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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsI'm getting my meds. Doc is furious that I might not get my pain pills. He's disgusted. So am I.
He's prescribing enough for 14 days so I can travel and not worry about my arthritic pain that literally has put me in tears.
He is not from here; he is from India. I'm glad he is my gp.
I'll pick them up at the pharmacy tomorrow.
Leaving Thursday. This takes a load off my mind.
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leftstreet
(40,674 posts)The feds need to stfu and stop telling them how to care for their patients
Aristus
(72,186 posts)Opioid medications can cause respiratory depression. So if I have a patient with asthma and severe COPD (and is still smoking on top of that), have decreased oxygen saturation, and they're begging me for opioid medication, I have to take into account that such treatment could cause more harm than good.
If I have a patient with a history of bowel rupture, opioid medications, which cause constipation, can cause a recurrence of the initial problem.
Also, if confronted with a patient with a history of opioid medication abuse (and/or overdose!), and wants opioid medication, do I just shrug and write out a scrip?
There are a million factors we clinicians have to keep in mind when trying to give our patients the best health care we can. But if it means no opioid medications, we often get hit with "You just want me to be in pain!"
It's clinical medicine's damned-if-you-don't, damned-if-you-do.
sinkingfeeling
(57,835 posts)Response to Aristus (Reply #10)
Rebl2 This message was self-deleted by its author.
crimycarny
(2,090 posts)I don't think the OP was suggesting that a doctor shouldn't use clinical judgment as well.
Aristus
(72,186 posts)is likely to complain that I just want to cause pain; (someone even actually accused me of being a sadist, and enjoying the pain of others!)
CTYankee would never do that, and there's nothing but love between us.
But lots of others have jumped in and piled on before.
MontanaMama
(24,722 posts)I can't imagine anyone on this board accusing you of enjoying anyone's pain. That takes my breath away. I am so sorry.
Aristus
(72,186 posts)But people just passing through have done it several times.
MedRxx
(58 posts)there have been several articles in the anesthesia literature looking at the LACK of efficacy of 'multi-modal' non-opioid post surgical regimens
Yeah, and I too see at least one patient a week nearly comatose in the recovery room who cannot be sent out because when aroused to wakefulness one of the MANDATED questions is 'what is the level of your pain' and (if they can stay awake long enough to answer) it is always 'TWENTY of out TEN'
Yep we, and our patients, are screwed by management, The Joint, politicians and just about all the paper-pushers who tell us how to practice medicine
Crunchy Frog
(28,280 posts)with essentially no pain management, I now have alternative arrangements for treating severe, acute pain. It's effective, but certainly far less safe than being treated for pain in an ER, or being given a prescription.
What I learned from that experience though, is that I should never again put myself in a position where I'm dependent on someone else for my pain management.
If I ever get another kidney stone, your (generic you) clinical judgment won't play any part in what I do about my pain.
liberal_mama
(1,495 posts)cutting me off (with no notice) of a small prescription of pain pills (2 hydrocodone caplets a day) that I'd been taking (prescribed by him!) for nearly 20 years. I have RA, lupus, diabetes, and psoriasis with psoriatic arthritis so I deal with a lot of daily pain and inflammation. I had a blood sed rate in the triple digits.
Doctors are afraid to prescribe anything narcotic now. There was no reason for the doctor to stop the pain meds except that the government has got him terrified. I never abused them, asked for anything stronger, or requested an early refill.
I take other remedies now and they are actually more effective than the hydrocodone for pain, but way more expensive. Instead of a 10 dollar bottle of pills with insurance, I have to spend like $400+ a month. And it's not as convenient. I can see why people have to turn to street drugs when they have pain that their doctor won't help them with.
Now I just don't bother to go to the doctor anymore.
marble falls
(71,919 posts)... my life when American men doctors ignored half of what I told them.
William769
(59,147 posts) Hortensis
(58,785 posts)And that your rx's are as needed on your return.
CTyankee
(68,200 posts)intolerable. I got hubby to get the thermostat down. It's a new system and I am afraid to touch it and screw it up. Another thing we need to fix. We live in an old house and have upgraded everything, even the windows.
Hortensis
(58,785 posts)The controls on ours are very not intuitive and months later my hubby is still the default expert, insists on it actually. 
At least you're on this side of your upgrades now.
CTyankee
(68,200 posts)one of the last houses built here in New Haven. It's a great house, good "bones," but old technology.
We bought it over 20 years ago and I remember plugging in the toaster and coffee maker and having everything go flooey. I had blown a fuse (I didn't even know what a fuse was)!!!
The windows were the old rope and pulley type and when the rope deteriorated and broke the window slammed shut. So we put in all new windows.
Ditto with flood in the basement -- the old water heater busted. I've replaced three of them over the years.
The stove was so old I had to light it with a match, but at least we had the prized gas stove people loved (when electric was a no-no for "real cooks"
--and I don't cook any more.
elleng
(141,926 posts)
Walleye
(44,799 posts)
slightlv
(7,790 posts)but I detest you had to go through crap in order to get what you need. Being a long time chronic pain sufferer, as well as having lupus and fibro, this issue is a hot button one with me. I've been through too much of my own issues trying to get my meds... some, not even narcotic pain meds. We patients have been here before, and we beat them back through patient's rights and a lot of screaming. I, for one, will always stand next to my brothers and sisters in pain. We are NOT druggies. We are NOT addicts. Taken as needed and prescribed, you don't get "addicted." However, as my physician of 25+ years told me, you are dependent on the drugs. Well... duh!!!! Do I want to be able to move and take care of my own life, or do I want to lay in a pool of pain and do nothing but cry? Of course I'm dependent on the drugs for a normal life. And these drugs should not be withheld from us, just because they are a short excuse for those who either cannot find anything about themselves to love, or give up on life. For us, these meds are life. It's others' choice if they use them to end life. Why should my life end because others can't control themselves? Addictive behavior is inherent in people, and it expresses itself in all kinds of ways... mostly bad.
I'm sorry... like I said... hot button issue with me. I'm in that last week before my pain meds get renewed. Anxiety about the hassles of getting it filled tend to pile up around this time.
FloridaBlues
(4,668 posts)Hopefully these shortages end soon for patients that really need them.
CTyankee
(68,200 posts)crimycarny
(2,090 posts)I mean, they are the magic pill--right?
It seems that the ONLY side effect that matters anymore is "potential" for addiction. It boggles my mind how chronic pain patients are being refused anything that is opioid-related out of fear of addiction. So fear of liver damage/failure by taking massive doses of Tylenol isn't a concern? (And, often, Tylenol doesn't work).
Some of the alternatives to opioids not only don't work, but they can cause far more damage. I just heard a podcast where an ER doctor, who advocates against opioids in almost any case, talks about prescribing his patients Haldol or Zyprexa for pain. And he jokes about using the generic name (HALOPERIDOL) so patients don't realize it's an antipsychotic med. He even joked "And I tell them they need to make sure they don't drive when taking it, that way they think there are getting the "good stuff"."
How is that not malpractice? The pendulum towards "opioid bad", and "anything else good" is infuriating. I'm just grateful that, knock on wood, I'm NOT a chronic pain patient. God forbid I ever am and I'm forced to take medications that do nothing to help my pain but cause major side effects.
Mossfern
(4,715 posts)I have spinal stenosis and am still recovering from laminectomy surgery on three vertebrae. I couldn't walk more than 30 yards before the surgery, but now can walk a couple of miles at a time. Before the surgery, my pain management doc warned me that after the surgery that I would be able to walk, but I would still be in pain. I take warfarin so NSAIDs are out. I was told that I would forever have pain, and now I have bursitis in my hip and developing arthritis in my hands (fun). I'm on 5 mg of Oxy as needed - usually two times a day. Without them I find it difficult to do anything because of constant pain which leads to depression. Those opiods are honestly saving my life! I don't take anything until I feel the pain coming on - I'm careful about that.
I can't tolerate Gabapentin or Lyrica. I get furious that some people (friends even) are appalled and concerned because I take opiods. They're a godsend as far as I'm concerned. I'm soon to be 75 years old and I intend to live my life in my later years instead of sitting around, doing nothing, being dependent, being bored and frustrated and in pain because some higher authority is "concerned" that I may become addicted. As per the 'rules' every three months I have to go in for a saliva test to make sure the drugs are in my system and I'm not selling them. Sheesh! I'm a little old lady for crying out loud!
crimycarny
(2,090 posts)slightlv
(7,790 posts)and after one month on Lyrica, I gained 30 pounds. My rheumatologist took me off it after that, of course. From that point until now, I've not stopped losing weight. Weird, eh? My girlfriend's daughter had the same effect, although weight has evened out for her now, after several years.
I went from a size 24 dress size pre-lyrica to 90 lbs now. Wouldn't suggest it as a weight loss drug, tho. I have no idea why it affected me and my friend's daughter like it did, but we had the same effects. These days, I just have to be very careful not to fall... no padding around bones that tend to break easily these days. (I've broken the same hip twice.)
These miracle drugs are being released right and left, and while I look forward to medical advancements, they're all about making money on a monthly basis. Cures for a disease seem quaint these days. The dementia study mentioned in DU yesterday was a rare exception... but even that drug (they eventually come up with) is going to have to be taken on an on-going status.
Plus, so many of these have side effects that, without enough testing and time, make us unpaid guinea pigs for the pharma industry.
I admit, having lived with pain most of my adult life makes me jaded and extremely opinionated on the issue, as well as very cynical. But look at all the quasi pain relief ads on tv for over the counter products, or in spam email or your game ads. They're targeting people who are in a very vulnerable position and it makes me angry. We have limited funds because so many, like me, were forced into early retirement... or just kicked out of work... because of our disabilities. And then, to add to the humiliation, greed masters are waiting to fleece us on products that are useless, while we have to fight for what does work for us against those who have other vulnerable people in mind to fleece (addictive personality types). Once again, those with money pit us against each other in a race to the depths of hell. These OTC "pain relievers" are just the latest marketing ploy, in the style of weight loss "aids." I'm sorry, the whole thing is just sickening.
And, while I didn't read the comment, I did see someone snark out about antidepressants. Snark aside, do you know trying to come off the antidepressants that were given out like candy a while back will take decades, if you want to keep from killing yourself while trying? I'm on Effexor, and it's kicked with arithrozirapine. It doesn't make up for the way the pharmacies treat you and leave you feeling. In addition, the kick time to safely titer off the Effexor was something like 10 years.
And they pitch a fit about toradol or hydrocodone. Give me a freaking break. No matter what you take, the pharma has you by the addicted cajones. If you need it to function in any way, they've got you.
Mossfern
(4,715 posts)I gained a bunch of weight from Lyrica on top of Covid weight (Hello Spinach Quiche) and have not been able to take it off. The good part is that my face looks great, unfortunately my rear looks like I've had a Brazilian butt lift - Kardashians, eat your hearts out, mine is natural.
slightlv
(7,790 posts)Gravity hit my butt so hard, I keep thinking I must be dragging it behind me, cause I sure as heck can't find it anymore!
crimycarny
(2,090 posts)It was my comment that was snarky about antidepressants. Not because antidepressants are bad in general, but because they are so overly prescribed for just about everything, and that's not seen as a danger because they aren't "addictive". I really take issue with the distinction between "potential for addiction" and being physically dependent on something. A person definitely becomes physically dependent on antidepressants! And they can often stop working so the doctor increases the dose. How is that not similar to "addiction"???
My sister was put on Prozac when it first came on the market. She was dealing with depression over having been fired from her job because she rejected her boss's sexual advances (this was way before the "Me Too" movement). She said the Prozac turned her into a zombie that didn't care about anything at all, emotionally blunted. Gained a lot of weight too. Then she started having nocturnal seizures which her doctor told her "couldn't possibly be due to Prozac" because seizures weren't listed as a side effect. Well, we know know that SSRIs can definitely lower someone's seizure threshold.
She decided to taper off on her own, slowly. She said it took her over a year of being off Prozac before she felt like her brain was back to normal. And she was only taking Prozac for maybe a year. I can't imagine 10 years' worth of taking an SSRI.
Pharmaceutical companies have to keep developing new drugs because once the patent expires they don't make $$. How many human diseases are there?
slightlv
(7,790 posts)after my hysterectomy. Was insistent I was going to go into depression because I didn't have a uterus anymore. (Male doctors!) I went off it pretty quick. I noticed after 6 weeks that I didn't care what my mom said or did, I'd turn around with a snarky retort and never think about how it must have sounded to her.
Knew then that stuff wasn't for me. I have deep feelings, and I generally really care about people, critters, and life in general. Prozac made me not care anymore. I couldn't take that. Besides, I was looking for something for anxiety at the time... I wasn't depressed! But you're right, they were pushing SSRI's on us right and left, often for no really good reason.
I started with the Effexor because it dealt with both GAD and depression. By the time I found it, my pain levels were impacting my quality of life pretty bad. So, I was willing at that point to give it a try. Now, they're ineffective enough that I have to kick them with an added pill. I get mad... angry... about politics and what's going on in this country and the world, but I'm still not chronically depressed. I can feel when I'm headed down that path, tho.
So I give myself a drug holiday on some weekends. Besides, at this point in my addled-brained life, I'm lucky to remember all the meds. I cule in, actually, to making sure hubs takes his.
GoodRaisin
(10,922 posts)spinal cord injury. I was also offered the opioids and declined. Lyrica is only part of my pain treatment, it is combined with Atavin, Cyclobenzaprine, and Diclofenac Sodium. All of those drugs combine to bring my pain level from the 8-10 range to the 5-7 range. I do suffer many of the side effects from Lyrica, but the neuropathic pain is essentially out of control if I withdraw it. The Lyrica doesn’t help the Sciatic pain I also have from lumbar spinal stenosis, which is acute pain, but rather works within my central nervous to reduce the amount of neuropathoc pain I feel throughout different parts of my body, most pronounced in my limbs, hands and feet in particular.
crimycarny
(2,090 posts)If the Lyrica works well enough for you that's great. But to prescribe Lyrica to a patient who has a different type of pain that Lyrica won't help with, merely due to the fear of addiction, is what is wrong with what the DEA is doing.
From what I'm reading other are some with debilitating pain that the ONLY thing which works is opioids, yet they are being refused these meds and forced to live in pain because of fears of addiction--even if the patient takes as prescribed.
Patients who are forced to live in pain are dying by suicide because they just can't bear the pain any longer. Opioid prescriptions are down to record lows and fentanyl ODs are at record highs.
It's heartbreaking.
GoodRaisin
(10,922 posts)Your title line of that post is misleading (and wrong) which is what I was pointing out. In fact, Lyrica has been studied and FDA approved for the exact condition I made reference to, as was mentioned in the link you originally supplied.
crimycarny
(2,090 posts)I included an article in the post you refer to that clarifies a bit more.
GoodRaisin
(10,922 posts)Perhaps you should consider editing your title line and and include at least one or two excerpts from that article you linked.
liberal_mama
(1,495 posts)and Gabapentin are way more addictive and dangerous in my experience.
I was on Gabapentin for 5 years.
After all that time, I was having difficulty with severe brain fog, I couldn't even pronounce most words anymore. The side effects from long term usage were awful. I decided to get off the Gabapentin and it was hell on Earth.
I've withdrawn from a lot of medications, benzos, opiates, antidepressants, ect, but Gabapentin was by far the worst. I still had withdrawal symptoms for several years after over a full year of tapering down and finally jumping off at 100mg/day.
It was really awful. Doctors don't warn you about this.
I've been in a Gabapentin/Lyrica withdrawal support group on Facebook for like 8 years. I took my last Gabapentin dose in December of 2017.
Doctors pass them out easily now to avoid prescribing opiates for all sorts of off label use and this is causing a lot of people problems.
slightlv
(7,790 posts)I hear you. I have to go in every 3 months, too. The middle appt can be telehealth with my doc, but the other two have to be in person. I'm 67... and can't get enough of a script to last me a full month to do what I'd like to being able to do. At 67, who the frack cares if I'm addicted, anyway? What the frack do they think I'm going to do if I was?! I'm now 4'9 1/2" tall, and I weight almost 90 pounds. Blow on me hard and I'll fall down! (LOL)
My doc moved from our little city almost a decade ago. I spent a year trying to find a doc to replace her here. Every single one of them treated me like a was an addict looking for scripts. That's even with my medical files available for them to peruse. But they couldn't be bothered. I was too much of a danger for their practices, I guess. I went more than a year with no pain meds of any kind, other than tylenol. No telling how much damage I did to my liver during that year, thanks to all the tylenol!!
I finally made an appt with my old doc in her new practice - an hour away. She's been through almost everything with me for longer than I like to think. I mean, I was an established patient when her first kids were born. They're now through college! She's good; she's thorough. And she understands I'm not going to take any chances on anything. She also knows I'm smart enough to see through all the "signed waivers" they make you sign. I flat out called her on it. After she said it was voluntary, and then admitted to me that I wouldn't get my meds unless they were signed, I asked her... do you see how, then, this is no longer voluntary... but done under threat of blackmail? She started watching my blood pressure as soon as Trump was elected. (gryn)
My problem is my driving isn't so great these days... and add on that I don't have really great transportation, anyway. I travel 2 hours roundtrip to see her 3x a year. My rheumatologist is an hour in the other direction. Strangely, his scheduling is every 3 months, too. And I just keep hoping my old car of 230k miles will keep on rolling down the road and getting me there and back safely. What the hell happens when it completely breaks down or I can no longer drive? If and when I allow that thought to cross my mind, that's when I make a beeline for my cats and take comfort from them. They may not lessen my pain; but they lessen the weight on my soul.
This country was never a great place when you got old. But SS and Medicare gave you a shot. Unfortunately, they've not kept up with inflation and the way we older people spend. We're so far behind the 8 ball it'd be laughable if it wasn't so tragic. But that's for another topic. (sigh) Growing old isn't for the feint of heart!
GoodRaisin
(10,922 posts)your pain. You do what’s best for you. I have suffered much of what you are suffering from and I know what chronic pain feels like. You go for what gives you relief. Our options aren’t exactly great. I didn’t opt for the opioids, but one of my treatment includes Ativan, which is very addictive, and I don’t care. It works, and that should be the bottom line.
Maru Kitteh
(31,759 posts)who live with addiction. It is so much more complicated than someone "giving up on life" or not being able to "control themselves." Addiction is a disease, something no one would choose.
Addicts need medical care, support, and sympathetic understanding to cope and heal. For those who have abused pain-killers, just like those who have abused food, great numbers will need to keep consuming the very thing that has harmed them in order to live.
Illness and injury are not moral failings. The opioid crisis has many victims across every spectrum and strata. We all need more kindness, and that starts with what we give.
I have seen first hand the difference adequate and effective pain management makes in the life of those who cannot function without it. I’m sorry for all of the turmoil and stress and restricted access you and so many others are facing. I wonder if the answer might be in the formation of local, state and national patient organizations, or class action. I don’t know what the answer is, but I care. Millions of others do too. 
NowISeetheLight
(4,002 posts)Honestly the best general medical care for family practice I've had is from Nurse Practioners. I had a DNP (doctorate) in South Carolina at the VA who was awesome.
multigraincracker
(37,651 posts)Down to earth and they actually listen to what I have to say.
pazzyanne
(6,759 posts)who put together my medical care team that includes a male Indian rheumatologist, a male Pakistani nephrologist, a female pulmonologist, and a female cardiologist. When this team was put together I had less than a year to live. It's now eight years later and I'm doing very well with a fatal autoimmune disease.
CTyankee
(68,200 posts)
pazzyanne
(6,759 posts) 
japple
(10,459 posts)called in on August 10th is still on back order. The pharmacist said that so many medications (even those for topical application like mine) are not available. She said that a number of the drugs used for ADD/ADHD in children haven't been available for a few weeks. I'll bet parents and teachers are having a tough time, as school started 2 weeks ago. Wonder what the problem is?
multigraincracker
(37,651 posts)They will make it for you.
japple
(10,459 posts)for Desonide Gel. The pharmacist said she would call the drs. office and ask if they would substitute.
Mosby
(19,491 posts)Is watching sales of amphetamines (Adderall, Concerta etc.) and benzos (Xanax, Ativan, Klonopin etc.) along with opiods.
So Drs and pharmacies are being careful with their purchases/scripts.
https://www.fiercehealthcare.com/health-tech/cerebral-under-federal-investigation-possible-violation-controlled-substances-law
I find it annoying as heck that I can only get a 90-day prescription for my sleep medication (a sedative/hypnotic - not amphetamine, not benzo, not opioid). I don't need to see the doctor evey 90 days, but if I have a period of insomnia in the 6-month period between visits I may run out between appointments. And each 90-day prescription requires a visit to the doctor.
Most times, I can go a full year on a 90-day prescription - and then I have to count pills when I head to my 6-month visit to see if I have at least 45 pills left for the remaining 180 days before my next visit. And then there are times like this last visit when the nurse asked if I needed refills, but apparently forgot to pass the message on to the doctor.
I find it highly annoying.
Hekate
(100,133 posts)I was pretty irked because we’d been refilling “just in time” for a long time and thus never had any on hand “just in case.”
I phoned the pharmacy (Costco) , asked about travel, and was informed that I had a 4 day leeway — that is, I could actually order 4 days before the calendar said I could. It changed everything. I calendared all our meds very closely, and at the end one one year I definitely had enough to go travel. At the end of two years, rather a nice cushion.
After we moved 6 years ago, my husband took over the ordering. Still, there were several months where a necessary med for him kind of disappeared off the various pipelines between India and here. Every month that he’d pull a bottle from our stock, I would murmur: you may thank me.
I hope someone can use this experience of mine. I hope it still will work for someone, somewhere.
Meanwhile, Godspeed, my friends.
MedRxx
(58 posts)Writing as a doc—one who did pain for years as no one else would (until it became too legally frustrating and dangerous)—the opioid crisis was created (and is now being 'treated') by a small group of physicians (who started with bogus articles denying the lack of the long-known addictive power of narcotics) pushed by narcotic manufacturers (especially the Sacks) and with the complicity of co-conspirators in The Joint Commission (starting with the declaration of pain as 'the fifth vital sign' (it is NOT a sign, but a symptom) and the political organizations (Congress voted down a bill which would have cracked down on 'pill mills' well over a decade before the 'crisis' (fully bipartisan, very few 'Nays' as I recall) and the insurance companies which tied reimbursement to 'patient satisfaction surveys' (that's why you're always being asked) an important component of which was satisfaction with pain relief. Around twenty years ago a correlation was already identified with high satisfaction scores for pain relief, and increased mortality.
It is late. Too late for me to write rationally about all of this because it makes me SO VERY angry that now people are being DENIED PAIN RELIEF.
I'm old, I've got arthritis. Cannot take Aspirin, Tylenol does not work (and—besides the known liver damage—there has been (again for over twenty years) evidence that chronic use can also damage the kidneys. Low-dose tramadol does work, but good luck finding someone who is willing to put up with the bullshit needed to prescribe it.
We have lost the plot...truly, I wish you luck (leave it in the container it is dispensed in, else TSA might seize it. This is true)
CTyankee
(68,200 posts)when, as an art historian, I went to Europe every year. The arthritis and my husband's increasingly challenging health stopped that.
Since my doc is now pissed about this, he is prescribing me what I need for the duration of the trip.