Prescribing narcotics and other habit forming drugs. A doctor’s view on why it can be complicated

by James Hubbard, M.D., M.P.H.

Like a lot of doctors, I have mixed feelings about narcotics.  They are great for severe, short-term pain and a must for some terminal cancer pain.   Some people abuse them for nothing more than the high they get.  And then there are all of the in-betweens.  We doctors are kind of caught in the middle, also.  We can lose our license if we prescribe too much or inappropriately.  We are told, by some groups, we prescribe too little to the patients that really need it.  But how do we know who really needs them?  If we are too gullible, we will be prescribing to a bunch of abusers, too strict and we are doing a disservice to those in need.

It is the long-term, chronic use that concerns us the most.  Narcotics are habit forming. They alter your mental state. If you take them long enough, you will have a physical withdrawal trying to get off of them.  Most people will become tolerant needing more and more to get the same effect.

So what to do?

 

Dr. Rob at Musings of a Distractable Mind writes an explanation of narcotics and why we have mixed feelings.  Although I differ a little from him in some of the definitions, his is an excellent primer, a narcotics:101.

In my opinion, the bottom line is don’t worry about becoming “hooked” if you need them for a week or two to get you by after an injury or surgery.  Just remember some people have side effects, and they can effect your mental state.  I have taken them twice in my life.  Once, in my teens, I took a tylenol with codeine before I went to bed and was in this crazy dream state all night trying to get the strength to put my head back on which I thought was next to me in the bed.  In my thirties I took a vicodin and felt like ants were biting me all over my body the entire night.  Needless to say, I won’t be actively asking for more.

The tragedy is people with chronic pain which can last for years.  My advice to those is find a doctor or pain clinic that utilizes all types of treatment such as physical therapy, counseling, biofeedback, acupuncture etc. and stick with it.  You have to learn to cope with the pain mentally and physically.

Please add your comments, critiques or experiences about this complicated subject.

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26 Responses to “Prescribing narcotics and other habit forming drugs. A doctor’s view on why it can be complicated”

  1. Jolene Says:

    Personally I’ve never been in chronic pain or had an injury that required narcotics, but I’m always interested in brain chemistry and addictive links. Narcotics can obviously be a slippery slope, hard call to make, all depends on the person and situation (glad I’m not a doctor :-)

    Of course I’m a fan of acupunture, biofeedback and the like. Love to see MD’s combine these therapies with their traditional practice as much as possible. I think that’s the best of both world’s.

  2. James Hubbard, M.D., M.P.H. Says:

    Thanks Jolene,
    For people with chronic pain, I think these ancillary therapies are important also.

  3. Steve Parker, M.D. Says:

    Over and over I see people admitted to hospital for various conditions who happen to be taking narcotics chronically for pain control. It seems to me a large percentage of them are still in significant degrees of chronic pain. So now they’ve got the chronic pain, plus narcotic dependence complicating their lives.

    Dr. Hubbard, I like your advice about a multi-faceted approach to pain control. I see too many “pain management specialists” who just want to do the high-dollar injections.

    I have a huge amount of sympathy for someone who has to live with chronic pain.

    -Steve

  4. jhubbard Says:

    Dr. Parker, it is true.
    Doctors and patients alike want a quick and easy fix. Sometimes that is just not possible. A good pain clinic educates you in active ways to cope with and alleviate the pain.
    I, too, feel sympathy for people who have to live with it. For most, there are better ways than just constantly numbing your brain, and, yes, some of those high-dollar injections are just temporary.

  5. Sagan Says:

    Very slippery slope. I guess it’s good to try to use those as a last resort- I can’t imagine what it would be like for people with chronic conditions. That’s got to be incredibly hard.

    Sagans last blog post..Life Lessons: Perfectionism

  6. cathy Says:

    I’ve been on narcotics 3 times – percocet after giving birth to both children, and codeine more recently. The codeine made me extremely nauseous,and I will never take it again if I can help it.

    I have watched loved ones resist narcotics when they were really called for (back injury) and saw that their recovery was probably longer than necessary without the drugs to help them relax.

    I think that taking a multi-faceted approach makes the most sense for those living with chronic pain. And I hope that it’s an approach that I never have to test!

    cathys last blog post..Friday Links

  7. Mark Says:

    I have never been prescribed a narcotic. Hopefully I never have to experience that! Very insightful post! Have a nice weekend!

  8. James Hubbard, M.D., M.P.H. Says:

    Sagan,
    For long-term use the patient needs to be educated on all options.

  9. James Hubbard, M.D., M.P.H. Says:

    Cathy,
    Some people are so afraid of addiction, they won’t ever take it. It goes to both exremes.

  10. James Hubbard, M.D., M.P.H. Says:

    Mark, I hope you never need one.

  11. Dr. J Says:

    Dr. Hubbard, you take on some very difficult topics very well!

    Having been a member of a pain center team for years, I’ve seen so many difficult situations. I don’t know the answers, but for myself, I have only taken a narcotic pain reliever on a few occasions related to dental surgery. I really do my best to avoid them. Being around medicine, as I’m sure you have also, I’ve know too many people who have become addicted to narcotics, and it is a difficult addiction to break :-(

    Dr. Js last blog post..Nibbles: Leptin gets another shot as obesity treatment, diabetes and mental function and screen time and unfit kids

  12. jhubbard Says:

    Dr. J,

    I can become complicated, and I think we all want to do the best for our patients.

    Thanks

  13. Dan Says:

    Often, medications for severe pain are made from opoid plants. These purple-flowered plants produce opium poppies, which are used in the production of opium. Opium is what we in the U.S. call narcotics, and they dull and numb one who ingests what may be made by these opium poppies, as there are several drugs that have been developed from what these plants provide that are these prevalent narcotics.
    Some medications are from natural opium, such as cocaine, or the opiates from the poppy seeds can be used to create semi-synthetic medications, such as Heroin. Heroin was marketed by Bayer Pharmaceuticals for 12 years by telling others that it was a non-addicting form of morphine (pure opiate drug), since there were many soldiers addicted to morphine after the civil war. During that same period of time, Bayer marketed heroin for children who coughed. Of course, Heroin is very addictive, and is no longer available.
    While Poppy plants exist and are grown in areas of IndoChina, Afghanistan is the number one producer of poppy plants. The United States is the number one country that consumes what is derived from these plants. Opium-derived medicines once could be bought freely in the U.S. by anyone less than 100 years ago. Yet now, they are classified by the Drug Enforcement Agency as narcotics, and are scheduled by them, according to the danger they potentially could cause another who takes them.
    While prescribed to patients for such issues aside from pain on occasion, such as chronic coughing and diarrhea, their greatest benefit is for the relief of pain experienced often by patients is the primary reason doctors prescribe opoid drugs, and they do so often. Vicodin, a mild narcotic, is the most frequently prescribed medication in the U.S. presently.
    If patients take opium-derived drugs for long periods of time, tolerance may develop, and the patient may need to take more of the drug to acquire an effect of relief. In addition, the patient may develop a dependence on these types of drugs, which can lead to addiction and possible abuse. This is why overdose of these types of medicine occur- as the reasons for taking these drugs initially become replaced with relief due to addiction in some who take narcotics for a long period of time.

    Dan Abshear

  14. James Hubbard’s My Family Doctor Blog » Blog Archive » Acetaminophen accidental overdose Says:

    [...] Of course the ones who are actually in pain worst of all (see my previous post).  [...]

  15. Shelly Herr Says:

    Hi
    I came on this blog on my search about stopping medications. My ‘new’ dr had given my 30 5mg vicodin about 2 months ago for severe pain from djd in both knees. My long time dr had me on tylenol 4. When I brought all the scripts from my former dr, he said, ok, bring me all the vicodin back. Well I didn’t have them, and came back, and he just said, no, he would not refill the tylenol 4, NOR would he refill my clonazapam or paxil. I am running painfully low on clonazapam and paxil, I asked about withdrawl, and he said, it shouldn’t be a problem for any of them. I have been on clonazapam for 15 years. I have no idea what to do now. Can a dr (btw head of the hospital/clinic in my area) just totally cut a person off all meds because I violated his rule? I feel like a criminal now
    Thank you

  16. JLB Says:

    Did I just read this above? Seriously?

    You have to learn to cope with the pain mentally and physically.

    I am 32 and have had pain all my life and until last year I have lived with it and “coped physically and mentally”. Recently I agreed to try Vicodin, and I have been in PT (again) and I am seeing a Chiropractor (again). I am tired of “living with it” and my three small children are also tired of living with it. For once when I hurt tremendously I can do something about it and go play with my kids instead of laying in bed begging my husband to come home or laying on the couch telling my kids mommy is in to much pain to play. The irony is that based on my MRI results I should be in debilitating pain daily and I am lucky to only have really bad weeks then OK weeks. Now my doctor is nervous about prescribing any more narcotics, I’m OK with that if he’s ready to do surgery, which he isn’t. It’s just frustrating.

  17. JRW Says:

    I have had severe headaches for around seven years. I’ve had six different neurologists prescribe the slew of “migraine” medicines and have had serious side effects including behavioral changes and hallucinations. Not one of those drugs was a narcotic. Once I found a doctor with a program that included narcotic therapy for chronic pain I was finally able to function like I was before. Yes, I did need to learn the “dependence curve” and must take what I call breaks but my doctor calls “holidays” from the hydrocodone which I consume on a daily basis. Once I learned this, managed it, and added chiropracty to my regime I was like normal again. Its sad that so many doctors are afraid to prescribe these ancient, time-tested, proven, efficient and low-cost medicines gifted to us by nature (while hydrocodone is a synthetic opiate- the poppy gets all the credit. I am an Environmental Health and Safety Division Manager and have an advanced degree in toxicology and industrial hygiene. If it weren’t for the daily use of synthetic opiates, I would definately, without a doubt, be on permanent disability, unable to work, unable to help my wife raise our four children, unable to cope. I do not get “high”, I get pain relief. Our country and its litigious nature have ruined this treatment for so many. For some it is entirely inappropriate, but for the last six years, I am a believer, reciever, and I live a relatively normal life now. Other progressive, developed countries don’t have such a problem with this issue (e.g. the United Kingdom). Its the doctor’s responsibility to monitor use closely and not let it get out of control. Its worked for me for six years, I’m great, my blood work is fine, my kidneys and liver are in good shape, and I can live without debilitation pain.

    Surgery is more dangerous than the maintenance meds I’m on, and there’s no guarantee that it would work. So doctors must push back against the litigators and regulators, else I’m moving to the UK.

  18. rzorbit Says:

    I would like to make a few comments on narcotic pain relievers. I myself have chronic pain, I have sever arthritis all over my lower back,by it self it makes everyday things hard. I also had neck surgery on my c-5,c-6,I had spinal fusion with a metal plate and all. That procedure did work, there was relief for about 9-10 months and then it started to hurt again and also my right arm started to get numb all the time. I also have right knee pain but i won’t get into that. My comments or problems i should say is that it is almost impossible to find a doctor that is willing to get into chronic pain relief! They send you to a pain clinic which will do everything they can, which mostly amounts to giving injections at the sight of your pain.Well for a lot of people that does help, but in my case it has’nt helped at all! and i’ve had 6 shots in my neck and 7 or 8 in my lower back with no relief. Now doctors don’t like to prescribe narcotics even knowing that they do help. NOw i know and understand problems surrounding the whole narcotic stigma, but i say if you take your meds. as prescibed and that will help you lead a more productive life then i think i should be adult enough to understand andbe able to have that as an option! 95% of the bad publicity,abuse and overusing ismainly from teenagers and addicts who have a problem with control or mental issues. I guess I’m just saying people like myself and i’m sure a lot of other people like me are’nt able to get the right medications we deserve to get so we might have a better quality of health. Its just not fair, and if anyone can help me or send me in the right direction i would be appreciated. thank you for listning, carl e-mail address-rzorbit@comcast.net

  19. Alicia Says:

    I have a doctor that was prescribing me 180 Lortab 10 with 4 refills at one time for Fibromyalgia along with 124 Xanax at one time with 4 refills. Of course I have a lot saved up to say the least. I refused Oxycodone and pain patches from him and his attitude toward me started to change. I could not mentally or physically go through a sleep study he wanted me to have done and I left him a message telling him why in November 2009. No one ever called me back. I then made an appt December 16 to talk to him about Savella so that I could possibly get off of the Lortab completely. I then received a phone call from his assistant stating that he would no longer see me since I would not do the sleep study even though I have no symptoms requiring this study. Also when I was with my husband in another doctor’s waiting room a man came through and said, “If anyone needs pain meds forget staying here, follow me to Dr. ***.” He was talking about the doctor I see. Does this sound like a problem? Can he just stop seeing me? I know a lot of people that go to this doctor and get the same kind of meds in the same quantities.

  20. Jay Says:

    People with chronic pain have to suffer do the insensitive needs of those who are utilizing narcotics for the brief “High . Most chronic pain suffers need narcotics in addition to conservative therapies to help control their pain and to beable to do their daily activities without severe pain. These therapies only lessen the pain. Most Dr’s should be prescribing longer acting pain medication that works by keeping the blood levels of the drug in the system longer. Most chronic pain users aren’t looking for the “High”. Most become dependent on the medication, not addicted. Anyway unless you suffer from chronic pain it’s hard to explain why pain pills are needed. I try to live everyday to the fullest, I do use some conservative therapies that really don’t help alot. But if you did all the therapies that everyone says to do, heat – cold, PT,exercise, and the list goes on, you basically have no life. If a pill lets you live, and is not abused – then more power to you. Let the Drs treat their patients, without coming under fire.

  21. chronic pain suffer Says:

    I have extensive cavaties in my teeth. It’s something that runs in my family. My mom had it and had to get dentures at age thirteen. My dad also had to get dentures now I’m facing having to get dentures. The pain that I have experienced with almost all my teeth gone bad is best described as throbbing, itching, stabbing pain, pain that does NOT go away with motrin, tylenol or aspirin. The only thing that has seemed to work is Lortab. I don’t get high off it but I do get pain relief and it enables to sleep better. Doctors for the most part where I live don’t take my pain seriously. I’ve been treated like a scum bag junky and I have anxiety disorder. Meaning that I’m the type who is nervous to take an aspirin! I don’t even drink, do not use recreational drugs but yet it seems I’ve been treated like a junky just because I am wanting pain relief. Today I saw a dentist and she and her greasy haired assistant was so mean and cold to me, just acted like the pain was in my head, had me leaving crying my eyes out! I went into a severe panic attack, have had asthma all night as a result of the panic attack and was even thinking about hurting myself because I am just so damn sick and tired of being pushed around by unsympathetic and uncaring doctors who just act as though I’m faking it or that dental pain isn’t anything to worry about, that it’s just something that can be treated with motrin. Well if motrin worked I would hardly be at a dental clinic wasting my time and money! Its all the freaking drug abusers who make t increasingly impossible for people like me who TRULY have pain to recieve pain medication and when I do recieve it it’s not much but I’m just so happy to actually get some that I don’t care if it’s only 12 pills or 16 pills! I just feel that medical professionals should KNOW the difference between a drug seeker and an actual person in pain! Why is it that the druggies are still able to get way more drugs than anyone with chronic pain could hope for yet people like me get treated like scum bag drug seeker who’s pain is all her fault. I’ve been made to feel ashamed, embarassed, threatend and down right just awful in addition to the ongoing pain! My life has been hell for the last few months! I am getting the teeth removed but it’s going to take time and most doctors and dentists a like are not comfortable with Lortabs even though I take them exactly as they are prescribed and don’t even take them as often as they tell me to take them! Yet I still get the run around when I need relief! I just don’t understand nor do I feel that it’s ethical. It seems really inhuman to be made to suffer, to be made to feel like a failure or a low life just because I’m in pain and am wanting relief! I really hate the damn drug abusers!

  22. c rogers Says:

    REALY I DONT EVEN KNOW WHERE TO BEGAN IM 38 AND HAVE HAD BACK PROBLEMS FOR OVER 18 YEARS AND UNFORTUNANTLY MY PAIN HAS BECOME SO UNBARABLE THAT I FINALLY HAD TO GET HELP WITH THAT SAID AND 4 YEARS NOW IN PAIN MANAGEMENT AS WELL AS PHY. THERAPY 3 XS A WEEK FOR 5 MONTHS (INSURANCE STOPPED PAYING AND THERIPISTS SAID NOT ENOUGH IMPROVMENT TO CONTINUE, INJECTIONS , ACUPUCTURE, AND NOW TRYING YOGA. NOT TO MENTION THAT THE MEDS WORK AND I HAVE NO ADVERCE SIDE EFFECTS AT ALL ONLY PROBLEM IS IM A VERY HIGH DOSAGE PATIENT AND HAVE BEEN FROM DAY ONE NEEDLESS TO SAY THIS PUTS ME AT THE MERCY OF A DOCTOR THAT DEPENDING ON THE WEEK I SEE HIM DETERMINES MY MONTH (WILL I BE ABLE TO WORK, TAKE CARE OF MY 7 YEAR OLD SON,HAVE SEX WITH MY WIFE HELP MY 65 YEAR OLD MOTHER WITH HER PARENTS BOTH OVER 90 G MOM IS IN A NURSING HOME AND G DAD JUST HAD HIS FIRST STROKE THEN WILL I BE ABLE TO PLAY WITH 1 OF ARE 6 AKITAS OR EVEN RIDE 1 OF ARE ATVS WITH MY SON ) ITS SO SAD THAT A PERSON CONTROLS SO MUCH OF MY LIFE ONE MONTH EVERYTHING IS GREAT IV BEEN PRESCIBED THE ADAJET AMOUNT OF MEDS SO I CAN LIVE A DESGENT LIFE OR I MEAN MONTH CAUSE THE NEXT MONTH ITS LIKE THE DOCTOR HAS NEVER SEEN ME BEFOR ( OH MY GOD YOU ARE TAKING ALL THIS ) THEN ITS CUT 50 % OF WHAT IT TAKES JUST FOR ME TO DO MY BARE MIN. OF TRYING TO LIVE A NICE LIFE WITH SOME RELIEF FROM THIS PAIN AND THEN ITS ON AND OFF THE COUCH MY 60 HOUR WORK WEEK JUST TURNED INTO A 20 TO 30 HOUR WEEK NOW I CANT HELP MY MOTHER , WIFE, PLAY WITH SON BARLY ABLE TO WIPE MYSELF WITHOUT TEARS IN MY EYES FROM PAIN. THIS IS MY LIFE IV GOT THE MRIS THEY SHOW EVERY 2 YEARS MY BACK GETS WORSE SURGENS SAY 30% CHANCE OF IMPROVEMENT WITH SURGERY SORRY THAT’S NOT GOOD ODDS . IM SORRY I WOULD THINK THAT AFTER BEING WITH THE SAME DOCTOR FOR 4 YEARS HE WOULD UNDERSTAND BE KIND AND HAVE SOME TRUST FOR ME AND ALITTLE UNDERSTANDING INSTEAD OF ALWAYS PLAYING SOME SORT OF GOD WITH ME . THANKS FOR LETTING ME VENT CAUSE I DON’T KNOW WHAT TO DO AS MUCH AS ID LOVE TO GET A NEW DOCTOR THERE IS NO DOCTOR THAT WOULD TAKE ME IM AT THAT POINT WHERE I JUST WANT TO BE DONE WITH IT ALL I REALY DON’T KNOW HOW MUCH LONGER I CAN BE THIS DOCTORS PUPPET I REALY HAVE HAD IT AND THAT’S BAD TO COME FROM SOMEONE THAT’S SEE A LOT IN LIFE GOOD LUCK TO ALL THOSE OUT THERE THAT HAVE FOUND SUCCESS
    SERIOUSLY IN PAIN FROM MARYLAND C ROGERS

  23. Chronic Pain Sufferer ( Jason ) Says:

    LMFAO @ anyone that says that you should just have to deal with your pain. I herniated my L4-L5 disk back in 1997. It originally hurt pretty damn bad with shooting pains going down both of my legs. After about a year the pain kind of went away. For the next 7 years I had minimal or no pain problems and I was able to function normally without any medication or therapies. I believe that I have re-injured my back at least once or twice since then, and in 2003 I had a bad flare up of Ulcerative Colitis, and had to be on 60mg of Prednisone for over a year. Finally once the flare up was under control, I was taken off Prednisone. My Gastroenterologist told me that such a large dose of Prednisone taken over that long can weaken your muscles , especially around the injury , and thats when I began to have problems. Thats when I went and had an MRI done confirming what I had thought. I was put on just 30 pills of Percocet ( Oxycodone – APAP ) a month and that was not enough at the time. The medicine seemed to work though at first, and I have been able to live and function normally with moderate pain from 2005 to about 2010. Thats when I really began to have more problems and more pain. During that time period I have been on and off the Percocet , and I was prescribed another drug called OxyContin ( Oxycodone ER ) < which is an extended release form of the Percocet without the Tylenol and at a higher dose ( cause its 12 hour acting ) and that was taken for 6 months , and I gained almost total relief from pain from taking this. I lost my medical insurance cause I was working and making too much money to afford Government Insurance anymore , and my Doc said he would no longer fill the OxyContin until I made an appointment to see him despite knowing my circumstances. Not even a month later, I acquired medical insurance again and I made an appointment. At the appointment , my Doctor said that he went through a file that was in the system from when I went and saw a Psychiatrist years and years ago, and said he read the info in the file and determined that I had told the Psychiatrist that I sometimes use Marijuana to alleviate Pain or Stress, FROM THE DAMN BACK PAIN ! Cause when you dont have anything prescribed and are unable to get the help u need sometimes you just have to take care of yourself. I was flabbergasted to say the least. He said that I have the personality to become addicted to Narcotics cause I had told them I smoked weed sometimes ( very rarely at that ) and that I did it to alleviate the stress or pain. He refused to fill the Oxy and said that he did not want to at all anymore, and he started prescribing me Depression and Anxiety medicine and Nerve medicines like Cymbalta and Neurotin. I played his damn game for 3 or 4 months and told him that none of the crap is working , and I need something for the bad pain ! He still refused and I told him I was going to find a new doctor that would be willing to help me get some pain relief. I would also like to add that one of my friends , that I have known for a while , has an addiction problem to Oxy, and went to my doctor cause I had mistakenly told him who my Doc was , and my Doc was FEEDING his damn addiction , but I who is in TRUE pain couldnt get anything ! Then I went to another Doc who put me on Percocet again , and gave me 90 pills a month, that somewhat seemed to curb my pain and I was HAPPY that I was getting some relief but was afraid to tell the Doctor that it really wasnt enough. He told me that I was going to become addicted to the medicine , like that it would happen no matter what ( which isnt true ) . That I could only take it and he would only prescribe it for so long. Now mind you , all of these Doctors had me go get Epideral and Facet Injections ( that have done way more harm and pain than any Good ) , and had me go to Physical Therapy. I have been through Physical Therapy at least 6 times now since 2005. I even went to an 11 week program at the Physcians Neck & Back Clinic , and I got some relief from my muscles strengthening at first, but now I cant even go to PT cause of the amount of Pain that I am in., I have also felt like a Guinea Pig for different drugs, and that I have been and keep getting sent to get these worthless costly Injections ( that might help some people ) but have hurt me more than helped me. Last Year in the Fall I had to quit College , and I had to quit my job and cant work cause of the Debilitating pain. I made several appointments and told the Docs that I saw , what the pills did for me as far as pain relief, and none of them wanted to give me anything different , and the one I was just talking about, told me that I shouldnt need more than 3 percocet a day . Like how the hell would he know what kind of pain that Im in, and what I should or shouldnt need ? Obviously he didnt. I decided to go without them for several months. Then I tried to get back to work and school last year , and this year , and had to quit once again. I even filed for Social Security Disability cause I dont know how long this is going to last. I have been to the ER several times for out of control back pain in the last 6 months, while even being on Percocet. Then I had made an appointment and told my Doc what happened and that the Percocet wasnt controlling my pain. So he said ok take more Percocet a day, went from 6 to 10 a day and he said do that for 2 weeks and go back down to 6. WTF ? He obviously doesnt know how to manage Pain. I have got grief for calling in a day or two early when I had to take more than his routine prescribed despite my constant appointments and communications with him. I have been to the Spinal Surgeon twice now since 2005, and both times two different Surgeons from 2 different groups told me that Surgery wasnt an option for me and the risks and benifits were outweighed by the negatives. Ive been to an Orthopedist, Chiropractor, and most recently , been to PT to get Massage Therapy, which has landed me in the ER twice now afterwards. And the PT just cant figure why I cant get off the damn table afterwards or why Im having extreme pain when shes wrenching on the knots in my back by my injury. Not only that but she is trying to get my Doc to OK other Modalities and treat it , other than massage therapy , which is only and specifically what my Doc had ordered. Just another person that thinks that she can do other shit that I have already had done to me that makes things worse and NO ONE seems to listen to me. I told my Doc that I have been on OxyContin and that seemed to work the best, and he said we as Doctos like to reserve medications like that for the people In Hospice or that have Cancer ! Unbelievable ! Then last night after I couldnt walk or get in the car and drive home after PT, the ER Doc prescribed me 12 pills of Dilaudid ( which didnt do much ) and told me that I might just have to accept that I have pain and live with it . I was quite upset that he said that he has no right and no clue how much pain that I am in ! Its affected all areas of my life now, Work, school, Simple chores, trying to get exercise, My memory , my mood, my appetite , sleep , family , friends, social activites. I been hyperventilating lately, face tingling, breathing problems from being in out of control pain. I have even had the ER doc tell me he cant give me anything cause I on a Pain Contract with my Doc , and thats crap cause my Doc said that the ER doctors can do whatever they want cause they best qualified to treat the pain ur in right now. Didnt matter though. Told me that I couldnt get anything different to take home thats their policy that I had to get them from my Doc, gave me a shot and sent me home. BS !! Then I keep telling my Doc and he said well u need to go to a Pain Clinic. Says that the appt will be at least 2 to 3 months to get in ! Are u serious ? What the hell am I supposed to do in the meantime ? On top of that he expects me to go down from 10 to 6 pills a day this week, and the pills barely work but at least its something, and I need to take 3 percocet at a time, anymore than that , and it would be OD on the Tylenol. And im sick of not being able to control the Tylenol, in so many words he has said that he didnt want to give me the ones without the Tylenol in them cause they can be easily abused bla bla bla whatever. HORRIBLE pain management ! I recenbtly got a few pills from a friend they were OxyContins 20mg ,I ended up taking 2 total and felt absolutely fantastic ! I could get things done, I had energy and I could actually function ! SO i took it upon my own to find my own Pain Specialist that I didnt need a refferal to go to, and I have to wait until the 27th. Relief from this pain should be coming soon. In the meantime Im stangnent stuck in this Bullshit cycle of worthless pills every 4 hours 3-5 times a day. Its really hard to fathom when u look online and see all the different medications they can prescribe, like a higher does of immediate realease Oxy for breakthrough pain and long acting Oxy that lasts all day. That my friends is the only damn thing that works for ME . This recent Facet injections I agreed to do , have hurt me so bad since I got them, my pain has almost doubled , and still nothing new from my Primary MD. Just have to wait I guess. Its pure torture. Undertreatment is a serious issue in America, and people like us that have bad pain and legitimate issues get to suffer cause of it. Doctors are afraid to write prescriptions, and its BS , if u look at all the research online about it , there are Docotors that post Blogs online about how that other Doctors are just scared and just dont need to be if the cause is Legit. You just cant not give the patient relief and help that they need for fear of the DEA or crap like that. Oh and it also says that 90 % of the opiates opiods that are prescribed in America are to NON Hospice and NON Cancer patients. What does that tell ya ? lol i guess if ur a DOC and reading this and disagree u better go get u some pain management courses or something , or just learn to trust people, if they abuse it , then its on them, not you … you have MRI's and records and tons of therapies already tried and there is a huge difference between someone that is Dependent on their Narcotics for pain relief, and someone that is addicted to them and takes them just for the HI they get . I dont fucking get HI , I get pain relief and thats fine with me , and Im way past the Tolerance of side effects there are none for me . They work just fine at least the OxyContin does. I could go on and on about this. Ive never done any other drug in my life besides Marijuana , and that does help with the pain when nothing else is available or when I am out of Meds. Another thing my Primary MD said is that after time your pain receptors began to get used to the Narcotic , and that u will need more and more of it to get pain relief. All right Ill buy that for only so long. But also my most recent MRI shows that my Herniated Disc is protruding into my L5 nerve root. I think that had to do with moving the furniture when I had to move. Also lately it feels like something is really wrong back there bad stabbing aching pains that make me so I cant even move sometimes just pure Misery. Also when I was feeling good, I could do things and not need the Narcotic and went on and off it for months at a time. I know that Im not addicted. I think the Docs theory may be true to some extent but u cant just say that and thats it. there is something going on back there that HURTS me BAD !! something I have never experienced before , with the pain level being that it is. Pretty easy Cop out to say that its ur pain receptors getting used to it and thats it. Bullshit ! This shit hurts and if u or anyone else had it , u would know what I mean. I am no Doctor and have no medical schooling, but I know my damn Body better than any Doctor as far as what is going on inside it and what works and what doesnt. I see so much of people that u can tell they are telling the truth about Docs screening them and treated them as a Junkie cause they need pain relief. So much Red Tape BS !! Go look around online and google certain words , and u will see all the people and docs that support patients and ones that chastise them for seeking Pain Relief. BTW its more crap like driving to a Pain Clinic that is 30 miles away , when I cant even drive a damn car cause of the Pain, and that they expect u to just do all these treatments and u dont have a damn job or anything cause of the Pain u are in. One simple choice any Doc has is to help his patient and its not just a choice its an obligation. Ive done everything any Doc has ever asked me to do to try and fix the root of this problem, and well nothin works and all I know is I cant go in everyday being Miserable in every aspect of my damn life. Now anyone that disagrees try and put somethin on that !

  24. Chronic Pain Patient Says:

    http://www.druglibrary.org/schaffer/asap/dilemma.htm

    Read that ….please

  25. Debbie Says:

    My husband has degenerative disc disease. His doctor started him on percocets 7.5, then he went to percocets 10, then to percocet 15 and added oxycontin, now he raised it to percocet 30 plus oxycontin 80′s plus xanax and some kind of sleeping pill. He is a complete legal drug addict now. He never bathes, or even gets out of bed and when he does, he is extremely abusive and mean. When he uses all his pain meds too soon, he just visits the hospital and tells them he has kidney stones (which he does have a history of) and the hospital gives him morphine and more perocets. My mother also has degenerative disc disease and hers is much worse then my husbands, yet she seems to do just fine on Advil. Yep……….doctors are creating drug addicts.

  26. Jaycee Says:

    To Debbie on July 9th,

    If this helps: A person can have several herniated discs and not have any pain at all. It all depends upon if the herniation is compressing or interferring with a nerve or nerve root-that’s what causes the pain, not the herniation itself. So there can be a significant difference in pain levels between two different people. If the MRI shows that there is this type of problem and the doctor treats it-that’s legit. The physician does to some degree have to rely on the patient’s report of pain also. So don’t blame the doctor. Other patients have legitimate pain problems and truely need treatment in order to function. Pain management is very misunderstood by physicians healthcare workers, patients and laymen. And there is abuse-but there are also patients in real pain that need treatment-so you can’t lump everyone into one catagory. You need to address your husband’s drug use with him directly and bluntly if there’s a problem-as seems to be the case. If he is willing hopefully you can get him the help he needs with your support as stopping these meds is going quite difficult and he also may be very resistant to getting help-as it seems he will be, if things keep up your family may fall apart. Good luck to you, you have my sympathy.

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