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RoseRed135

The Opioid Crises - How do you believe it should be handled?

49 posts in this topic

The title question speaks for itself, I think...

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Fortunately we've avoided drug addiction within my immediate circle. 

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My older sister has numerous medical conditions an nearly as many drug allergies.  She has a non correctable back issue and after many years, she was prescribed opiates for her pain.  She has never abused them and has even learned to cope on a half a dose.  She is very concerned about this new law and wonders how she will get through day to day.  She works closely with her pain doctor.  

This time last year when her husband who is wheel chair bound but has driven with hand controls for many years fell and broke his hip, she found a "driver" and still uses her from time to time.  There are responsible people out there who are prescribed opiates because they need them.  She hasn't a clue what her medical future holds for her.

Though "addicted" she is not an drug addict.

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My heart goes out to your sister, Sue. She will be in my prayers...

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I got caught in hospital guidelines that said Drs did not have to treat someone w/chronic pain. So, there i was, my pain specialist was out of the country for months, did NOT have anyone managing his case load, my GP wasn't allowed to Rx narcotics (long story, that guy ended up going to the UK on vacation and not coming back), and I was at the ER, w/a note from my GP, stating that this is the dx I had, he couldn't treat it, and that if I needed narcotics, to please dispense them for me.

I sat in the ER w/screaming pain, for hours, until one of them deigned to see me. My hand was swollen and purple. And I got lectured about how LUCKY I was he decided to treat me, and blamed for my GP not Rxing meds, AND he demanded to know how my pain specialist could leave patients unattended. LIKE I KNEW ANY OF IT, or had any power over the situation.

If he'd refused to treat me, and I went to another ER, I would've been labelled a drug seeker. Despite having a clear dx of severe chronic pain disability. Next time I saw my pain specialist, I demanded 'break through' meds, b/c leaving me like that was horrific. I also told the ER dr that I wondered what would happen to the suicide rates among chronic pain sufferers, b/c if they're in the ER, it's b/c whatever they've got isn't working. They're already desperate (every chronic pain person I know lives in terror of being labelled a drug seeker, and/or becoming addicted).

I got 'lucky'. My pain specialist gave me break through meds, and I've been fortunate enough to have Drs since that know what my dx is (it's rare enough that I have to explain it to ER drs, OBs, and GPs. If they're not a pain specialist, anestisiologist, neurologist, or physiatrist, 99% chance they've never heard of it). I'm super careful about taking them, in fact I've been lectured, repeatedly, b/c I won't take them until pain levels are to the point I can barely think. I'm supposed to take them much earlier than that, but I loathe them so badly, and feel 'hung over' for at least a day after.

Thankfully, I'm in Canada, and there are other options for pain management now that doesn't have the side effect that the other narcotics do. so I'm able to achieve a better quality of living w/those, but still have the other narcotics as back up.

ETA: Here, ERs have signs about if you have chronic pain, you will be refused treatment for it. And, there's a GP shortage in many areas...but walk in clinics ALSO refuse to Rx narcotics. So, unless you've got a specialist, or a GP, and have chronic pain, you're twisting in the wind. That's why we travel 2+ hrs each way to ours.

Edited by ImpishMom

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@ImpishMom- So sorry you went through this! Glad you have other options now, but still... feel for you and your having to "travel 2+ hours each way" to your GP. :(

Edited by RoseRed135

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4 minutes ago, RoseRed135 said:

@ImpishMom- So sorry you went through this! Glad you have other options now, but still... feel for you and your having to "travel 2+ hours each way" to your GP. :(

The problem is, chronic pain patients are lost in the shuffle. And it's our quality of life that suffers, and with us, our loved ones. Chronic pain patients commit suicide b/c they can't take it another moment.

And having a blanket policy as to refusing to treat it...well, it might prevent some from faking, but it's punishing those that legitimately live with it.

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1 hour ago, ImpishMom said:

The problem is, chronic pain patients are lost in the shuffle. And it's our quality of life that suffers, and with us, our loved ones. Chronic pain patients commit suicide b/c they can't take it another moment.

And having a blanket policy as to refusing to treat it...well, it might prevent some from faking, but it's punishing those that legitimately live with it.

That's a horrible "catch 22"...it's not that different here. DH's medical oncologist was very on board managing his pain as was his internist...they worked together to keep him as comfortable as possible. I think he lived on Norco for several years. 

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1 minute ago, Mame925 said:

That's a horrible "catch 22"...it's not that different here. DH's medical oncologist was very on board managing his pain as was his internist...they worked together to keep him as comfortable as possible. I think he lived on Norco for several years. 

Honestly, it's one of the big reasons I've been for legalization of marijuana. 

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Just now, ImpishMom said:

Honestly, it's one of the big reasons I've been for legalization of marijuana. 

Totally agree....is CBD oil available in Canada? If so, its available online...DH couldn't smoke pot as the cancer metastasized to his lungs, but he did eat it and took it in pill form (Marinol, available by prescription here). I didn't know about the availability of the oil until after DH's death.

Here is a reasonably comprehensive report, if you aren't already familiar with the properties.

Medical News Today CBD Oil

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Yep, I have both CBD and THC strains. One for pain, one for sleep (sleep = less pain more effectively for me).

ETA: they are legally prescribed for me, not something I'm just winging, to clarify.

Edited by ImpishMom
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Take on the big pharma companies that started this crisis and knew going in how addictive and destructive these opioids are.   Bleed them dry like we did the tobacco companies who also knew about nicotine addiction and its effects; put very strict controls on who gets to use these meds going forward, use the profits you take from big pharma to fund research into effective rehabilitation- namely developing drugs that can be taken to shut off the need to use opioids and other drugs like heroin.  Scripps Research Institute is working on a vaccine for heroin - which is so promising.  A vaccine like this may open the door for other vaccines like ones for opioids; Permanently remove licenses from docs and aggressively prosecute docs who prescribe these drugs to fuel an addiction and not for the intended purpose of the drug. 

**** Trigger **** This hits home with me as my DS's closest friend from high school overdosed and died 6 weeks ago from a heroin overdoes that started with opioid usage.  He was 18 years old, a sweet boy who loved his family, funny, witty, a gifted violinist, exceptionally bright kid - started freshman year of high school with the goal of being valedictorian as he was that smart and determined.  By his senior year he was in rehab.  He managed to get clean and graduate high school.  My DS talked to him the week before he died, and he sounded good and upbeat about his sobriety and his future as he postponed college to focus on his recovery.  He obviously relapsed and used heroin which is a common drug opioid users switch to as it is easier to get and cheaper - and he died.   Had it not been for the opioids that were so readily available to him that started this addiction, I think he would still be alive today.  His story is not unique, unfortunately.  This is an epidemic with devastating consequences to those effected by it. 

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3 hours ago, ImpishMom said:

The problem is, chronic pain patients are lost in the shuffle. And it's our quality of life that suffers, and with us, our loved ones. Chronic pain patients commit suicide b/c they can't take it another moment.

And having a blanket policy as to refusing to treat it...well, it might prevent some from faking, but it's punishing those that legitimately live with it.

Hmmm... It's almost as if, in some places, there's a kind of overall social/political denial that such conditions exist...  sad...

Edited by RoseRed135

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11 minutes ago, BSW said:

**** Trigger **** This hits home with me as my DS's closest friend from high school overdosed and died 6 weeks ago from a heroin overdoes that started with opioid usage.  He was 18 years old, a sweet boy who loved his family, funny, witty, a gifted violinist, exceptionally bright kid - started freshman year of high school with the goal of being valedictorian as he was that smart and determined.  By his senior year he was in rehab.  He managed to get clean and graduate high school.  My DS talked to him the week before he died, and he sounded good and upbeat about his sobriety and his future as he postponed college to focus on his recovery.  He obviously relapsed and used heroin which is a common drug opioid users switch to as it is easier to get and cheaper - and he died.   Had it not been for the opioids that were so readily available to him that started this addiction, I think he would still be alive today.  His story is not unique, unfortunately.  This is an epidemic with devastating consequences to those effected by it. 

So sorry for the loss of DS' friend and how it happened. Very sad.

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12 minutes ago, RoseRed135 said:

Hmmm... It's almost as if, in some places, there's a kind of overall social/political denial that such conditions exist...  sad...

Actually, it's more of a matter of, a chronic pain patient has no visible injury, ergo, it's hard to determine if it's real in the ER...or so they say. Here, all things are connected via the mighty computer system and provincial health care number. Easy enough to pull up the file, and oh! This person was dx'd w/this condition 9 years ago, this is what they've been on this is the last time it was filled, blah blah blah. I don't understand why they don't pull up such things during admitting, when they're doing all the other paperwork. 

I know when I see one specialist, my GP can pull up their notes and see what was discussed, what meds are Rx'd, etc.

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27 minutes ago, ImpishMom said:

I know when I see one specialist, my GP can pull up their notes and see what was discussed, what meds are Rx'd, etc.

This is a huge benefit of the electronic superhighway...and should be used everywhere. This is a very simple way to track patterns of prescriptions/abuse. Reading Imp's "summary" would show her diagnosis/date/ongoing care. Treating her, while a very complicated scenario, would be relatively straightforward. 

Frankly, the corporate medical community needs to get the suits out and the practioners back in as directors...and get back to patient care focus and not $$$ focus.

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54 minutes ago, Mame925 said:

This is a huge benefit of the electronic superhighway...and should be used everywhere. This is a very simple way to track patterns of prescriptions/abuse. Reading Imp's "summary" would show her diagnosis/date/ongoing care. Treating her, while a very complicated scenario, would be relatively straightforward. 

Frankly, the corporate medical community needs to get the suits out and the practioners back in as directors...and get back to patient care focus and not $$$ focus.

That's the hilarious part: it's really NOT complicated. I've been dealing w/this for 9 yrs now.

I take *one* break through med, as needed, for when the THC/CBD isn't covering it. 

That's it.

But b/c one's a narcotic, and the other is marijuana, only 2 sources will Rx it for me.

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10 hours ago, BSW said:

Take on the big pharma companies that started this crisis and knew going in how addictive and destructive these opioids are.   Bleed them dry like we did the tobacco companies who also knew about nicotine addiction and its effects; put very strict controls on who gets to use these meds going forward, use the profits you take from big pharma to fund research into effective rehabilitation- namely developing drugs that can be taken to shut off the need to use opioids and other drugs like heroin.  Scripps Research Institute is working on a vaccine for heroin - which is so promising.  A vaccine like this may open the door for other vaccines like ones for opioids; Permanently remove licenses from docs and aggressively prosecute docs who prescribe these drugs to fuel an addiction and not for the intended purpose of the drug. 

**** Trigger **** This hits home with me as my DS's closest friend from high school overdosed and died 6 weeks ago from a heroin overdoes that started with opioid usage.  He was 18 years old, a sweet boy who loved his family, funny, witty, a gifted violinist, exceptionally bright kid - started freshman year of high school with the goal of being valedictorian as he was that smart and determined.  By his senior year he was in rehab.  He managed to get clean and graduate high school.  My DS talked to him the week before he died, and he sounded good and upbeat about his sobriety and his future as he postponed college to focus on his recovery.  He obviously relapsed and used heroin which is a common drug opioid users switch to as it is easier to get and cheaper - and he died.   Had it not been for the opioids that were so readily available to him that started this addiction, I think he would still be alive today.  His story is not unique, unfortunately.  This is an epidemic with devastating consequences to those effected by it. 

I understand- I agree completely- And Im sorry he didnt make it- Few do- Families nearly die trying to keep those they love from relapsing- Its devastating- 

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On ‎11‎/‎7‎/‎2017 at 9:38 PM, Komorebi said:

I understand- I agree completely- And Im sorry he didnt make it- Few do- Families nearly die trying to keep those they love from relapsing- Its devastating- 

Twenty years from now, I think more people like my DS's friend will be able to rehab and not relapse due to advancements being made in pinpointing why it is that some people can use drugs or drink alcohol and not get addicted vs. the ones who do - and discoveries in drug therapy to treat this part of their brain so that the need to use opioids is shut down.   

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I think it's crazy the way opioids are prescribed for everything from root canal, broken arm, to post major surgery but back at home. Opioids have their place in pain management but are treated like aspirin without thought about possible addiction by far too many doctors who seem to be in a hurry to get a patient out the door instead of investigating what is really needed to treat a problem. My list was all the things I experienced and was given a prescription for opioids but did not fill the prescription. I was OK on Tylenol and didn't need stronger drugs. I had temporary pain, I  could cope and just needed enough relief to sleep and rest. Why offer powerful, addictive drugs before it's known if a patient actually needs them?   Obviously different people have different levels of pain tolerance and some conditions need more help with pain than others, but wouldn't it be much wiser to wait and see instead of passing out opioids before trying a safer alternative first?

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What few opiods I've ever taken have given me night terrors....not gonna get any restful, healing sleep that way! So I won't take them. Most OTC pain relievers have a "prescription strength" dosage not listed on the container that your doctor should be telling you to try first. For a surgery, since I refuse the hard stuff, my doctor prescribed 500mg of naproxyn...two every 8 hours as needed...thats 1000mg...the OTC pills are 225mg...the prescription is more meds in each pill. It worked well, no side effects. 

Same with things like Mucinex...coughs from my colds are legendary....with accompanying chest congestion...I was advised to double the recommended package dose...and got good relief. 

ASK QUESTIONS...participate in your own care...made the doctors to their job...they can be just as complacent and lazy as everyone else.

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5 hours ago, missmm said:

I think it's crazy the way opioids are prescribed for everything from root canal, broken arm, to post major surgery but back at home. Opioids have their place in pain management but are treated like aspirin without thought about possible addiction by far too many doctors who seem to be in a hurry to get a patient out the door instead of investigating what is really needed to treat a problem. My list was all the things I experienced and was given a prescription for opioids but did not fill the prescription. I was OK on Tylenol and didn't need stronger drugs. I had temporary pain, I  could cope and just needed enough relief to sleep and rest. Why offer powerful, addictive drugs before it's known if a patient actually needs them?   Obviously different people have different levels of pain tolerance and some conditions need more help with pain than others, but wouldn't it be much wiser to wait and see instead of passing out opioids before trying a safer alternative first?

The few times I've had an opioid prescribed, the doctor always said, in effect, "If you need it." IOWs, the idea was to fill the prescription if Tylenol or Advil didn't suffice. I never filled any of those prescripttions. I hope most people don't, unless the pain just isn't eased by over-the-counter meds. As Mame suggests, we need to "participate in (our) own care."

Granted, I realize, a patient can have a real need for the opiate and then become addicted. I'm just speaking here^^^^ of those who do well on a "safer alternative."

Edited by RoseRed135

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3 hours ago, missmm said:

I think it's crazy the way opioids are prescribed for everything from root canal, broken arm, to post major surgery but back at home. Opioids have their place in pain management but are treated like aspirin without thought about possible addiction by far too many doctors who seem to be in a hurry to get a patient out the door instead of investigating what is really needed to treat a problem. My list was all the things I experienced and was given a prescription for opioids but did not fill the prescription. I was OK on Tylenol and didn't need stronger drugs. I had temporary pain, I  could cope and just needed enough relief to sleep and rest. Why offer powerful, addictive drugs before it's known if a patient actually needs them?   Obviously different people have different levels of pain tolerance and some conditions need more help with pain than others, but wouldn't it be much wiser to wait and see instead of passing out opioids before trying a safer alternative first?

Here's the problem. Pain often amps up at night. So, you go home, and round about 1am, the pain starts to scream. So, now what? Head to the ER? You can, but runs the risk of 1. not being treated and 2. Hello, costs. and 3. White knuckle it til the Drs office opens, and pray they'll fit you in, and then there's the bill for 2nd appointment. (Here, narcotics can't be phoned in).

It's better, from the Dr's perspective and standard of care, to give an Rx to use if the patient needs it. Leaving a patient to suffer for hours, needlessly, isn't a choice a physician would make. Falls under the 'do no harm', I would think.

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So many stories about opioid addiction start with " My daughter/son had their wisdom teeth pulled(or some other procedure) and was prescribed an opioid, two weeks worth. And then they were addicted and living hell began".  There are a lot of people who do think that if a doctor prescribed something then it's both safe and the doctor meant them to use it. And the US is in a major crisis with opioid abuse so I would think that looking at how the drugs are prescribed and for what would be a good place to at least start. It's a lot easier to prevent an addiction than to treat one.

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1 hour ago, missmm said:

So many stories about opioid addiction start with " My daughter/son had their wisdom teeth pulled(or some other procedure) and was prescribed an opioid, two weeks worth. And then they were addicted and living hell began".  There are a lot of people who do think that if a doctor prescribed something then it's both safe and the doctor meant them to use it. And the US is in a major crisis with opioid abuse so I would think that looking at how the drugs are prescribed and for what would be a good place to at least start. It's a lot easier to prevent an addiction than to treat one.

But it's also not ok to allow people to suffer, either. There's a need to balance the suffering of the patient vs potential risks.

People who are left with inadequate pain management have a host of related health issues. Including higher rates of suicide. That's not acceptable either.

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