s/o Walmart limiting prescriptions...explain opioid issue

link - I think this is an interesting article suggesting why some people are more vulnerable to addiction.

There are so many gateways into addiction. In my county, there have been numerous stories about high school athletes getting addicted after injury and surgery. We take the risk seriously enough that we requested no opioids after both of my daughter's major surgeries and restricted my son to only 1/2 pill before bedtime the first night after his most recent surgery. Maybe that's ridiculous over worrying but I don't think any human being wakes up and decides "I want to get addicted to drugs today." Maybe it's one bad decision by kids whose frontal lobes aren't developed yet, maybe it's self-medicating, maybe it's a genetic predisposition that gets turned on after being legitimately prescribed these types of drugs.

Honestly - i'm glad you have a hard time understanding it

because that likely means you aren't affected by addiction in your life

i live in an area that is drowning in drug activity -

and quite frankly, i'm sick and heartbroken

it directly affects my family and so many of my friends

and it's honestly hard for me to see some of the things i see said here

the stigma that is right under the surface

and the 'not my family' (even if subconscious) that lingers

it's never 'my problem' until it is

gina

The myriad reasons for addiction aside, the warnings are there because there are measures that exist to prevent death in case of an overdose. All of the PSAs I've seen so far are about not using alone and having a Naloxone kit on hand.

Personally speaking, I strongly believe there is a genetic component. My personality is such that I become obsessed with things very easily. I have bipolar disorder and in my 20s when my mania was at it worst alcohol was starting to become an issue for me in that I never had a drink, I had at least half a dozen. Alcoholism ran in the family. People with mental disorders often self-medicate. But I have chronic pain, and I have taken gobs of hydrocodone in my lifetime. My doctors have (rightly) shown concern for addiction based on my other issues. It has never done anything for me but (moderate) pain relief, I have never gotten any other benefit, never felt happy or high and not even had the slightest feeling of that kind of need. I'm still very cautious, and I consider myself extremely lucky.

It’s hard to say what would have helped. In a third example, a family member with a congenital hip defect takes opioids that are rationed like gold by the doctor, and manages them extremely well. I do feel like having a 30 day supply makes it easier to take an extra one when the pain is bad and then going through a 30 day supply in 20 days and I think this is a contributing factor. Slowing the flow of meds could potentially slow the rate of intake and perhaps slowed the problem. I don’t know.

I sympathize with very sick patients who can’t get to the pharmacy once a week to get their meds and think there should be protocol for this.

I think billboards and other social media information can be quite valuable. I read recently very alarming statistics on how addictive opiods are, how fast you can get addicted through an informatiooal campaign. If I remember correctly, something like 20% of all users will get addicted with 14 days of use. And it's not uncommon to get handed a prescription for that long. I had NO idea some people can get addicted so fast. I forwarded that article to everyone I know.

It's really important to know that because many doctors are still handing out prescriptions like lollipops. I have a relative who went to the ER after an accident and the doctor gave her a prescription for oxy very casually. No warnings, no discussions of pain managment options, just a prescription for a wildly addictive drug. She did not ask for pain meds at all. He just handed it to her. She had read the article and shredded the paper when she got home. I have a friend who was injured on the job -- very minor injury -- and the employer insisted she go to the doctor. She insisted she was fine at the doctor and was just there to make her employer happy, but to her shock, he gave her a prescription for oxy. She had read the article too and destroyed the prescription What if these patients had been more passive and thought they should just do what the doctors ordered? They could have been part of the epidemic.

Maybe doctors are being monitored, but I still know of so many people who get handed prescriptions for oxy as if it's aspirin that I have a hard time believing teh monitoring has any teeth.

Education can save lives. It really can.

I have Fibromyalgia and have been on various Facebook groups inhabited by people who were Rx'd opioids. When they were cut off they became whining, shrieking, wretches. I have never taken heavy duty drugs and manage my condition with careful pacing and the lightest dosage of meds that allow me to function.

I'm not blaming the people who have been set with their opioid dependence, but it needs to somehow be stopped. Doctors refusing to Rx is the only way I see of stopping it.

I absolutely think doctors are a huge part of the problem. In particular, minor surgeries where they not only give you excessive pills but utterly push the "stay on top of the pain" message to a point of ridiculousness IMO. In the last 5 years, our family has had 5 different surgeries - all relatively minor. In no case did we not leave without a prescription of at least 15 days (and that was for a 13 year old) and in most cases were 30 days. In NONE of those surgeries was anything other than ibuprofen needed. In every single case there were multiple warnings by the medical team about not waiting to take pain meds - in NO CASE was there a discussion about the potential addictive nature of these drugs by the doctor. As studies show 14 DAYS of use will cause a chemical addiction - doctors should damn sure stop writing prescriptions for 30 days without an excessive discussion with the patient.

www.consumerreports.org/drugs/knee-surgery-linked-to-painkiller-addiction/

My sister who is also my best friend is in chronic, intense pain. There are many days she has confided to me that she has considered killing herself just to make the pain stop. She has many health issues which I won't go into here and has been on disability for many years. In the last couple of years here in Maryland she has had to fight tooth and nail in order to get her pain relief prescriptions filled. She has to go to a pain clinic, sign paperwork saying she won't smoke cigarettes, do a monthly urine test so they can check for illicit drug use, and as the weeks go by they reduce her pain medication more and more to the point now where it is almost intolerable.  She has years and years of documented records to prove that she needs this medication and this is still happening. All because of the opioid epidemic. The same epidemic which counts illicit heroin use when it makes up it's opioid figures! 

This is insane in my opinion. While I understand the idea of trying to protect the general public from opioid addiction (which I do realize is very easy to fall into with pain medication) it should not come at the expense of patients who are daily struggling with excruciating pain. I'm talking about pain that makes it difficult for you to breath. That kind of pain. Pain that makes your life unbearable. 

The government does nothing to try to protect us from alcoholism by limiting our access to alcohol (other than the age limits)  so why should this be any different? The access to pain medication (opioids) is much more strictly controlled (even before this crisis) than alcohol ever was not counting prohibition. Just trying to throw an analogy out there. I think our government is overreaching here. I don't need a "father figure" to protect me from my actions regarding taking opioids for pain medications. If my doctor prescribes a valid medication (opioid) for pain medication it is up to me as an adult to use it sensibly. If I don't that's on me. 

If you've never yourself been in that kind of chronic pain or had a family member I don't think you  understand this side of the opioid issue. As far as selling them on the street? What? My sister treats her pain medication like gold as another Pea mentioned. She'd rather sell her liver on the street than her pain medication. It's the only thing that barely gets her through the day. At 6:00 pm it wears off and she doesn't have any to get her through the night so she has to suffer until the morning due to the recent stricter bans. 

When I was traveling in Germany last May I met a female doctor while I was having dinner alone in one of the towns I was travelling in. She was having dinner alone so we got to talking. We ended up talking for 2 1/2 hours. One of the things we talked about was health care USA vs. Germany. I told her about my sister and lack of pain medication and she said that would never happen in Germany. She said patients are taken care of that are in chronic pain and are made sure to be made comfortable and not to suffer. 

birukitty I'm so sorry about, and for your sister. Even as someone with bipolar disorder with extreme depression I never understood actually wanting to die. I was fine existing in a semi-comatose state in my depression, except for what it did to my family. But then chronic pain became an issue and it was a sad, scary day when I realized...I understood. Until I got the severe pain better controlled I could not fathom living the rest of my life in that kind of pain.

I didn't realize heroin was counted in the numbers. Logically, of course it is, but I feel like they should also have seperate representation for pain medication as avoiding and fighting the addiction is so different. I applaud the efforts to stop hand them out like candy, I think a huge effort needs to be made to educate people when they are prescribed, but it kills me when the systems they put in place to stop people from abusing the system make people like your sister suffer.

a nationwide DEA database that lists all prescriptions for every patient, would go a long way towards preventing over access to drugs from doctor shoppers. If you go to fill your scrip, the pharmacist should be able to easily view all your prescriptions and when they were last filled. This database should be view-able by doctor's offices, hospitals, etc

Pharmacists and doctors can get a list, but it's not fast-it needs to be setup so that you cant write or fill a scrip if someone has exceeded their allotment of specific classes of medication.

that doesn't do anything for heroin addicts though-many of whom switch to heroin when they can't get their pain meds filled. or can't afford the medication anymore.

I honestly believe that mindfulness based stress reduction should be taught to ALL kids in public schools on an ongoing basis, starting in grade school. self medication of anxiety and depression are two things that are almost always present in addicts and if people were taught adequate coping mechanisms for these two issues alone, we could probably cut abuse by more than 50% IMO. Add in mental health therapy readily available to all who need it, and I think the problem could be beaten before it even begins in most cases.

I'm happy to answer your query.

Opioid addiction is an addiction that has officially crossed all economic, social, ethnic and cultural barriers. I sure wish opioids had been better regulated until now. My mother died in October, years before she should have, due mostly to her addiction. She died in a horrible manner.

She was from an affluent family with a nice monthly pension. She had a nice apartment. She had a nice sport car. I'm sharing this because she didn't fit the profile of an "addict." Until now. If I'm not mistaken, opioid addicts among this demographic are the fastest growing group of addicts.

My sister, daughter and I performed an intervention last May. She politely refused. She continued to doctor shop, faked pain to get morphine shots in the ER, etc. This is not the life she chose for herself during her retirement years. Her addiction grew out of two car accidents that left her in severe physical pain.

She mastered the art of obtaining the meds. Due to patient confidentiality, when she doctor shopped, the next doctor had no idea of her previous prescriptions from her former doctors.

Addiction is a disease. People do not CHOOSE to become addicted. One is either chemically "made up" to be an addict, or they aren't. Those who don't become addicts are the lucky ones.

Not to be flippant, but I'm not at all sorry for increased opioid management. It is long past due. Maybe my mom would still be alive today if scripts had been more rigorously managed. The past 11 months have been the worst year of my life. I miss her every day. As do my babies.

    Thanks so much Dewryce for your kinds words and thoughts.     They mean a lot to me. I understand exactly what you mean about depression and not wanting to die. I myself went through 10 years of what was diagnosed as "treatment resistant depression" and not once did I want to die-I was more or less catatonic-just "blah". I am so worried about my sister, but she's been telling me lately she's been feeling a bit better about continuing to live even though she's in more pain these days. I don't know if she's just telling me that to make me feel less stress or not-I hope not. 

Most people don't realize heroin is included in the numbers. That's why when the "opioid crisis" is mentioned all you ever hear about is an uproar over pain medication. I agree with you completely-they should have a completely separate number-facts and figures for pain medication addiction. I also agree with you that education is key. Handing out an informative flyer with each prescription filled warning about the dangers of how easily those pain medications can become addicting, how to avoid it, how to carefully take them and so on would be a great first step. Each pharmacy worker can point out to the customer that the flyer is inside the bag and how important it is to read it. 

Then I think it is up to the patient. People need to accept responsibility at that point in my opinion. Do we really want a government that holds our hands like a Big Brother? The other restrictions are already in place. The doctors I have come across (and I see a lot of doctors) aren't handing them out like candy, but are very careful these days not to do so at least here in Maryland. I of course believe the Peas who have said otherwise. So maybe that is changing.

In fact when I had my rotator cuff surgery in 2016 I was in agony when I woke up (because I'm basically immune to Lidocaine (like Novacaine I metabolize it super quick so it takes double the amount for me) and they used that for the nerve block-forgot to tell the doctor that) and I had to beg and beg the nurse for some pain medication. She finally let me have one pill (forgot what it was-something narcotic) orally but made me wait until I ate some applesauce which took about an hour from waking up time until she agreed. I have no idea why she didn't just put it into my IV. That didn't even touch the pain and I had to beg and beg again until she finally gave me another one and that just touched the edge of it. Worse experience of my life. Mean nurse. I guess she didn't believe me about the nerve block not working. But I don't lie-I get it from my Dad. Hate it when you are telling the truth and people don't believe you. Lying makes me feel so guilty inside. I mean, couldn't she tell by how much pain I was in that I was telling the truth? I guess a lot of people lie to get narcotics so they are used to seeing it? Ruins it for those of us who are in actual pain.