I agree with both of you whole heartedly!!! Should be left up to Family Physician (the one you see the most)! Unfortunetly, ppl get meds & sell on street jeopordizing us that really suffer pain. After many years of SEVERAL different meds & methods I finally got ONE med that WORKS but can only get 20 about every 60 days. Makes it really difficulty to get off Disability & work a JOB!
dr. borigini,
i have been going to pain management for two years, and have overheard conversations between patients, and doctors and their nurses in reference to the stiff rules that have been imposed on the doctors. when a doctor is making an educated decision in the treatment of a patient, for the relief of pain, why is the government second guessing his judgement, ( which he has earned the professional level of making such judgements, and sworn an oath to uphold the ethical and moral standards that have been established in conjunction with the p.h.d. he or she has earned from a university of medicine), and placing the doctor in the position of being drug enforcement agent, or physician with any kind of concern for the level of pain and suffering that the patient may have, along with placing in the back of his mind, if i do my job and anything that my patient does after he or she leaves the office that is illegal, i may be held accountable for, or charged as being involved in their actions, is actually doing the law abiding patient and doctor a dis-service. unfortunately the government cannot catch all of the ones who are committing the crimes of illegal sales, and or subscribing of the pain medications, but you cannot make the law abiding ones become victims of profiling, due to the bad judgement and choices of the few. why make them suffer and do without the medications they need to lead a normal life, or have to accept a medication that does not do anything for the patient but take money out of their pocket. and if that is all the doctor is allowed to prescribe because of over-policing of the doctor (maybe he had a patient that was suspect of selling their medications, admitedly, i have had concerns about the validity of why some people are in the doctors office myself), and now he or she is under the microscope, how fair is that? and is that any kind of solution to the latest craze of some of our youth to make stupid decisions, jeopardizing their health by taking medications they do not need, and taking them in excess at that, making it harder for those of us who need them all that more difficult to get and harder for the doctors to make the decision to prescribe them. lets face it, sometimes life is not fair, but i would hope that my police task forces would not be so quick to judge everyone as the same, stereo-typed in a way that only some of our elite media can do. i hope they take a step back and re-consider the way they are approaching a solution to the war on anyone who takes medications for a legitimate reason, and those who obtain them for the sake of money and greed, or, are truly abusing them. thank you for allowing me to state my opinion, chronic pain victim, holiday,fl.
hi folks i have had chrontic pancretitis for 20 plus years,and my docr took me off my pain med in oct 2009,(because i took a urine test and no opioid showed up) in the test now i have pain for the last 5 months do i have a case??(p.s.i live in a rural area and there's one doctor in thirty miles) should i suedoug
dug, i would find an attorney and go to town. it is illegal for a doctor to just cut you off your treatment like that, and put you in danger, and in pain. i am not an attorney, but i do know some of my rights, and some of the laws surrounding my pain management. there are laws that have been put in place to keep doctors from doing that. granted there are some people that use doctors just to get meds, and they are begining to deal with those people, but if you have been getting treated for your pancretitis for that long of a period, it is quite obvious that you are not in it for that, and to fail one piss test, is not just cause enough to just drop you as a patient, and cut off your meds. what is wrong with your doctor? does he not like you or ? the test could have been wrong, it could have been done wrong, or who knows why it didn't show up. assuming that you are taking the meds like you are supposed to. he should have had a discussion with you about the test, to see if you missed your meds or ? and try to solve why they didnt show up and correct it.
Thankyou for responding to me! i will have to find another doctor to treat me ,and yes if a lawyer you say i should look into this i live in ashland,new york,} was from long island (this never happen down there )this doctor is worried about losing his lic. but all of my reports from my other doctors on right on know all good lawyer!! thankyou very much for your concern
Dear Anonymous in Holiday Florida, You are right in your post about the injustice of people in pain not getting proper treatment because of the bad choices of others, however, although you state that you feel it is unfair to judge everyone the same, I feel you may be judging as well. I have had chronic pain for six years. My problems began when I was 23. I have now, finally, been taken seriously by a doctor. I have been in doctor offices where older individuals looked at me as though I did not belong. Although I knew I belonged there, the way the doctors and other patients made me feel unworthy of treatment caused me to almost doubt myself. I would be at home and know I deserved treatment, and once at the doctors, I would feel unworthy, like I should not be complaining, as if I was crazy and it was all in my head. From my experience I have learned to never assume you understand, or doubt, someones pain. I would see my step father wake up every morning, jump into the shower, come out singing a tune, and make coffie, then want to go shopping; he has had back surgery, and recieves medication, which he only needs to take every other day or so; but for his pain, he is trying to get disability. Then me, well I would wake up at 4am in so much pain I had to get out of bed and sit in a recliner that supported my back, I could not wash my hair because my arms would get so sore just from being elevated for over 30 seconds, my toes were always numb, I had sharp spontainous pains in my buttock that would make me yell out loud, my shoulders had electric tingling and a feeling of uncomfortable cold sensations, I was always exhausted, the smallest of tasks made me exasperated, my legs felt like led weights and it was MISERABLE. Now, I ask how come at 23 years old, am I envying a 60 year old mans health? You say the 'youth' are making the stupid dicisions, but honestly, the older population is just as much to blame. This is not a 'youth craze' this is a much larger social issue. Many middle aged people who are in need of money say they are in pain when in fact they want to sell their meds and make a 'good' living. Doctors have a hard time because although two people have a buldged disk, for example, one may have pain while the other does not. So please, just don't think this is problem is a result of the youth wanting a high. I am sure there are plenty of people such as myself that are in serious pain, and being doubted. I was in a seriously bad spot, how was I to function like a twenty year old when I was in worse shape than most sinors. My mother, who I live with, is 64 and she was astounded that I was in the condition I was in and not recieving treatment. I was not living a proper life, it was so unfair. Next time you are at a doctors office, just don't be so quick to judge. The untruthful person may just as well be the 58 year old man with the cain.
i have chronic pain in both my back and my knees,(arthritis & herniated discs),my docotor will not give refills without a docotors visit each month sometimes twice a month,in the long run i'm spending close to $200.00 a month for a 30 day supply of pain medication. at this time i really can't afford pain management clinics on what i make.every day is a stuggle to get up with up for work....
I was seeing a rhumatologist for several years when the goven't passed this new law. Suddenly she said I must come in every other month, I couldn't afford it. When I moved my primary dr to the town I live in I quit the other. I explained everything to her,transferred all past drs I had seen. Finally I don't have to go ALL the time. She keeps a good watch and does the blood tests when needed. I searched for years before we found out what was wrong, and the right pain meds. Sometimes you just have to find a really good dr.
Thank you Dr. Borigini, hopefully every dr will come to your conclusion.
After reading many of the posts on here, I have come to realize just how lucky I have been. I have been sick since late 1996. The first time I went to the ER, I discovered that the Dr. who had treated me that night had just purchased the practice of the elderly dr I had used for "emergencies". I had no insurance and he was just starting his pracice but he saw me (sometimes 2-3 days a week) without asking me for any payment. He also made sure that he gave me samples of my medications. After a few months, I became eligible for medicaid and since he wasn't an approved provider, he refered me to a dr. who thougt that all of my physical problems were due to my depression! Long story short, after a couple of years, I was able to return to my oridional dr. At that time, I was dealing with many different health problems but none of them caused much, if any, pain. About 3 years ago, the arthritis in my knees became so bad that I could barly walk. He did prescribe a narcotic until I could be seen by an orthopedic dr for steriod injections in my knees. Over the next two years, the lower back problems (bulging discs and sever arthritis). He and I had many discussions about the real need for pain management along with the fear most drs have for helping patients with cronic pain.
About April, I went for a regular visit. the office was closed with a note on the door that said they were closed b/c of an emergency and they would call to reschedule appointments. The next morning, I received a call from my pharmacist letting me know that the DEA had suspended his licence and his DEA number which ment that even non-narcotic prescriptions with refills would not be honored.
At the time, I had roughly 20 monthly prescriptions for every thing from hypertension, athsma, stomach problems, depression, and anxiety - in fact, only 4 of my 20 Rx's were narcotics - AND one of them was my sleeping pill and 1 other was for anxiety!
As I started looking for a new dr., I quickly learned what you guys have been talking about - one local internist refused to even see me when I told him who my former dr was! I went to a "pain management" dr. who first told me that the meds on my list were the same "coctail" that killed Heath Ledger, that if you put a 50 mcg/hr on a race horse (I live in Kentucky - horses everywhere!), it would knock the horse out, AND he NEVER prescribed narcotics!!!
I left devistated! Then, a new neighbor moved into my apartment building. She suggested I see her dr. He is WONDERFUL
the first time I saw him, he was in the exam room with me for about 1 1/2 hours!! We went over my whole list of medicines and in the last 3 months he has done many tests. He has raised the dosage of a couple, while cutting out some others. I am also working with a pain dr He just did a trial of a device that sends electrical impulses to the nerves in my back it worked well enough for me to get the permanet device - which involves cutting into the bone which then regrows around the device. Both drs comunicate with each other frequently which is always a plus. I do have a contract that my pcp is the only one to write rx for any controled substance and that I will only use one drug store - both things that I had been doing on my own for several years.
I don't think you mentioned which rxs you are one or where you live, but depending on that, your dr may have a legit reason for wanting to see you so often. I'm in Kentucky and the narcotics I am on (for pain) require a new, handwriten Rx each month and cannot be faxed as they do for anything else I need refills on - however, I have been on lower types of narcotics where the doctor could (and DID) put several refills on them.
Sorry - didn't start out to write a book but this is one of my pet peeves!
I so agree with this article as I suffer from chronic migraine pain and have tried just about EVERYTHING else to alleviate and treat the pain. So far NOTHING works except for the opiodes. But don't treat like I am faking...just live one day in my life of suffering because I always run out of the real painkillers that work for me. I do see a neurologist regularly too!
In my opinion, medications are made for a reason. Whether they be antibiotics, or Pain Medications. A physician is obligated to "stabalize" any patient that walks into their waiting room. That means; get them comfortable, get them out of pain and then make sure that when they leave, they feel like that office visit was worth the $240.00 the Doctor is going to charge you. If the physicians go to school, get Board Certified and then claim that they can help you, THEN, DO IT! In the past 6 months, I have been to about 5 doctors. They bounce me from one to another, etc.. The first one decided that I had Fibromyalgia, so he put me on Lyrica. This is a terrible drug, with no relief. No relief because I did not have Fibromyalgia. Finally, I have a real diagnosis of RSD. I am learning what it is, but I can tell you that I have been in horrible pain for many, many months. Every Doctor seems to overlook my main problem-PAIN and work around it. Like, they put me on anti-inflamitories, they give me Lidocaine patches to stick on the "parts" that are hurting; basically they don't help at all! The bottom line is that I have not been out of pain for longer than I can remember. I know there are drugs out there to help me, yet the great and wonderful Physicians are only worried about that one, yes only one per cent that have problems with them. Now, I have an M.P.H. and an M.S., so any study that would show me these results, I wouldn't be too worried about getting my patients STABALIZED! The problem is only one per cent that become addicted and that is a tragedy, but we have help for those people where we don't have any hope for people like us, just looking for one day of "no pain", or when we can walk, or do things that we cannot do without the Narcotic Medication. So think about it and wish me luck! I do wish all of you luck (Remember, 1 per cent; not an epidemic or Pandemic).
Doug
I agree with all of you , I have been experiencing chroic pain for 2 1/2 years following 4 major spine surgeries and have developed , post laminectomy syndrome( failed back surgery syndrome ) and have excruciating peripheral neuropathy in both legs and feet. I finally get some relief with 2 narcotic meds, but as said I really take care not to up them forr fear of addiction. Also having found a pharmacy that realizes my condition has helped alot with the prejudice I used to get when I first was put on them/
I sympathize with all of you who are in need of meds and are having a difficult time in having them prescribed..I am blessed with the pain specialist I have been with for the last 2 1/2 years.
You and I have almost the same problems. I recently had to have more neurosurgery and I thought it would FINALLY bring me SOME relief. Now it's almost worse because I have developed nerve pain from the surgery which I never had before. I also have "failed back syndrome" and have been down this road for a long time. I have a morphine pump and take oral Dilaudid . One thing I will tell you, Patrick and I say this from the bottom of my soul please take your meds and don't worry about addiction. You, as I, are DEPENDENT on your medication. As time goes by, your body WILL need more of the meds as a natural response. Studies have shown time and time again that chronic pain patients rarely become addicted to their meds. Would you refuse a diabetic an increase in his insulin? Of course not. Take your meds and at least get some relief.
Matt'smom
If only 1% of patients prescribed narcotics were abusers I think things would be a whole lot different. Unfortunately statistics indicate that it's more like 17%. (Opiod Guidelines in the Management of Chronic Non-Cancer Pain, Pain Physician, 2006:9:7, ISSN 1533-3159). I agree that the medical community should be doing their level best to help relieve suffering, however, I don't believe that obligates them to meet any and every patient's demand for narcotics. Unfortunately, abuse is rampant and training regarding pain management and addictions is lacking. I truely hope that you find pain relief methods that help you regain the ability to enjoy life. I know you're frustrated and hurting, but I hope you press on to find relief.
The argument of one per cent or 17 per cent is not the point. The actual problem here, is that doctors, nurse practitioners, etc. are very much responsible for people "self Medicating". If you go to your doctor to seek help, yet he/she is not willing, then you are going to do whatever you can to get out of that pain; ie street drugs, alcohol, etc.
It really isn't very hard to get narcotics, as a nurse, you know. So, why don't physicians understand this fact and "keep control", rather than let the patient go out an self-medicate? One could compare it to abortion; a woman's body is her own business. The same applies to people living with terrible pain and no quality of life. We SHOULD be allowed to be in control of our bodies. A bottle of 100 10 MG Vicodin HP (Generic) costs 30 dollars, a bag of heroin costs about ten dollars. Which should a patient, who is living in severe pain, buy and use? Doctors are doing a disservice (and some of their nurses too, as they act as the "gate-keeper"), by not STABILIZING a patient. That is the number one thing a health care professional is OBLIGATED to do. Get that person out of pain! There is no gray area there.
Yes, people are going to abuse the medicine, but that does not support what these doctors are Not doing; PAIN MANAGEMENT!
I am SO sick of all of the allied health professionals who have a "chip on their shoulder" regarding this subject. I am sure that all of you know what I am talking about. When you call to speak to the doctor, but the "nurse" won't let you. It is a form of POWER and a thought that "they know better". I understand what these (we) people see everyday, however, they only see a very small per cent of a person's life, when they only spend fifteen minutes with them, regarding their pain. If the doctor or nurse spent a day with their patients (customers) and saw what struggles they have, I think the health care community would be much better (I include myself in this statement).
So when the patients are seeing 3 or 4 different doctors and acquiring 300 or 400 percocets, xanax, ms contin etc. a week, and when they're going to several different pharmacies and paying cash to avoid an insurance trail, and when their complaints change to a new pain source every other visit, when they look at you with a straight face and say, "my pain is 10 out of 10" and we've actually seen people in 10 out of 10 pain, so we KNOW they're lying, and when they refuse to have random drug tests to see if they're using coke or heroin and showing an abuse pattern, and when they call the office every hour to request meds and curse us out on the med line for not giving them "the meds they need to control their pain", and when they get out of prison after selling their meds on the street to the kids at the local high school, we in the medical community are supposed to "stabilize them" and "help them deal with their pain"???
Really, do you think that perpetuating this behavior is helpful to the "patient", to the community, to ANYONE???
The really sad thing is that people feel victimized for having pain because the narc seekers and drug seekers make a mess of all of the medical community's effort to help the people who are actually in pain. I honestly believe you think you understand what it's like to deal with the junkies and the dealers, but trust me, you don't. I spend about 2 hours of every day diverted from helping people who actually need help by people who are over using their meds or selling them. PLEASE don't try to make me feel bad about resenting the 17% that screw it up for the other 83%. We in the medical community may not be responsible for people abusing their drugs, but we ARE responsible for protecting the rest of our patients, our community and ourselves.
I live with OA daily I have had surgeries on my back too.
I am so blessed to have a wonderful family doctor 'who really cares about the patient and NOT the money".. I signed a Pain Mngmt contract and he gives me my PP every 2 months. This is just fine with me.. I take 3 to maybe 4 pills a day depending on my pain.. But mostly 3 daily if needed. My last visit he wanted a UA test, I said fine but why. He states the DEA policy on RX pain meds. He has to make sure we are all honest with him. He just found out one of his patients had 5 different pain pills in her system and HE only precribled ONE to her. Needless to say he dismissed her from his practice. I have no problem with a UA every visit if that is what it takes to help the doctor and yourself. Honesty is the best way to go. IF you are lying to the doctor on your meds. he will find out.
I guess until you have to deal with the loved one that is addicted to these "Wonderful" drugs, you will never fully understand. I will post again to let you know when my Mother's funeral occurs because she is inevitable going to die at the hands of her prescriptions that she so swears she needs. She needs them ok, her body needs them because it is so addicted she cannot stop without HORRIBLE withdrawal which makes her hurt worse than she ever hurt prior to the meds. My mother may have been in some pain, but at least she was still my Mother. Now, she can't even talk half the time, can't feed herself, falls down at least 1 X per day (broke her nose last week), can't function as a normal human being anymore. I'm sorry to disagree, but her quality of life was MUCH better when she lived in pain. Now, she is not living at all.
Typical "Health Professional" attitude. As a PA, you should know, that the very first OBLIGATION you have, according to every law in this country, is to STABILIZE the patient. That means, if a patient sees you, do not immediately assume that they are drug seekers. You must get them out of their pain, immediately. Growing up with a mother who is an MD and a Hospital Administrator, my spouse a pharmacist and I have two graduate degrees in science and public health, I have seen the big picture on this subject. Yes, you don't just hand out narcotics "because people want them", however, it is a Health Care Professional's responsibility to make sure that patient is not in pain. Have you or anyone here studied the people that cannot get quality health care and end up buying drugs on the black market? Or, even worse, start using illegal street drugs. There is a lot of supporting information that Health Care Professionals drive people from their offices to the streets. Something to think about, next time you or anybody else cares for their patients. I feel like I need to bring my CV into a practice, just to calm the damned Doctors down and think I am "less-than", because I might need certain medication. It is SAD!!!
I can give you a different opinion and I hope to help you...I am a nurse and a pain patient. I have been a pain patient for over 10 yrs, and without the help of a select few doctors, probably would have killed myself long ago. I have chronic, debilitating pain...but with PROPER pain meds and close following by my dr, I am able to work full time as a Neonatal Intensive Care Nurse and have a pretty normal life. Without proper medication, I was unable to work or function at all...spending every day in bed with no hope. There is a difference between "addiction" and "tolerance". I feel you mother may have an addiction as well as tolerance. Tolerance occurs to anyone who is on a narcotic/opiate med longer than a month or two. You will get some side effects of withdrawal if you stop them abruptly. So, no one should be scared to take narcotics...when and if your pain subsides, your doctor can wean you off of your meds slowly so as not to have withdrawal. If your mother is "falling down" and her quality of life is worse than before her med treatment, then it is NOT the right treatment for her. From personal experience, your mother is afraid, or scared to death, to change dr's or meds for fear that her pain she had before will come back. But, you need to get her into an inpatient pain treatment facility....Johns Hopkins in Baltimore, Md. has a great one...if you're not near there, call them and see if they can refer you to one in your area. She needs care by physician's who won't over treat her, but won't under treat either. She needs followed also for depression which is VERY common among people with chronic pain. Hope this helps...work with your mom and remember that you love her...help her as much as you can even if she is resistent...she'll thank you later...
I feel your pain, and don't need pain meds to cure it! The 17% happen to be people I love and care about who became addicts DUE TO PAIN MANAGEMENT ! Nobody starts out addicted, they "become" addicted. Some, just dependant, but almost everyone I know, addicted. Right now as I speak (type) I am ready to scream due to the man I love (who happens to have pain every day) twitching like a freakin crack head in the bed because he had no meds to put in his body today. The delusion to him is that he is in pain and needs them for that. I'm sorry, but the pain he is suffering without his drugs is WAY worse than the pain he deals with normally.
My Mother is the same. Addicted due to an accident with her neck. She is no longer a functional human being due to meds. My step father, same, junkie... His Brother, dead from overdose of phentenol patch, My boyfriends uncle, dead - overdose, his sister, vegetable in hospital due to a motor vehicle accident while she was on MEDS, his other sister, junkie... Don't know how much more I can endure. I have no way to help these people now that they are out of control. Any suggestions?
How do you help someone in pain who is also addicted to the meds that are going to help them? Do they hae to live in pain the rest of thier life, or live as a junkie the rest of their life? I don't get it, seems that the lesser of two evils are still two evils to choose from.
Help someone!
OMG!!! This should be on a plaque in EVERY Pain Management Office in the US. Yes, of course there are patients who get narcotics and abuse/sell them but there are ways of seeding them out. For the rest of us (like me) we need to be treated properly and consistently. I've been out of work for over 3 years, lost my car and house and live on what my wife works. If I had ONE doctor that would not be such a freakin wimp and look at my situation; MAYBE i could get my life back and return to work! There should be a Network for people like us so we don't sit back in pain as some dude outside of our house sells and pops narcotics like candy. IT'S RIDICULOUS!! Anyway.... thanks for what you wrote!
How many of YOUR patients are seeing 3 or 4 different doctors? Also, you said that you "KNOW" when you see a drug seeker. As a nurse, I am assuming that you have at least an AA, maybe a BSN, not a PhD. Maybe you are a Sociologist too! I don't really know, except that you are a NURSE. Frankly, it is impossible for you to KNOW how every single person in this world reacts to pain.
Anyone experiencing CHRONIC PAIN, may figure out how to meditate or control thier "outward" appearance to you. Unless you are qualified to CONFIRM that these people are NOT in pain, then it is the Doctor's responsibility to weed out those patients (probably 3-5 per cent of your calls...MAYBE). People should not be treated as second class, just because YOU don't think they need it!
Until you get your NP Psy., or PhD., then I would be a caring nurse, meeting the EXPECTATIONS of those who pay your salary.
One of my Master's thesis was on this subject and I DO KNOW what it is like "out there"! I've studied at more Methadone clinics in San Francisco and New York I have created needle exchange programs in large cities, so yes, I can pretty much understand the problem. As it is said in this forum, the drug war should not be fought in the physician's office, monitored by a nurse, whose only education is 2 or four years of education. If one is an LVN (LPN) it is even less education!
All I would ask of you, is to keep an open mind and do not treat patients as if they are drug seekers. Try to develop a relationship with them. Talk to them about the Suboxone/Subutex option. Don't treat them like animals and be cruel. That is the very last thing an "addicted" individual needs. They need YOUR support and kindness.
bingo! I dont want to go to the streets! But Im in wa state and cant find a dr wiling to write rx s. Im legitame. I have been on 4-5 methadone a day and my ritlin and my synthroid and premerin and celexa for years! Yes I did sign a pain contract and went byit. I was dissmissed for being lat to an apt. . . . ? which i doubt was the reason! the dr and I I felt were close and even friends but her moyher runs her new office and it was obvious she has a problem with me. . . so now hwre i am no dr cant find one oh sure theyll see you chg you and say no live with it. . . . what the heck? im a good person dont even smoke or do extr drugs ets. . . how can they just cut you off? let alone once youve been dissmissed just try to find a new dr. . . its a small town but its like theyre covering their own butts and to heck with yours! its all money they heard people to rehab bet what about the ones in real pain ? its been almost 2 months of being in bed many phone calls to state and i hear trhere are alot of us out there this is happening to!!! so what do we do? like its been said go to the streets? Im not that way then no one would help me but i feel like that now i cant find anyone to help me !!! my mother lives down the road and shes up in arms too! i tell her everything . . im 50 yrs old and not a kid and i hate the fact u try to look good when going out but he told u dont look sick! Im hurting and need help and hate that im actuly thinking that the street may be my only help at this point or do myself in and im not sure which is worse / / / any sugestions for a dr in wa state thanks for listening! imahurtin!
WOW! I bet you have a hell of a bed side manner! You sound like a real jerk that should not be in the nursing profession period! Maybe you should be a psychic since you seem to be able to know everything each patient is feeling. Why ask what their pain is on a 1-10 scale if you can use your psychic abilities to get the "real" answer. Get some therapy for your bitter and nasty attitude and a new profession while you're at it!
you know, i really feel for you, i really do. to watch a loved one change from one person to another and another and another as time goes by has to be horrible, but you really need to look into what the level of medication and dosage rate you mother is supposed to be at. it sounds like she is over medicating herself, and not using the drug(s) the way they are supposed to be used. they really are designed to manage the pain, and if used correctly, they will do that. please look into that and see if you can help her maintain a level of consistancy with her dosage times and quantity, i will bet that you will see a change for the better if this is done. good luck and i really do understand your frustration. it is really too bad that a few of the people that seek meds for the wrong reasons, have messed-up the way that doctors, nurses', phamasist, and down the line medical staff treat the patients. either they just shuffle them through as a customer,( not a person with a real medical problem that needs to be treated, and kept under control), or like one of the people who are there just for the meds and dont really have a medical problem that needs treatment, just a monkey on their back. these are the ones that doctor shop, and they are cracking down on that and it will help to get the doctors offices back to a more one on one, where the doctor can really spend time with you to address your concerns, and manage your pain. the good doctors are afraid to do that, in fear of creating a monster, even if it is just one person who is doctor shopping, gets cought, and takes the doctor down with him. even if the doctor was un-aware of it, now he is in trouble until he can prove that he had nothing to do with the patients fraud. when this can be brought to a stop, then the doctors can do what they have been given the abilities to do, legaly, moraly, and ethically.
This is the first time I have ever used this website. My pain management physician changed my medication today to something I've never heard of, so I wanted to read learn more about it before I had it filled by my pharmacy. I am only 34 years old and have had to already have over 40 different surgeries for my condition, my first was December of 1999. My health problems started at just 7 years old, making me one of the youngest to receive the diagnosis. I have been blessed with some very good caring Dr.'s from pcp to sergeants. I would have to say that in my opinion as a patient whom has lived with chronic pain most of my life, that I am certain just by reading your judgmental comment regurarding patients in your medical office that you have an awful bedside manor. I may look perfectly normal fully clothed, hair done, makeup applied to perfection everytime I visit my Dr. and yet my pain level that day may just be 10. If you are in the medical field surely you must know that patients who live with chronic pain for so many years develop a higher pain tolerance than a patient who have temporary pain for some reason. The fact that I may not roll around doubled over, cring and screaming for a PA with your attitude does not mean a damn thing. It does mean though that I have been living with pain song age 7 and I have accepted that life pain free for myself will only come with my death. I promise without a doubt you couldn't walk 5 minutes in the shoes of any patient who has left a comment on this article including mine. I wonder why did you waste years of collage to work in the medical field, when you have a heart that seems cold and frozen for patients that pay your salary. Last but not least you calling yourself "anonymous" with your comment proves that you must be somewhat ashamed to flaunt such a title as PA. I refuse to see my Dr.'s PA if he can't see me because I made that mistake 5 years ago, my Dr was in meetings and I had an emergency. I told the PA my problem and exactly how my real Dr. would treat the issue. I think she was embarrassed that I knew what needed to be done and she didn't, well that PA no longer has a job or a license to practice, her stupidity caused me 2 emergency surgeries and 23 days in ICU, the first 10 in a coma!!
This is the first time I have ever used this website. My pain management physician changed my medication today to something I've never heard of, so I wanted to read learn more about it before I had it filled by my pharmacy. I am only 34 years old and have had to already have over 40 different surgeries for my condition, my first was December of 1999. My health problems started at just 7 years old, making me one of the youngest to receive the diagnosis. I have been blessed with some very good caring Dr.'s from pcp to sergeants. I would have to say that in my opinion as a patient whom has lived with chronic pain most of my life, that I am certain just by reading your judgmental comment regurarding patients in your medical office that you have an awful bedside manor. I may look perfectly normal fully clothed, hair done, makeup applied to perfection everytime I visit my Dr. and yet my pain level that day may just be 10. If you are in the medical field surely you must know that patients who live with chronic pain for so many years develop a higher pain tolerance than a patient who have temporary pain for some reason. The fact that I may not roll around doubled over, cring and screaming for a PA with your attitude does not mean a damn thing. It does mean though that I have been living with pain song age 7 and I have accepted that life pain free for myself will only come with my death. I promise without a doubt you couldn't walk 5 minutes in the shoes of any patient who has left a comment on this article including mine. I wonder why did you waste years of collage to work in the medical field, when you have a heart that seems cold and frozen for patients that pay your salary. Last but not least you calling yourself "anonymous" with your comment proves that you must be somewhat ashamed to flaunt such a title as PA. I refuse to see my Dr.'s PA if he can't see me because I made that mistake 5 years ago, my Dr was in meetings and I had an emergency. I told the PA my problem and exactly how my real Dr. would treat the issue. I think she was embarrassed that I knew what needed to be done and she didn't, well that PA no longer has a job or a license to practice, her stupidity caused me 2 emergency surgeries and 23 days in ICU, the first 10 in a coma!!
We need to look at ONCOLOGISTS practices, not PAIN MANAGEMENT DOCTORS!
My mother was prescribed oral morphine sulfate. My mother was so happy when her oncologist prescribed the med. The oncologist DID NOT discuss with my mother how to properly store her meds. (I store mine in a locked safe.) The oncologist DID NOT make my mother sign an opiates contract (She should have--my mother has engaged in drug seeking behavior.) My mother's oncologist DOES NOT require that my mother bring in her med bottles at EVERY visit. Two weekends ago, my mother showed me a box that contained 6 100ml bottles of Morphine Sulfate. She showed me this box when we had a house guest present--one of my girl friends. Fortunately, my girl friend is not a druggie. We were both shocked and I was very, very upset.
I've contacted my lawyer and my doctor. I know that to report my parents means that I will be persona nom grata with them and the rest of the family. If I report my mother, I'm sure that I will be attacked by the rest of the family. Had my mother's oncologist followed the procedures most pain management doctors follow, I would not be in this very tricky situation.
I have yet been to a doctors office that required a lie detector test when giving your medical history although I have been present while a multitude of test results have been studied along with the available history.
If the doctor is prescribing too high of a dose a simple phone call should correct the situation although as your mothers condition worsens well you do the math.
One other thing to consider one day you my be in the position of needing heavy duty pain meds and then you will find out first hand the damage that over reaction by snitchs and abuse by addicts has caused!
1stRed, your response was cruel and callous. Shame on you!
The vast majority of chronic in patients who have been prescribed opiates to control severe pain use their medications appropriately. They do not use their medications recreationally. They appropriately store their medications. Their doctors provide an appropriate level of supervision.
The problem with is not with our community. It's with people outside of our community. Since writing the original post, I have spoken to my pain management doctor about the situation. He believes that my mother's oncologist recklessly prescribed the opiate. He says that this happens all the time. He thinks that providers who prescribe opiates should be doing continuing medical education activities on this. My mother IS NOT a chronic pain patient. My mother does have a history of using bad judgement while traveling--that is not going to the ER when she has a medical emergency while traveling, driving home and then going to the ER. Her oncologist is aware of this. My mother tried to get her doctor to prescribe barbituates. He would not do it. According to my pain management doctor, there are enough warning signs (the irresponsible traveling) that say that she should be kept on a much shorter leash. He said that the vast number of people who get in trouble with opiates got them from doctors who are not up-to-date with how to prescribe them.
My pain management doctor advised me to WRITE, not phone the doctor. He told me that, under HIPAA, the oncologist will not be able to give me information. The oncologist should be able to independently verify my story--how much he prescribed and the concentration. He should be able to determine if I saw all the opiate he prescribed. What I want is for the oncologist to force my mother to get a neuropsychiatric evaluation. I have evidence that her reality testing is not what it should be. I think my mother needs to live in a supervised environment, such as a Senior Independent Living apartment complex. I think my mother needs to give-up the RV and travel with a tour group instead. I also think my mother needs psychiatric care. The only way for this to happen is for my mother to get in trouble.
My point, 1stRed, is this: I WOULD NOT BE IN THIS AWFUL SITUATION HAD MY MOTHER'S ONCOLOGIST PROPERLY SUPERVISED MY MOTHER. I know I'm not alone. I know other people who find themselves in similar situations because THERE ARE SOME DOCTORS WHO PRESCRIBE OPIATES WHO ARE NOT PROPERLY SUPERVISING THEIR PATIENTS--AND THE PROBLEM IS NOT WITH PAIN MANAGEMENT DOCTORS, BUT OTHER SPECIALISTS WHO, AS A PART OF THEIR PRACTICE, HAVE TO PRESCRIBE OPIATES.
WOW! I see "CONTROLLING" personality all over this post! I hope you are not a Pharmacist, who thinks that they can unilaterally decide what do dispense, or not. I love my mother more than anyone else in this whole world, however, that does not give me the license to get involved or try to control her or her activities. I can encourage her, support her, educate her, but I cannot control another human being. Nobody has the right to control another person's life, regardless of your relationship to them.
What if I was your brother and I think all you are doing is completely crazy? Do I have the right to make you go into a locked, psychiatric hospital? NO! We are all responsible for our own bodies. Medications are created and manufactured for a reason. I don't know your mother's specific diagnosis or other problems, but SHE is responsible for HER acts, NOT YOU! I don't want to come across as being harsh, but it is just reality. Stick to your own life and be there for your mother. Show her love and support, rather than hostility and control. I am confident if you continue on this road, it will end very BAD!
I hope your mom's cancer goes into remission and never comes back, but meanwhile, you are not in her skin, so you cannot make her decisions.
I have chronic pain and take several pain meds to control the pain. I don't have any problems with my Doctor but I do have problems every time I go to get my medications filled at the Pharmancy. They act like I am a second class citizen and they treat me horriable. I have to fight every time I go in there I really hate the way I am cought in the middle of all this. I am sick like alot of other people and all I want is my medications filled without all the judgement. I am not someone off the street and never will be. I have a illness and I have a right like everyone else to be treated with respect and honor.
Hi Brenda,
I've had the exact same treatment up here in Canada. My local pharmacist actually
phoned my Dr to lecture HER on the pain meds she's prescribed to me. I was blown away and came to the defense of my Dr. saying until she had a phd in medicine and knew my physical history to withhold her judgement. Every time I would get my r/x filled there I would get "the look", once having to defend myself in front of a line up of customers. So now I go to a big box retailer pharmacy instead and have no problems. I've got to say I feel so bad for you patients in the U.S. who have to pay sometimes hundreds of dolloars for a Dr's appt. Up here each and every Dr. appt. is covered by our provincial healthcare, we don't pay a penny. And since I see my Dr every 30 to 60 days I can see how that could add up. I really hope you guys get the changes you need to your health care system,
your supportive Canadian friend
The same thing happened to me, with my Walgreen's Pharmacist and my physician. "HE" (Pharmacist) thought that my doctor was prescribing too much of a particular medication. Keep in mind, I have been on this regiment for over FIVE years! I guess he was just bored and thought that he needed to set my Doctor straight!
I visited my physician after that phone call and all she did was laugh hysterically! In fact, she did not bring it up to me, I asked her about the phone call. She basically rolled her eyes and said that this particular pharmacist "was a little off". That made me feel really good, because I HATE going to the pharmacy and treated like a street, drug user! If my doctor, after five years, decides I need certain medications, then all the Pharmacist has to do, is count the pills. Don't throw attitude or make me feel "less than". It is ridiculous!
I hate my once-a-month visit to the pharmacy! It isn't just the Pharmacist either, it is "Pharmacy Techs" too! Power is a very bad thing, in the hands of the wrong people. They give you that evil eye and make you feel weak, just because you need these medications. I no longer tolerate that behavior. If an EMPLOYEE treats me inappropriately, I go straight to the Corporate Offices and tell them about my experience. They need to know.
Doctors spend massive amounts of money and time to earn the right to use the suffex Dr. in front of their names this I am sure of. I have also heard that they are required to take an oath to do no harm of this I'm not so sure.
A case in point I have two girls both of whom are now addicted to narcotic pain medications which they started recieving in their late teens for menstral cramps!
They seem to have no problem getting perscriptions at will and have been doing so for 10 plus years along with buying off of the street.
I on the other hand have multiple ruptured disc's with nerve root impengement along with a few other painfull ailments am in my 50's with a degeneritive disk condition and am effectively disabled so when I ask about somthing for the pain ( by the way I also have a blood condition I am a bleeder so I can't take over the counter pain relivers) I'm told that I shouldn't take any thing because I may become addicted?
Is it just me or is there somthing wrong here?
Hi! This is my first time writing. I read everybodies email and I feel for everyone of you. I'm in chronic pain all the time. I got e-coili 3years ago and liver diease. They gave me 6mos or less to live. They put in an old folks home and on hospice, to let me die. I was in that home for 5mos and the doctor they had for me did not touch me once. He would come once a month and would say, see you next month. I laid in bed all that time. My kness frozen up on me,(my legs were straight out). My boyfriend of 6mos took me out of the home to live with him. He lived in another state, 4 hours away from my family. I was bedridden for 2yrs. Alot of theraphy and doctors, I'm walking today. I went from bed, wheelchair, claw cane, now regular cane. I have neuoraphy, arthris and osteoporoisis. I take morphine, vicodin, neurontin and plenty of other medicines. My family doctor referred me to a pain management doctor to see if he could help me better with my pain. Well he said he would first take me off the morphine and vicodin. That was the last visit with him. My family doctor knows from my records that if he did that I would be bedridden again. I want to say their is doctors out there that will help you, just got to find them. Thanks for letting me get this off my chest. I think of all the people who I read on this website. God Bless you all.
I have cronic back pain from a herniated disk and leg pain that began with a car accident. I Became determined to over come this pain naturally (after some extensive study and what seemed to be good advice. After phys. theripy and one year of narcs. to control pain, I commited to one year of no narcs. I did not even call the g.p. or the sergeon, who seem to be knife happy, for that year. The sergeon retired, the g.p. moved out of state and now no doctors in my area will accept me because of my condition.
Amen to Dr.Borigini... I have had Chronic pain for over 8 years now. Before i was diagnosed with Fibromyalgia and Chronic pain and i would need to go to the ER to get some relief for my pain, the docotors in the ER would talk behind my back and they have even classified me as a drug addict. One doctor put in his notes that he offered me drug addiction help and he never said a thing to me. I cannot go to the ER here because when i show up they start talking about me and they do not give me the proper care that they should. I do take narcotics now and have for almost 3 years but if my pain gets to where my pain meds aren't working i have to suffer because they will not help me. Even the doctor that i see for my pain will not adjust the dosage of my pain meds now matter how much pain i tell him i am in on a daily basis. Sorry for the rant but this is a very touchy subject for me.
Hopefully someday things will change and all of us that suffer from Chronic pain will be able to get the help we need.
I am a 42 year old female. I have suffered with chronic migraines since I was a child. Also I suffered a dislocated knee cap from basketball around age 12. I elected to not have the "experimental surgery" offered at the time, so the dr. ordered opiates for my pain, this was after the standard non-steroid anti-inflamitories were tried with no relief. Also, we now know that these nsaids can cause other health problems, ulcers, stomach bleeding, heart trouble, but dr.s are so scared of the government that they will risk these health problems and not treat your pain adequately.
I now have severe arthritis in above mentioned knee, not ready for knee replacement, but hurts all of the time, limits my ability to function normally, and hurts so bad that I cannot sleep at night. I do try home remedies (heat, hot baths, epson salts, wear my knee brace) so when i go to the dr to ask for meds I am usually at the end of my rope, depressed, and need relief. I do have a family doctor that has treated me for over 20 years and knows my history. He will not hesitate to give me my lortabs when I need them. He does not overprescribe. I have no interest in moving on to a more potent opiate. He also does not treat me like a drug addict. As for my migraines which I get a couple a month, we have tried all of the migraine medications available, I have also seen a headache specialist and he put me on depakote which altered my moods so bad that I just wanted to give up. I am a single mother of an eight year old daughter and I cannot afford to be in a constant swing of moods. I told the headache specialist that in the past that usually opiates combined with an anti-nausea would either abort the migraine or at least make it tolerable enough to function. Still he acted like all i wanted was the drugs and tried to put me back on another migraine med I tried before and did not work, needless to say I do not see him any more.
As I mentioned before, my doctor of 20 years is always very understanding of my migraines and if he cannot see me in his office to receive a shot, he will send me to the ER with instructions on how to treat me.
My problem now is that I am out of work and out of private insurance coverage. I am on state coverage and the dr.s must be trained on not how to keep a patient out of pain or how to treat them when they are. The dr that is a state HMO that I am currently seeing will not write me anything stronger that 800 ML motrin. Tried to explain to him that after all of the years of having to use opiates (30 yrs) that this is like me taking a baby asprin. Told him that using opiates for true pain does not cause a person to become an addict. He tells me that he does not "like" to write those kind of meds. I told him that I don't "like" to be in pain, does not matter he still wants to waste my limit of 5 prescriptions a month of stuff that does not work. I want to find a dr that is not scared to treat pain, but do not want to be labled an addict or drug seeker.
I do agree that some doctors are irresponsible when it comes to writing opiates, but some are not, and are honestly trying to uphold the oath they took when they got their medical license. To treat a patient with compassion and to the best of their ability. The government needs to stop this war on doctors and go after the real drug dealers that sell cocaine, meth, heroin, crack. More lives are lost from these drugs including alcohol and cigarettes, which are legal.
When will the government realize that it is a doctors responsiblity to practice medicine and make sure that their patients take their meds correctly?? Big Brother is taking our healthcare out of our doctors hands and many people are being made to live a life of pain and suffering because of it.
My 82 year old grandmother has cancer in her one remaining kidney, plus a cracked vertebra that was never diagnosed and has now developed in to arthritis. Her doctors, the oncologist and her family doctor, both believe in keeping her out of pain. She has tried pain management, they put her on morphine which was way to strong for her, she is small person. In the end they have put her back on her Lorcet and I firmly believe if they had not kept her on her meds that we would have lost her about 10 years ago. DEA needs to consider that a person's quality of life makes a great difference and constant pain is not a good quality of life..Leave the doctors alone and let them do the jobs that they are trained for!!!
There are no good doctors anywhere in the US for patients who suffer from ME/CFS who take Medicare patients. I hear this complaint from hundreds of people from coast to coast. The problem is that doctors care more about the money they make than their patients. Then they have the nerve to complain about patients? They do not read any of the latest info available on this subject. At my next appointment I will give my doctor a copy of the Canadian Consensus Document, then I'll probably never see him again. He's worthless anyway.
Hi there,
just curious, what is the Canadian Consensus Document? I live in Ontario, Canada with chronic pain on a daily basis, being treated effectively by a wonderful Dr., I'm one of the lucky ones. However, I'd really like to know about this document you mentioned it and where you found it,
thanks,
Andrea
Let the physicians AND the patient decide on the need for and use of opiods, not the DEA...a patient should not have to suffer nor the physician be fearful...the patient has every right to be treated for pain and as one who suffers from daily chronic pain I say we need more patient rights advocates and less government interference...get out of my relationship with my doctor!
It would seem to me that there would be a place for people to write or email the DEA or whomever we should send it to, to complain about pain medication we may need to live a life that is as close to normal that we will ever get If there is a place to write, I would like the email so I can let them k now that not all of us can live without thepain medications and live.
I have been going through this for several years now. My doctor who once prescribed narcotics, now never does at all. You have to get into a pain clinic, or do without. Still at the pain clinics, you are still treated as a drug seeker, and I have cancer which has metastisized. I kind of feel sorry for the doctors who know they have patients who need pain medications; but are still too afraid to prescribe them. They also are looking at higher insurance either way. It is the drug abusers who can also take most of the blame for this situation. You wouldn't believe how brazen these people are when they find out you are on narcotic pain relievers. I have neighbors who are harrassing me on a daily basis since my roommate told them what I was taking. I have turned them down several times, and they are trying to make my life hell because they can't get what they want. I try to keep my medication information as secret as possible; but once they find out, watch out! I can't feel comfortable in my own home anymore out of fear of someone robbing me or my home. These are the people we can thank for most of these problems we are having today with no pain medications being prescribed.
Legitimate patients who require pain medication should not be hindered or discouraged in their quest for neurological and psychological relief by physicians who are apprehensive about the so-called "impending doom" possibly awaiting them from supervisory, authoritative entities that claim to be protecting the public from potential misuse or abuse of such pharmaceuticals. If a diagnosis is rendered, then appropriate treatment should follow. HIPAA should protect any external inspector from meddling with the professional services between a MD and a patient. That's the bottom line, in my opinion.
i am a stage 4 lung cancer patient on medicaid and can't find a doctor who will prescribe me the pain meds that i have been on for 2 1/2 years....the doctor i had quit taking my insurance so i am stuff and in so much pain....what to do
I am so sorry! Anybody in stage 4 lung cancer should have access to anything they want! Anything! What do these doctors think is going to happen to you? Get addicted? That is the LAST thing they should think about. I know people are limited to activities, due to their finances, but if you can travel out of your area and find a doctor you can trust, it would be well worth it.
I am staying in a "psychotic" city in a "psychotic" state, so I have to travel almost three hours to find a tolerable (not great) physician. Many Doctors, Nurse Practitioners, Physician Assistants have the GOD complex. They hold all of the control (so they think) over your body and that is wrong. It should be a relationship, in which both parties are satisfied with the treatments and medications.
I have started "Interviewing" my doctors, prior to committing seeing them. If I don't like them, I move to another, until I find a doctor that remembers WHY he/she is a doctor; to keep their patients comfortable and functional. If they cannot do that, FIRE them! Even though it is your health at stake, to the doctors, it is a business, so you should treat it as a business. Ask them questions; what Med School, are they Board Certified, what training, what is their philosophy, etc.? If they are annoyed, or think that you are over-stepping, then MOVE ON!
These ***** Doctors need to learn that THEY do NOT have all of the power in your relationship. You have 50 per cent input and they should respect that!
I guarantee you, if that doctor were suffering from the same sort of pain you are in, he/she would make damned sure they have all of the medications that they need/want. I KNOW this from personal experience!
Seriously, I hope you find your heroic doctor, that treats you correctly and makes certain that you are comfortable and living the best quality of life possible. I will do my best to see that you are given a personal "Angel" to get you through this (and I am not even religious, much less a Christian).
Our thoughts are with you and stay strong!
It is not fair for the DEA to control pain Meds when the person needs it to live a life that is meaningful.I have this problem and it is not fair.I told my Dr. that I was running short each month by about 12 pills.I would wake up in the middle of the night and was hurting so bad I couldn't get back to sleep. So what do you do when there is relief in the Medicine cabinet. You take a pill and 45 minutes later you go back to sleep. I told him this and I think he should have adjusted the amount I was getting. But no,he let me run short for three months. The 3 or 4 days before my appt.I was out of Meds. Then they took a blood test and it showed there was not enough of the drug in my system,So he Quit prescribing my Meds. He said he would not jeopardize his license for anyone. I told him he had not been paying attention to me when I had explained what was happening some nights. He said you signed a form when you started coming to my practice,that you would take the meds as prescribed. I told him that he also agreed to control my pain,which he fell short on doing. I blame it on,to many patients in his office. He was running us through there like cattle. Not enough time for anyone,to hear our complaints. Now I am surfering. What has our country come to. Besides that I feel he was running scared of the DEA. Maybe he has a History of Problems with the DEA. Thank you
i have suffered from chronic pain since 2003. i had a laminectomy with fusion (back surgery with rod and screws and bone graft) in 2003. i suffer from degen.disk disease. i have bad disk from C-3 thru C-7 in my neck. i suffer from fibromyalgia. i have had a stroke and have had atrial fibrilation so i am on coumadin...and have other health issues and i am only 56 yrs old. i was a substance abuse counselor and had to go on disability in 2003. i did try pain management and was on ms contin for about a year but i took myself off of it. i am now taking percocets and they help some and i refuse to take the ms contin again...i too feel like the second class citizen when i go to the pharmacy and we all should not have to feel this way. i am not in pain management anymore and my family doctor has now retired so i am getting my pain medication from a new doctor and it is such a struggle. when i got my last prescription he had written on the prescription " patient should have filled this on such and such date...do not fill until time"....i was furious when i saw this....i felt like a druggie...and i am taking this prescription back to him next week for him to rewrite it because i am not taking this to my pharmacy to be embarrassed...how dare him to do that?...that made me feel like a second class citizen AGAIN !!!!....thanks for letting me vent.....
I too suffer from chronic pain, with spinal(cervical) stenosis,herniated c5-6 level disk,and herniated L-4 disk, and had surgery last year for two herniated l5-s1 disks.I have been with the same chronic pain management M.D. for 16 months now.I do know for a fact that you docs have it rough with the DEA, vut it really angers me that pain patients are not taken seriously,for the docs fear of the the DEA.I had that problem with my primary care M.D.He knew that My disk was herniated and was having severe sciatica(bilaterally),and he actually said that he could not write anything stronger than ultram,whicdh wasnt too good seeing that I am severely allergic to this med.He stated that the DEA was on him hot and heavy.So while these DEA people are riding the docs back, how would they feel if they were in a situation, and needed medicine, and could not get it,because they(DEA) have scared the docs with fear of losing their license, and facing prison?These druggies out there just make me sick, and angry,because it really makes it hard for a person whom has legitimate pain issues to get the kind of treatment that they so need!!!!!
I just registered here a moment ago, while researching when is the proper time/condition to prescribe barbituates. I have yet to see referenced here a condition which is known among neuorologists/surgeons.
It is called "pseudo addiction". My neurosurgeon had to actually call my family doctor and explain it to him. My family doc was rather incensed about the conversation, he having been corrected by a "big city" surgeon in St. Louis. The result of that incident led my doctor to a refusal to treat me further, and he dropped me as a patient.
The effects of this condition mirrors almost exactly a truly addicted patient. The patient will always focus on pain meds during appointments, what types of pain med and the dosage etc. But in this pseudo addictive condition what the patient is actually expressing is a very heightened fear of the pain he/she has experienced, and the horror of being tortured with no end or relief in sight.
Maybe each of you in your own instance and experience might want to research this a bit.
So now we jump to present day, muscular dystrophy and a whole new set of chronic, acute pain conditions. I don't want to go into describing all of my exposure to pain here. Just suffice it to say that I believe I have a Doctorate in pain and many of the varieties and depth of it all.
I have a primary doctor who was prescribing really good meds, but he got spooked by some problems outlined in one of his medical journals, telling me that the only reason someone would need that many meds is a result of addiction. Never mind that he was the one to suggest that I needed the strength of meds I was on.
Just by luck he referred me to a pain management physician, who had recently opened a new clinic. I knew I was in luck when one of the forms I had to fill out was acceptance of guidelines for opium med treatment. This doctor is prescribing all of the pain meds that I was taking through the family physician before. She actually increased the dosage (tamadol and vicodin) based solely on my report of the effectiveness of her opiate therapy.
What I have found is that the DEA pretty much focuses on general and family doctors who do not have the specialized education to properly dispense the more addicting meds. "Properly dispense" being whatever the DEA thinks it should be at that moment. Pain management is a medical specialty now, becoming more sophisticated as new studies and information are made available through proper clinical trials etc., and so the DEA cannot suppose to be experts in this field any longer. Thus, doctors of this relatively new specialty are not scrutinized to the extent of the family doc.
Pain management doctors and clinics are pretty much like any other area of medicine. The new doctor I mentioned has found a market niche, and as word gets out that she considers opiate drugs to be a focal point of her regime, she is going to have all of the business she can handle. That is unfortunate for me, since her waiting room is never crowded, for now. Of course she has to have a basis for treating pain in a patient that warrants narcotics. She isn't handing scrips out like candy.
I know it's hard with Medicare, or no real health insurance which disallows some from financial resources for a specialist. I am on Medicare as well, so I do know the frustration you might be feeling, and all of the red tape so often necessary to get to the solution. And being so horribly wretched and tortured makes it very hard to do all of the legwork and information gathering to find a solution. Please believe me when I say that without treatment your pain will reach a point where the work endured in searching is less hellish than the actual condition you encountered in the first place.
Just wanted to let you know we do have a portion of an article here that explains pseudo-addiction. You can read the article here: Opioids: Addiction vs Dependence
You make some very good points. Thanks for sharing.
I know from personal experience and from the experience of hundreds I have spoken to with fibromyalgia. This letter may not mean a thing to anyone and may not be read. But I will speak.
Narcotic pain relief is the only thing that touches my excruciating pain of this illness. I never needed or asked for a narcotic until my 40's when this disease took my life over and changed it forever. Yes there are risks to long term use of narcotics. But people with painful chronic conditions who have found no other relief should not be treated as "drug seekers" or "hypochodriacs" or "drug pushers". We suffer stigma. The research that says "narcotics don't work for FM pain" is pure fallacy considering the experiences of the real FM patients.
I don't sell my medication, I don't give it away, I take it as prescribed in a responsible manner. I do not get "high" from my vicodin. I only get some pain relief. Over the counter meds do not help to touch this miserable pain. Yes, I know, but I "look just fine". But many of us are extremely frustrated with the labels we have. We need pain relief. Give us the risks vs. benefits of long term narcotic medication. However, we DESERVE the choice to help our pain. Lyrica does not work for many. And also I have heard from the majority of the people I have talked to that it loses its effectiveness for fibro after a short period of time even at the max dose. It did not help me after a few months. And it NEVER relieved this pain that feels like I have been beaten with a board everyday of my life.
Go hard on the drug seekers. But try to differentiate between the "druggies" and the patients who simply need pain relief.
Debra Van Ness RN
As far as I know there are few if any medical cirriculum requirements surrounding exactly how to educate a Doctor on how to prescribe narcs and how to spot an abuser/addict. This results in very inconsistent prescribing practices among physicians. Teaching Opiod Pharmacolgy in one semester and Addictions and Abuse theory in a single unit in another semester makes connecting the dots on prescribing methods difficult to say the least. If the educating Attendings don't put forth a focused effort to teach appropriate and consistent pain management and opiod parameters during Residency training, new doctors are left to make their own way regarding prescribing practices. The DEA and the State Board of Medicine may be the only ones providing guidelines. I believe this is an area of physician education that is sorely neglected; therefore malprescribing (either over prescribing or underprescribing) is often due to lack of education rather than reckless or evil intent.
I certainly agree that there are many people who suffer needless pain and judgement due to predjudices and misconceptions in the medical community. Being in constant pain without hope of a cure is surely one of the most challenging situations any person can encounter. While my heart goes out to those who are truely suffering, a few facts from "an interventional pain practice" may help to put this situation into perspective:
17.8% of patients in the studied interventional pain practice were found to be abusing prescribed pain medicine on some level. It's mind boggling to realize that close to one fifth of the patients in this practice were abusing prescribed narcotics. Granted, only 8.4% of these patients were Moderate to High Grade abusers, but those are still some pretty staggering statistics. However, even the criteria for determining abuse behavior varies from practice to practice, so this statistic is subject to scrutiny. According to an article in Pain Physician Vol. 9, No.1, 2006 "there is no widely used screening tool in current practice." That means that what one Doctor considers abuse, may not be considered abuse by another doctor and "reckless prescribing practices" is a term that can't be clearly defined. It would be negligent to not point out that the inferred statistic here is that 82.2% of patients in this practice were not abusing their prescribed pain medications. Unfortunately this means that the majority is stigmatized because of the minority.
In summary, the DEA and the State Boards of Medicine are trying to do a job that our Medical Schools and Residency Programs should be doing. Because of this many people who are in pain are not getting appropriate help, and the people who are abusing the system are not being stopped. Until we address these inconsistencies in the Physician Education system, I don't see how we can make a positive impact on the challenges presented by the dichotomy of legitimate chronic pain management and opiod abuse.
Well, that is why CONTINUING EDUCATION UNITS are needed. There are always (daily) new drugs coming to the market. There are also new ways of treating pain, with certain combinations.
If you see a physician or nurse, who graduated in 1973, they will absolutely know less than a physician graduating in 2007. Any licensced professional needs to keep up on the latest drugs, therapies, etc. That is the physician's obligation and that is why all of us MUST have a certain number of CEUs a year, to renew our licenses.
I don't think those "fun" advertisements on the television will actually teach medical professionals pharmacology! Health care professionals have to be hungry to learn and keep UPDATED on new diseases and how to treat them.
I would love to send you a video of my Mother in her current state due to prescription narcotics and these money hungry Pain Management Dr.'s. Lets see, last week she fell down and broke her nose due to having too many opiates, muscle relaxers, valium and anti-depressants in her system (thanks to her wonderful Dr.) I sure can't wait for the day either when they have an effective pain managment plan that doesn't involve addiction and possible death due to the treatment.
When I read about people suffering needlessly,it makes me sick.A friend of mine has RA and is in constant pain.She is 58 years old and though she is clearly unable to work,Social Security has denied her 3 times so she has no insurance thus she can't even go to a Dr.It's really sad but becoming more common everday.I am a breast cancer survivor and I've been on Oxycontin,Oxycodone and Dilaudid for 3 years now.I was blessed to find a pain management Dr that understands pain.I signed a pain contract,which I was glad to do.I have to go to her every month,take all my meds for pill counts and have random drug tests.I take my meds as directed and everything works out fine.
where is this at the doctors around me think everyone wants pain meds to get high on, but some of us do kneed it, i had back surgery in 2005 and have sciatica becouse of it. also have fibro and 2 disc in my kneck out with ra. tennessee is verey strict i guess, i am on percocet 10mg and it doesnt work all the time
i had heart surgery and my lungs quit and i was in extreme pain and my doctor started screaming get out im writting divorce papers on you and you wont see anther doctor the waiting and patient rooms were full and he opened the door so everybody could here him screming all kind of awful things so now im not going to be able to get another doctor
I must say Florida sucks letting patients suffer this kind of stuff didnt ever happen in NY where i am from I just moved to Florida 2 months ago and have found it hard to get a doctor to continue my pain regimin which i have been on for 7 years they have all my medical records but say that they have new regs since the Micheal Jackson thing... WTH i am not MicheaL AND MICHEAL had enough money to buy any drugs he needs why is it we have to suffer this only causes people to look and use illegal street drugs to get relief from pain!!!!!!! i mean come on in Florida with medical records MRI and the doctor knowing you need med let you suffer r/t worrying about getting in trouble for prescribing this is BS docotors loosing their compassion for their patients needs im so fed up may have to go back to NY just to live pain free... Some days the pain is so bad i think death would be a good answer to relieve all the suffering......
I had 2 discs rupture 7 years ago. in 2005 i had failed back surgery.with sciatica that was not there before My DR. was so in tune with my pain,( she was a European) I had never taken narcotics before so I trusted she knew what was best for me- she had me on 30 mg morphine and 20 mg oxycodone for break-threw- I was pain free! I did everything that I had done before my back went out on me!did I mention I am a mother of a child with severe cerybral palsy and thats how my back went lifting her all the years( she was 10 at time) so anyways im volunteering in all 4 kids classrooms cooking breakfast lunch and dinner keeping my house clean on and on then she got pregnant and left for maternity leave and BOOOOM! I was immediate being taken down on my meds- I guess she was never able to come back and went into private practice and takes no insurance now $400 just to see her... any ways they have me now on 10 mg methadone and 10 mg oxycodone and want to take the oxycodone away- I cant do anything anymore I do not volunteer I barely cook my house is a disater not to mention everyone pretty much hates this grouchy screaming BI...the med only takes the edge off for me.I still feel severe pain..is this ok for them to do - I have always past my uas never have gone to another dr. and do everything I am told. And i have 2 other discs that have ruptured since!why isn't there some kinda of way for dr.s to want to help a persons quality of life? I to sometimes feel it would be best for everyone if i were not here. I need some help!!!!!
I mean does it matter, every candidate is only going to make it worse. They came out with 20 mlg Oxycodone's & instead of paying ( & This is with a Prescr. Discount card ) what I would for 180 oxycodone HCI 30mlg wich is $110.00, Now you can hardly find them & I am from this area, & have to have these meds not just for pain. With out them after a total of 12 yrs of takeing them ( & at this point there is no Euphoria ) I am very sick, So now I cant work like I norm. do last month I lost 2 & 1/2 weeks do to not being able to get my meds. They change them to Dilaudid, Now I cant fill it. It has the same prblem. I am literaly on the verge of Just finding a dealer threw my little nefew who's __yrs old just so I can have some type of releif so I can get to work ( I mean I have 4 kids & a wife who is on the verge of leaving me ) I blame it on some of the Pharmasists & the DEA & the un-understanding at the fact that every yr our Population goe's up. Of course we need to have enough medicatoin for those who would need it. & Un-Fourtunatly I can't afford anything else over 300 a bottle. Right now when they are in (If I get lucky its a total of 300 to get 2 bottles of my meds, & if not lucky, for 1 is 1,400, the other is 500. Thats you're indipendent pharmacys, like SUPERSAVER! Who charge big dollars, I went with out for all-most 3 wks last month because it was there or no were at all. Thats B.S, I'm not paying that. (PLZ TELL ME WERE TO GO TO START A PETITION OR SIGHN UP TO ONE STARTED FOR THE USA OR SPEC. FOR FLORIDA, WERE I'M AT.) post by colt45sonfire@gmail.com plz plz plz write back. Thank-U
Dumb but not so dumb. The light eyed person as opposed to the darker eyed person taking an opiate will draw more attention to themselves by family, police, etc. The pinning of eyes is so dominant. Then there is the doctor who is aware of previous addiction problems and with the DEA and ATF being so unforgiving they are so non giving of the meds needed. How bad is it. IV Heroin addict. Stopped at 40. Always had a bad back from the trade I was in. Contracted Hep C. I got plenty of Ibuprofen, Tylenol 3, you get the picture. My stomach bottomed out. Finally found a Dr who cared. Codeine Phosphate or sulphate. 6 30 mg per day. Oops there goes the eye pupils. Calls made by family to Dr stressing detox. At first Doc cut down to 4 per day. I tried those idiotic moves 90 codeine pills from one of those overseas mills for $300.00. That is until a family member intercepted one package. And she called the ATF. So what do I do? Currently live alone. I divorced her. Off all narcotic pain killers. Massive stomach bloating from non narcotic pain killers. Stay home a lot. And I live in pain in the 8 to 11 column sometimes 4 to 6 hours a day. I can't stand up for more than 30 minutes without leaning on something. Nuff said
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Very well said!!
I sympathize with doctors who are put in an almost impossible position – often being forced to chose between helping their patients and jeopardizing their careers. But I also understand why patients get so frustrated and angry, knowing there are medications that will give them some pain relief but unable to find a doctor who will presribe them.
I completely agree with you, Dr. Borigini. The war on drugs needs to be waged in the streets and at the borders – not in the doctors' offices.
The issue of prescribing medications, I feel, should be up to the Doctor and Patient. The only exception would be if the relationship between the two were relatively new. I feel very strongly drugs should come off the streets and stop all these endless killings.
I have an excellent relationship with my doctor, after trying several, and we've been together for over 35 years.
So, regardless of the opiinion mentioned earlier, drugs have to stay off the streets.
"Hello" My name is Neal Baker and I'm an injured worker and I do receive worker's comp. I have a back injury that happened in o4/10/2008 and this being a accident that accrued while working for a non-profit private organization that is a state and Federal funded program. My Doctor and my Neurologist has been telling B.W.C that I need surgery. I suffer from a Sprain Lumbar Region; L4-L5, Herniated Disc, Levoconvex Scoliosis L3-4, Retrolisthesis at L3-4, Multi-Level Degenerative Disc L3-4,Facet Disease L3-4, L3-4 Mild Disc Bulging with mild spinal canal stenosis, Disc bulges at L3-4 and Disc bulges at L5-S1. I keep telling my Doctor about my pain medicine, it just does not work any more (Hydroco/APAP 10-660 MG). It's my belief this war about pain prescriptions is the reason my Doctor doesn't give me something stronger. I've ask him for some type of sleeping medicine and he wont give it to me. I hear Florida is not scared to give pain meds to people who need them but, is it against the law to go out of state (Ohio) to Florida to obtain pain meds because, I really could use something for my pain.? After 2 years it don't work any more.
Hi Neal,
It's normal to build up a tolerence when you've been taking an opioid medication for quite awhile. When that happens it is necessary to either increase the dosage or switch to a different opioid. Since you're taking the maximum dosage available of hydrocodone, you would need to be given something different, like perhaps oxycodone.
You're right – most doctors are extremely hesitant to prescribe anything stronger than hydrocodone for fear of the DEA. You really need to see a pain management specialist for that. Here is a link to a directory of pain management doctors that might help you find someone: Doctors for Pain
As for going out of state, every state has their own laws regarding prescribing opioids so you'd have to find out what the laws are in Ohio and Florida. However, I think the distance would be problematic. When it comes to Schedule II Controlled Substances, which includes most opioids except hydrocodone, there are no refills allowed and prescriptions can only be written for a maximum of 30 days worth of medication. So each month you have to show up in person to get a new handwritten prescription. I think you'll be better off trying to find a good pain management specialist in your own state.
I hope you can find a doctor who can help you soon. – Karen
i to was injured on the job and there done w me.reached medical maximum improvement.yet find it hard to do anything wo pain.Im finding its hard to get anything accept off the street.scarry cause its expensive and risky.to many peaple abusing them for anyone that really needs them.what do we do?
In your search for pain relief have you been to a Pain Clinic? That is where I found relief and I have as many degenerative discs as you. I also have kept all my medical records which shows the years I've been suffering with chronic pain and it helped me make the case for stronger medicine. I would not advise going out of state or to begin doctor shopping for narcotics. You will then be put on a list of drug seekers. Have you tried accupuncture or chiropratics? It may take a combination of therapies to get you relief that you seek.
Ken
Hey Samithius thanks for your infor but my medical case is weird. It is B.W.C and the security guard almost shot me and ever body in the hearing room. Go to WSAZ.COM and see details.
Neil, I feel for you. I'm a disabled fire Captain (failed back fusion and several heart attacks-pain) and I didn't get it until it happened to me. They say European are more sympathetic than Americans to pain sufferers. The belief, "pick yourself up and back at it" ... might work when your young but not when your OLDER (in men).
Please attempt to "assist" your Adrenal gland. It's "shot" from all your stress. Please try natural products to help it function. It's true about accupuncture.
My heart goes out to you. Maybe we should picket in front of legislators homes and let them see people in pain. My problem is I that look "fine" but x-rays and mri's show light metal items, mini-computers, stents, pace-maker,
spinal cord implant. I can't take a mri anymore due to the equipment inside....but damn if I don't look "good".
Good luck.
Mike
I also agree that Drs. have to worry too. My husbands Drs have tried every med known most of them made him a cranky vegetable in constant pain who couldn't tie his shoes they finally found a combonation that worked Morphine and perc with soma although a very strong combo he is able to work with little pain and is not the cranky couch potato he was. Now his Dr is telling him (he has been a patient for 10yrs) that because of the FDA they can no longer write his scripts, they say because of the toxic effect on his liver mind you he gets his liver checked every three months by the same DR because he is on bp meds too.
The FDA had no problem 2yrs ago when he started taking these meds. WHY NOW? and I hear the withdrawal from these meds are worse than the effects on the liver. He needs these meds he isn't selling them on the "STREET" why aren't they going after the people who really are and not those who NEED these meds.
Sorry but it seems wrong to me!!!!!!
I'm sorry to hear your husband is having to face not getting the meds he needs. I don't know what his Dr. is talking about regarding the FDA. Although they have been discussing possible changes that would place more controls on prescribing opioids, as of now there have been no changes made. In fact, they just recently announced that they will not make the decision until sometime in 2011.
Perhaps your husband's Dr. is anticipating the changes he thinks they'll make and has decided he doesn't want to deal with it and so just won't prescribe opioids anymore. Or maybe he's had some problems with the DEA and doesn't want to take any chances of losing his license and practice. It's hard to know what is going on. But it sounds like your husband needs to look for another pain management specialist. Here's a link to a directory of pain doctors that may help you in your search: Doctors for Pain
It is so wrong that it borders on abusive for the sufferer, and there are quite sadistic "doctrors" as well. After 20 years of pain I had to find a new PCP. My pain meds were started by my neurologist, and increased a bit by my old PCP.
The NEW one met me last month, and closed the door and looked me up and down with digust and obvious distain. She BEGAN by saying "so you take pain meds? I don't believe in them". When I went into details & history she shook her head NO at each bit of info. She was verbally abusive, then physically abusive with the PELVIC exam as if to say "I'll show you pain!"-all other words sarcastic and INSULTING. She hurt my insides to top off the neck to hand/back 24/7 pain!
Just found she reached neurologist to say she thinks I'll get a drug problem so to cut them and I'll get surgery quicker. I'm 57 and she wants me to be in AGONY to the last breath, cause surgery may leave me worse or never walk or move again. Where do you report a sadistic "dr"??? I may as well die cause w/o pain relief I can do nothing and must move, but can't bend to even pack anything.
When my Doctor retired, another took his place. We had a few words because of the way he was being rude to my elderly mother. He than refused to fill out my persciptions knowing that my other had ran out that day. I'm an acute pain sufferer because of several sever injuries to my back as a child. I went two day with sever withdrawals, and in so much pain I could hardly breath. My family were so upset that they put their money together to aquire just enough pain killer to get me buy on. Just to show how desperate people are going to get. My disability worker tried everything to know avail. Because I am no longer able to drive safely ODSP has been paying for my rides, and soon homecare for my mother and I because I was looking after her. I am so mad because I am aware that our gov. is fighting with Prudue Pharm. to aquire the patent for oxys. Prudue Pharm. has complete controle over priceing. Does that say anything to anyone? Good luck to you pain suffer because our government wont stop until everyone is taken off pain killer and we'll all have to buy our own relief anywhere we can.
Hey bud I live right in trhe haert of were you're talking about going & from what we see on the New's & its every day now. They are fighting this as if its just like Scheduled 1 street narcotics, & you're answer is no Florida is not the place to come all the Dr,s R now turning those away that come from out of state. Not to mention that you would have to stay here for up to three wks just to get them from a pharmacy, as you can not get them filled out of the county they are wrote in. & on top of that there are only a handfull of Citys to get the Meds from down here. Everyone from all over the state come to my town here in florida, there are only 3 more towns to go to. All the pharmacys down here ( Well CVS, Publix, Walmart, & alot of other known ones ) stoped giveing out Narcotics (ALL that is) & there not ewcepting plpl from out of state no more, if they do it's a crooked Doc. Its a matter of time before they shut him or her down, at one like that. Iv'e been to 6 in the last 4 yrs & thats because the DEA is Targeting all of the Pain places. They don't under stand no one can afford a specialist, or sergery.
I, Neal Baker wrote that letter back in 03/06/2010. Wow, just on 03/17/2010 The Ohio Fedural Government tried to kill me? On March 17, 2010 my wife and I, was at my BWC/IC hearing in Portsmouth, Ohio and that day was strange right from the start because, we were the only one's in that hearing waiting room and on a normal day, its full of injured people. Anyway, they call my name over the enter com to go to room #3. I walk in and only the hearing officer is present and he ask me " where's everybody at " meaning to 2 Attorneys. I said that I didn't know but, seen them in the hallway earlier. And, he tells me to go back into the waiting room. I go back and tell my wife what a strange situation I was just in. About, 10 minutes later they call my name again to go to room #3. This time I walk in and everybody is present me, the 2 Attorneys and the hearing officer and we get started with the hearing. About 10 minutes into the hearing while my attorney is reading a document, the IC security guard walks in this room, turns, grabs the door and at the same time he yells out loud " are you F**k**g with me " and at the same time pulling his gun out. Now, the door is closed and this guard is standing behind me and my attorney. He is standing in a defense stand, knee's slightly bent and both arms stretched out with the gun in hand. This gun is in between my head and my attorneys head but, the gun is pointing across the table at the employers attorney ( Mike Jones ) and this Mike Jones is the City Solicitor for Portsmouth, Ohio. My attorney turns and sees what is happening and turns back around and continues reading. I look at the hearing officer and he nodded his head at me as to grab the gun? Now, we all know this was a set-up. 2 weeks before this happened, I requested 10 applications for unsafe work conditions at my former work place where my injury occurred. And, the statue of Limitations was going to end the next month on April 10. 2010 just a few weeks away from the 17th. It looks like my former boss Roger Patton the business director of Pike Community Action didn't want to pay for my surgery's and my worker compensation. Just think if I did grab the gun all the money the government would've saved? Lets see: If I did grab the gun, the security guard would've lost his retirement, the City Solicitor would've lost his job and me, I would've gotten my surgeries, medicines and workers compensation checks, WOW, thats a lot of money but, it didn't work. So, this hearing was cancelled because, of the guard pulling his stunt. So, I applied for an " Emergency Hearing " and got another hearing set for the following week. BUT GUESS WHAT HAPPENED? I went to my hearing on March 24, 2010 and won my case but, the next day, that night the Hamman Church next to my house caught fire and there are only 4 homes around this church. I do believe they were trying to lure me outside that night. With our police scanner on we heard the whole story. They did get a suspect and guess what? The suspect slit his wrist while in the custody of the sheriffs jail. And, now that means all testimony the suspect gave that night well not be allowed in court. And, in the Waverly watchman news paper thats what it said that the suspects " GOVERNMENTS ATTORNEY " had all testimony throwed out of court. Now, we will never know whom sent him to start the fire nor, whom was with him when he started the fire. Wow, people you really should watch Jesse Ventera because, he knows what our Government is doing to people. You know I can't get an Attorney to even look into my case? The AFT fired my wife from her first job then at her second job the FBI got involved? Come on now, it is obvious that we are targets of the federal Government all because, I was injured at a private state agency and they don't want to pay for my back injury. How sad but, when their related family got hurt they got the best medical attention even for a little scratch on his arm. How sad, this is all very true my name is Neal Baker and I'm on face book, check it out.