The demonization of opiates is hurting people.

[cali]

Opiates are bad, bad, bad blare politicians and newspapers.

But what about people who actually need them?

Yes, this is personal. I don't like oxycodone- it makes me weepy, but I need them. Yes. NEED them. Some days I can't exercise without them, and exercise is vital for me. Some nights I can't get to sleep because of the pain, or the pain jolts me out of sleep. Do you know what that's like? It sucks.

I've tried everything. I've tried sympathetic nerve blocks administered into the spine. I've tried gabapentin and lyrica and topical ketamine and much more.

I am proactive as hell regarding my RSD/CRPS (Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome): I have type 2 with major nerve damage as well as traumatic arthritis and "massive" (according to my orthopedic surgeon) soft tissue damage.

Complex regional pain syndrome (CRPS) formerly reflex sympathetic dystrophy (RSD), "causalgia", or reflex neurovascular dystrophy (RND) is an amplified musculoskeletal pain syndrome (AMPS). It is a chronic systemic disease characterized by severe pain, swelling, and changes in the skin. CRPS is expected to worsen over time.[1] It often initially affects an arm or a leg and often spreads throughout the body; 92% of patients state that they have experienced a spread, and 35% of patients report symptoms in their whole body.[2]

Complex Regional Pain Syndrome is a multifactorial disorder with clinical features of neurogenic inflammation (swelling in the central nervous system), nociceptive sensitisation (which causes extreme sensitivity or allodynia), vasomotor dysfunction (blood flow problems which cause swelling and discolouration) and maladaptive neuroplasticity (where the brain changes and adapts with constant pain signals); CRPS is the result of an "aberrant [inappropriate] response to tissue injury".[3] Treatment is complicated, involving drugs, physical therapy, psychologic treatments, and neuromodulation and is usually unsatisfactory, especially if begun late.[4]

CRPS is associated with dysregulation of the central nervous system[5] and autonomic nervous system resulting in multiple functional loss, impairment, and disability. The International Association for the Study of Pain has proposed dividing CRPS into two types based on the presence of nerve lesion following the injury.

Type I, formerly known as reflex sympathetic dystrophy (RSD), Sudeck's atrophy, reflex neurovascular dystrophy (RND), or algoneurodystrophy, does not have demonstrable nerve lesions. With the vast majority of patients diagnosed with CRPS being of this type, most of the literature thus refers to type I.
Type II, formerly known as causalgia, has evidence of obvious nerve damage. Type II CRPS tends towards the more painful and difficult to control aspects of CRPS; type II scores 42 out of 50 on the McGill pain scale [6] (however there is seemingly little or no data pertaining to type I specifically here). In Type II the "cause" of the syndrome is the known or obvious nerve injury, although the cause of the mechanisms of CRPS Type II are as unknown as the mechanisms of Type I.

CRPS has the unfortunate honour of being described as the most painful long term condition (of those that have been tested), scoring 42 out of a possible 50 on the McGill pain scale, above such events as amputation and childbirth.[7] Lack of social awareness has inspired patients to campaign for more widespread knowledge of CRPS,[8] and lack of clinical awareness has led to the creation of support groups seeking to self-educate with the latest research.[9]

<snip>

http://en.wikipedia.org/wiki/Complex_regional_pain_syndrome

I get that opiate addiction is a real problem, but the nonsense that someone like me (and my doc) has to go through now, is becoming absurd. My doc told me that I am only one of 5 people that she treats with opiates in her busy practice. Now she's retiring and I wonder what I'll have to go through to get my new doc to understand why I use opiates. CRPS is a rare disorder and lots of doctors don't know much about it.

I've learned a lot from dealing with intense physical pain and I live and enjoy my life. Opiates (and steroid injections) are a piece of my being able to live, not just exist in a haze of pain.

Sorry about venting. I can't sleep because of.... the pain.

[burrowowl]

1. Codeine Works for Lots

of stuff and is cheap.
Oh my God there are more expensive drugs available, use them instead.
It used to be drugs couldn't be advertised.

[MannyGoldstein]

2. Sorry for your pain and your trouble in obtaining meds!

First opioids were bad, terrible. Then they were okey-dokey. Now they're becoming bad, terrible again.

The reality is that they're like any powerful tool - they can great stuff, but care is needed. But the US doesn't seem to do middle ground very well anymore.

[cali]

4. thanks Manny. Actually, I don't have any trouble obtaining them

but other people do. My primary care physician has educated herself about CRPS and I've been diagnosed with it by experts at varying institutions and my orthopedic surgeon was actually the guy that diagnosed me. But other people who may not be as good at advocating for themselves certainly have trouble getting the pain relief they need.

You are certainly spot on about how we don't do the middle ground very well.

[truedelphi]

20. When my general physician pulled out of the clinic

That took my health insurance, I shopped around for a doctor within the insurance providers' network who would be able to help me and also bill the insurance.

The lady physician I then saw was aghast at my taking vicodeine. She did not do any over all overview of the situation - that going ten years abck, I started taking it for back pain, usually no more than 4 a week; then when another illness set itself upon me, I was taking as many as six a day. Then when I discovered this "illness" was a sensitivity to gluten, and began eating gluten free foods, I was back down to three vicodeine a week.

No she just wanted me off vicodeine, because "you know - it is a controlled substance." It also has to do with her being a Seventh Day Adventist, and she wouldn't do pain pills, so I must do as she does!

What did she propose instead? She wanted me to take a major anti-depressant, which she claimed would deal with my pain as well as the vicodeine. When I got home, I researched that med - it had so many side effects that I was ill just reading about them.

I finally returned to the fold of using my old physician, but I have to pay out of pocket.

[sorefeet]

100. It should be criminal

My brother Pinkie had end stage liver disease, Hepatitis C cancer. I took him to the clinic where the made him 8 different appointments with 7 different doctor(quacks) to assess pain management. Each one ask him what he was there for, gave him the pain chart and end of visit. Never once talked about cancer or pain. after over 2 months of visits the offered him LYRICA. He had one visit with an oncologist(no pain meds). The only thing he was offered was hospice. I got him to my sister in Illinois where he got treatment and pain meds, bought a cute little trailer, raised some homing pigeons and lived for another year and a half pain free.

[truedelphi]

127. I am so glad that both you and your sister were there for him.

The fact that he was able to have time to spend with his pigeons and a good quality of life says a great deal about what good work you did on his behalf.

The medical system in this country sucks. It really does. I spent almost twenty years doing elder care.

Until the mid-nineties, I was pretty confidant that common sense situations and decent medical knowledge would prevail. But then came an era of physicians being afraid of prescribing pain meds.

And also, many RN's and LVN's, at least in the SF Bay area,were replaced by nursing assistants. Not to put down Nursing Assistants, as that was what I was too, but to have an entire hospital staffed with floating nurses who do not know where anything is and nursing assistants that barely speak English - well, it is criminal. Then combine the above with the fact that many operations get performed on people while they are in the hospital, but then the patients are "early released" into nursing homes, which are nothing more than barbaric concentration camps that cost the family $ 3,000 plus each month.

I had clients who had "Nothing by mouth" orders, and then no IV''s to provide fluids. Since the physicians only come into the nursing home maybe once a month, people don't get evaluated very well.

It so happened that one of my clients, I went to visit him, even though on leave of absence while he was in the nursing home, and it was over 95 degrees in the nursing home.

I stopped in his room, and he was suffering from dehydration. I ran to the coke machine, bought him a coke, and he downed it in a minute flat. Then I had to hear from half a dozen nursing assistants that "Nothing by mouth" meant just that. Their rules and regs state "Nothing by mouth" well, then that is how it will be even if the doctors don't show up for an eternity. And since none of them had been trained to do IV's - he really would have been so dehydrated that heat stroke would have done him in. But that cogent fact was above their thinking level.

(The family called his physician that night and got the "Nothing by mouth" order rescinded, since it was obvious that he needed fluids and that his swallowing ability was fine.&quot

[Enthusiast]

102. I share your problem with the gluten, truedelphi.

I wish you the best in dealing with your issues.

[RKP5637]

105. Typically, IMO, the US often punishes the majority on moralistic crusades with little thought to

solutions. Often, the only solution the US seems to come up with is punitive. Often I've said to friends, what's next, no anesthesia during operations?

People do have incurable pain. I have a friend with arthritis, what they go through is horrible, and medication is doled out like they were being given some horrific drug creating lots of guilt and anxiety in them.

And then these utterly stupid laws on pot and medical use. For Christ sake, what the fuck is wrong with this inane country? Often I've said, US = United Stupidity!

And then we have euthanasia laws wherein apparently those setting themselves up on pedestals love to see others whither away in horrific pain and end of life situations. I guess they enjoy the pain and suffering of others.

Oh fuck it, some days I just give up on the US, its future and its Idiocracy!

[MFM008]

3. i get it

I use it when my back spasms or the spinal stenosis acts up. I had sciatica for about 8 months, it was terrible. People need those drugs, after my knee replacements the relief from those drugs was almost total. Yes you have to watch it, but if you need it-----take it.

[cali]

6. I'm more likely to become a steroid addict than an oxycodone addict

don't like the stuff. Recently I had a cortisone shot to the ankle joint and I love not having to take oxycodone during the day. Alas, I can only have the shots 4x a year at most. I have no withdrawal symptoms when I don't take oxycodone. I feel better emotionally and I'm good at handling pain and distracting myself from it, but when the pain gets to the point where it's swallowing up everything else, I need the pain relief. Nothing entirely eliminates the pain, but it helps.

[NutmegYankee]

96. Steroids are a godsend.

Last edited Mon May 26, 2014, 09:40 AM - Edit history (1)

I got two injections (epidurals) right into the fluid sac that surrounds the spine near my neck. Instant pain relief as the pinched nerve swelling goes down. It's a shame you can only have 3 or 4 a year.

[cali]

111. No one should have more than that. It causes liver damage.

Love the relief from the traumatic arthritis pain. I feel like one of those people who hobble into church on crutches and leaving bounding down the aisle.

[NutmegYankee]

132. I didn't know it caused liver damage.

Oh well.

[JJChambers]

5. Blame the demonization of opiates?

Why not blame the throng of addicts who abuse opiates and make legitimate pain sufferers like yourself have to jump through hoops to receive proper treatment.

[cali]

8. because common sense should come into play here. People like me

with clear conditions that benefit from opiates shouldn't have to jump through the same hoops as those without such conditions.

And addicts are not people I blame. I feel compassion toward them.

Compassion. Empathy. Surely those aren't foreign concepts to you.

[JJChambers]

12. The problem is doctors can't see pain

Your case sounds clear cut to me and you certainly shouldn't have to jump through hoops. But what about the cases that aren't so clear cut?

[cali]

19. actually, with CRPS they can kind of see pain

there are differences that are apparent- swelling, discolorization, temp differences. As for other conditions, I don't feel qualified to address those, but I know of too many cases of needless suffering to just say err by not prescribing.

Here's what my pain is like: A few months ago I was making a creme caramel and I stupidly managed to pour some boiling caramelized sugar on my hand. My first thought was "you can handle this. It feels like your foot does when the pain gets bad."

People's tolerance of pain differs. I have a high tolerance for it (partly I suspect because I'm so easily distracted). I know I have a high tolerance for pain because when I suffered the initial grave injury, I managed to crawl on my stomach, out of my house, up my dirt driveway and up the dirt road to get help. The hospital staff and my surgeon were pretty damned impressed.

[mopinko]

25. any doctor that cant tell the diff should be fired.

run out of town on a rail.

i have a friend that has been addicted to norco for YEARS. she does have arthritis.
but- norco is not something you prescribe for arthritis.
doctors have allowed this woman to throw her life away.

then, my daughter, who has some complex and real issues, gets treated like shit at mayo clinic and by her own shrink because she is a drug seeking hypochondriac.

cutting out the sexism would go a long way, just to start.
just sayin.

[moriah]

30. She might not be able to take NSAIDs.

The only one that doesn't hive me is Celebrex, and I lurrrrve the stuff.

I have arthritis in several joints, as well as fibromyalgia and fairly intense scoliosis. Without my Celebrex I'm barely able to get out of bed. Glad I don't need opiates, but if it wasn't for Celebrex, I probably would need them or another pain reliever.

[sorefeet]

94. Celebrex gave me terrible

heart palpatations, I had to quit. I thought they took that stuff off the market like Vioxx.

[Enthusiast]

104. They did remove celebrex from the market for a short time.

The demand for it was so strong that they now allow it even though it has some very adverse side effects.

[hunter]

120. Big Pharm lied about Celebrex.

They cut off the studies as soon as they began to show the usual nasty NSAID side effects.

I had a prescription for it and my stomach went bad in the common NSAID way before this scandal broke, but I was thinking, "No, they're still advertising this as being different."

Lately I'm on a long cycle between OTC NSAIDs and acetaminophen. I take the NSAIDs until I have stomach trouble, and then I take the acetaminophen until my stomach calms down for a few months and concerns about my liver start to nag me.

Sigh... Arthritis sucks.

I have a sibling with fibro and the family arthritis; it's a rough adventure in the U.S. health care system even finding a doctor who is willing to honestly work with a patient who has chronic pain issues.

[moriah]

122. All I know is it doesn't break me out in hives, and it works.

And I'm glad there's no need for me to be on anything stronger yet.

[REP]

49. I can't take NSAIDs due to advanced kidney disease

So I am prescribed Norco for my arthritis, tendinitis, tenosynovitis, ulnar neuropathy, etc. There are other drugs, but they are incompatible with me continuing to live. I've had my lifetime limit of cortisone injections and had two AC joint resections as well as PRP therapy and tendon release surgery. My severe arthritis is being addressed comprehensively; my doctors just don't want to give me (or other kidney patients) the class of drug guaranteed to make their condition worse. Leave the prescribing to doctors.

NSAIDs, by the way, are nephrotoxic. Every one of them.

[madfloridian]

24. Absolutely....common sense needed.

And no lectures from those who haven't experienced the problems some must deal with.

[Enthusiast]

103. Plus one a whole bunch.

[nomorenomore08]

66. Anti-drug hysteria is the problem. Period.

Alcohol and nicotine are extremely addictive and I don't see anyone advocating banning them.

Note that I'm not saying opiates should be available just OTC. Merely advocating having some perspective.

[kcr]

114. Yes, this.

It's trendy to bash drugs and the people who need them. They're "over-prescribed" and pushed by "Big Pharma" I'm constantly seeing a med I need for a chronic condition bashed in the media and on forums in this manner. If the medicine you need is a controlled substance, it's even worse.

[nomorenomore08]

136. +1

No one should be denied the drugs they need, period. Fuck this neo-Puritanism.

[Corey_Baker08]

7. Have You Considered Methadone Treatment?

My father who has bad knees went through the same thing with his doctor recently suggested a pain management clinic that prescribes Methadone because it has a longer half life than regular narcotic pain pills...

Just Wondering?

[cali]

9. I haven't. I prefer not to take anything with a longer half life. I take a low dosage

for someone with my type of condition and largely rely on endorphins from intense cardio to provide me with pain relief- and steroids.

[moriah]

35. Long-acting opiates actually help reduce tolerance and dependence likehlihood compared to ...

... the pills that only work for 4-6 hours at a time and get to theraputic levels very quickly after taking 'em.

My dad did far better on methadone for pain relief because there weren't as many "ups" and "downs" -- his levels stayed constant, and since he had an addictive personality he definitely didn't need to deal with opiate spiking and associating the nice feel-good spike so closely to the time he took the pill. He was able to take it as prescribed and not feel the need to abuse it.

Glad there *are* options available, it just sucks that doctors have to be so afraid of them.

[cali]

61. as tolerance and dependence aren't issues for me, fortunately,

it just makes sense for me to stick with what works once I find it.

[COLGATE4]

62. Methadone is a wonder drug for pain.

When my pain specialist (after trying everything else in the book) prescribed Methadone my first reaction was one of horror - I thought I'd be slinking off to the local addiction treatment center and lining up for my daily cup. But, fortunately it's not like that. With a tiny dose (two 5mg tablets a day) he finally brought severe pain I'd been experiencing for twenty years almost totally under control. And, because of the longer half-life it's not a problem if you're late (or even miss) a dose. Plus, since it's a synthetic drug it's very inexpensive. You might be pleasantly surprised.

[OwnedByCats]

128. I took it for pain in the UK

It works great. Can't get that here though, or anything else for a chronic headache issue.

Opiate free now for the last 6 miserable years. I'm probably going to die from a stomach ulcer from ibuprofen ... but nevermind. As long as I don't end up on opiates, who cares how bad a quality of life one has? At least, that's how it is in my part of the world.

[exboyfil]

10. When my dad was dying of cancer

he took skin applied opiates which did not cut it. He was in constant pain. I hate that some people abuse it, but if Louisiana law allowed IV opiates for at home hospice his passing would have been much better. I am willing to take the societal risk that some will abuse it to seeing what happened to my father happen to anyone else. My dad did not have a choice. Addicts have a choice.

[cali]

13. I understand. Years ago, when my dad was dying and in a lot of pain

I had a discussion with his doc about increasing his morphine and so what if it depressed his breathing. Fortunately, the doctor got it.

I don't know that I'd say that addicts have a choice.

[nomorenomore08]

67. There's an *element* of choice involved, certainly. But opiate addiction is an extremely powerful

"hijack" of the brain which nearly always requires professional help - including medication - to overcome.

[cali]

72. I ffeel really lucky that I don't like the emotional effect of it.

I can take it for the better part of 3 weeks and then not take it for a week or so- I just have to be careful of not letting the pain start to spiral, and I've gotten pretty good at knowing when that's about to happen.

[nomorenomore08]

135. Honestly, my heart goes out to anyone suffering with chronic pain.

Makes my own (largely self-inflicted) medical issues seem petty by comparison.

[hunter]

123. I don't know that fun. Opiates just make me feel gross, never euphoric...

...although they are effective pain killers.

Prednisone, on the other hand, that scares me.

The human "diversity of mind" is interesting.

So far as opiates go, I think the "war on drugs" does much more damage than good.

Drug addiction is a medical problem, and ought to be treated as such.

It ought to be a lot easier to walk into a clinic and get what you need in a safe environment, even if it's pharmaceutical-grade drugs at first, than it is to buy drugs on the street.

[nomorenomore08]

134. Agreed. "More damage than good" is an understatement. n/t

[Spider Jerusalem]

11. Blame the overprescription of opiates in the US for that

you've had years of doctors handing out scripts for Vicodin and Oxycodone like it was candy. (Not helped by the amazing irresponsibility of aggressive marketing of drugs like Oxycontin by pharmaceutical companies which helped contribute to their overprescription.)

And for chronic pain conditions opiates aren't really the best choice anyway because of two things: Opiate-induced hyperalgesia and the development of tolerance (which means that it requires higher doses for the same effect, or moving from oxycodone to a stronger opiate like fentanyl).

[cali]

16. Are you an RSD/CRPS specialist?

I've been taking oxycodone for almost 3 years now with no increase in dosage and as I've said, I've tried a plethora of other treatments. It helps me to function on a high level. It enables me on bad days to do my hour of cardio.

Each case of chronic pain is individual. There is NO hard and fast rule about opiates and RSD/CRPS. Oh, and I turned down the offer of a fentanyl patch.

[truedelphi]

21. Fentanyl had me thinking the cartoon characters in a commercial

Were going to come through the TV screen and get me.

I despise the stuff, and truly hate that they make people take it, without any regards to the side effects.

[Spider Jerusalem]

23. But the number of people who actually need opiates for pain management...

is far lower than the number of people prescribed them.

[cali]

26. that's uncontestable, but what has that to do with my comment about common sense?

[madfloridian]

27. You have no way of knowing that. Statistics are what they are....often meaningless.

A doctor and his patient are the ones who should make the decisions, not the federal government based on quotas.

[Spider Jerusalem]

46. No-one said anything about quotas.

Sensible guidelines would probably help though. And yes, they're overprescribed. The USA has 5% of the world's population and consumes 80% of the opioids produced. I don't really think that there's that large a discrepancy between the number of chronic pain sufferers in the USA vs elsewhere. What there IS in the USA however is a profit-driven healthcare system, pharmaceutical companies that can advertise prescription drugs on television, and no centralised prescription database which makes it easier for people abusing the system to shop multiple doctors across state lines to get prescriptions from them.

[Comrade Grumpy]

68. There's another way of looking at that stat about 5% of the population and 80% of the opioids.

And that's that people in large parts of the world are suffering needlessly from untreated pain.

Here's what the World Health Organization has to say:

http://www.who.int/medicines/areas/quality_safety/Impaired_Access/en/

Severe undertreatment is reported in more than 150 countries, both developing and industrialized. They count for about 80% of the world's population. Annually, at least 6 million people suffer from lack of access to controlled medications. Most of them are pain patients, but also other conditions are involved. The impact of impaired access to these medications is huge.

And here's what Human Rights Watch has to say:

http://www.hrw.org/sites/default/files/reports/hhr0511W.pdf

<snip>

In 2009 and 2010 Human Rights Watch surveyed palliative care experts in 40 countries to map
the barriers that impede the availability of palliative care and pain treatment worldwide. We
asked them about the situation in their country in three areas that WHO has said are critical to
the development of palliative care: health policy, education of healthcare workers, and drug
availability. We also analyzed publicly available data from all countries on consumption of
opioid medications that can be used to treat chronic pain and compared them to cancer and
AIDS mortality data to assess how well the need for pain treatment is met.

We found enormous unmet need for pain treatment. Fourteen countries reported no
consumption of opioid pain medicines between 2006 and 2008, meaning that there are no
medicines to treat moderate to severe pain available through legitimate medical channels in
those countries. In a further eight countries that do not report their consumption of opioids,
the situation is likely similar, as governments participating in the international drug control
regime will not export opioids to those that do not. Thirteen other countries do not consume
enough opioids to treat even one percent of their terminal cancer and HIV/AIDS patients.
These countries are concentrated in Sub-Saharan Africa, but are also found in Asia, the
Middle East and North Africa, and Central America.

Some of the world’s most populous countries have very poor availability of opioids for pain
relief. Consequently, in each of China, India, Indonesia, Nigeria, Russia, and South Africa, at
least 100,000 people die from cancer or HIV/AIDS each year without access to adequate
pain treatment. The combined suffering due to lack of opioid pain medicines worldwide is
staggering. Our calculations confirm that more than 3.5 million terminal cancer and HIV/AIDS
patients die each year without access to adequate pain treatment, a very conservative
estimate that assumes that all opioids are used to treat this patient group. It should be
considered merely an indicator of the enormous unmet need for pain treatment. In reality,
the limited opioids that are available are used to treat patients suffering pain from other
causes too. So the real number of terminal cancer and HIV/AIDS patients with untreated pain
must be higher, and many other patients with non-terminal cancer, HIV/AIDS, and with other
diseases are also suffering untreated pain.

In many of the 40 countries surveyed we found multiple barriers to palliative care in each of
the three areas. Only 11 of the countries surveyed have a national palliative care policy,
despite WHO’s recommendation that countries put in place such policies. Most of the
countries surveyed have inadequate opportunities for medical education in pain
management or palliative care and in four of the countries surveyed–Cameroon, Ethiopia,
Jordan, and Tanzania–no such education is available at all.

Thirty-three of the forty countries surveyed impose some kind of restrictive regulation on
morphine prescribing that is not required by the international drug conventions. Thirty-one
of the countries require that a special prescription form be used to prescribe morphine, and
fourteen require doctors to have a special license to prescribe morphine. Although WHO has
recommended that countries consider allowing nurses to prescribe morphine in order to improve
accessibility to this essential medicine, only three countries (the United States and Uganda) do so

[Laelth]

82. Informative post. Thanks. n/t

-Laelth

[kcr]

146. And you're so sure of this how?

Because you read it somewhere or saw a fearmongering story on the news?

[TheFrenchRazor]

78. no, blame the hysteria over alleged over-prescripption of such drugs. no person with pain should

should be denied pain relief because of some one else's abuse of opiates, real or imagined. period.

[LeftyMom]

14. I've posted this before, but a family friend was undermedicated while dying of cancer.

The fear was that she'd become dependent. She was, as I said, dying. She had two entirely separate cancers, and the least dangerous one had a 50% five year survival rate. The other, if I recall correctly, was 5%. There was no question that she was going to be alive long enough for dependence to become an issue: she absolutely wasn't. She was in terrible pain. Finally she tried to kill herself to escape the pain by overdosing on the weak ass pain pills she was getting. She survived. They cut her dosages back still further because she was a suicide risk.

The same doctors refused to arrange for her to have a wheelchair and insisted that she needed physical therapy to strengthen her legs. So she spent her dying months at home and in great pain. They finally authorized a wheelchair about two weeks before she died, but by then she was too sick to go anywhere.

It was the most inhumane thing I've ever seen. I wouldn't treat a sick dog that way.

[catbyte]

33. That's barbaric! How horrific for her. It's infuriating. of course you become

dependent on the meds, but there is a world of difference between physical dependence and addiction. It's just ignorance & misinformation about pain.

[mopinko]

34. physical therapy?

i want to shoot someone just for that right there.

[cali]

47. that is a very infuriating and depressing story.(though

I think the talk, however innocent, of shooting someone, is, uh, ill-advised.

[mopinko]

52. i would generally agree

but since we are discussing matters of life or death here, and since we are talking about those who deem themselves up to the task of weighing same, i feel this is a unique circumstance.

[LeftyMom]

48. She was poor and obese.

So by god she was going to get up and move around and not be such a lazy fatty, even if it killed her (she had a heart condition.) It had nothing to do with her health, it was a moral crusade.

It was the sickest shit I've ever even heard of.

[REP]

51. Happened to my father when he was dying of bone cancer

He had weeks left, but they didn't want him to get addicted. WTF

[LeftyMom]

54. I'm sorry. Was that recently?

Back in the 90's when my grandmother was dying, by the time the cancer had spread to her bones she had a home morphine drip and enough pain pills to anesthetize a horse. There wasn't any question that she might get too much, the only question was how to balance out her lucidity and her pain control and the person who had the biggest say in that was her.

I think this evil trend toward letting the dying suffer is a recent thing. I hope it's not a long-lasting one.

All I know is that after what happened to my friend? If I ever get a cancer diagnosis I'm going straight from the parking lot to the border, and I'm going to buy up half a pharmacia.

[REP]

119. It was 1994

His started as bladder cancer, which they thought had been cleared. He'd been having back pain and during arthroscopic surgery on his spine for the supposed arthritis, they discovered the metastasis (my SIL is was just found to have bladder cancer and I was just dx'd with a similar spinal arthritis, so we're all a little ... nervous. And my mother died suddenly and completely unexpectedly 4 days ago). After the bladder cancer treatments, he didn't want any more needles, so he was just on patches and pills.

Thanks. It was a while ago, but I'm obviously still pissed off about it.

[Laelth]

84. That's barbaric.

Thanks for posting that story (again).

-Laelth

[madfloridian]

15. The whole war on drug use is out of control. Doctors are afraid to prescribe what patients need...

because as one specialist told me....they get called out by the feds if they have too many prescription of certain drugs. He really got started, he was furious.

I saw an interview on TV this last week where some talking head was saying the bad seniors demanded too many drugs. He went on spinning.

People are being deprived of what they need for pain because of a war that has outlived its usefulness.

Before my husband died he had the worst case of shingles the doctors had seen, up his spine. He was in terrible pain. They gave him pain pills, one bottle. Then they gave him 3 different kinds of drugs for fibromyalgia which in his weakened state made him shaky. They refused to give him anything else for pain but tylenol.

Fed up with it.

[cali]

17. I'm so sorry about what your husband and you went through.

Horrible.

[madfloridian]

18. Your post really moved me. People should not have to go through that when medicine is available.

It really angers me.

[cali]

22. thanks MF. No, I'm OK. I have been treated with respect and consideration

by my orthopedist, my primary care doc, the folks at Fletcher Allen Center for Pain Medicine, Dartmouth-Hitchcock, etc. But I'm a strong advocate for myself and my primary care doc has been my doc for about 25 years and knows me well. I don't mind the pee tests but they're dumb in my case, because if the stuff doesn't show up, the state gets suspicious that I'm selling my meds, and I don't take it if I can function OK without taking it. Catch-22 if it weren't for my great doc.

It's your story about what your husband suffered that makes me want to cry.

[Hissyspit]

31. +1. It's been this way for a long time.

[madfloridian]

37. I remember when Nancy Reagan had school kids march in the Just Say No parades.

I was at a new school that year, late 80s I think. The teachers hated it, the kids laughed at it. We had long noisy parades through downtown for 2 years.

Is that when this so called war got started? Under Reagan?

[catbyte]

28. Amen, Cali. I have post-herpetic neuralgia after 8 bouts of

Shingles down my right sciatic nerve over the last 15 years. My most recent bout was during Thanksgiving. I take a long lasting opiate every 8 hours for maintenance & quick acting suckers for breakthrough. I don't get the least bit stoned, have been on the same dosage for 8 years & work 40-50 hours a week. If not for these meds, I would be on SSD, curled up in the fetal position on my couch 24/7, sobbing. Or I would've checked myself out. As you well know, nerve pain is that bad. It shreds your soul. Luckily I have a clear diagnosis & a gutsy pain doctor--these days doctors who are willing to prescribe sufficient pain meds are getting harder & harder to find. I've tried all the anti-seizure drugs, most recently topamax, but the side effects are horrendous. Almost as bad as the pain. Elavil, lyrica, you name it. I've tried them all with disastrous results. I developed an anaphylactic allergy to aspirin/NSAIDS from taking too much advil, etc.

I get so mad at jackasses like Limbaugh & those idiots who died after chewing fentanyl patches who abuse pain meds because all they do is hurt people like you & me.

Thank you for the post, Cali. Take care.

[madfloridian]

32. My hubby never really recovered from his bout with shingles.

He continued to hurt even after the rash was gone. All the meds you mentioned, they tried. Plus gabapentin, which really bothered him. One of them gave him seizures one day.

Shingles are awful... I sympathize.

[catbyte]

43. It's the two-pronged pain that really gets you. Your skin feels like it's on fire,

but on top of that you have the deep nerve pain which I can only describe as a shooting, toothache-like pain throbbing down my right leg. I'm so sorry your husband was so undermedicated & suffered. My doctors can't figure out why I keep getting them. My immune system is normal. I guess I'm just "special".

[madfloridian]

60. I had them in the early 2000s. Had to go to ER with severe pain on a week-end.

My whole left arm was one mass of shingles. The docs lined up in the ER, said it was most classic, worst case they had seen.

They gave me something started with a P. percocet or percodan...whichever is weaker. It did NOT even touch the pain. Went to my doctor that Mon. She gave something very strong. I went to an accupuncturist, and the pain was gone within a week. It was amazing.

It's truly awful stuff.

[mopinko]

29. it is a FACT

that people who have actual pain are not the ones who become addicted to opiates.
if you have actual pain, take an opioid, it works on the pain, all good
no pain, take an opioid, goes a whole different pathway.

doc too dumb to know the symptoms of that should get jobs at mc donalds.

[nashville_brook]

113. [phone]

[Ghost in the Machine]

137. " it is a FACT... that people who have actual pain are not the ones who become addicted to opiates."

mopinko

29. it is a FACT

that people who have actual pain are not the ones who become addicted to opiates.
if you have actual pain, take an opioid, it works on the pain, all good
no pain, take an opioid, goes a whole different pathway.

doc too dumb to know the symptoms of that should get jobs at mc donalds.

Where do you get your "facts" from?? I really, REALLY NEED to know, so I can make my body aware of this fact. Due to a work related accident 11 years ago that left me disabled, I have been in pain management for the past 4 years.

When I first got hurt, the doctor gave me some pain pills to take, but all they did was knock me out for a few hours. You see, before I got hurt I wouldn'y even take an aspirin for a headache because I hated taking pills of any kind. The pain pills made me unable to function, and I couldn't have that as I was a single father with 2 young children and had to take care of them... do laundry, help with homework, cook dinner, keep the house clean, etc., etc.

My Neurosurgeon told me in 2004, after 2 major neck surgeries, that he had done all he could for me surgically and all he could do was refer me to pain management for the rest of my life. I fought against going for close to 7 years, choosing instead to self medicate with cannabis. My Neuro had no problem with this and even told me, off the record of course, that" marijuana was the best pain reliever known to man". He would write me a script for 90 10 mg oxycodones and they would last me a year because I only took them on the days/nights when the pain was unbearable and I couldn't sleep because I was near tears.

To make a long story a little shorter... After so many years, I built up a tolerance to the marijuana and was spending $300/$400/month when I got the thought of "hey, I have insurance to go to the doctor and my co-pay for meds at the time was only $1.10 for generics, $2.60 for name brand. I had to get my system cleaned out from the THC before any pain clinic would accept me, and that took a few months to do. I started out on oxy 10s, but within a year was on 180 mg/day... one roxicodone 30 mg every 4 hours, which was 6 per day! Now I'm on what is supposed to be "long acting 12 hour pills", but I'm lucky if they last 8 to 9 hours. I'm on 2 40 mg Opana Extended Release pills, and 2 short acting, immediate release 15 mg roxicodones for "breakthrough" pain. I take my pills as directed, do not abuse them and damn sure don't share them, give them away or sell them. They work great for the time that they do work, and I have NEVER gotten "high" like people who use them recreationally, I just stop hurting. BUT.... yes, there's always a "but", isn't there? Let me go more than 6 hours past my regular schedule without taking my meds and I start going into withdrawals. I know I'm dependent on them to keep me out of pain, and dependency is different than addiction... just like people who depend on insulin for diabetes, or heart medications or any other medications to keep them healthy or alive... but the withdrawals make me think I'm addicted too, even though I don't display any other addictive qualities, such as seeking out extra meds from other people or from other doctors, I don't run out early and call my doctor and say mine were stolen, lost or anything else. In 4 years I have never failed a drug test or a pill count...

It just seems to me that the withdrawals I experience negate your statement that "people who have actual pain are not the ones who become addicted to opiates."

Am I wrong??

Peace,

Ghost

[phleshdef]

139. Thats not a fact at all.

I am not against the prescription of opiates when its legitimate pain. But having grown up in southern WV myself, the pain pill addiction capitol of the country, I can tell you straight up that I've had friends and relatives get the pain killers for the pain and then remain hooked on them after the pain is gone and the injuries are healed, etc.

[mopinko]

144. then their doctors failed.

if they were still taking them after the pain was gone, then that violates what i just said.

if fact, the way you said it- the kept taking them after the pain was gone and THEN they got hooked. that is exactly how it works, and good pain docs know how to do it.

now, when pain care is take these pills, hope you feel better, goodbye- whole nother thing.

[cbayer]

36. cali, what do you see as a possible solution to the complex problems

presented by opiates?

There is no doubt that some patients have to have them and that there is no other real alternative.

But what about the abuse, over-prescription by some practitioners, potential for addiction, horrible withdrawal, etc.?

How do we most easily make the distinction and make sure that they are being used responsibly, as it is in your case?

[cali]

39. Education of docs and legislators.

As I said, I have to take pee tests to ensure that I'm consistently taking my medications and not selling them. I don't mind the pee tests but the rationale is nuts. I don't want to take opiates when I don't absolutely feel the need for that kind of pain relief.

And it horrifies me that any idiot would "worry" about addiction in a dying patient. There's a lot of that from what I hear anecdotally.

[cbayer]

125. Agree about education of both groups.

I also think that physicians needs to do a much better job of self-monitoring. They often know all too well who the problem docs are, but tend to turn a blind eye.

The pee tests are stupid, imo. If someone has opiates in their system, that doesn't mean they aren't selling. If they don't, that doesn't mean they are selling.

The issue of the dying patient is somewhat separate, and good hospice programs are usually very comfortable with using opiates very successfully.

[mopinko]

115. part of it is just giving more respect to pain as a problem in itself.

if they cant get any better at digging out and fixing the root problems.

i think that more people having health insurance is gonna help this. i suspect for a lot of people pain meds are a holding pattern for something they cant afford to fix.

but i also think that the docs that are writing what they know are bogus scripts are the ones writing the bogus scripts. i really dont understand why they dont get cracked. i have a friend addicted to norco. she has some arthritis, but other than that, no really physical problems. and yet a doc is writing her norco, which isnt even appropriate for arthritis. for years. and years. and this is medicaid, too.
why aint this doc in jail?

[cbayer]

124. I absolutely agree with you about the bad doctors.

There is no denying that they are out there and a huge part of the problem. Why there is not more aggressive action against them is often really unclear. It's partially a problem with law enforcement/DEA, but fellow physicians also hold some responsibility because they often know very well who the culprits are.

They have made things very hard on everyone and, in particular, for those with legitimate pain whose needs would be best met by a thoughtful regimen of opiates.

[mopinko]

126. i dont know what to do about this one, either.

my friend is really about to lose it all. she is a wraithe.
i mean, your tax dollars at work.

[Egnever]

38. A customer of mine is in a similar situation

He has severe back pain and literally can not function without his oxycontin.

His doctor recently moved offices and at the same time changed his dosage. This apparently set off all kinds of alarms and it caused his pharmacy (walgreens) to drop him as a customer and tell him they would no longer fill prescriptions for him. He has been filling his prescriptions at walgreens for 20 years.

In the end he got it sorted out after lots of phone calls and documentation but the fact that he had to go through it was a little frightening.

I hope you are able to continue to get what you need.

[cali]

40. Thanks. I feel so fortunate about my medical care. I don't worry about

my being able to get what I need. As I said, I'm a strong advocate for myself. Others are, too often, not as fortunate.

[mopinko]

41. the wages of 15 minute medicine.

no small part of the problem. my rheumie does my head meds, including pain, whatever it is. if i need it, he writes it. if they fight it, he trashes them.

BUT he has been taking care of me for nearly 10 years.
it isnt just about in "real" pain v not "real" pain.
it is about the depth of a relationship that you need for someone to truly take care of you.

[cali]

50. that's true. My doc has been my doc for over 20 years

I started going to the practice before she joined it when it was just two (good) country docs. Now it's part of Dartmouth-Hitchcock and it's big and busy and doesn't have the heart it did when I first went there.

[LadyHawkAZ]

42. Codeine and oxycodone are the only two prescription painkillers

that work on me (hydrocodone, for some reason, does not, and unfortunately it's the one they usually try to give me). I am lucky enough to rarely need them, and I have a supply from Mexico, but they are difficult to get in the States anymore.

Maybe you ought to connect with a new doctor now while they can still communicate with your old one, before she retires? That might make the transition easier.

[cali]

45. I have done just that. And I am familar with my new-to-be

doc. He's a neighbor of mine. Much as I'll miss my wonderful old doc (how dare she retire? she's younger than I am by several years- just kidding), I'm looking forward to the change in a way because the new doc is 5 minutes away rather than 40. I moved and my doc stayed put, but I'm so fond of her that I couldn't see changing.

[bossy22]

44. everyone has a right to live a life free of pain

[TheFrenchRazor]

79. word. if the gov't forces me to live in pain such that i can not function, then they can damn well p

pay my bills for the rest of my life.

[Laelth]

89. +1. n/t

-Laelth

[grilled onions]

53. It's no longer survival of the fitest

"We" survive and fight all the time. Right now I have severe arthritis,infection requiring a vac pump and a fusion pump for antibiotics. I have a herniated disc and several other assorted back issues. I require a walker and wheelchair and get flack for what I am on. Predisone,Gabapentin,NSAID and Norco just for the pain. I worry every day I will be yanked off of the Norco simply because some junkie likes them for parties and OD's or takes such pills with alcohol,again ending up in ER. Just because "we" use similar pills for our pain we are labeled as a junkie.
They do not label someone an alcoholic if they buy a case of beer. If you have,say a form of cancer associated with smokers, but you have never smoked, again you are as bad as the thirty year smoker.
We should be judged by our conditions and doctors should have more compassion than the fear of being a pusher. We should not be punished simply because we have chronic issues, chronic pain etc.

[cali]

56. I'm so sorry. that sounds rough.

and having to worry about access to needed medication just aggravates the situation and the pain.

I wish you the best.

[Dustlawyer]

55. Small fiber sensory neuropathy for me! I am allergic to most things they have tried.

I have to drive 240 miles round trip every month for my doctor and personally pick up my script. People have no idea!

[cali]

59. Can't your doc send your prescription to you or your pharmacy in the mail?

That's what mine does.

[Dustlawyer]

129. No, it is a schedule 1 which has to be done

Face-to-face. This is one of the many agrivations. Another is my insurance requiring me to use a mail order pharmacy when my work has me traveling up and down the Gulf Coast with no set place to have them mailed. My schedule changes daily.

[Fuddnik]

57. I agree 100%.

I've had a prescription for oxycodone for about 8 years. I hate that shit. They make me sick as a dog. Not always, but about 30-40 percent of the time. But, they work where nothing else will, and I only take them when absolutely necessary.

I have severe joint deterioration in the lower back, stenosis, and they're usually accompanied by sciatica. When it hits, I can't walk without them. And when I take some, I call it a day, and I'm not leaving the yard or house.

I declined back surgery and my orthopedist put me on a six day program of Prednisone. It was like a miracle. for almost a year, I was nearly pain free, and what I had could be managed with aspirin. When it came back, I went in for another treatment, and it's lasted for over a year. I haven't filled the oxy prescription in over a year, and half of it is still sitting in the medicine cabinet.

I can even play golf again. I feel it afterwards, but that's usually when I play by myself, and play 3 balls for 18 holes.

[opiate69]

58. I agree!!

[LiberalLovinLug]

63. I say so what if its addictive.

It should be a persons choice to accept addiction or not if it actually works for them. Don't most of us do this with coffee already? We choose to have this addiction in order to jolt us into action in the morning.

I have a mild oxycodone prescription too. I suffer from a degenerated back disk as well as arthritic knees. But I only take a small amount and not every day. I thankfully do not need to take them to the point I am addicted to them.

But I have a friend with severe colitis among other things and he has passed Oxycontin and is now on some kind of synthetic morphine. He actually is addicted and admits it. But so what? Sure it also has some physical reprecusions as well. But its his body and if he needs it to live a fairly normal life, even if the medication ends up shortening his life, that's his choice. Or it should be.

I've never understood the hysteria around the word "addictive"....even in pain management cases.

[DJ13]

64. I also have RSD, had it since an auto accident in 1998

When I was first diagnosed the assorted specialists gave me lots of Vicodin, and a really strong depression drug (the name of which has long been forgotten) which I stopped after a week of being a near vegetable.

In the years since, the best pain med I've tried wasnt hydrocodone, it was oxycontin, but where doctors will prescribe the hydrocodone based Vicodin/Norco they are deathly afraid to give patients oxycontin for fear of having the FDA knocking on their door threatening their license.

Its absured.

So I cope with severe pain, and deal with the swelling and the alternating freezing/burning in my entire left leg and foot, and take the ineffective pain meds the doctors arent afraid to give me.

Thanks for the thread cali!

[cali]

69. so sorry, dj. It's in my left leg and foot as well.

I'd like to p.m. you with some strategies that I've found really helpful. Would that be OK?

[DJ13]

75. Sure

[Tom Ripley]

65. Have you tried replacing or supplementing the opiates with kratom?

Many people have had very good results.

[cali]

71. never even heard of it until now. Just looked it up. How interesting

thanks so much. Maybe it wouldn't make me so weepy like oxycodone.

[Tom Ripley]

73. I...uh...uh...use...it...for mainly recreational purposes, but have seen many testimonials

for its pain relief effectiveness. I would recommend an online ethnobotanical source rather than a "legal high" or head shop retailer.

Glad I could help.

[OwnedByCats]

138. I use Kratom for a variety of things

Since getting scripts for my pain is almost impossible, I use Kratom - it works much like an opiate for pain, it also helps me with my depression and sleep issues. It's not quite as good as using an opiate, but it's pretty close. Just something to consider if you ever have trouble in the future. Even if you just want to cut down, you'll probably get away with taking less of your opiate pain meds, or for some people, stopping it all together. There are different strains, just need to figure out which ones work best. For me, red vein varieties are most like opiates in it's painkilling properties. It's not FDA approved of course, technically it's not supposed to be sold for human consumption, but people still consume it.

Unfortunately it is illegal in 4 States now I believe .... It's getting the same bad reputation that marijuana got (and still gets in some places). It's a completely natural plant, not some synthetic crap. The tree it comes from is actually from the coffee family. There are people who market it as a legal high where you can buy it, but trust me when I tell you that if what you want is a high, you'll be utterly disappointed. Never buy it from head shops or smoke shops, those places give it a bad name. There are many online vendors who sell better qualities and for much less $ than those shops. Right now those of us who use it for pain, depression, anxiety, energy boost etc are fighting to keep it legal.

I'm afraid big Pharma is trying to get this stuff banned because more and more people are turning to Kratom to replace pain meds, antidepressants and antianxiety meds, and of course most especially since they can't patent it in it's natural form.

[blkmusclmachine]

70. But there's MONEY, LOTS of MONEY, to be made off the phony, forever "War on Drugs."

The US' phony "War on Drugs:" It's a cash cow. A real golden goose.

[cali]

74. that's for sure.

[JNelson6563]

76. Sadly many have fucked it up for the few.

You may not be aware of this but people out there who somehow seem to have endless prescriptions of morphine and the lije who turn around and sell it. Yeah, the pay their co pay of ten bucks and then sell those 200mg morphine pills for 20 a pop on the street. I know several people who now revolve their entire lives around getting that stuff. Oh and don't even get me started on what their poor kids endure!

So yeah, there are assholes out there abusing the system and ruining lives. Thank them, not those who point out what's going on.

Julie

[cali]

77. sorry, but as I point out upthread, it's incumbent on docs and legislators to use

some common sense.

[JNelson6563]

90. I put much of the responsibility on the doctors.

They're the ones getting many hooked on the stuff to begin with. And it seems their idea of a preventative measure against those who sell their scripts is to give them ascheduled drug test at each appointment. Yeah, cause the patient who resells isn't smart enough to keep a few on hand so as to test positive on those days.

And let's talk about those doctors and the appointments. You get a few folks strung out (on the drug or the cash from resale) and you can bet they will schedule as many appointments with you as you say the need. Talk about low hanging fruit!

Sorry but there are a lot of doctors out there who have the morals of Dick Cheney. And the patients who exploit the serious addicts enslaved to the shit, they make me wish there really was a hell.

Julie

[nashville_brook]

116. [phone]

[TheFrenchRazor]

80. no, the government fucked it up for legitimate pain sufferers. nt

[JNelson6563]

88. Yes, they are typically reactionary.

People abuse the drugs and the system so government reacts by handling it wrongly.

Julie

[HuckleB]

92. Let's see the peer-reviewed research that supports your claim.

"The many" vs. "the few."

Wow! Just wow!

[JNelson6563]

93. Wow just about sums it up, doesn't it?

I marvel at how widespread the problems of addiction are. Those who weep for the persecuted doctors, aka distributors,obviously have not seen it.

Big pharma and their partners, the sainted doctors, are at the root of this worsening problem.

Julie

[HuckleB]

130. I see you choose to ignore those who are in pain.

And strawmen arguments are not helping make your case. Neither does the fact that you present zero actual epidemiology.

[kcr]

148. That is always the response

No different thatn anti-vaxxers. They've bought the notion that pain pills are overprescribed and shilled by big pharma and doctors, combined with the war on drugs hype, and there is no changing their mind, evidence be damned.

[cali]

85. huh? what codespeak? what secrecy. I could hardly have been more detailed or plainspoken

I have no fucking clue as to how much the street value is. I don't fucking deal drugs, dear. And what a visit to my doctor costs is none of your business, sweetiepie. I made it clear that I am prescribed oxycodone. the strength, number of pills, how often I see my docs is none of your fucking business, pumpkin.

go the 7^*$^! away. got it?

[OwnedByCats]

142. What a fucking troll

that person was! People with that attitude is part of the damn problem!

Glad that post was hidden. Idiots are everywhere!

[NutmegYankee]

98. What a cruel and inhuman response.

The problem is people can be so inconsiderate about others in pain until they feel it for themselves. When I hemorrhaged two cervical disks and got the nerve bundles to my arm pinched it felt like my elbow was on fire while someone stabbed me in the lower shoulder with a giant kitchen knife, pulling it out an inch and then twisting a little before running it back in Over and over.

Bet you'd think about it differently if you were in that kind of pain!

[Violet_Crumble]

107. It definitely was. I'm glad my fellow jurors felt the same way n/t

[nashville_brook]

108. +1 sadly, some people prefer the delusion that pain doesn't exist

to the truth that it indeed is a problem that we're refusing to remedy. the innuendo that all pain patients are selling their medicine fits into a weird conservative view of the world where only addicts need opiates.

major chronic pain sufferer too... 3 herniated/degenerated disks that are crushing nerves to greater and lesser degrees depending on the day, and luck. result of an infection that kept me in the hospital for 4 months. the disk pain seems to have generated other myofascial pain syndromes. it sucks.

[NutmegYankee]

133. The referred pain is the worst.

The knowledge that massaging the painful site will do nothing as it's just a nerve sending the pain really sucks. I'm slowly starting to heal. The doctor wants to see if the disks will heal on their own completely. I bounced back rather quickly from the most painful stage to not needing pain meds most days. I do worry sometimes as I'm only 34. I have a long time ahead of me to hurt...

[davidpdx]

83. I personally don't know what it's like

But I have a student this term who has spinal problems and was in the hospital for 6 weeks. He's back in class now, but I think in pain most of the time. He told me that the doctors gave him some pretty strong stuff to kill the pain.

[cali]

86. CRPS is widely recognized as the most painful of the chronic pain nerve conditions

I have been quite successful tackling it. I don't take a lot of drugs. I control my condition with lots of exercise, meditation, diet and other techniques, but sometimes it's bad- particularly at night. Like tonight. Been up all night with it. Lots of herb tea (I'm going to float away) and aromatherapy.

Oh well. There are things of value that I've learned from pain.

[davidpdx]

87. I don't ask him a lot since I'm his teacher and try not to overstep the bounds that relationshiip

But I do ask him from time to time how he is doing. Last week he finally got his midterm made up, so he'll do well in my class.

[HuckleB]

91. Indeed. Recommended!

[NutmegYankee]

95. Two hemorrhaged cervical disks.

Doc has me trying the "let it heal" approach. For the most part I'm not in much pain anymore, but on some bad weather days, hello Ultram!

[TBF]

97. It's hard enough to buy Sudafed

these days - without needing opiates. I can only imagine the hoops people have to jump through. It's ridiculous.

I have chronic pain also and so far ok with NSAIDs and biologics. Some days better than others. ((hugs))

[sorefeet]

99. Severe neuropathy from head to toe

I have tried all the pain pills and hydrocodone works best for the neuropathy. It does very little for my stenosis and degenerating spine. I am not addicted but I am dependent. Without pain meds I can't even walk. Not just from pain but from balance also. I treated it for years with alcohol, like so many people treat pain with. Now I know why Granny on Beverley Hillbillies called it her medicine. I was kicked out of the pain program because I also used medical marijuana (legal). Cold turkey get out of my office. I had to hop the Amtrak all the way too Ill. where my sister ran a clinic, hooked me up with a doctor and mailed me prescriptions once a month. Until I wrote Dr. Petzel ( resigned VA undersecretary of the VA scandal) and told him the VA refused to treat me for pain. That is when he wrote the directive allowing states with legal medical marijuana to write opiate prescriptions to legal medical users. States that are not legal STILL refuse to treat VETS for pain that use medical marijuana.
I am actually looking for poppy seeds to cover my ass for the next time some over zealous quack decides I don't need them. I actually had a doctor tell me "If I don't do what the DEA tells me they will take my privilege to write scripts". Do they really wonder why 22 Veterans commit suicide everyday. If they cut me off again and the pain was back with a vengeance, it would seem perfectly logical and the only answer would be to kill myself. It would be obvious the doctor didn't care and it isn't like you are going to live forever anyway. That is the way a mind in pain rationalizes. It's the end of the road and it's ok. I'm sure the majority of people in real pain have thought about suicide a lot.

[cali]

109. I'm so sorry that you went through all that.

It sounds like a nightmare. I've been so fortunate with my docs. they support me and it makes a huge difference.

I'm hoping that things go more smoothly in the future for you re medications

[Enthusiast]

101. K&R!

I'm sorry you have had to suffer this way, cali.

I suffered tremendously because of a surgical center's fear of over prescribing opiates.

During pre-surgery counseling the lady said I would be given pain medication after surgery. I asked about the dosage. She told me everyone got the standard dose. I said, "You mean even though I am nearly 6'4" and 300 pounds I get the same dose as the 5' 100 pound patient?" She confirmed that was the case.

This didn't sound right to me. I was correct. After I left the hospital and returned home I couldn't sleep from the pain. I was receiving vicodin and taking the maximum dose allowed. After several days of frustration we called the surgical center and they cheerfully prescribed percocet. But by the time I took the first percocet the real bad pain had finally started to recede. I have been pissed off ever since.

When we returned to speak with the surgeon after six weeks they remarked on my progress favorably. And the surgeon confirmed that I had an especially difficult surgery. Jesus Christ.

[Violet_Crumble]

106. I've got Trigeminal Neuralgia, so I kind of feel yr pain...

I read that they're closely related conditions, but with TN it's restricted to the face. I know exactly how it feels to not be able to sleep or being jolted awake by the pain. Having given birth, I can safely say that TN's more painful, and yr condition sounds like it's worse than my flare-ups where I can have months between them now...

It really, really sucks that you have to jump through hoops to get yr medication. Being in a different country I don't have any problem, as my doctor just asks what's the pain like on a scale of 1-10 (my honest answer is always 10), and then prescribes the meds when I need them. I'm on Lyrica. It affects me badly with drowsiness, dizziness and not being able to think properly, but the alternative is so much worse...

Vent away to yr heart's content, Cali. When I've suffered sleepless nights because of my condition, I've gotten up and posted because doing *something* to try to take my mind off the pain is the only thing I can think of doing....

*hugs*

[cali]

110. me too, Violet! I'm an inveterate putterer and I've turned into a devoted craft type

though I know there are people who see me coming and fear I bear another crocheted scarf. My son, poor guy, is awash in my not very good homemade thingies; bookmarks, pickles, scarves, etc.

I've found that a quality I always thought of as negative- that I'm easily distracted- is actually a boon now.

[nashville_brook]

112. boy do i feel 'ya!

i have chronic pain from degenerated disks and myofascial response to nerve compression. sometimes i have pain spasms that are so violent i've literally broken things from trying to steady myself.

one of the things that bothers me about the exile of pain patients is that if you're not getting treatment from your regukar doctor, then you're not getting real treatment. pain doc just dispense medicine... the generally don't look for causes. so, i've been stuck getting worse, in pain, and without decent medical care just bc of this cultural weirdness. the medical problem is challenging enough - having to fight a drug war via my health condition is just too much to ask. i'm literally paying for with my life.

(pardon ipad typos)

[gvstn]

118. "I'm literally paying for with my life." Perhaps literally...

When you feel pain, the nerves in your body send signals to your brain to tell you to stop doing whatever painful thing you're doing—but, actually, the pain itself might be killing you. Mice who had their TRPV1 pain receptors genetically knocked out displayed a "youthful metabolic profile at old age," giving researchers a clue about why pain—especially in old age—might be in and of itself deadly.

http://motherboard.vice.com/read/ending-pain-could-make-us-live-longer

[kag]

117. I, too, have TN..

But only in one of the three nerves on the right side of my face. It is mostly under control with Neurontin.

I also have back pain from a couple of disc problems--one herniated, one bulging. I had surgery to remove/fuse the one that ruptured, but I still have a lot of back pain, and my last MRI showed a lot of degeneration in some other discs.

I'm so glad you posted about the problem with opioid paranoia. I have a GREAT set of docs, especially at the pain clinic I go to. But when the whole "crackdown" began last summer my life was a nightmare trying to learn all the new rules, and get my meds in time to not go into withdrawal. I am dependent on long-acting hydromorphone and take oxycodone for breakthrough pain.

The worst part was when my regular pharmacy stopped taking scripts from my pain clinic. Any scripts. Even for antibiotics. It it was from any of the docs at my clinic, they wouldn't take them. So I switched, and the head pharmacist at my new pharmacy treated me like a criminal every time I came in. It was so humiliating. I finally switched again (which is generally against the rules at the clinic, but all of the patients were having such trouble that they eased up on that rule) and now have a pharmacy I like.

Anyway, thanks for posting about this.

[n2doc]

121. Another horror story published yesterday

http://www.democraticunderground.com/10025002069

[Prophet 451]

131. I use opiates several times a day

Quite apart from my mental issues, my knees and back have deteriorated to such a degree that I can only stand for a couple of minutes and even for that, I have to use crutches and take painkillers. I'm on a 30/500 mix of dihydrocodeine and paracetemol and take 8 to 12 a day of them. Am I addicted? Probably but at least it's a monitored addiction this time.

[phleshdef]

141. I'm very sorry for your pain. This is a complicated problem.

My late father was addicted to pain pills. He got started on them after an ATV accident, but after the healing was done, he had an addiction and it did him in. Its not what killed him, but it definitely contributed to him winding up in a privately owned jail where they totally turned a blind eye to his cancer symptoms until it was too late.

I am not at all against prescribing opiates for legitimate pain, especially the chronic kind as it seems you are suffering from. At the same time though, there is definitely an epidemic of pain pill addictions because of doctors overprescribing and/or not doing enough to work with the patient on ways to avoid addiction.

[OwnedByCats]

143. My father had severe arthritis in his hip

He had bone on bone pain, with bone fragments all over the place. The hoops he had to go through to get pain meds was outrageous. That's why I don't even bother to try anymore for my pain. I just use Kratom now, while quite effective, it's not quite as good, but better than nothing.

My father died in a lot of pain because it wasn't being managed effectively. Unfortunately he only died a week ago. I'm still reeling from that

[B Calm]

145. Morphine works for me.

[geek tragedy]

147. my wife has chronic pain due to an autoimmune disease.

it takes a toll, psychologically as well as physically.

she's much tougher than I am--I would have probably cashed out.

whatever can make life worth living under such circumstances should be allowed/prescribed.