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Post by refugeepea on May 8, 2018 22:45:00 GMT
My SIL takes Tramadol and other pain meds, as a result of a car accident. After 20 years on these meds I'm guessing he is addicted and will be in the deep weeds if his doctors reduce his access Your guessing. I'm surprised by your comments and others on here about how they know about other people's medical histories. Unless it was my minor child or spouse, I don't ever ask. one of the hardest things is to think 'it's all in your head' with no real solutions. Whether someone else tells you or you think that yourself. Being in pain in general messes with your head and those that do have the pain also are afraid to be labeled or flagged as 'drug addicts'.. I wish there was a solution so that those that do have them don't suffer because of those who have abused it. Even being on them long ter Thank you! A year ago I could not walk straight for two and a half months. I was only comfortable in one position sitting on the couch. That wasn't something I could do for the rest of my life. I tried for two years to avoid back surgery. I had epidural steroid injections and physical therapy. I did not take anything stronger than tramadol until a couple of weeks before I had to have surgery. The surgeon said it was one of the worst bulged discs he'd seen and was the one who recommended percocet. He was surprised I was still functioning. It messes with your head big time! I was fortunate that my surgery was minor and the relief was immediate! I also found out I have early onset arthritis in my back and I have a special needs child who is very physically demanding. The last two weeks have been hard with him. The last prescription I had for tramadol was in February. I took my last one today and I've been working up the nerve to call the doctor for a refill because of the stigma. I know I'm careful. I make sure I won't be driving for a few hours and childcare is covered if I might feel bad. I actually do better and have far less side effects with percocet, but that requires an office visit every time I need a refill. So I deal with the side effects of nausea and the possibility of getting a migraine if I move too quick. My cousin's wife is in the last stages of MS and he has a condition where he doesn't heal well at all after surgeries. He also has long term side effects from the West Nile virus. My heart hurts for them if this trend continues of going every seven days. I'm all for a national data base and a way to cut down on the doctor shopping.
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Deleted
Posts: 0
Sept 16, 2024 9:50:20 GMT
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Post by Deleted on May 8, 2018 22:56:06 GMT
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. I am so sorry for your loss Hon. We have a friend that had double knee replacement surgery several years ago, and yes, that is painful! He's been on Morphine ever since. But, now, because of the doctor's being under scrutiny, they are working with him to get him off the morphine. The morphine addiction was a BIG factor in his and his wife's divorce (after being married for over50 years). It has changed his personality so much, and made him a mean and ugly person to most everybody. He was my husband's best friend for 40 years. It's so sad to "lose" him even though he is still here. He has been able to cut down the amount he was on, but it's going to take quite some time to get past this time in his life.
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NoWomanNoCry
Drama Llama
Posts: 5,856
Jun 25, 2014 21:53:42 GMT
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Post by NoWomanNoCry on May 8, 2018 23:15:44 GMT
i felt the same way after reading the thread but i acknowledge that my own experience will skew how i view this topic but i do warn the general public to be care of 'not me/or mine' syndrome 'not my kid' can come back and punch you in the gut 100% agree with this. You never, ever know. I always feel there's an underlying tone of condescension and superiority by some who think it could never happen to them. I completely agree with both Gina and Fuji. DH is a cop and works also in the drug task force and he always tells me when it comes to the people addicted to pills they usually come from families that are "oh not my kid, not my family, were not "those" kinda people" and he's right..I remember in school the kids who popped pills were mainly the ones from good homes, some from wealthy families and a lot kids in honors classes..the families would rather sweep it under the rug than have their name ruined and face the issue. So yeah, I always do a big eyeroll when I see a Pea come on acting like it won't happen to them or that their family aren't "those" types of people because you just never know.
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Post by birukitty on May 8, 2018 23:23:01 GMT
That article is about recovering from surgery after returning home. Her pain was managed with pain medication while she was in the hospital, and hospital stays in Germany are longer than they are in the USA. Also my story regarding my sister is about 20 years of chronic, unrelenting, excruciating pain. Not healing pain after one surgery. The doctor I had dinner with in Germany was a trauma surgeon. She never said Germany is a source for more opioids than the USA. nor did I. What she said was that my sister wouldn't be left to suffer the way she is these days with her pain medication being reduced so forcefully after 20 years of using it without any problems whatsoever. Of course she wouldn't, she wouldn't have been prescribed the opioids there in the first place. Are you saying then that my sister would be left in this chronic, unrelenting, excruciating pain for 20 years which nothing can touch or fix except narcotic pain medication had she been living in Germany for the past 20 years? Are you saying she absolutely would not have been given narcotic pain medication? If so, then I'll ask you when was the last time you lived in Germany? Have you ever been to a German doctor or spent time in a German hospital? My grandmother lived there her entire life. My mother lived there for 25 years. I lived there for the first 5 years of my life. We have traveled back to Germany off and on numerous times throughout the past 20 years.
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Post by Darcy Collins on May 8, 2018 23:33:50 GMT
Of course she wouldn't, she wouldn't have been prescribed the opioids there in the first place. Are you saying then that my sister would be left in this chronic, unrelenting, excruciating pain for 20 years which nothing can touch or fix except narcotic pain medication had she been living in Germany for the past 20 years? Are you saying she absolutely would not have been given narcotic pain medication? If so, then I'll ask you when was the last time you lived in Germany? Have you ever been to a German doctor or spent time in a German hospital? My grandmother lived there her entire life. My mother lived there for 25 years. I lived there for the first 5 years of my life. We have traveled back to Germany off and on numerous times throughout the past 20 years. No - I'm saying she wouldn't be given the same high dosage as it is extraordinarily rare outside of cancer or palliative care. And yes I have been to Germany - but I wouldn't need to - there's only 500,000 studies comparing the extremely high dosage rates in the US with other European countries. Are opioids sometimes used - of course - but usually at much lower dosages - they are also more likely to use other medications and types of care: Look at the statistics - the same population in the US would see 97% on HIGH dose opioids. www.ncbi.nlm.nih.gov/pubmed/21933101When study after study after study shows our prescription rates are 2-3x other countries and studies showing increased PAIN sensitivity in long term opioid use - we damn sure should be looking at the issue from many different angles.
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Post by lesserknownpea on May 8, 2018 23:36:52 GMT
You know, I didn’t get that vibe from any of the posts. That addiction only happens to other people.
I did read, and happen to agree, that individuals, even amongst close family members, have very different biological and emotional responses to drugs. And alcohol, for that matter.
In my own family, my mother and 4 of my siblings have the “addictive” thing. Mom was just a functioning addict and drunk during a time when doctors happily prescribed whatever she asked for. My sister, too, very respectable, but prescription drugs, alcohol and Dexedrine are just her normal. My other sister was practically a walking pharmacy. How she’s still Alive, I don’t know. She and my younger brother are those in the ER with the big drama seeking drugs. I’ve been there and seen it I’m sorry to say.
My dad and I are the ones who hate the feeling of overuse of alcohol, and pain meds do nothing for us except hopefully take the edge off the pain. Any more than necessary just leaves us nauseated. We are in no way better, more disciplined, or anything like that. We’re lucky we dodged a bullet that runs through my family.
My poor DD did inherit it. She as a teen described it to me as taking opioids was the only time she felt “right”, the rest of the time was a torment to her. ( fortunately, in her 30’s, now, she’s found healthier ways to feel good😀).
I’m sure anyone with enough use will become dependent. But not everyone will have the same experience. Pointing that out is not saying addiction only happens to “ other” people.
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Post by birukitty on May 8, 2018 23:40:35 GMT
Are you saying then that my sister would be left in this chronic, unrelenting, excruciating pain for 20 years which nothing can touch or fix except narcotic pain medication had she been living in Germany for the past 20 years? Are you saying she absolutely would not have been given narcotic pain medication? If so, then I'll ask you when was the last time you lived in Germany? Have you ever been to a German doctor or spent time in a German hospital? My grandmother lived there her entire life. My mother lived there for 25 years. I lived there for the first 5 years of my life. We have traveled back to Germany off and on numerous times throughout the past 20 years. No - I'm saying she wouldn't be given the same high dosage as it is extraordinarily rare outside of cancer or palliative care. And yes I have been to Germany - but I wouldn't need to - there's only 500,000 studies comparing the extremely high dosage rates in the US with other European countries. Are opioids sometimes used - of course - but usually at much lower dosages - they are also more likely to use other medications and types of care: Look at the statistics - the same population in the US would see 97% on HIGH dose opioids. www.ncbi.nlm.nih.gov/pubmed/21933101When study after study after study shows our prescription rates are 2-3x other countries and studies showing increased PAIN sensitivity in long term opioid use - we damn sure should be looking at the issue from many different angles. When have you been? Once? For a vacation? That's not like living there or having family there. And you have NO idea what dose of medication or what kind of medication my sister takes because I haven't told you. She has tried other types of care throughout the 20 years she has had these conditions. Nothing else has worked. So I guess in your eyes she should just gin and bear it, huh? If she had to do that she would kill herself. But I guess that's just par for the course...as long as Dick or Harry over there don't get addicted.
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Post by 50offscrapper on May 9, 2018 0:16:57 GMT
Let's just say all this makes me so angry! I get angry that doctor's don't warn their patients to NOT take more than prescribed. Drs should warn their patients that taking more and more outside of the amount prescribed per day, they will most likely become addicted. Second, Dr's can easily see if you are doctor shopping. They can get you to sign a form and see any prescription that you take. There's a national database. So, doctors were making money on this. Third, pharmaceutical companies are well aware how often over prescribing happens. They have access to sales data. They turned a blind eye. See below. "The Charleston Gazette-Mail reported in December how drug companies shipped nearly 9 million hydrocodone pills over two years to one pharmacy in the town of Kermit, West Virginia, population 392. All told, the newspaper reported, drug wholesalers distributed 780 million pills of oxycodone and hydrocodone in the state over six years. “The unfettered shipments amount to 433 pain pills for every man, woman and child in West Virginia,” the story said." www.propublica.org/article/drug-distributors-penalized-for-turning-blind-eye-in-opioid-epidemicUnfortunately, I am not hopeful that much will change here. They OWN most of Congress. We need to have campaign reform. Fourth, as much as I understand that the tendency to addiction can have a genetic component, people need to take some responsibility for abusing their medications. Good people get addicted, I get that. I've seen it. If alcoholism runs in the family then don't drink. I suffer from constant pain and I have always been scared of addiction so I have always been super careful. Pain so bad that I cry myself to sleep. Pain level 9. I consider child birth no drugs, about a 6 pain level. I found that pain medication masks the problem. I found massive relief in an excellent physical therapist that didn't just had me exercises but worked on myofacial release, cupping and using K tape on me. Unfortunately, physical therapy is way more expensive than giving someone a pill. Dr's need to be trained to look at the whole person and truly diagnose. So often, it's here's a pill, here's an antibiotic, rather than truly figuring out what is wrong. Training for doctor's has to CHANGE! The whole thing is upsetting. I honestly think that all this has happened because of the money that was being made in all of this. Unfortunately, good people got caught in the process and now we need to figure out how to help them. They deserve our help as do all drug addicts. That is another thing that makes me angry. Why are prescription drug addicts somehow more worthy of help than a coke addict? Finally, we need to be careful that we don't remove opioids from people that really need them to function and aren't addicted. We need to monitor closely but it's not fair to them to go through life living in excruciating pain because someone chose to abuse the medication or sell their medication. It's all about the all mighty dollar! End of rant.
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Post by Darcy Collins on May 9, 2018 0:18:00 GMT
No - I'm saying she wouldn't be given the same high dosage as it is extraordinarily rare outside of cancer or palliative care. And yes I have been to Germany - but I wouldn't need to - there's only 500,000 studies comparing the extremely high dosage rates in the US with other European countries. Are opioids sometimes used - of course - but usually at much lower dosages - they are also more likely to use other medications and types of care: Look at the statistics - the same population in the US would see 97% on HIGH dose opioids. www.ncbi.nlm.nih.gov/pubmed/21933101When study after study after study shows our prescription rates are 2-3x other countries and studies showing increased PAIN sensitivity in long term opioid use - we damn sure should be looking at the issue from many different angles. When have you been? Once? For a vacation? That's not like living there or having family there. And you have NO idea what dose of medication or what kind of medication my sister takes because I haven't told you. She has tried other types of care throughout the 20 years she has had these conditions. Nothing else has worked. So I guess in your eyes she should just gin and bear it, huh? If she had to do that she would kill herself. But I guess that's just par for the course...as long as Dick or Harry over there don't get addicted. What the ever loving hell. You need to take a giant step back - YOU introduced your sister to this discussion with the fairy tale that she would be so much better off in Germany. I have never once suggested anything about gin and bear it - I have suggested that the screwed up pharmaceutical companies in this country led doctors to over prescribe for decades resulting in a whole lot of chemical dependent people in this country and that we should take a good hard look at why doctors in other countries manage pain without excessive amounts of opioids. But you keep throwing around bullshit like Dick or Harry getting addicted. There were 142,000 opioid overdoses in the US last year. This isn't a Dick or Harry problem.
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Post by birukitty on May 9, 2018 1:09:48 GMT
When have you been? Once? For a vacation? That's not like living there or having family there. And you have NO idea what dose of medication or what kind of medication my sister takes because I haven't told you. She has tried other types of care throughout the 20 years she has had these conditions. Nothing else has worked. So I guess in your eyes she should just gin and bear it, huh? If she had to do that she would kill herself. But I guess that's just par for the course...as long as Dick or Harry over there don't get addicted. What the ever loving hell. You need to take a giant step back - YOU introduced your sister to this discussion with the fairy tale that she would be so much better off in Germany. I have never once suggested anything about gin and bear it - I have suggested that the screwed up pharmaceutical companies in this country led doctors to over prescribe for decades resulting in a whole lot of chemical dependent people in this country and that we should take a good hard look at why doctors in other countries manage pain without excessive amounts of opioids. But you keep throwing around bullshit like Dick or Harry getting addicted. There were 142,000 opioid overdoses in the US last year. This isn't a Dick or Harry problem. Fairy tale? Are you so much of a flag waving USA supporter that you can't admit our health care system isn't as good as the other countries in Europe that have national health care? Of course she'd be better of in Germany. And don't tell me to take a giant step back. Last I checked this was a user board where everyone had a right to their opinion. The reasons other countries don't have the opioid overdose numbers that the USA has comes from a multitude of reasons. We are the only 1st world country that doesn't have national health care. The pharmaceutical companies in the country are in a for profit business along with the health insurance companies. That isn't the case in other 1st world countries. Germany and Holland have access to medications that we don't have. When I was in Holland about 8 years ago I had a migraine that turned into a 9-10 on a pain scale. They get like that for me about once every 2 years. I travel to Holland frequently with my father because we have family friends there. When they get that bad my regular migraine medication can't take care of the pain and I normally have to go to the ER for an IV of narcotic pain meds. Like I said it only happens once every two years or so. My father drove me to a Dutch hospital clinic and we went in and explained what was happening. When I told them what I normally take they said, "Oh we don't do that here we have something better". I wrote the medication down. It was something my doctor hadn't heard of, we can't get it here but it worked amazingly well. Took that migraine away immediately and it didn't come back. I think if my sister were in Germany her chronic pain would be managed so that she would be in as little pain as possible without narcotics. She wouldn't have to struggle from 6 pm until the morning with no pain relief at all and she wouldn't have to worry about the laws getting stricter and stricter and cutting off her pain medication. Something is very wrong when we don't have access to the kinds of medication that work for pain control that they have in Europe (they are probably expensive) while the narcotic pain relief is cheap. Again it always seems to come down to money and greed. I realize how much of an opioid crisis we have in the USA. Over 20% of the population are addicted. But that includes all of the heroin addicts as well. I also realize we need to do something about it. But restricting chronic pain patients like my sister's medication, cancer patient's and people like this isn't the right way to go about it.
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Post by birukitty on May 9, 2018 1:10:24 GMT
What the ever loving hell. You need to take a giant step back - YOU introduced your sister to this discussion with the fairy tale that she would be so much better off in Germany. I have never once suggested anything about gin and bear it - I have suggested that the screwed up pharmaceutical companies in this country led doctors to over prescribe for decades resulting in a whole lot of chemical dependent people in this country and that we should take a good hard look at why doctors in other countries manage pain without excessive amounts of opioids. But you keep throwing around bullshit like Dick or Harry getting addicted. There were 142,000 opioid overdoses in the US last year. This isn't a Dick or Harry problem. Fairy tale? Are you so much of a flag waving USA supporter that you can't admit our health care system isn't as good as the other countries in Europe that have national health care? Of course she'd be better of in Germany. And don't tell me to take a giant step back. Last I checked this was a user board where everyone had a right to their opinion. The reasons other countries don't have the opioid overdose numbers that the USA has comes from a multitude of reasons. We are the only 1st world country that doesn't have national health care. The pharmaceutical companies in the country are in a for profit business along with the health insurance companies. That isn't the case in other 1st world countries. Germany and Holland have access to medications that we don't have. When I was in Holland about 8 years ago I had a migraine that turned into a 9-10 on a pain scale. They get like that for me about once every 2 years. I travel to Holland frequently with my father because we have family friends there. When they get that bad my regular migraine medication can't take care of the pain and I normally have to go to the ER for an IV of narcotic pain meds. Like I said it only happens once every two years or so. My father drove me to a Dutch hospital clinic and we went in and explained what was happening. When I told them what I normally take they said, "Oh we don't do that here we have something better". I wrote the medication down. It was something my doctor hadn't heard of, we can't get it here but it worked amazingly well. Took that migraine away immediately and it didn't come back. I think if my sister were in Germany her chronic pain would be managed so that she would be in as little pain as possible without narcotics. She wouldn't have to struggle from 6 pm until the morning with no pain relief at all and she wouldn't have to worry about the laws getting stricter and stricter and cutting off her pain medication. Something is very wrong when we don't have access to the kinds of medication that work for pain control that they have in Europe (they are probably expensive) while the narcotic pain relief is cheap. Again it always seems to come down to money and greed. I realize how much of an opioid crisis we have in the USA. Over 20% of the population are addicted. But that includes all of the heroin addicts as well. I also realize we need to do something about it. But restricting chronic pain patients like my sister's medication, cancer patient's and people like this isn't the right way to go about it. My dinner is getting cold so I'm done with this topic for tonight.
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Post by Darcy Collins on May 9, 2018 1:19:22 GMT
What the ever loving hell. You need to take a giant step back - YOU introduced your sister to this discussion with the fairy tale that she would be so much better off in Germany. I have never once suggested anything about gin and bear it - I have suggested that the screwed up pharmaceutical companies in this country led doctors to over prescribe for decades resulting in a whole lot of chemical dependent people in this country and that we should take a good hard look at why doctors in other countries manage pain without excessive amounts of opioids. But you keep throwing around bullshit like Dick or Harry getting addicted. There were 142,000 opioid overdoses in the US last year. This isn't a Dick or Harry problem. Fairy tale? Are you so much of a flag waving USA supporter that you can't admit our health care system isn't as good as the other countries in Europe that have national health care? Of course she'd be better of in Germany. And don't tell me to take a giant step back. Last I checked this was a user board where everyone had a right to their opinion. The reasons other countries don't have the opioid overdose numbers that the USA has comes from a multitude of reasons. We are the only 1st world country that doesn't have national health care. The pharmaceutical companies in the country are in a for profit business along with the health insurance companies. That isn't the case in other 1st world countries. Germany and Holland have access to medications that we don't have. When I was in Holland about 8 years ago I had a migraine that turned into a 9-10 on a pain scale. They get like that for me about once every 2 years. I travel to Holland frequently with my father because we have family friends there. When they get that bad my regular migraine medication can't take care of the pain and I normally have to go to the ER for an IV of narcotic pain meds. Like I said it only happens once every two years or so. My father drove me to a Dutch hospital clinic and we went in and explained what was happening. When I told them what I normally take they said, "Oh we don't do that here we have something better". I wrote the medication down. It was something my doctor hadn't heard of, we can't get it here but it worked amazingly well. Took that migraine away immediately and it didn't come back. I think if my sister were in Germany her chronic pain would be managed so that she would be in as little pain as possible without narcotics. She wouldn't have to struggle from 6 pm until the morning with no pain relief at all and she wouldn't have to worry about the laws getting stricter and stricter and cutting off her pain medication. Something is very wrong when we don't have access to the kinds of medication that work for pain control that they have in Europe (they are probably expensive) while the narcotic pain relief is cheap. Again it always seems to come down to money and greed. I realize how much of an opioid crisis we have in the USA. Over 20% of the population are addicted. But that includes all of the heroin addicts as well. I also realize we need to do something about it. But restricting chronic pain patients like my sister's medication, cancer patient's and people like this isn't the right way to go about it. The giant step back is for insinuating that I don't care about the people affected by this and they should just grin and bear it until they kill themselves. It's utter bullshit and nothing I've said indicates anything of the kind. I can't tell if you're being deliberately obtuse or just not reading my posts. I'm SAYING we should be looking at other countries. It's no mystery why they don't have the same opioid crisis we do - they didn't spend the late 90s and early 2000s handing out opioids like candy. Our prescription rates are down significantly over the last 5 years and Germany STILL prescribes HALF the dosage of opioids per million people than the US. I am FOR finding non-opioid methods of dealing with pain. It's a vicious cycle and well past time we realize that it isn't working.
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Post by not2peased on May 9, 2018 1:27:21 GMT
When have you been? Once? For a vacation? That's not like living there or having family there. And you have NO idea what dose of medication or what kind of medication my sister takes because I haven't told you. She has tried other types of care throughout the 20 years she has had these conditions. Nothing else has worked. So I guess in your eyes she should just gin and bear it, huh? If she had to do that she would kill herself. But I guess that's just par for the course...as long as Dick or Harry over there don't get addicted. What the ever loving hell. You need to take a giant step back - YOU introduced your sister to this discussion with the fairy tale that she would be so much better off in Germany. I have never once suggested anything about gin and bear it - I have suggested that the screwed up pharmaceutical companies in this country led doctors to over prescribe for decades resulting in a whole lot of chemical dependent people in this country and that we should take a good hard look at why doctors in other countries manage pain without excessive amounts of opioids. But you keep throwing around bullshit like Dick or Harry getting addicted. There were 142,000 opioid overdoses in the US last year. This isn't a Dick or Harry problem. there is a strong pea-tendency to insist that an individual's personal experience trumps any amount of research or science-strange, but I've seen it over and over and over again in the many years I have been a pea. IME, doctors almost never provide serious alternative therapies for pain management or even require that patients try alternative therapies before getting meds, and even if they did recommend alternatives, people will have a million excuses as to why the alternative therapy won't work. and no, that statement is NOT directed at anyone here. Just a general observation and something I have read about as being a contributor to the ill health of people in this country in general. people WANT a pill, they don't want to hear that losing weight will help, or practicing yoga, or a better diet or whatever the advice is to address their medical issues. to be fair, some of the alternative therapies are cost prohibitive and/or aren't covered by insurance which makes it really hard. examples: people with arthritis not working at losing weight to help address the load on their joints. People with anxiety that refuse to try meditation or yoga just to name a couple off the top of my head. I tried an experiment recently with my dad-he has anxiety and was taking meds for it (and no, I never said a word about his medication as it wasn't any of my business) I stayed with my parents for 2 weeks and we practiced 15 minutes of chair yoga, once a day. his anxiety levels decreased markedly and when I took his blood pressure before yoga, and after, we were all amazed at the difference in the numbers. and before I get bombarded, I am NOT talking about anyone on this thread with my comments about alternative therapies- I would never presume to know enough about anyone's personal or medical history to make a judgement about how they treat or manage their medical issues.
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Post by iamkristinl16 on May 9, 2018 2:09:23 GMT
Are you saying then that my sister would be left in this chronic, unrelenting, excruciating pain for 20 years which nothing can touch or fix except narcotic pain medication had she been living in Germany for the past 20 years? Are you saying she absolutely would not have been given narcotic pain medication? If so, then I'll ask you when was the last time you lived in Germany? Have you ever been to a German doctor or spent time in a German hospital? My grandmother lived there her entire life. My mother lived there for 25 years. I lived there for the first 5 years of my life. We have traveled back to Germany off and on numerous times throughout the past 20 years. No - I'm saying she wouldn't be given the same high dosage as it is extraordinarily rare outside of cancer or palliative care. And yes I have been to Germany - but I wouldn't need to - there's only 500,000 studies comparing the extremely high dosage rates in the US with other European countries. Are opioids sometimes used - of course - but usually at much lower dosages - they are also more likely to use other medications and types of care: Look at the statistics - the same population in the US would see 97% on HIGH dose opioids. www.ncbi.nlm.nih.gov/pubmed/21933101When study after study after study shows our prescription rates are 2-3x other countries and studies showing increased PAIN sensitivity in long term opioid use - we damn sure should be looking at the issue from many different angles. I agree. This clearly is a complicated issue and one solution does not fit all. But I think that we need to include looking at other alternatives to pain management, looking to the source of the pain, and other angles. There are side effects of taking medications—any medications. That can include rebound effects and more pain. My experience is also that many people don’t know how strongly the meds are affecting them. I had this on a more minor level after my c-sections. I noticed that I was extremely tired and thought it was from hormones and surgery. But after I stopped the Percocet I realized that was a big part of my fatigue. I took half of the dosage that I was prescribed, and only as needed. I’ve talked with people who take high doses of meds and they think they are fine, even though they are falling asleep as we talk. I would venture to say that very few people who are dependent or addicted would say that they are. They feel that since they are taking the meds for a legitimate, prescribed reason, that addiction can’t happen to them.
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Post by slkone on May 9, 2018 2:30:47 GMT
I'm a retired RN who worked on a post-operative orthopedic unit. I have an immediate family member who is addicted to Oxycontin. I am chronic pain patient who has been on opiates for 7 years. I have been interviewed by the LA Times about Oxycontin for their expose on Purdue Pharmaceuticals, who essentially kicked off this entire epidemic in order to make money. So you can say that I have a unique perspective and a lot of experience.
Back in the mid to early 1990's, there was a big push for doctors to treat pain levels as the 5th vital sign within the hospital and in their outpatient care. Pain levels were monitored more frequently in the hospital. Patients were encouraged to stay on top of their pain. There was a general feeling that a life completely free of pain was a patient's right, side effects be damned. Therefore, more drugs were handed out. At the same time, physicians have a ridiculously small amount of time devoted to learning about pain and pain management in medical school.
In the mid-90's Purdue started pushing Oxycontin, which is also called "Hillbilly Heroin." It is a time-released drug and it was SUPPOSED to last 12 hours so a patient would only have to take it twice a day. Purdue drug reps used to come into medical offices and romance the doctors with free swag, lunches and dinners for them and the office staff. In exchange, doctors would listen to their spiel and believe everything they were telling them about this new miracle drug. The reps would tell the doctors that oxy was unlike any other opiate - its slow release formula meant patients would be less likely to become addicted. Oxy quickly became the #1 selling pain med on the market. The bad thing was that patients started to tell their doctors that the drug did not last 12 hours - it lasted maybe 8. The doctors increased their dosage, telling them to take the med every 8 hours instead. Doctors reported this to the drug reps. The drug reps gave feedback to their bosses. Their bosses basically said, "Do not allow more frequent dosing, instead INCREASE the strength of the pill!" So now patients were getting higher dosages that didn't last 12 hours. They weren't getting relief, so they'd take it more frequently. Doctors, wanting to give their patients relief, prescribed for every 8 hours instead of every 12. So either way, patients were getting way more narcotics than they should have. Purdue even knew before the drug went on the market that it didn't last 12 hours, but brought it to market claiming that anyway. They really pushed that narrative because that 12 hour claim made their medication stand out over the cheaper alternatives.
I was on Oxycontin, the same drug my family member is addicted to, for years. It was one of the hardest decisions I ever made to take that drug. I know for a fact that it did not last 12 hours. There were times that I felt like I was going into withdrawal not even 8 hours after taking a pill. And the withdrawal is intense. This cycle of a few hours of pain relief, the pain returning, horrible withdrawal symptoms along with the pain, back to pain relief and possible euphoria after the next dose is taken is a recipe for addiction. To clarify lest anyone judge me as an addict, you can have withdrawals if you are dependent on medications. Having withdrawals does not automatically make you an addict. Thankfully, because of my experience with my family member, I knew I didn't want to be like him and was adamant about taking my meds as prescribed so I didn't fall into an addictive pattern with Oxycontin or any other narcotic.
Addicts also quickly found out that they could get a fast, intense high by chewing the Oxy tablets or crushing them and snorting or mixing them with water and injecting them. People who do this are taking a huge risk because they are getting an enormous amount of medicine that is supposed to last for 8 hours all at once. It is extremely easy to overdose that way - it is harder to OD on short-acting pain pills because you need way more pills to get the equivalent amount of narcotic that you get in a long-acting pill.
Yes, there are over-prescribers out there - pill mills and doctors who don't keep up on current studies regarding pain medication and its risks. But so much of the blame lies on Purdue and pain as the "5th vital sign" push in the mid-90's. One should never expect to have all of their pain relieved. The goal of pain relief is to get pain to a tolerable level. The risks of taking enough narcotics to obliterate all pain is often too great so there must be acceptance by the patient that they are most likely not going to be completely free of pain.
Rural communities are hit hard because pain meds are easy to give to patients while finding them local alternatives, like injections or physical therapy, way more difficult. The economic downturn 10 years ago caused a huge spike because people were self-medicating in order to escape the stresses of job loss and economic instability.
Now that we have corporations dictating patient care and more unhelpful "guidelines" and regulations being put in play, the pendulum is swinging the other way. The increasing crackdown on opiates harms innocent people who are just going to find cheaper and less safe ways to get relief. Either that, or they will kill themselves. Most chronic pain patients are NOT addicts. They don't want to screw up the one thing that gives them relief and makes them functioning members of society, so most of them follow their doctor's instructions and take their meds as directed. The vast, vast majority of patients who are prescribed a reasonable amount opiates after routine surgery don't become addicted. Otherwise you'd see way more kids walking around post-appendectomy or post-tonsillectomy addicted to drugs. Or tons of senior citizens post heart surgery becoming addicted. So once again, people who abuse the system dictate policy for everyone else and innocent people get hurt.
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Post by lesserknownpea on May 9, 2018 2:41:19 GMT
I'm a retired RN who worked on a post-operative orthopedic unit. I have an immediate family member who is addicted to Oxycontin. I am chronic pain patient who has been on opiates for 7 years. I have been interviewed by the LA Times about Oxycontin for their expose on Purdue Pharmaceuticals, who essentially kicked off this entire epidemic in order to make money. So you can say that I have a unique perspective and a lot of experience. Back in the early 1990's, there was a big push for doctors to treat pain levels as the 5th vital sign within the hospital and in their outpatient care. Pain levels were monitored more frequently in the hospital. Patients were encouraged to stay on top of their pain. There was a general feeling that a life completely free of pain was a patient's right, side effects be damned. Therefore, more drugs were handed out. At the same time, physicians have a ridiculously small amount of time devoted to learning about pain and pain management in medical school. In the mid-90's Purdue started pushing Oxycontin, which is also called "Hillbilly Heroin." It is a time-released drug and it was SUPPOSED to last 12 hours so a patient would only have to take it twice a day. Purdue drug reps used to come into medical offices and romance the doctors with free swag, lunches and dinners for them and the office staff. In exchange, doctors would listen to their spiel and believe everything they were telling them about this new miracle drug. The reps would tell the doctors that oxy was unlike any other opiate - its slow release formula meant patients would be less likely to become addicted. Oxy quickly became the #1 selling pain med on the market. The bad thing was that patients started to tell their doctors that the drug did not last 12 hours - it lasted maybe 8. The doctors increased their dosage, telling them to take the med every 8 hours instead. Doctors reported this to the drug reps. The drug reps gave feedback to their bosses. Their bosses basically said, "Do not allow more frequent dosing, instead INCREASE the strength of the pill!" So now patients were getting higher dosages that didn't last 12 hours. They weren't getting relief, so they'd take it more frequently. Doctors, wanting to give their patients relief, prescribed for every 8 hours instead of every 12. So either way, patients were getting way more narcotics than they should have. Purdue even knew before the drug went on the market that it didn't last 12 hours, but brought it to market claiming that anyway. They really pushed that narrative because that 12 hour claim made their medication stand out over the cheaper alternatives. I was on Oxycontin, the same drug my family member is addicted to, for years. It was one of the hardest decisions I ever made to take that drug. I know for a fact that it did not last 12 hours. There were times that I felt like I was going into withdrawal not even 8 hours after taking a pill. And the withdrawal is intense. This cycle of a few hours of pain relief, the pain returning, horrible withdrawal symptoms along with the pain, back to pain relief and possible euphoria after the next dose is taken is a recipe for addiction. To clarify lest anyone judge me as an addict, you can have withdrawals if you are dependent on medications. Having withdrawals does not automatically make you an addict. Thankfully, because of my experience with my family member, I knew I didn't want to be like him and was adamant about taking my meds as prescribed so I didn't fall into an addictive pattern with Oxycontin or any other narcotic. Addicts also quickly found out that they could get a fast, intense high by chewing the Oxy tablets or crushing them and snorting or mixing them with water and injecting them. People who do this are taking a huge risk because they are getting an enormous amount of medicine that is supposed to last for 8 hours all at once. It is extremely easy to overdose that way - it is harder to OD on short-acting pain pills because you need way more pills to get the equivalent amount of narcotic that you get in a long-acting pill. Yes, there are over-prescribers out there - pill mills and doctors who don't keep up on current studies regarding pain medication and its risks. But so much of the blame lies on Purdue and pain as the "5th vital sign" push in the mid-90's. One should never expect to have all of their pain relieved. The goal of pain relief is to get pain to a tolerable level. The risks of taking enough narcotics to obliterate all pain is often too great so there must be acceptance by the patient that they are most likely not going to be completely free of pain. Rural communities are hit hard because pain meds are easy to give to patients while finding them local alternatives, like injections or physical therapy way more difficult. The economic downturn 10 yeas ago caused a huge spike because people were self-medicating in order to escape the stresses of job loss and economic instability. Now that we have corporations dictating patient care and more unhelpful "guidelines" and regulations being put in play, the pendulum is swinging the other way. The increasing crackdown on opiates harms innocent people who are just going to find cheaper and less safe ways to get relief. Either that, or they will kill themselves. Most chronic pain patients are NOT addicts. They don't want to screw up the one thing that gives them relief and makes them functioning members of society, so most of them follow their doctor's instructions and take their meds as directed. The vast, vast majority of patients who are prescribed a reasonable amount opiates after routine surgery don't become addicted. Otherwise you'd see way more kids walking around post-appendectomy or post-tonsillectomy addicted to drugs. Or tons of senior citizens post heart surgery becoming addicted. So once again, people who abuse the system dictate policy for everyone else and innocent people get hurt. Thank you for sharing your knowledge, experience, and good sense.
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Post by Darcy Collins on May 9, 2018 3:13:30 GMT
I'm a retired RN who worked on a post-operative orthopedic unit. I have an immediate family member who is addicted to Oxycontin. I am chronic pain patient who has been on opiates for 7 years. I have been interviewed by the LA Times about Oxycontin for their expose on Purdue Pharmaceuticals, who essentially kicked off this entire epidemic in order to make money. So you can say that I have a unique perspective and a lot of experience. Back in the mid to early 1990's, there was a big push for doctors to treat pain levels as the 5th vital sign within the hospital and in their outpatient care. Pain levels were monitored more frequently in the hospital. Patients were encouraged to stay on top of their pain. There was a general feeling that a life completely free of pain was a patient's right, side effects be damned. Therefore, more drugs were handed out. At the same time, physicians have a ridiculously small amount of time devoted to learning about pain and pain management in medical school. In the mid-90's Purdue started pushing Oxycontin, which is also called "Hillbilly Heroin." It is a time-released drug and it was SUPPOSED to last 12 hours so a patient would only have to take it twice a day. Purdue drug reps used to come into medical offices and romance the doctors with free swag, lunches and dinners for them and the office staff. In exchange, doctors would listen to their spiel and believe everything they were telling them about this new miracle drug. The reps would tell the doctors that oxy was unlike any other opiate - its slow release formula meant patients would be less likely to become addicted. Oxy quickly became the #1 selling pain med on the market. The bad thing was that patients started to tell their doctors that the drug did not last 12 hours - it lasted maybe 8. The doctors increased their dosage, telling them to take the med every 8 hours instead. Doctors reported this to the drug reps. The drug reps gave feedback to their bosses. Their bosses basically said, "Do not allow more frequent dosing, instead INCREASE the strength of the pill!" So now patients were getting higher dosages that didn't last 12 hours. They weren't getting relief, so they'd take it more frequently. Doctors, wanting to give their patients relief, prescribed for every 8 hours instead of every 12. So either way, patients were getting way more narcotics than they should have. Purdue even knew before the drug went on the market that it didn't last 12 hours, but brought it to market claiming that anyway. They really pushed that narrative because that 12 hour claim made their medication stand out over the cheaper alternatives. I was on Oxycontin, the same drug my family member is addicted to, for years. It was one of the hardest decisions I ever made to take that drug. I know for a fact that it did not last 12 hours. There were times that I felt like I was going into withdrawal not even 8 hours after taking a pill. And the withdrawal is intense. This cycle of a few hours of pain relief, the pain returning, horrible withdrawal symptoms along with the pain, back to pain relief and possible euphoria after the next dose is taken is a recipe for addiction. To clarify lest anyone judge me as an addict, you can have withdrawals if you are dependent on medications. Having withdrawals does not automatically make you an addict. Thankfully, because of my experience with my family member, I knew I didn't want to be like him and was adamant about taking my meds as prescribed so I didn't fall into an addictive pattern with Oxycontin or any other narcotic. Addicts also quickly found out that they could get a fast, intense high by chewing the Oxy tablets or crushing them and snorting or mixing them with water and injecting them. People who do this are taking a huge risk because they are getting an enormous amount of medicine that is supposed to last for 8 hours all at once. It is extremely easy to overdose that way - it is harder to OD on short-acting pain pills because you need way more pills to get the equivalent amount of narcotic that you get in a long-acting pill. Yes, there are over-prescribers out there - pill mills and doctors who don't keep up on current studies regarding pain medication and its risks. But so much of the blame lies on Purdue and pain as the "5th vital sign" push in the mid-90's. One should never expect to have all of their pain relieved. The goal of pain relief is to get pain to a tolerable level. The risks of taking enough narcotics to obliterate all pain is often too great so there must be acceptance by the patient that they are most likely not going to be completely free of pain. Rural communities are hit hard because pain meds are easy to give to patients while finding them local alternatives, like injections or physical therapy, way more difficult. The economic downturn 10 years ago caused a huge spike because people were self-medicating in order to escape the stresses of job loss and economic instability. Now that we have corporations dictating patient care and more unhelpful "guidelines" and regulations being put in play, the pendulum is swinging the other way. The increasing crackdown on opiates harms innocent people who are just going to find cheaper and less safe ways to get relief. Either that, or they will kill themselves. Most chronic pain patients are NOT addicts. They don't want to screw up the one thing that gives them relief and makes them functioning members of society, so most of them follow their doctor's instructions and take their meds as directed. The vast, vast majority of patients who are prescribed a reasonable amount opiates after routine surgery don't become addicted. Otherwise you'd see way more kids walking around post-appendectomy or post-tonsillectomy addicted to drugs. Or tons of senior citizens post heart surgery becoming addicted. So once again, people who abuse the system dictate policy for everyone else and innocent people get hurt. Thanks so much for sharing your experiences. I agree with most of this - particularly the root cause from Purdue pushing their product and a desire for zero pain. The one question I have for you as someone who's taken these for chronic pain - what's your thoughts on the studies showing less effectiveness of opioids long term for chronic pain - especially 1 year out? I'm very concerned that too many of the initial studies on the safety and efficacy of these drugs were done with 3 months studies. Now that we're seeing studies 1+ year where the tolerance is factored in - the results are concerning - particularly considering the risks associated with these drugs. jamanetwork.com/journals/jama/article-abstract/2673971?redirect=true
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Post by mrssmith on May 9, 2018 3:17:12 GMT
slkone - thanks for sharing. I was working in a hospital in the late 90's and remember that well. Here's an interesting/enraging article about Purdue Pharma. The Family That Built an Empire of PainDid you know it is a privately held company? The Sackler family has/is raking in billions from pushing opiods. They are following a similar playbook in other countries now that there has been more of a crackdown in the US. Sorry to hear how many of you have been personally affected by opiod addiction.
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bbchangeup
Shy Member
Posts: 38
Jun 25, 2016 18:46:59 GMT
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Post by bbchangeup on May 9, 2018 4:03:13 GMT
To everyone on this thread who has suffered addiction in your family, I am very sorry. It is unfathomable to those who haven't experienced it how disruptive and life-ruining it is. Not only for the addict, but for the family.
Are you aware that hospitals are paid better if patients are satisfied with their care? You know those satisfaction surveys you fill out? If you leave the hospital feeling your pain wasn't controlled, and you fill out your survey to say so, the hospital is likely to be reimbursed less for your care. There is pressure on hospital personnel - especially nurses, who are administering pain medications - to be sure that the patient's pain is controlled. What does that mean? It means different things to different people. Some people think that they should be pain free, others expect pain and just want it tolerable. Pain perceptions and thresholds are different in different people - it's a very complex issue.
The theorist who has been considered the expert in pain management is Margo McCaffrey, and her theory is this: Pain is "whatever the experiencing person says it is, existing whenever and wherever the person says it does." In other words, don't doubt patients, believe them. This has been drilled into health care providers, and for good reason. Before her theory was widely accepted, the nurse had to "decide" if the patient was in pain based on their verbal and nonverbal behavior. Studies showed that nurses ability to accurately know whether a person was truly in pain was not very good. Some nurses were quite cynical about pain and a lot of people would experience considerable pain in the hospital after major procedures such as joint replacement, etc. There was a need to control pain better for patients. Yes, there are some who are drug-seeking, but it was thought that we MISSED a lot more people in pain by not believing them than we were "fooled" by. This theory has kind of snowballed to where we are struggling to be able to accurately assess pain in our patients.
The theories are changing somewhat, but we haven't landed on a good "in-between" yet. I've been a nurse for 40 years this month, and I have met no nurses in 40 years who don't want to do their best for patients. That said, misuse of prescription drugs is becoming a huge problem. There are many studies currently underway about how to best approach this, and until those are completed and replicated, the management has involved things like you've read about here --- limiting the number of doses of pain medication without rechecking with the physician, etc. It's a serious issue that can take a perfectly normal life and spiral it downward before the person even knows it is happening. We look forward to meeting the needs of patients while not putting them in a position where they could possibly abuse prescription medication.
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Post by not2peased on May 9, 2018 12:27:50 GMT
To everyone on this thread who has suffered addiction in your family, I am very sorry. It is unfathomable to those who haven't experienced it how disruptive and life-ruining it is. Not only for the addict, but for the family. Are you aware that hospitals are paid better if patients are satisfied with their care? You know those satisfaction surveys you fill out? If you leave the hospital feeling your pain wasn't controlled, and you fill out your survey to say so, the hospital is likely to be reimbursed less for your care. There is pressure on hospital personnel - especially nurses, who are administering pain medications - to be sure that the patient's pain is controlled. What does that mean? It means different things to different people. Some people think that they should be pain free, others expect pain and just want it tolerable. Pain perceptions and thresholds are different in different people - it's a very complex issue. The theorist who has been considered the expert in pain management is Margo McCaffrey, and her theory is this: Pain is "whatever the experiencing person says it is, existing whenever and wherever the person says it does." In other words, don't doubt patients, believe them. This has been drilled into health care providers, and for good reason. Before her theory was widely accepted, the nurse had to "decide" if the patient was in pain based on their verbal and nonverbal behavior. Studies showed that nurses ability to accurately know whether a person was truly in pain was not very good. Some nurses were quite cynical about pain and a lot of people would experience considerable pain in the hospital after major procedures such as joint replacement, etc. There was a need to control pain better for patients. Yes, there are some who are drug-seeking, but it was thought that we MISSED a lot more people in pain by not believing them than we were "fooled" by. This theory has kind of snowballed to where we are struggling to be able to accurately assess pain in our patients. The theories are changing somewhat, but we haven't landed on a good "in-between" yet. I've been a nurse for 40 years this month, and I have met no nurses in 40 years who don't want to do their best for patients. That said, misuse of prescription drugs is becoming a huge problem. There are many studies currently underway about how to best approach this, and until those are completed and replicated, the management has involved things like you've read about here --- limiting the number of doses of pain medication without rechecking with the physician, etc. It's a serious issue that can take a perfectly normal life and spiral it downward before the person even knows it is happening. We look forward to meeting the needs of patients while not putting them in a position where they could possibly abuse prescription medication. EXCELLENT point-I used to work in a hospital and have friends in healthcare, those surveys are EVERYTHING
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Post by slkone on May 9, 2018 13:33:33 GMT
I'm a retired RN who worked on a post-operative orthopedic unit. I have an immediate family member who is addicted to Oxycontin. I am chronic pain patient who has been on opiates for 7 years. I have been interviewed by the LA Times about Oxycontin for their expose on Purdue Pharmaceuticals, who essentially kicked off this entire epidemic in order to make money. So you can say that I have a unique perspective and a lot of experience. Back in the mid to early 1990's, there was a big push for doctors to treat pain levels as the 5th vital sign within the hospital and in their outpatient care. Pain levels were monitored more frequently in the hospital. Patients were encouraged to stay on top of their pain. There was a general feeling that a life completely free of pain was a patient's right, side effects be damned. Therefore, more drugs were handed out. At the same time, physicians have a ridiculously small amount of time devoted to learning about pain and pain management in medical school. In the mid-90's Purdue started pushing Oxycontin, which is also called "Hillbilly Heroin." It is a time-released drug and it was SUPPOSED to last 12 hours so a patient would only have to take it twice a day. Purdue drug reps used to come into medical offices and romance the doctors with free swag, lunches and dinners for them and the office staff. In exchange, doctors would listen to their spiel and believe everything they were telling them about this new miracle drug. The reps would tell the doctors that oxy was unlike any other opiate - its slow release formula meant patients would be less likely to become addicted. Oxy quickly became the #1 selling pain med on the market. The bad thing was that patients started to tell their doctors that the drug did not last 12 hours - it lasted maybe 8. The doctors increased their dosage, telling them to take the med every 8 hours instead. Doctors reported this to the drug reps. The drug reps gave feedback to their bosses. Their bosses basically said, "Do not allow more frequent dosing, instead INCREASE the strength of the pill!" So now patients were getting higher dosages that didn't last 12 hours. They weren't getting relief, so they'd take it more frequently. Doctors, wanting to give their patients relief, prescribed for every 8 hours instead of every 12. So either way, patients were getting way more narcotics than they should have. Purdue even knew before the drug went on the market that it didn't last 12 hours, but brought it to market claiming that anyway. They really pushed that narrative because that 12 hour claim made their medication stand out over the cheaper alternatives. I was on Oxycontin, the same drug my family member is addicted to, for years. It was one of the hardest decisions I ever made to take that drug. I know for a fact that it did not last 12 hours. There were times that I felt like I was going into withdrawal not even 8 hours after taking a pill. And the withdrawal is intense. This cycle of a few hours of pain relief, the pain returning, horrible withdrawal symptoms along with the pain, back to pain relief and possible euphoria after the next dose is taken is a recipe for addiction. To clarify lest anyone judge me as an addict, you can have withdrawals if you are dependent on medications. Having withdrawals does not automatically make you an addict. Thankfully, because of my experience with my family member, I knew I didn't want to be like him and was adamant about taking my meds as prescribed so I didn't fall into an addictive pattern with Oxycontin or any other narcotic. Addicts also quickly found out that they could get a fast, intense high by chewing the Oxy tablets or crushing them and snorting or mixing them with water and injecting them. People who do this are taking a huge risk because they are getting an enormous amount of medicine that is supposed to last for 8 hours all at once. It is extremely easy to overdose that way - it is harder to OD on short-acting pain pills because you need way more pills to get the equivalent amount of narcotic that you get in a long-acting pill. Yes, there are over-prescribers out there - pill mills and doctors who don't keep up on current studies regarding pain medication and its risks. But so much of the blame lies on Purdue and pain as the "5th vital sign" push in the mid-90's. One should never expect to have all of their pain relieved. The goal of pain relief is to get pain to a tolerable level. The risks of taking enough narcotics to obliterate all pain is often too great so there must be acceptance by the patient that they are most likely not going to be completely free of pain. Rural communities are hit hard because pain meds are easy to give to patients while finding them local alternatives, like injections or physical therapy, way more difficult. The economic downturn 10 years ago caused a huge spike because people were self-medicating in order to escape the stresses of job loss and economic instability. Now that we have corporations dictating patient care and more unhelpful "guidelines" and regulations being put in play, the pendulum is swinging the other way. The increasing crackdown on opiates harms innocent people who are just going to find cheaper and less safe ways to get relief. Either that, or they will kill themselves. Most chronic pain patients are NOT addicts. They don't want to screw up the one thing that gives them relief and makes them functioning members of society, so most of them follow their doctor's instructions and take their meds as directed. The vast, vast majority of patients who are prescribed a reasonable amount opiates after routine surgery don't become addicted. Otherwise you'd see way more kids walking around post-appendectomy or post-tonsillectomy addicted to drugs. Or tons of senior citizens post heart surgery becoming addicted. So once again, people who abuse the system dictate policy for everyone else and innocent people get hurt. Thanks so much for sharing your experiences. I agree with most of this - particularly the root cause from Purdue pushing their product and a desire for zero pain. The one question I have for you as someone who's taken these for chronic pain - what's your thoughts on the studies showing less effectiveness of opioids long term for chronic pain - especially 1 year out? I'm very concerned that too many of the initial studies on the safety and efficacy of these drugs were done with 3 months studies. Now that we're seeing studies 1+ year where the tolerance is factored in - the results are concerning - particularly considering the risks associated with these drugs. jamanetwork.com/journals/jama/article-abstract/2673971?redirect=trueThe issue that I have about studies like this is they concentrate on only a few causes of chronic pain - for which, IMO, should have never been treated with opiates. These conditions should not be used as an umbrella to dictate how all chronic pain is managed. Conditions such as these are more effectively managed with NSAIDs, physical therapy, and injections instead of opiates. Opiates do nothing to alleviate pain - they just mask it - so the outcome is going to be poor when there is unaddressed inflammation in the body. But like I said above, rural Americans do not have access to other treatment modalities so that leaves rural doctors with fewer non-narcotic alternatives to treat the pain. My pain doctor is amazing. He is very upfront with me about how these drugs become less effective over time because of actual changes within the cell. Now that my pain is more controlled by my TNF-inhibitor (Cimzia) we are planning on opiate "vacations" from time to time which allows my body to re-develop its own endorphins. Therefore the meds will become more effective again if I have to restart them. More focus needs to be put on things like palmitoylethanolamide, which can be taken as a supplement. It was helpful to me but it was expensive and had to be shipped from overseas.
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Post by mustlovecats on May 9, 2018 14:52:02 GMT
This seems to depend at least in part on the condition. Today’s joint replacement paients are often ready to leave the hospital with a relative minimum of pain and on OTC pain medications. On the other hand in situations where there are complications such as a fracture of the bone or injury to vascular structures during fixation of the implant some patients experience extreme pain for a time and need more relief. And others come out of hospital with a variety of pain conditions that may require more pain relief. Or the knock on effect of ongoing pain or severe pain can outweigh the risk of addiction. Your husband may have had different medical needs than the dgd in this example. It isn’t helpful to compare the two in this manner. LOL, I thought it goes without saying that individual situations can vary greatly, but apparently it doesn't, so... "the duration, dose etc of pain medication can vary greatly depending on many factors" the main point of my post was that zero pain levels is not always the end goal these days and there is an increased understanding that some levels of pain (again, given individual circumstances) may exist under certain circumstances. in the past, any pain was viewed as unacceptable, no matter what (the 5th vital sign mentality) that view has changed quite a bit in the medical community- in large part due to the opioid crisis. My point was that your illustration actually demonstrates the variety of circumstances in which pain medication is used and how different those circumstances can be. Even where “no pain” is not the goal there are times when it takes a heavy pain medication to take a 10+ kind of pain to a 5-6 kind of pain. Your illustration is of a procedure that has a fairly expectable course of pain that is different than the course of pain experienced by people with more complications to the same surgery or people with different conditions/surgeries. Even if “no pain” is the goal the approach is not “no pain medication”. That’s all I’m saying is that your illustration of your husband’s THA isn’t necessarily a good comparison to other people’s experience.
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Post by not2peased on May 9, 2018 15:37:15 GMT
LOL, I thought it goes without saying that individual situations can vary greatly, but apparently it doesn't, so... "the duration, dose etc of pain medication can vary greatly depending on many factors" the main point of my post was that zero pain levels is not always the end goal these days and there is an increased understanding that some levels of pain (again, given individual circumstances) may exist under certain circumstances. in the past, any pain was viewed as unacceptable, no matter what (the 5th vital sign mentality) that view has changed quite a bit in the medical community- in large part due to the opioid crisis. My point was that your illustration actually demonstrates the variety of circumstances in which pain medication is used and how different those circumstances can be. Even where “no pain” is not the goal there are times when it takes a heavy pain medication to take a 10+ kind of pain to a 5-6 kind of pain. Your illustration is of a procedure that has a fairly expectable course of pain that is different than the course of pain experienced by people with more complications to the same surgery or people with different conditions/surgeries. Even if “no pain” is the goal the approach is not “no pain medication”. That’s all I’m saying is that your illustration of your husband’s THA isn’t necessarily a good comparison to other people’s experience. I never said it was a good comparison-just sharing my individual situation-not sure why you are placing so much weight on the one situation I mentioned as it was never meant to speak for others or their situations-just an incidental example of a situation recently experienced by him.
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Post by birukitty on May 9, 2018 18:22:28 GMT
Fairy tale? Are you so much of a flag waving USA supporter that you can't admit our health care system isn't as good as the other countries in Europe that have national health care? Of course she'd be better of in Germany. And don't tell me to take a giant step back. Last I checked this was a user board where everyone had a right to their opinion. The reasons other countries don't have the opioid overdose numbers that the USA has comes from a multitude of reasons. We are the only 1st world country that doesn't have national health care. The pharmaceutical companies in the country are in a for profit business along with the health insurance companies. That isn't the case in other 1st world countries. Germany and Holland have access to medications that we don't have. When I was in Holland about 8 years ago I had a migraine that turned into a 9-10 on a pain scale. They get like that for me about once every 2 years. I travel to Holland frequently with my father because we have family friends there. When they get that bad my regular migraine medication can't take care of the pain and I normally have to go to the ER for an IV of narcotic pain meds. Like I said it only happens once every two years or so. My father drove me to a Dutch hospital clinic and we went in and explained what was happening. When I told them what I normally take they said, "Oh we don't do that here we have something better". I wrote the medication down. It was something my doctor hadn't heard of, we can't get it here but it worked amazingly well. Took that migraine away immediately and it didn't come back. I think if my sister were in Germany her chronic pain would be managed so that she would be in as little pain as possible without narcotics. She wouldn't have to struggle from 6 pm until the morning with no pain relief at all and she wouldn't have to worry about the laws getting stricter and stricter and cutting off her pain medication. Something is very wrong when we don't have access to the kinds of medication that work for pain control that they have in Europe (they are probably expensive) while the narcotic pain relief is cheap. Again it always seems to come down to money and greed. I realize how much of an opioid crisis we have in the USA. Over 20% of the population are addicted. But that includes all of the heroin addicts as well. I also realize we need to do something about it. But restricting chronic pain patients like my sister's medication, cancer patient's and people like this isn't the right way to go about it. The giant step back is for insinuating that I don't care about the people affected by this and they should just grin and bear it until they kill themselves. It's utter bullshit and nothing I've said indicates anything of the kind. I can't tell if you're being deliberately obtuse or just not reading my posts. I'm SAYING we should be looking at other countries. It's no mystery why they don't have the same opioid crisis we do - they didn't spend the late 90s and early 2000s handing out opioids like candy. Our prescription rates are down significantly over the last 5 years and Germany STILL prescribes HALF the dosage of opioids per million people than the US. I am FOR finding non-opioid methods of dealing with pain. It's a vicious cycle and well past time we realize that it isn't working. I'm tired of fighting with you. I've asked you before if we can agree to disagree. I'm asking you again. For myself I am stepping away from this thread. I've made my position very clear. You have your opinion. I have mine. We are each entitled to our own opinions.
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