@“Cardinal Fang” – I totally agree with the idea that people should be able to hold two ideas at the same time. that’ why I find it perplexing when people can talk about the opioid epidemic and understand how truly awful it is, yet at the same time talk about people in pain being “inconvenienced.” Please read the Harper’s article I linked upthread. It’s not about inconvenience; it’s about people in such constant, chronic pain that their lives become meaningless, to the point of suicidal for some.
I don’t think we can just write them off with an “oh well.” A true middle ground has to really comprehend their situations, and not just think of them as unfortunate casualties of an epidemic that they are not responsible for.
The OP was not in such constant, chronic pain that her life became meaningless, and neither was her husband. Because her husband’s doctor screwed up and wrote a prescription that was too long, she had to pay full price for a prescription that she could get reimbursed for 7/10s of. That is called “being inconvenienced.”
I do know someone who had wisdom tooth surgery and was prescribed opioids and told to take them until used up. After they were used up, he got some uncomfortable annoying symptoms for a while that he later realized were withdrawal symptoms.
The hard part of managing pain and opioids is that no third party can directly tell if the patient’s pain really is severe and is not responding to other treatments, or if the patient is just trying to feed an addiction by exaggerating the pain level and pretending that other treatments do not reduce the pain.
In one study, male teenage athletes had a higher chance of being prescribed opioids than male non-athletes, a higher chance of having taken too much of those opioids, and a very much higher chance of having taken opioids to get high. This is not proof that young athletes being prescribed opioids can cause addiction, but it’s certainly strong suggestive evidence that prescribing opioids for sports injuries leads to addiction for some young men.
This discussion has gone far beyond simply the OP’s situation, and your comments really are not considering the idea of people being in truly bad situations without adequate pain meds. I have no dog in this hunt either way, but i think it’s heartbreaking that people’s extreme distress is being written off as not important to the issue.
Some people who are taking opioids for genuine chronic pain are getting addicted. That is why the overdose epidemic is so terrible in blue collar areas where many middle aged to older people have held hard physical jobs their entire lives. They have real back pain, real joint pain, real honest-to-goodness chronic pain from a life of hard work. Nobody denies their pain. And many got opioids, and some got addicted.
Adolescent boys as well as professional athletes got sports injuries, and then some got re-injured but still wanted to play, and they were prescribed opioids, and some got addicted. Again, we’re talking about real, undeniable pain, ending up with addiction.
We can’t dismiss the overdose epidemic as being restricted to drug-seekers. Plenty of people who became addicted didn’t start out as drug-seekers. Therefore, when someone is suffering from real pain, we have to consider the chance that if prescribed opioids, a person might become addicted.
Again, if you would read the article I posted above, it makes an important point about the difference between being “dependent on” and being addicted. People can be dependent on a drug long term to make life livable. That doesn’t make them drug addicts. I’m not dismissing the drug problem, but you are dismissing the pain problem.
Call it 7%, then. Seven percent of ten million people is a lot of people! I’m not willing to write off 700,000 addicts. And I’d like to point out that plenty of people who are addicts have not been carefully diagnosed as addicts.
So let’s do a little back of the envelope here, and say that for every two people who are prescribed opioids for chronic pain and who have been carefully diagnosed as being addicted to opioids, there’s another person prescribed opioids who is addicted but has not been officially diagnosed. Now we are up to ONE MILLION PEOPLE who are prescribed opioids and also addicted to opioids. I’m not talking about people dependent on the drug, but on people who are addicted to the drug.
There is no simple answer here. There are people who depend on opioids to have any semblance of a normal life, and plenty of them. There are people who are addicted to opioids, and plenty of them, and plenty of people in chronic pain who, if given opioids, would become addicted and have their lives ruined. We can’t ignore any of these groups. Just saying that people who are in chronic pain should have opioids ignores that a whole lot of people’s lives have been ruined or ended because they were in chronic pain and were given opioids.
Dependence is not the same as addiction, but there are addicts who are also physically dependent, and there are addicts who are not. Two separate but important issues. The limit to the number of pills is to fight both dependence and addiction. Yes, we need to acknowledge that those in pain need something to relieve the pain, and if we were serious about doing so, we would be looking to other drugs that don’t have the same profile of both addiction and dependence, including marijuana. We also need to understand that pain has a purpose, and stop telling younger people that proper pain relief eliminates all pain. How many of those people with chronic pain might have avoided it, if when they had serious injuries, they were given enough pain relief to take the edge off, but not so much that they never completely healed, because they couldn’t feel the additional damage they were doing?
Probably not very many of them. If you look at the reports of people with chronic pain, you don’t typically see people who pushed through the pain of an injury because they were over-medicated. A lot of them seem to have non-injury pain, and the ones with injury pain often are suffering from chronic use injuries like back pain rather than acute injuries like an ACL tear. If your back hurts and you need to go to work to put food on the table, you go to work.
I am thinking of my own father who has chronic use injuries, and had both knees replaced plus multiple back surgeries. I know the rehab he had was never adequate, and nobody tried to address his gait and other factors that contributed to the degeneration of his knees. He wasn’t referred to a pain specialist until he was almost 70, and it was too late to rehabilitate his knees. It was far easier for the previous doctors to throw pain pills at him than try to correct the underlying problem.
Just to muddy the waters further–the studies that say NSAIDs is bad for bone healing aren’t conclusive in the least. M
Maybe what we need is more common sense and less over reaction that leads to an “all or nothing” approach.
"In Conclusion
In the current state of practice in which the standard of care relies upon evidence-based medicine, there is no clear evidence that allows surgeons to advocate for or against the use of NSAIDs following orthopedic procedures. Using all available evidence in animal studies, we can conclude that NSAIDs may affect the early phases of bone healing. However, this is dependent upon the type, timing, dose and length of exposure.
With that consideration, it is unclear how NSAID use may interact with other comorbid conditions that affect bone healing and one must take the patient’s overall health into consideration. Furthermore, one may not accurately extrapolate the results obtained with the use of NSAIDs in the axial skeleton to the appendicular skeleton."