Underdosing, Not Overdosing, Is the Real Problem

hi karen, i watched the video, that went along w/ this post...i feel very strongly about marijuana being legalized fro medicinal purposes..my mom, who passed a few years ago, had breast cancer that mestastisized to her organs, she was i a terrible amount of pain..no, not terrible...unbearable amount of pain. no matter what they gave her , or were afraid of giving her (can you believe they said she would get addicted to the pain medication, if they upped it??)...she was passing away from us everyday, so WHY did it matter? i am trying to be very composed at this time, (it is hard)...and i will say, understanding that i could possibly get in trouble for this, but at this point, do not really care...i brought in some marijuana, she could not smoke it, because she was so very weak, so i would blow the smoke into her nostrils and mouth for her...to relieve the nausau she had. it cracked both myself and the other person that was with us, because she would try and tell us we were doing ssomething illegal, and wouldn't we get in trouble?? up until the moment she left us, she was still worrying about her "daughter and others"...but this was the only way, i found i could help her in such a small part....and after s o much pain, she endured, because the drs. did not "want her to get addicted to strong opiates"...she passed with a smile on her face....to continue the story, no it is not over yet :(.....my father who had rhuemotoid arthritis, depended on my mom to do things for him, everyday things, that we all take for granted...(before she got so bad herself)....lovingly shaving his face for him. clipping his toenails, so they would not get infected, helping him get dressed, cooking and cutting up his food for him, brushing his teeth for him...you see, my fathers rhuemotoid arthritis was not only a disability to him, but his hands were like claws...claws, that caused him such pain, he could not do anything for himself...such pain, that he was only prescribbed vicodin for....which did  n o t h i n g  for the pain he endured...that one day, a policeman came over and asked if he could come in ( i knew at this time, someting very wrong had happened)....he came in, with his partner, told me to have a seat, i just wanted for them to tell me what had happened....my father, took a .38 to his head and blew his brains out...sorry, this is just so hard for me to write about...but it must be written about, my daddy, not only could not do things for himself, but the pain was way too much for him too bear, and i am not talking only about his lovely wife of almost 50 years, i am talking about the PHYSICAL pain he could no longer endure...it is way too sad that the government can manage the amount of pain medication, a dr. can prescribe...WITHOUT knowing that particular patient..HOW can the government even begin to think they can KNOW what kind of medication a person needs???? please, please, can someone answr me this?......left alone, without a parent....cindi

Thank you! I think that is time for us people in chronic and intractable pain, to start writing to the Whitehouse, Congress and the House of Representatives, to make sure that we are not affected anymore by the new shift in Washington.

I totally agree with your view.  I worked for peer review organization that had a contract with the federal governent to review admission, billing and quality of care issues in hospitals.  It was for once something good that the Health Care Financing Administration did.  Unfortunately, they disbanded it.  I became ill over 10 years ago and most of my experience with the medical community has been as a chronic pain patient.  I like many people in the U.S. had a lot of trouble getting diagnosed and then finding a good painmanagement doctor who would help me control my pain.  Most people don't understand about chronic illness and chronic pain and how it is different from acute pain.

There has been too little education to the general population about the benefits of narcotics used in the appropriate way with the supervision of a qualified doctor.  I think that the trend of the government interfering increasingly in distribution of prescription pain medications under doctor's supervision is ludicrous and reminds me of futuristic science fiction films in which the government has totally invaded personal rights and freedoms. 

The number of people who will benefit from the use of prescribed narcotics supervised by a phsycian will only increase as baby boomers move into their elderly years.

I think that the federal government has enough problems that they need to handle and also the DEA was created to focus on illegal drug distribution.  They still have plenty of work in that area and they continue to create more for themselves to do.  To interfere with the practice of medicine, and the doctor-patient relationship.

Yes, there is an increasing problem with illegal use of prescription pain medication but people need to be informed that most of that usage does not come from doctor's prescribing too many narotics.  As articles have pointed out, people in chronic pain are undertreated and this is primarily because of the DEA.

Most doctors are careful about prescribing narcotics to their patients.  Patients who need time released pain medications such as Fentanyl, long acting morphine, etc. are almost always patients who have chronic pain patients and people with pain from chronic illnesses whose pain has not responded to most other forms of therapy.  When the patient gets to the point that they have to use these medications, they have spent many years in pain and have exhausted alternative paths for relief from their pain.

The majority of doctors who prescribe these medications are certified in pain management.  I know from personal experience that as a chronic pain patient that doctors require a large amount of information and proof that the patient has been involved in alternative therapies and these have not proved successful.

Because of the DEA, doctors who deal with patients in chronic pain have had to start practicing defensive medicine.  We are already required to sign pain contracts, submit to urine tests, blood tests, etc.  This sort of thing has also driven up the cost of practicing medicine because of bureaucratic  requirements of more documentation, more red tape and having to hire more people in the doctor's office to deal with all the documentation and regulataions. 

As far as most people's view of these added things that we are required to do to obtain the care that we need to survive seem like no more than a nuisance.  Some pain contracts require that the physician is to be informed and receive a record of every visit that the patient makes to other physicians.  Also, if a patient is ever discharged from a pain management doctor's care for any reason, the patient is asked to reveal this at the time of making an appointment with a new physician and most pain mangement practices will not see anyone who has been previously discharged from another pain management doctor.

I personally have experienced how ridiculous and inconvient providing a urine sample can be.  One day I was called by my doctor's office and told to come in that day for a drug screening.  I told them I wasn't feeling well that day but the person that I was talking to said I must come that day.  So, I came in under the veiled threat that my pain medication might be taken away.  I waited and waited and waited.  I went to the desk several times and I was told the doctor was busy and I would have to wait.  I asked if I could come back another day and I was told absolutely not.  So, I sat there until someone came to lock the front door.  Finally, I was allowed to leave a urine sample.

Why not just go to another doctor.  Pain management clinics that deal with prescribing pain medications to their chronic pain patients are very much on the decline due to the DEA's past practice of making examples of other doctors.  There enough published accounts of family practice doctors' offices being raided as well as small pain management practices in which a doctor is forced to give up his pain management practice.  Whether people understand this or not, the DEA already keeps records of doctors who prescribe pain medications and patients who take medication by keeping records of prescriptions of certain classes of narcotics. 

There are various reasons why they target certain doctors.  Once they targeted a doctor whose patient was the head of an internet pain support group who had drafted and sent a reccomedation for change in policies regarding prescribing pain medication to a government offical.

Either before or after they target a physician's practice for review, they will generate lists of patients and amount of narotics prescribed to the patient.  The problem with this is in the number of narcotics prescribed they also incude any prescriptions by other doctors.  Also, they flag patients who have prior drug charges, etc.  Sometimes, they will offer immunity to patients who they find have pending drug charges if they will rat on their physician.  Although most pain contracts require that a patient document information there is no way to know what patients are doing other than drug screening which does not occur at every appointment and drug screens will not give you information about the people who are taking some of their meds and selling the rest, etc. or if the patient sells other recreational drugs. 

When the DEA investigates a physician, they have access to all records and they will also raid doctor's offices as if they are raiding a crack house.  So, they find out all sorts of information from different people and they sometimes use this information to put pressure on the doctor to either stop prescribing narcotics or to close the practice.  If the physician goes to court, his or her reputation is almost always ruined whether or not they are found innocent of the charges.

Granted the raiding of doctor's offices isn't prevalent, but it is enough to change the way doctors practice medicine.  In some states only doctors who have a speciality in pain management are allowed to prescribe the classes of narcotics that most pain patients take.

If you are taking  pain medication for pain via the intructions you are given by your physician, you will not get high and also very few people who are taking pain medicine as it is prescribed do not develop a phsycological addiction.  They do develop a physical addiction to the medication.  This is a biological process that cannot be avoided.  Unfortunately, most people including the relatives of the chronic pain patient, think of physical addiction being a sign of drug abuse which it is not.

Clamping down on the illegal use of prescription narcotics by targeting the doctor and the patient does nothing change the fact that people will abuse pain medications.  A doctor can be extremely careful about who he prescribes the medicine to and there will always be people who abuse it, sell it, or take it from people who are being prescribed the medication.

The DEA as it has been mentioned intend to soon take even more intrusive measures that will cause the number of doctors who prescribe pain medications to decrease even further and will cause more even large pain clinics to stop prescribing pain medication to their patients.  Pain management practices can still thrive because they provide injections and alternative therapies for the chronic pain patients and they already require most of their patients to partake in these other procedures and therapies.  Some of these procedures are expensive and they drive up the cost of health care because of increased billings to Medicare/Medicaid, etc.  One of the main reasons for doctors requiring these procedures and therapies in all patients whether they will benefit from it or not is due to the DEA's increasing involvement in the practice of medicine.

I have personally experienced this having been a chronic pain patient for several years.  One of the more ridiculous requirements of a particular doctor caused me to stop goinig to his pain clinic and have to search for another doctor because the therapy that he required me to do was not covered by my insurance.

If anyone thinks all of this doesn't matter because it doesn't affect them, they may be in for a big shock.  With the increasing numbers of baby boomers getting older the chances that a person will have to deal with this problem are dramatically increasing.  It will be likely that either a person themself or someone in their family or who they love will require these classes of narcotics for pain relief.

Recently, there has been progress made in the understanding of chronic pain and how it affects the long term health of a patient.  Chronic pain is not only painful but it rewires the body's neurochemical balance as well as nerve pathways.  This can lead to all sorts of problems including organ damage.

But these studies are not as well funded as programs in the area of cancer and AIDS research.  They are discovering that certain medications may help and I am on some of these medications but for me as well as most chronic pain patients, the primary relief for chronic pain is still narctotics.

Now, I will climb off my soapbox.

To anyone who has read this entire post, thank you.

I`m in PAIN 24/7! And have to pee in a cup to keep getting my medications. As far as I`m concerned the government should be concerned with other things than screwing up my doctor/patient relationship and harassing my doctor and myself!  I take my meds the way my doctor tells me to and I do NOT let anyone else have ANY of my medications! Although once I had my meds stolen off my kitchen table. Now my meds are locked up, ALL the time. And the person (s) responsible for the theift are not allowed in my home, at all! I just wish that this government would get a clue and realize that prohibition does not work. All it does is create a "black market" and more crime... People ARE going to find ways to get what they want to get. A lot of drugs that are used for fun can kill !!! I wish people would get that through thier heads!! Stop making people in REAL pain suffer!

If a person has RSD or a terrible back problem and the doctor does not stabalize that patient, in order for him or her to have a quality of life, that patient will find "anything" to relieve the pain. Therfore, physicians that underdose and to not control the pain effectively, CREATES illegal, street drug abuse!

We live in America! I personally know exactly how and wher to get anything I want, off the streets. Yes, it is more expensive and yes it is illegal, but when you are in so much pain, you will do anything to relieve that pain.

Drugs are created for a specific purpose. Opiods are MADE to get people out of pain. As the author mentioned, just because a famous celebrity abuses prescription drugs, we all suffer!

Find a doctor that you can trust and that trusts you. That is what I have done and it seems to be working quite well. Now, going to the pharmacy (especially Walgreens), they always "look down" on you, when you get a narcotic filled. Almost like a police or sherriff. It has become a crazy world, regarding pain management.

I have RSD (CRPS) and I also have a MPH, so I understand this whole idiotic cycle we (Americans) are in.

Thank you!

This was a very interesting post. I could not watch the video because of my Internet connection, however the rest of it really made me think.

For many years my doctors said the pain was "all in my head" and refused to help me at al. I finally found a doctor who would give me whatever I needed and didn't care what the govt. thought. Certainly, she was careful. She wasn't going to jeopardize her license. But it was important to her to control the pain whatever it took. The problem was that I was afraid to take what she have me because I was afraid of being labled a drug addict. I couldn't bare the thought of my family and friends treating me like a junkie.

So I'm still in tremendous pain. I've moved and will need to find a new doctor. It scares me to think who I may end up with. I'm at a point where I would take whatever she gave me even with the worry of my body becoming dependant (which is not the same a addiction, I now realize).

My point is, it isn't just the doctors who "underprescribe" or the nosy government, it is society in general who feel the need to judge things they do not understand. I pray for changes soon so we can all suffer less without being labled or judged.

Yes, it is a much greater percentage of a problem if I were to guess.  They will not EVER talk about someone who is in chronic life altering pain and does not get relief because the doctors are afraid to RX.  You will NEVER hear of the people that take meds for the pain only and who might get some quality of life from narcotics RX'd.  I am tired of the media's one sided basis for reporting on narcotic pain meds.  I am fed up.  How many of us might take these meds for the rest of our lives which might be a long life?  And how many of us NEVER kill ourselves on our pain meds?  Never damage ourselves with our pain meds?    MANY of us.  But you won't hear that story in the media.

learnFMnow !!!!!

Debra

As I can understand the government wanting to protect people with all of the celebrity deaths from accidental or purposeful drug overdosage, why target the little people.  Obviously the celebs are able to obtain these meds because of their high status and their money.  We are but mere peons trying to get along with our daily lives.  Are there dirty Dr's and drug pushers out there of course.  And no matter what the government does there always will be.  We have a hard enough time finding a good physician that will believe our pain and treat our pain without further interference.  If the wish to interefere, then interefere in Hollywood with the celeb Dr's and leave the little people out of the mess.  Michael Jackson alone had meds in his medicine cabinet that were not even prescribed to him, enough said.  All of this has to stop.  I am only 36 and have 3 children 12, 8 and 3, and have along, long way to go yet with my chronic pain.  They don't realize that by cracking down they are only going to cause people to turn to other alternatives to relieve their pain.  Going to those drug pushers on the streets to get relief.  Is it not better that the medication be monitored by a trained physician.  Let it go already!  Leave us little chronic pain people and our Doctors alone!

I think that this is ridiculous the people that are in pain that really need the meds dont get them while people on the streets have them .Were are they getting the pain meds if people that go to the doctor cant? I went to the doctor i have a dislocated knee so bad my doctor wont even do surgery on it.And i had a MRI done and i have disk degeneration and a couple of buldging disks.The proff is in the x-rays and the mri its not like i am going there and nothing is wrong with me and they dont give me anything.The proff is in the tests that were done but they still wont help me! I do not need pain meds daily just a couple times a week when i am on my feet a lot working becase it puts a lot of strain on my knee and back.So i dont understand how someone that goes to the doctor goes through getting all the tests done,mri,x-rays,and physical therapy cant get meds.Why would i go through the trouble if i really wasn't hurting.Mean while i walk around in pain ,cry i get depressed ,i could be making more money working but ill hurt to much if im on my feet alo.Mean while my doctor is at home watch t.v laughing pain free with his money .This neesd to stop the people that need pain meds should get them.I still dont get were some of these other people and young kids on the streets are getting them and they dont even need them.i HAD A FRIEND THAT TOLD HIS DOCTOR HIS BACK HURT AND HE GOT 90 PAIN PILLS.ONE DAY HE TOOK A WHOLE BUNCH I WAS MAD I SAID WHATS WRONG IS YOUR BACK HURTING HE SAID NO HIS GIRLFRIEND BROKE UP WITH HIM AND HE WAS SAD AND WANTED TO FEEL BETTER.I THOUGHT THIS JUST IS NOT FAIR

Karen,

Thank you for posting the link to this video. It says what many of have suffer with daily. I hope that it will teach a few people something, r at least get them to thinking.

Reta

In my opinion the government has NO right to interfer with DR/patient relationships! And The government has NO right to tell a doctor that he can not prescribe anything what-so -ever!  My doctor told me that it might be a good idea to smoke some pot so I can get to sleep at times, when I`m not able to get any sleep.

 All I have to do is take 2 or 3 hits and I have NO trouble sleeping, BUT the government would rather put people in jail or KILL them rather than let marijiuana become legal! None of it makes ANY sence to me...

I am Sue, who wrote a comment earlier. 

After researching, and researching, I went back to my regular doctor, carrying the Merck Manual, and he made the comment that "maybe I was researching too much!"  Now where is that?  Does anyone think I will look for another primary?  People cannot see your pain, and until you are using a cane or a walker NO ONE knows. 

My 'terrific' doctor just had to put his hands on my back, neck and shoulders to know where I was.  If he could just be cloned!