Wisdom teeth extraction is one of the biggest causes of opioid over prescription and getting teens addicted. My daughter had hers out last year and I think we got 5 or 6 prescriptions, so I asked the pharmacist what they all were and which were the most important to take, as I knew she wouldn’t take them all. There were 2 or 3 pain killers in the group, including ibprofin. There were 20 percoset pills. Now, that is my favorite when I’m in real pain, but I think she took 2-3 of them. I wouldn’t let her take them back to college with her. I do think insurers are trying to cut down the number of pills prescribed so now only allow 7 days.
When I had a tooth extracted, I was in real pain. My dentist fought me over percoset, and finally prescribed 4. I think my dentist went too far the other way and wouldn’t prescribe pain pills when I really needed them
Ibuprofen is an excellent pain reliever for the short term. When my D had gall bladder surgery, they sent us home without any prescription for pain medication. Ibuprofen didn’t make her pain free, but it held her well enough. However, all the NSAIDs have serious and sometimes life threatening side effects when taken long term. People with real and devastating chronic pain are being denied relief or put at risk because of this country’s misguided opiate policies. There needs to be a reality check. Stop giving month’s long prescriptions for simple procedures, but stop denying relief to those who truly need it.
My husband and kids can’t take ibuprofen due to their bleeding disorder. It was a real handicap for my two kids who had their wisdom teeth pulled. There was so much swelling that they looked like chipmunks and there was nothing we could do for them!
I think the OP understands why there are restrictions on the number of pain pills, the bigger question was why is that not a universal policy rather than being mandated by insurance companies? Her insurance would only pay for a 7-day prescription, but when she switched to private pay she was allowed to fill the 10-day prescription.
If there truly is a risk in giving people more than 7 days’ worth of opioid pain pills, then the same rules should apply to all patients, regardless of their ability to pay out of pocket.
Insurance companies limit supply because of money not because of any benefit to society. It’s to benefit their pocket books. And they love playing doctor. Another insurance company would have given you the 10 day supply–or 3.
Take bisacodyl (Dulcolax) or senna tablets along with opiods – go ahead and start with them after first or second dose to help with constipation.
@MaineLonghorn --your doctor could possibly have prescribed prednisone for the inflammation after surgery if your son couldn’t take Motrin. (depends on his condition).
Wouldn’t hurt to ask doc for post-op scripts while getting pre-op scripts. No harm in asking!
Docs want to give you enough pain med all at once in one script–now it’s worse to write more scrips than hand out pills all at once. No, it doesn’t make sense.
People who want drugs will get drugs. When the supply of prescription opiods goes down the tendency is to go to crack and fentanyl . Because they are easy to synthesize the market for these doesn’t dry up. Oxycodone (drug of choice) has changed it’s coating so it’s VERY hard to pulverize and inject. Which now leads to crack and fentanyl use which is even more addictive. One goes down, the other up.
@twoinanddone --“There were 20 percocet pills”–which is about 3-5 day supply if she actually needed them.
Saying “people who want drugs will get drugs” doesn’t explain how the rate of use of opioids skyrocketed in recent years. If the supply of drugs has no effect on use of drugs, why do so many more people want opioids now than wanted them fifteen years ago?
While my control group is limited to the teens I’ve known who have had them out (my kids, their friends, cousins), no one has ever needed more than 5, yet hundreds of kids are getting 20.
“In my state you can always fill a prescription for less than the prescribed amount.”
I have done precisely that on at least one occasion.
When I had major surgery I was also prescribed Percocet. While the maximum dosage (according to my prescription) was one every 4 hours, I found that within 3 days I was down to two per day, and within a week I was down to one per day at bed time. Thus the alleged one week supply that I was given (6 pills times 7 days) was in fact quite a bit more than I needed until the two week point, after which ibuprofen was easily sufficient.
To me this does however seem like something that should be up to the doctor rather than the insurance company.
I have a co-worker (lawyer) who has absolutely no addiction issues. He had knee replacement and was very careful in his use of the pain meds. He used the absolute minimum, but he did need them for several weeks. He said he was horrified by how he felt weaning off of them. It really scared him.
“Cardinal Fang: Saying “people who want drugs will get drugs” doesn’t explain how the rate of use of opioids skyrocketed in recent years. If the supply of drugs has no effect on use of drugs, why do so many more people want opioids now than wanted them fifteen years ago?”
Because they heard from their friends about it or got it for some procedure, or took it from the medicine cabinet at home when mom or dad got some, decided they wanted some, and created a condition that required ongoing prescriptions.
“MomofWildChild: I have a co-worker (lawyer) who has absolutely no addiction issues. He had knee replacement and was very careful in his use of the pain meds. He used the absolute minimum, but he did need them for several weeks. He said he was horrified by how he felt weaning off of them. It really scared him.”
I literally do not know how anyone can take these for a few weeks. I’ve received them for a couple of different surgeries and by two days in, it must be abandoned if I ever want to go to the bathroom again. Dulcolax was not a fix.
For from having nothing to do with the supply of opioids, this has everything to do with supply and is exactly why some people say that prescriptions of opioids should be limited duration. If there are no excess pills in mom and dad’s medicine cabinet, junior can’t take them.
“gouf: Insurance companies limit supply because of money not because of any benefit to society. It’s to benefit their pocket books. And they love playing doctor. Another insurance company would have given you the 10 day supply–or 3.”
Putting bureaucratic hassles in the way of people who legitimately need opioids to treat pain makes it MORE likely that these people will hang on to excess pills.
When my husband was prescribed an antibiotic that turned out to be unnecessary, he threw the unused pills in the trash when the doctor said to stop taking them. But if he has Percocet left over after he recovers from his surgery, I can’t see him throwing those pills out. Who knows what bureaucratic complications he (or I) might face the next time one of us needs pain medicine? We’re going to want to have some on hand.
The problem in the OP is the pharmacy or pharmacy tech. Any place should gladly fill a prescription for less than the prescribed number of pills without batting an eye. They do it for me when they don’t have enough pills, and then I come back later and pick up the rest.
The pharmacy worker should have had adequate problem solving skills to work through this, I hope you talk to the pharmacy manager.
As to the dilemma of undertreating pain vs. enabling addiction, that’s a problem to solve when you are not on your way home from the hospital with a hurting spouse. And I don’t know the answer.
Marian, I was thinking the CVS in Montgomery Village is marginally closer to me – but I was having a hard time imagining the reception DH would get if he showed up there at 2 am looking for pain pills for me. The CVS stores in our neighborhood wouldn’t even order S2’s ADD meds for me – they do not keep them in stock.
"Cardinal Fang: For from having nothing to do with the supply of opioids, this has everything to do with supply and is exactly why some people say that prescriptions of opioids should be limited duration. If there are no excess pills in mom and dad’s medicine cabinet, junior can’t take them. "
Who is talking about excess pills? What if someone is on a current prescription? Not everyone pays great attention to detail and knows exactly how many are left at any given time. Not everyone’s kid would touch them. But some would.
If anyone were on a current prescription and their access was strictly limited, they would notice IMMEDIATELY if someone was stealing from them, and before that person developed an addiction. I recall being prescribed addictive medication for a short while and the doctor would describe only a tiny amount, made me count out exactly how many I had taken and when, and would have made me come back if I had needed more.
1 - limit supply. As already mentioned, if there is a limited supply in the medicine cabinet, there is less opportunity for someone to take them either for themselves or for the black market. This is the same reason insurance companies limit the amount of some ADHD meds - there’s a significant market for Ritalin. If someone has a need for more, there is a process through the insurance companies to cover more. (And yes, I think the limits should apply to all, with a medical review to get larger amounts even if self-pay).
2 - required follow up. For someone prone to addiction, it can happen with fewer than those 7 doses. If they’re given in the hospital, hopefully the staff is aware enough to see the impact and do something about it. But now we send people home from the hospital quicker, and do more procedures outpatient, so there is no health professional watching over the patient. With a limited supply of opioids, if a patient needs more, the doctor is made aware of that need, and can watch for signs of addiction. This is a case of most of us being inconvenienced because of the small percentage of patients that are prone to addiction. Most of us won’t become addicted (some of us hate the feeling of being on even a half-dose,) but it’s a serious problem for those who can, and prevention is key to keeping it from happening.
I’ve had the pharmacy cut prescriptions when our insurer wouldn’t cover the full amount, and as annoying as that it, the restrictions (at least in our state) on buying decongestants drive me crazy. With a family of 5 I can only buy enough cold & allergy meds to last a week, and certainly can’t stock up when they go on sale, even though they’re sold over the counter.