I have had serious back and neck problems for decades. I always marvel at these stories about doctors giving out pain medicine like candy. In all the years I’ve had injuries and pain episodes, I have NEVER ONCE been offered narcotic pain pills. The only exceptions have been after surgery.
I worry that the backlash against narcotics will result in pain medicine being withheld from people who really need it. Addiction/abuse is a big problem, yes, but it’s not true that everyone gets addicted to it. People who have had surgery need pain relief. The docs just need to make sure not to give excessive refills. I think that’s how people get into trouble. The first course of medication is fine, and appropriate. But then the refills start coming when the patient could actually cope with NSAIDS or tylenol products. JMO.
People with chronic pain have particularly challenging issues. Every medication has adverse side effects, including those which do not contain narcotics. Pain management is becoming its own medical specialty.
“I worry that the backlash against narcotics will result in pain medicine being withheld from people who really need it.”
It is already happening. I saw a sign in the elevator in the medical building that said that the urgent care will not give more than a day’s supply of painkillers to folks who come there no matter what their medical issue is. This is not a slum, this is a techie town.
bunsen I went to a sports medicine doctor who has a sign in the waiting room that states they will not prescribe any pain killers. I know they do prescribe stuff like Meloxicam. maybe if they really think you need oxy or something they do but big sign in waiting room stated no acceptations. I was just happy I did not have a broken ankle…I was not looking for meds.
Because of this (above, giving one day’s supply), people are not tossing painkillers after a procedure. Everyone I know is hoarding the painkillers they have because they are afraid they won’t be prescribed the next time they need them. A friend of mine had a procedure last month and was given nothing for pain, told to take OTC Tylenol. I had the same thing 18 months ago and was given a week’s worth of Vicodin. A teacher at my school actually asked me if she could have my leftovers! Pain medication is a slippery slope that I hope to never slide down.
So people in techie towns don’t get hook on drugs??
I remember when I was younger still living in Brooklyn how everyone was shocked to learn about the people on wall street doing cocaine. Of course us people from the slums wasn’t shocked at all because we knew that people from Manhattan, the suburbs, etc… would come to the hood and buy drugs all the time. Having money or living in a nice area doesn’t make you immune to drug addiction.
Heck, we’re not even treating this like the last heroin epidemic. (See Eric Schneider, Smack: Heroin and the American City for a fantastic overview.)
I can’t believe we’re still fighting this failed war on drugs. The government does a lot of ridiculous things but our nearly everything we do regarding drugs is completely counter to best practices. I completely agree with someone upthread who said they’d take their loved one out of the country to get treatment.
I’ve always kept the leftover painkillers. In my teens and twenties I had terrible dysmenorrhea. My gyns would never prescribe adequate meds. I once got a regular Dr to write a codeine script, and I made that dozen little pills last a year.
“His point was more about the demographics of the user.” yes I figured that it was said with an agenda…not based on evolving views in society. but just because someone has an agenda does not make them correct. so much has changed in the last 3 decades. and slowly but surely more people are waking up to one of the last frontiers of intolerance (mental health) you hear less and less about people with mental illness needing to toughen up or it is a bad up bringing etc… these societal moves on substance abuse, gay rights and slowly mental health in general make me very pleased. a talking head with an agenda just makes me shrug my shoulders.
I got a dozen narcotic pain pills for my wisdom teeth extraction and another dozen for delivering each of my 2 kids. I may have taken one from each Rx. I believe we still have those bottles around somewhere. I suppose we ought to toss them. We also have my kids Rx from their wisdom teeth removal–don’t think they took any pills either, only NSAIDs.
H got 10 narcotic pills for rotator cuff shoulder surgery recently. After the first few pills, he switched to NSAIDs because he didn’t like to constipation get effect of the pain meds and it could mostly be controlled with the ibuprofen or alleve.
In regard to backlash with doctors: that is in process in a big way. A few years ago, the government and powers that be were vilifying doctors for being insensitive and inadequately treating pain. Now the same people are wanting to prosecute doctors for manslaughter when malingering opiate addicts overdose “recreationally.” It is all madness and it will make it difficult for patients with legitimate need for opiates to obtain them.
Many primary care doctors, who tend to get stuck with these problems, try to avoid it as much as possible by referring patients to pain clinics. The pain clinics want to do interventional pain treatments, not manage chronic misery. So legit patients are sometimes caught in the middle of the liability concerns. Opiate addicted patients are also very disruptive and time consuming. So apart from liability concerns, dealing with them is a general nuisance that is almost impossible to avoid in general practice. These patients often peregrinate from practice to practice, hospital to hospital, so keeping tabs on them is very difficult. State databases help but those are also somewhat time consuming and usually not integrated into electronic health records.
FYI, the patients who get the big doses of opiates are patients with cancer related pain, especially if the patient is terminal. Younger, drug-addicted relatives steal those drugs routinely so keep them locked up. And don’t forget to dispose of them after a person dies. Not to be too morbid but these cases happen all the time and dying grandma does not want to press charges against her sociopathic granddaughter stealing her meds and it becomes a big mess.
I predict that Suboxone will be the next major medical scam that flows out of the rampant opiate use. Suboxone is not a cure all, it is abusable, and it does have street value. The government and others, in an effort to “do something” is advocating Suboxone as the mainstay of treatment for opiate addiction. There are many doctors who are not experts in psychiatry or addictions who have a “private practice” which focuses on Suboxone and the opiate addicts are very adept at finding those practices.
Zobro do you understand how the minority community could see how the difference could be more than our new enlightened outlook on dealing with drug addiction
Big Pharma is getting a lot of the blame, in some cases all the blame, for the blame, for the opioid crisis. Big Pharma is a big target and an easy target. Perhaps it is too easy of a target. But it gets public officials. good publicity to rant against them. I have no connection to Big Pharma BTW.
The Gloucester, MA police chief who got national press for demanding to meet with Big Pharma CEO’s has recently been suspended.
tom1944 people can believe what they choose. that is their right! to each his own. I see it different.that is the cool thing about opinion’s … I see some really positive forward motion on many things… others always want to have some twisted negative reason… . thankfully we are seeing leaps and bounds not only about drugs but in LGBT rights and slower but steady progress on mental health conditions and the people who have them. I am sure you can offer up some reason that this is occurring too…other than a steady societal shift of beliefs,understanding and tolerance for those who fall into these categories.
tom of boston I do agree it is to simple just to blame big pharma. I also do not think the problem is larger now, just the drugs have shifted. people have been addicted to different drugs threw out history. opium, heroin (which has come back…never really left) other stuff comes and goes in popularity…ecstasy, lsd,angel dust …qualudes. flakka , etc…of course alcohol ,cocaine ,meth etc…
people do not get hooked because it easy to score. they get hooked because they are drawn to the use of drugs. it does not make them bad people it is just a mechanism we each have which helps guide us. like I do not do drugs or drink alcohol (I choose not to…not because of moral reasons just like to be in control and I am afraid of getting addicted…if I stay away than I protect myself from myself) I also do not bungee jump,cave dive or do whitewater rafting.
I don’t think that opiates are “easy to score.” In over a half century of living I have never encountered opiates apart from a brief prescription following a surgery. In fact, one has to lie, cheat, and steal to abuse opiates. It is difficult to maintain an opiate addiction so much so that opiate addicts are among the world’s most adept manipulators. They are outstanding malingerers as well.