????? Sent me to the pain clinic. B/c I take tramadol for chronic OA pain. I LOVE the doctor there and now I see the PA. They laughed at me, in a good way-told me I was the easiest pt. No heroin, methadone, no___ contin.

I think the increase in pain specialists is a good thing though not commonplace yet. I wish your mom could find a decent pain clinic.

Yes. Need more pain specialists who know what they are doing and have good alternative measures for pain control as well. You have to be careful here...I've experienced one who was closer to a "street drug dealer" than a legit physician. All his patients adored him, but he gave me the creeps. Very "touchy feely" in a not so good way. Once I had the surgery that took care of the cause for my pain, I told him I wanted to go through the plan for weaning off. He acted shocked and said,. "You mean stop altogether?". I said..."well yes.". He wasn't as friendly after that so I accomplished it with my primary in the end. Patients who have real pain, ongoing, have a very hard time getting good care. You can be jerked around from one extreme to the other. Either the "gate keeper type" who make you feel ashamed because you still have pain, or the opposite I described before. I am blessed that my problem was correctable. For so many, it's a life-long battle.

[RNOTODAY, BSN, RN]

This is a tough subject, for sure. You have docs who are scared to death to write for Vicodin and Percocet scrips, ... fearing the DEA will bust through their doors at any moment, shutting them down . And, yes, it HAS happened, absolutely, and not only to docs who were shady- to honest, law abiding physicians, treating the pain their patients had... however, there are the patients who are completely lying to feed their addiction, or to sell their scripts ... and those patients who legitimately have true pain ? Well nowadays, they are simply screwed !!! Oh, and the addicted ones? Well, they aren't too much more well off, because NOW, with a pill nowhere to be found or bought...they progress to HEROINE, and they are DYING... I know changes needed to be made re: shoddy pain med prescription practices.... but, I'm just not convinced that they did the right thing , or went about it the right way..because with the end result basically being , legitimate pain patients go without , and then" others" are ODing on Heroine ?

No, that doesn't sound like success or progress.. to me , anyway...

[LovingLife123]

This is a tough subject, for sure. You have docs who are scared to death to write for Vicodin and Percocet scrips, ... fearing the DEA will bust through their doors at any moment, shutting them down . And, yes, it HAS happened, absolutely, and not only to docs who were shady- to honest, law abiding physicians, treating the pain their patients had... however, there are the patients who are completely lying to feed their addiction, or to sell their scripts ... and those patients who legitimately have true pain ? Well nowadays, they are simply screwed !!! Oh, and the addicted ones? Well, they aren't too much more well off, because NOW, with a pill nowhere to be found or bought...they progress to HEROINE, and they are DYING... I know changes needed to be made re: shoddy pain med prescription practices.... but, I'm just not convinced that they did the right thing , or went about it the right way..because with the end result basically being , legitimate pain patients go without , and then" others" are ODing on Heroine ?

No, that doesn't sound like success or progress.. to me , anyway...

This 100%!! It's so sad. I deal with chronic pain all I had an understanding primary doc until the new laws came out and the DEA came in to three local physicians and scared the crap out of my primary. For the record, my primary was not a part of their raid. But, I got transferred to a pain management doc who is understanding depending on what day it is. He works with me.

Meanwhile, the county I live in has now turned to Heroin and they are dying. There is now a needle exchange station, and babies are born addicted to heroin and meth.

Good work US government. I applaud you for taking a problem and making it so much worse, as usual. It happens because little Timmy died from snorting 10 Oxys up his nose and dying. Now Timmy's mom wants someone else to blame because Timmy was such a good boy. She wants a law in his name. And you know, in your grief I get you want something to blame. I totally get that. But as a society we need to get Timmys mom to see that it was his fault. But too many legislators worry about getting elected again so nobody will her it's not anybody's fault but Timmy's that he decided to illegally obtain a drug, crush them, and snort an insane amount up his nose.

Unfortunately, the people who really need these meds are left out in the cold to suffer and die. Being in horrible pain everyday without treatment can be maddening to the mind. Maddening.

I hope somebody can help your mom.

[dec2007]

This 100%!! It's so sad. I deal with chronic pain all I had an understanding primary doc until the new laws came out and the DEA came in to three local physicians and scared the crap out of my primary. For the record, my primary was not a part of their raid. But, I got transferred to a pain management doc who is understanding depending on what day it is. He works with me.

Meanwhile, the county I live in has now turned to Heroin and they are dying. There is now a needle exchange station, and babies are born addicted to heroin and meth.

Good work US government. I applaud you for taking a problem and making it so much worse, as usual. It happens because little Timmy died from snorting 10 Oxys up his nose and dying. Now Timmy's mom wants someone else to blame because Timmy was such a good boy. She wants a law in his name. And you know, in your grief I get you want something to blame. I totally get that. But as a society we need to get Timmys mom to see that it was his fault. But too many legislators worry about getting elected again so nobody will her it's not anybody's fault but Timmy's that he decided to illegally obtain a drug, crush them, and snort an insane amount up his nose.

Unfortunately, the people who really need these meds are left out in the cold to suffer and die. Being in horrible pain everyday without treatment can be maddening to the mind. Maddening.

I hope somebody can help your mom.

The Timmy analogy is what happens when no one is expected to take responsibility for their own behavior. You are right...it is sad!

[HH_RN13, ASN, RN]

I am sorry your mom has to go through this. I hope you find a doctor who can properly diagnose and treat her condition and make her more comfortable. This new wave of "everyone is a drug seeker" is making a lot of real patients with real pain miserable and endangering them. I had a patient who has been on OxyContin up to 120mg per day for their chronic pain for over 20 years! Pt admitted to the hospital and believe it or not in this crazy race to fight opioid crisis they sent this pt home with 10 OxyContin pills at barely 40mg per day and pain specialist appointment for a month away. Poor pt suffered severe withdrawal symptoms and pain for 2 weeks before primary agreed to put pt back on the regular regimen. I completely understand what your mom must be going through. Don't give up! Find another provider who cares enough to get an actual diagnosis and treats the condition rather than just masking symptoms. Good luck!

[Hospice Wings]

My mother had some of the same issues. I would recommend having her enrolled in Palliative Care if you have it in your area.

[mmc51264, BSN, MSN, RN]

Had a bit of an epiphany this weekend. We get a lot of complicated pts from OSH. I have noticed that these OSH don't give PO pain meds! IV dilaudid. Every three hours. When they get to us, we usually start off conservative with PO and then IV available for unresolved pain. It is a process to find the right pain plan. The pts get really upset because they are used to getting the IV all the time and it makes it almost impossible to manage pain that way. If someone is in the hosp for 2 weeks while they are healing and getting that much IV narcotics, that is setting them up for addiction. (we had a patient that after doing the math, had received 40 mg of IV dilaudid in a little over one shift. SMDH.

We are lucky that we have an Acute Pain Team that works with patients. They use Ketamine and lidocaine drips for hard to manage pain-and regional nerve blocks when possible. There is only so much narcotics people can take.

[dec2007]

Had a bit of an epiphany this weekend. We get a lot of complicated pts from OSH. I have noticed that these OSH don't give PO pain meds! IV dilaudid. Every three hours. When they get to us, we usually start off conservative with PO and then IV available for unresolved pain. It is a process to find the right pain plan. The pts get really upset because they are used to getting the IV all the time and it makes it almost impossible to manage pain that way. If someone is in the hosp for 2 weeks while they are healing and getting that much IV narcotics, that is setting them up for addiction. (we had a patient that after doing the math, had received 40 mg of IV dilaudid in a little over one shift. SMDH.

We are lucky that we have an Acute Pain Team that works with patients. They use Ketamine and lidocaine drips for hard to manage pain-and regional nerve blocks when possible. There is only so much narcotics people can take.

What does OSH stand for?

[traumaRUs, MSN, APRN]

OSH - outside hospital.

I work at a tertiary level 1 trauma center (700 beds) and anything coming from the "region" is an OSH.

Hope that clarifies it.