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Posted: 2/25/2019 8:15:27 PM EST

[#1]

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I have an answer, most of GD would rather take chemicals then use a plant that has no reported deaths.

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So, what would you have someone who is in excruciating pain and has found an opioid that works for them, take?

Just tough it out with some ibuprofen?

"Oh, you have 5 crushed disks and constant nerve pain? Well, we can't have you taking an opioid. You might get addicted. Much better for you to live in agonizing pain so we feel better about ourselves".

I have an answer, most of GD would rather take chemicals then use a plant that has no reported deaths.

There was that one guy who tried to hacky sack a tarantula...

Posted: 2/25/2019 8:16:21 PM EST

[#2]

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Yeah, like shooting them with a fentanyl-tipped dart

You know how "admitting you have a problem" is the first step in addiction management? It's because a shitload of addicts are in denial. The pain becomes a means of justifying the addiction, even when the body reacts more violently to withdrawal than to the existing condition. I'd have no problem letting people zonk-out on their Soma of choice if they prefer being stoned to reality, but it becomes my business when they crash cars, crime, expose kids to the stuff, attract pushers, and fund a foreign government's destructive ambitions on my nation's soil.

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It’s almost like you don’t understand how black markets work, and why they exist.

Posted: 2/25/2019 8:17:38 PM EST

[#3]

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If it isn't a function of free will then we must treat addicts as victims whose station in life is due to factors beyond their control. Ergo, the addict that is intoxicated and gets in a car wreck and kills your family cannot be held accountable no more than the diabetic that suffers a diabetic emergency and gets in a car wreck and kills your family could be held accountable.

Free will doesn't factor in the ease of doing something, just the conscious choice to do it or not. An addict will most definitely have a difficult time freeing him/herself of the addiction, but at any given time he/she has the free will to make the choice to start down that road.

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Yes, some people are more vulnerable to addiction in general as well as opioid-specific problems, some are more or less effected by the numbing effect. These factors partially explain why some have no issues, why others have terrible issues, but are completely irrelevant to the fact that obviously far too many users have issues for whatever reason. Your argument that "many can handle the drugs so they aren't the problem" is as worthless as me claiming the same about pain. Many can handle the pain, after all (so called "pain tolerance").

The remainder of your post suggests addiction is a function of free will, and addicts are only a problem to themselves. OK, then, lol, I think we're done here.

If it isn't a function of free will then we must treat addicts as victims whose station in life is due to factors beyond their control. Ergo, the addict that is intoxicated and gets in a car wreck and kills your family cannot be held accountable no more than the diabetic that suffers a diabetic emergency and gets in a car wreck and kills your family could be held accountable.

Free will doesn't factor in the ease of doing something, just the conscious choice to do it or not. An addict will most definitely have a difficult time freeing him/herself of the addiction, but at any given time he/she has the free will to make the choice to start down that road.

LOL, we either tolerate junkies or we can’t punish them accountable for anything.

Sounds like junkie-logic, lol

Posted: 2/25/2019 8:34:46 PM EST

[#4]

So I was taking pain meds after two failed back surgeries. One in 2004 & one in 2007. Back this past year I was taking 4 of the 10/325 Norcos or hydrocodones a day. My pain doc who was a staff anesth. at the hospital said he was under increasing scrutiny over pain med scripts and that he had to cut me back to 3 per day in two months. He suggested that I break them in half and start tapering down to 3 a day.

So I did this, but every 3 or 4 days I kept reducing my doses. Long story short is that I completely quit the meds in just over three weeks. I jonesed a bit at night but nothing severe. So after stopping my pain meds I still have pain but surprisingly have less than when I was on the meds. I still take Gabapentin and a muscle relaxer at night but if I start hurting really bad I take a Tylenol.

The thought of going cold turkey if I showed up to my doc's office and he stopped being able to write scripts was not a pleasant thought. I think I was blessed to be able to come off those meds so easily. I can't use cannabis due to my position doing defense contract work. If that should change you bet I'll go that route.

Posted: 2/25/2019 8:40:03 PM EST

[#5]

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So I was taking pain meds after two failed back surgeries. One in 2004 & one in 2007. Back this past year I was taking 4 of the 10/325 Norcos or hydrocodones a day. My pain doc who was a staff anesth. at the hospital said he was under increasing scrutiny over pain med scripts and that he had to cut me back to 3 per day in two months. He suggested that I break them in half and start tapering down to 3 a day.

So I did this, but every 3 or 4 days I kept reducing my doses. Long story short is that I completely quit the meds in just over three weeks. I jonesed a bit at night but nothing severe. So after stopping my pain meds I still have pain but surprisingly have less than when I was on the meds. I still take Gabapentin and a muscle relaxer at night but if I start hurting really bad I take a Tylenol.

The thought of going cold turkey if I showed up to my doc's office and he stopped being able to write scripts was not a pleasant thought. I think I was blessed to be able to come off those meds so easily. I can't use cannabis due to my position doing defense contract work. If that should change you bet I'll go that route.

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Awesome to hear and very reflective of what studies have shown. Do you go to a physical therapist as well?

Posted: 2/25/2019 8:44:41 PM EST

[#6]

No, not now. I haven't done any therapy in over 12 years. It only seemed to aggravate my symptoms. I have some permanent spinal cord damage and will have to live with some level of pain the rest of my life. I've just learned to know my limits. I can't do all the things I used to do. Just have to pace myself. Walking seems to help me more that anything. Also good bourbon and cigars.

Posted: 2/25/2019 8:46:19 PM EST

[#7]

Have I been missing these kind of threads? This is better than an abortion/taylor swift thread

Posted: 2/25/2019 9:06:53 PM EST

[#8]

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I keep seeing everybody talk about long term side effects but nobody actually says what those are? Can you provide links or studies that show what 1 year, 5, year and 10 year managed morphine or opiate use does negatively? Are people just regurgitating talking points or can you drop some real info?

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Muh drug war!

Posted: 2/25/2019 9:12:53 PM EST

[#9]

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Muh drug war!

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I keep seeing everybody talk about long term side effects but nobody actually says what those are? Can you provide links or studies that show what 1 year, 5, year and 10 year managed morphine or opiate use does negatively? Are people just regurgitating talking points or can you drop some real info?

Muh drug war!

Yep, here's the thing. Even with the negatives of opiates you also have some pretty negative effects from being in long term pain. So given the option most people will op for less pain and some negative, versus pain and also negative issues from the pain. You really can't win if your in chronic pain. All the other shit listed like Nsaids, benzo's, gabapentin all that shit has equal amounts of negative side effects as well.

Posted: 2/25/2019 9:19:57 PM EST

[#10]

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Have I been missing these kind of threads? This is better than an abortion/taylor swift thread

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In my short time here, I've learned that arfcom is very passionate about the pain pill topic.

Posted: 2/25/2019 10:38:53 PM EST

[#11]

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What else should they tell them? The "opioid crisis" has little to do with chronic pain sufferers who are taking a medically prescribed treatment and much more to do with people who chose to illicitly inject street drugs like heroin and fentanyl which are being imported into the country by the container load.

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lol

The opiod crisis, just like the obesity crisis, is the result of human nature, nothing else. It's not the government's "fault" it's not the FDA's "fault" - it the fault of peoples' choices.

Dr's prescribe them based on the labeling though, so as noted with posters above, they are told, "keep shoveling these pills in your mouth".

What else should they tell them? The "opioid crisis" has little to do with chronic pain sufferers who are taking a medically prescribed treatment and much more to do with people who chose to illicitly inject street drugs like heroin and fentanyl which are being imported into the country by the container load.

There's probably a selection bias because I don't hang out with certain types of people, but every narcotics addict I know personally started with medically prescribed treatment. Some were already alcoholics and just switched to narcs, some were pretty imbalanced, and some were normal people with no interest in getting high, they just had the meds after joint surgery because they hurt like crazy, and when it came time to quit.... found that they couldn't. At least one that I know went back to his doctor and told him straightforward... "Doc, I'm having a really hard time quitting." The doctor (and I hope this is uncommon) didn't seem to care, he just said "Well, try to taper off of them", and then... refilled his prescription.

Posted: 2/25/2019 11:25:04 PM EST

[#12]

Haven’t read every post in the thread. When I was in residency it was the the tail end of “pain as the 5th vital sign” and beginning of, “anyone coming in with a complaint of diverticulitis or anyone allergic to morphine and synthetic equivalents, but did ok with an accompanying dose of IV Benadryl “ was a thing. My last year of med (Podiatry) school I witnessed 2 inpatients narc out within a month and participated in both of their codes. First year of residency, during orientation, we were casually informed that hospital reimbursement was tied to patient’s satisfaction scores, 20% of which was comprised of pain control, if you get my drift.

Thoughts and protocols started changing 2012/2013, but we were still pressured by admin for above average patient satisfaction scores. By the end of my 1st year I was checking certain patients against other system facilities as they seemed to say all the buzz words. I noticed that they would rotate through the different hospitals in the system on a 2-3 week schedule. Brought this up to my team leader (most senior internal medicine resident on my 12 month internal med rotation) and he almost got suspended by an attending for denying excessive pain meds, specifically dilaudid with an IV Benadryl kicker, to a frequent flyer. I respected the shit out of him for willing to take a look and back me up after reviewing the medical records.

This wasn’t the norm, but was a common enough occurrence that we were all checking previous admits for telltale signs of drug seeking behavior. It wasn’t just me, it was all of the newer residents noticing a shift in the way that patients reacted to questions and their willingness to tell us they would negatively rate the hospital for pain management satisfaction Becca of the weight placed on pain management satisfaction scores for Medicare reimbursement.

Posted: 2/25/2019 11:35:27 PM EST

[#13]

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So I was taking pain meds after two failed back surgeries. One in 2004 & one in 2007. Back this past year I was taking 4 of the 10/325 Norcos or hydrocodones a day. My pain doc who was a staff anesth. at the hospital said he was under increasing scrutiny over pain med scripts and that he had to cut me back to 3 per day in two months. He suggested that I break them in half and start tapering down to 3 a day.

So I did this, but every 3 or 4 days I kept reducing my doses. Long story short is that I completely quit the meds in just over three weeks. I jonesed a bit at night but nothing severe. So after stopping my pain meds I still have pain but surprisingly have less than when I was on the meds. I still take Gabapentin and a muscle relaxer at night but if I start hurting really bad I take a Tylenol.

The thought of going cold turkey if I showed up to my doc's office and he stopped being able to write scripts was not a pleasant thought. I think I was blessed to be able to come off those meds so easily. I can't use cannabis due to my position doing defense contract work. If that should change you bet I'll go that route.

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There is some evidence that patients taking high doses of opiates on a regular schedule become resistant to the analgesic effects and that decreasing dosage gradually can actually make them a bit opiate naive and have a better pain relief response after dialing back the dosage and changing the combination of medications for chronic pain. This was research presented to us in 2014 by our pain management and addiction faculty when I was finishing residency, so my info may be a bit dated. Now, I prescribe for acute, post op pain and will refer to pain management/ physical medicine and rehab when I am dealing with chronic pain patients.

I also will not prescribe ANY narcotics to a surgical patient already under care of a pain management doc. All of them have contracts with their patients with regards to medications and I am not going to be the guy that causes a breach of contract. After setting up a surgery, my first call is to the pain doc to inform them of the planned procedure to talk about symptoms, likelihood of success, as well as post op pain protocols.

Posted: 2/26/2019 12:54:24 AM EST

[#14]

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This wasn’t the norm, but was a common enough occurrence that we were all checking previous admits for telltale signs of drug seeking behavior. It wasn’t just me, it was all of the newer residents noticing a shift in the way that patients reacted to questions and their willingness to tell us they would negatively rate the hospital for pain management satisfaction Becca of the weight placed on pain management satisfaction scores for Medicare reimbursement.

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A neighbor of mine is a pharmacist, and says that a not-insignificant portion of every single day is spent dealing with drug-seekers. "Oh, someone stole your freshly-filled bottle of narcotics for the third time this year? Sure, just get us a police report for the theft, and we'll replace it."

Posted: 2/26/2019 12:59:35 AM EST

[#15]

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A neighbor of mine is a pharmacist, and says that a not-insignificant portion of every single day is spent dealing with drug-seekers. "Oh, someone stole your freshly-filled bottle of narcotics for the third time this year? Sure, just get us a police report for the theft, and we'll replace it."

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This wasn’t the norm, but was a common enough occurrence that we were all checking previous admits for telltale signs of drug seeking behavior. It wasn’t just me, it was all of the newer residents noticing a shift in the way that patients reacted to questions and their willingness to tell us they would negatively rate the hospital for pain management satisfaction Becca of the weight placed on pain management satisfaction scores for Medicare reimbursement.

A neighbor of mine is a pharmacist, and says that a not-insignificant portion of every single day is spent dealing with drug-seekers. "Oh, someone stole your freshly-filled bottle of narcotics for the third time this year? Sure, just get us a police report for the theft, and we'll replace it."

Yep, I have diverticulitis, IBS, Crohns, I’m 10/10 pain, but I’m allergic to narcotics. The only thing I can tolerate is IV dilauadid, but it makes me itch so bad, I also need Benadryl.

Posted: 2/26/2019 1:03:25 AM EST

[#16]

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There is some evidence that patients taking high doses of opiates on a regular schedule become resistant to the analgesic effects and that decreasing dosage gradually can actually make them a bit opiate naive and have a better pain relief response after dialing back the dosage and changing the combination of medications for chronic pain. This was research presented to us in 2014 by our pain management and addiction faculty when I was finishing residency, so my info may be a bit dated. Now, I prescribe for acute, post op pain and will refer to pain management/ physical medicine and rehab when I am dealing with chronic pain patients.

I also will not prescribe ANY narcotics to a surgical patient already under care of a pain management doc. All of them have contracts with their patients with regards to medications and I am not going to be the guy that causes a breach of contract. After setting up a surgery, my first call is to the pain doc to inform them of the planned procedure to talk about symptoms, likelihood of success, as well as post op pain protocols.

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I hate to ask, but what the hell it's GD, and I think I got an expert here.

What kind on injury would be like a bone bruise in the heel area that when I had it xray'd/eval'd in November by a sports Dr. showed nothing wrong. She diagnosed it as a bone bruise. This is the most nagging injury I've ever had. She gave me a boot, and I wore it the prescribed time. I knew it wasn't doing it's job though even when wearing it. It simply won't get better, I guess my next step is to get in the tunnel.

Posted: 2/26/2019 1:17:27 AM EST

[#17]

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I hate to ask, but what the hell it's GD, and I think I got an expert here.

What kind on injury would be like a bone bruise in the heel area that when I had it xray'd/eval'd in November by a sports Dr. showed nothing wrong. She diagnosed it as a bone bruise. This is the most nagging injury I've ever had. She gave me a boot, and I wore it the prescribed time. I knew it wasn't doing it's job though even when wearing it. It simply won't get better, I guess my next step is to get in the tunnel.

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Bone bruise in the heel... when does it really hurt, like you can’t walk? Does it get a bit better you “ walk it off” over a couple of minutes? Have you gotten a steroid injection in your heel, or have you been prescribed an oral steroid like prednisone? Do you go barefoot at home? Are you on your feet a lot for work? Have you tried a decent arch support (not dr scholl’s) in your shoes? My recommendation would be superfeet or powerstep. You can find both on amazon for $50 or less.

That advice is expensive, which is stupid. Fucking insurance companies.

Posted: 2/26/2019 1:23:32 AM EST

[#18]

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What kind on injury would be like a bone bruise in the heel area that when I had it xray'd/eval'd in November by a sports Dr. showed nothing wrong. She diagnosed it as a bone bruise.

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The last one I had, the doc said 1-3 months to heal. A month or two later, it wasn't healed at all. Doc said that hot soaks would speed it up, I started soaking in a hot tub every night, it healed up a few weeks later. They can take a long time. Like your case, they don't really show up on x-rays.

Posted: 2/26/2019 1:23:47 AM EST

[#19]

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Yep, I have diverticulitis, IBS, Crohns, I'm 10/10 pain, but I'm allergic to narcotics. The only thing I can tolerate is IV dilauadid, but it makes me itch so bad, I also need Benadryl.

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This wasn't the norm, but was a common enough occurrence that we were all checking previous admits for telltale signs of drug seeking behavior. It wasn't just me, it was all of the newer residents noticing a shift in the way that patients reacted to questions and their willingness to tell us they would negatively rate the hospital for pain management satisfaction Becca of the weight placed on pain management satisfaction scores for Medicare reimbursement.

A neighbor of mine is a pharmacist, and says that a not-insignificant portion of every single day is spent dealing with drug-seekers. "Oh, someone stole your freshly-filled bottle of narcotics for the third time this year? Sure, just get us a police report for the theft, and we'll replace it."

Yep, I have diverticulitis, IBS, Crohns, I'm 10/10 pain, but I'm allergic to narcotics. The only thing I can tolerate is IV dilauadid, but it makes me itch so bad, I also need Benadryl.

I don't get it, what does the benadryl do?

Posted: 2/26/2019 1:26:07 AM EST

[#20]

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I don't get it, what does the benadryl do?

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This wasn't the norm, but was a common enough occurrence that we were all checking previous admits for telltale signs of drug seeking behavior. It wasn't just me, it was all of the newer residents noticing a shift in the way that patients reacted to questions and their willingness to tell us they would negatively rate the hospital for pain management satisfaction Becca of the weight placed on pain management satisfaction scores for Medicare reimbursement.

A neighbor of mine is a pharmacist, and says that a not-insignificant portion of every single day is spent dealing with drug-seekers. "Oh, someone stole your freshly-filled bottle of narcotics for the third time this year? Sure, just get us a police report for the theft, and we'll replace it."

Yep, I have diverticulitis, IBS, Crohns, I'm 10/10 pain, but I'm allergic to narcotics. The only thing I can tolerate is IV dilauadid, but it makes me itch so bad, I also need Benadryl.

I don't get it, what does the benadryl do?

Antihistamine, It will stop the reaction that is causing the itch

Posted: 2/26/2019 1:28:03 AM EST

[#21]

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Bone bruise in the heel... when does it really hurt, like you can’t walk?Only the first month or so after the injury was it almost crippling to walk on it for more than minute or so, these days I can walk for about 10 mins. on a time pain free usually, and then the ache slowly builds to wear I got to take the load off. Does it get a bit better you “ walk it off” over a couple of minutes? really the opposite, anything over 10mins of activity on it, and I start to notice the building ache....granted I never take advil for example for it, as simply sitting down with weight off it will alleviate the pain Have you gotten a steroid injection in your heel, or have you been prescribed an oral steroid like prednisone?Nope, I'm hard headed and weary of doctors even though my sister is a trauma/general surgeon

Do you go barefoot at home? Almost never, have a pair of new balance shoes I walk around in til it's bed time Are you on your feet a lot for work? Just depends, some days several hours on and off Have you tried a decent arch support (not dr scholl’s) in your shoes? My recommendation would be superfeet or powerstep. You can find both on amazon for $50 or less. Great advice, and I'll look into grabbing a pair

That advice is expensive, which is stupid. Fucking insurance companies.

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Your the man, I sincerely appreciate the reply. Fucking insurance is right, I got BCBS and paid $250 out of pocket for that boot

This was a truly stupid injury cause by me continuing to kick a old dirt bike's kick starter. I just can't believe it's so nagging. I took feet for granted til this incident.

Posted: 2/26/2019 1:29:22 AM EST

[#22]

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The last one I had, the doc said 1-3 months to heal. A month or two later, it wasn't healed at all. Doc said that hot soaks would speed it up, I started soaking in a hot tub every night, it healed up a few weeks later. They can take a long time. Like your case, they don't really show up on x-rays.

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Thanks so much for that reply!!!

I'm going to do just that treatment!

Posted: 2/26/2019 1:29:30 AM EST

[#23]

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Antihistamine, It will stop the reaction that is causing the itch

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Oh, I figured they must be using it to their advantage to get even higher somehow.

I've never been in a position to ask or remember a lot of questions and answers in the situations where I was receiving IV narcotics.

Posted: 2/26/2019 6:10:45 AM EST

[#24]

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Haven’t read every post in the thread. When I was in residency it was the the tail end of “pain as the 5th vital sign” and beginning of, “anyone coming in with a complaint of diverticulitis or anyone allergic to morphine and synthetic equivalents, but did ok with an accompanying dose of IV Benadryl “ was a thing. My last year of med (Podiatry) school I witnessed 2 inpatients narc out within a month and participated in both of their codes. First year of residency, during orientation, we were casually informed that hospital reimbursement was tied to patient’s satisfaction scores, 20% of which was comprised of pain control, if you get my drift.

Thoughts and protocols started changing 2012/2013, but we were still pressured by admin for above average patient satisfaction scores. By the end of my 1st year I was checking certain patients against other system facilities as they seemed to say all the buzz words. I noticed that they would rotate through the different hospitals in the system on a 2-3 week schedule. Brought this up to my team leader (most senior internal medicine resident on my 12 month internal med rotation) and he almost got suspended by an attending for denying excessive pain meds, specifically dilaudid with an IV Benadryl kicker, to a frequent flyer. I respected the shit out of him for willing to take a look and back me up after reviewing the medical records.

This wasn’t the norm, but was a common enough occurrence that we were all checking previous admits for telltale signs of drug seeking behavior. It wasn’t just me, it was all of the newer residents noticing a shift in the way that patients reacted to questions and their willingness to tell us they would negatively rate the hospital for pain management satisfaction Becca of the weight placed on pain management satisfaction scores for Medicare reimbursement.

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I sustained an iatrogenic, permanent back injury. The facility that injured me denied it ever happened, and of course refused to give me pain meds. My PCP refused to give me pain meds. Three pain management doctors refused to give me pain meds. I'm talking two slipped disks, both SI joints inflamed and out of place, a fractured coccyx, a non-functioning yet painful right leg, and symptoms of pelvic nerve damage, all at once, because of that injury. The muscles of my entire body locked as tight as they would go and I do not exaggerate; I discovered muscles I never knew I had because they became rock-hard and took weeks of massage from my husband to even start to relax. (It was about 2 months before they finally did relax.) This is on top of the sports hernia that they failed to diagnose. I was in so much pain I kept begging my husband, and later the ER staff, to please kill me so that I could just stop hurting so much. And I meant it. Because my pain was not managed at all, I kept going to the ER for both pain relief and to try to get answers for why I was in so much pain. I went to the ER 13 times in four weeks. You'd have described me as a frequent flier, and probably denied me pain meds. A couple of ER docs did, in fact, deny me pain meds, and may they rot in hell along with the retard who let me fall off a hospital bed and onto the floor. Thank God for the few ER docs who gave me pain meds and permitted me a few blessed hours of relief.

I say all this to point out that as doctors stop prescribing effective pain meds, people like me will become more commonplace in the ER. The ER is becoming the new pain management clinic, like it or not. You're going to have more and more "frequent fliers" who are actually legitimately in pain. The entire situation is fucked for everyone involved.

Posted: 2/26/2019 7:30:21 AM EST

[#25]

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The whole "opioid crisis" is another stupid left-wing manufactured propaganda piece foisted on the ill-informed and dimwitted by the Democrat Party. It's no different than them focusing on firearms instead of the underlying problem (bad people doing bad stuff). The underlying problem [in the "opioid crisis"] is addiction. If you eliminated all opioids today the addicts would just transition to something else (more than likely meth, cocaine, alcohol, etc.). People need to stop being so gullible and focusing on the inanimate "thing" and instead focus on the underlying behavior.

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More people die annually from alcohol abuse and obesity. It’s not really a crisis. Like every other “war on drugs” it wil punish the good people. War on meth— can’t get cold medecine worth a shit. Can still get meth. “War on opioid” law enforcement telling doctors what the can and can’t do.....it is almost as if they are trying to drive pain patients to using illegal narcotics to manufacture a crisis.

Posted: 2/26/2019 7:34:32 AM EST

[#26]

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So, what would you have someone who is in excruciating pain and has found an opioid that works for them, take?

Just tough it out with some ibuprofen?

"Oh, you have 5 crushed disks and constant nerve pain? Well, we can't have you taking an opioid. You might get addicted. Much better for you to live in agonizing pain so we feel better about ourselves".

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With the people like that you gotta let them have opioids IMHO.

It is the abusers and "fakers of chronic" pain who are the problem.

Posted: 2/26/2019 8:03:28 AM EST

[#27]

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With the people like that you gotta let them have opioids IMHO.

It is the abusers and "fakers of chronic" pain who are the problem.

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It's really not that. Half the population has a decent pain tolerance. The other half are whiney, cranky, sniveling children who expect to never feel pain even after an open heart surgery. Of this second half we have about 15% that absolutely refuse to even have a slight twinge of pain. Usually they are absurdly anxious and are unable to tolerate even small deviations from their expectations! That is the population who gets hooked, and thanks to patients bill of rights we are unable to adequately nitrate their pain meds down.

Believe it or not the pain seekers are a small percentage. Super-users, but we'll surpassed by Suzy housewife who can't take the excruciating pain of a hangnail removal.

Posted: 2/26/2019 8:17:02 AM EST

[#28]

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I hate to ask, but what the hell it's GD, and I think I got an expert here.

What kind on injury would be like a bone bruise in the heel area that when I had it xray'd/eval'd in November by a sports Dr. showed nothing wrong. She diagnosed it as a bone bruise. This is the most nagging injury I've ever had. She gave me a boot, and I wore it the prescribed time. I knew it wasn't doing it's job though even when wearing it. It simply won't get better, I guess my next step is to get in the tunnel.

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Sounds like bone marrow edema. MRI will make the diagnosis.

Posted: 2/26/2019 8:36:09 AM EST

[#29]

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It's really not that. Half the population has a decent pain tolerance. The other half are whiney, cranky, sniveling children who expect to never feel pain even after an open heart surgery. Of this second half we have about 15% that absolutely refuse to even have a slight twinge of pain. Usually they are absurdly anxious and are unable to tolerate even small deviations from their expectations! That is the population who gets hooked, and thanks to patients bill of rights we are unable to adequately nitrate their pain meds down.

Believe it or not the pain seekers are a small percentage. Super-users, but we'll surpassed by Suzy housewife who can't take the excruciating pain of a hangnail removal.

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With the people like that you gotta let them have opioids IMHO.

It is the abusers and "fakers of chronic" pain who are the problem.

It's really not that. Half the population has a decent pain tolerance. The other half are whiney, cranky, sniveling children who expect to never feel pain even after an open heart surgery. Of this second half we have about 15% that absolutely refuse to even have a slight twinge of pain. Usually they are absurdly anxious and are unable to tolerate even small deviations from their expectations! That is the population who gets hooked, and thanks to patients bill of rights we are unable to adequately nitrate their pain meds down.

Believe it or not the pain seekers are a small percentage. Super-users, but we'll surpassed by Suzy housewife who can't take the excruciating pain of a hangnail removal.

It isn’t just that group of people though, it’s a large percentage of construction/trade workers as well. Messed up backs, knees, sore all over from an injury. There are a couple options, the best being rest up and let the body heal. Unfortunately that means limited income, or sometimes and often, no income. What do you do? Go to the dr. and get pain meds. So much better. Then you keep going to work and your body doesn’t heal. Then you need more pain meds, and more and more and more. You get hooked on them, even if they aren’t truly helping your pain, and they damn sure aren’t treating the problem. You drink with them, mix other drugs to take the edge off, and when the dr cuts you off, you move to illicit drugs, often the same drugs you have been taken but now with no dr oversight or management plan at all.

Yes, I see it a lot. I’m in the trades and anyone that thinks this scenario isn’t real needs to take the blinders off.

Posted: 2/26/2019 8:56:47 AM EST

[#30]

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So I was taking pain meds after two failed back surgeries. One in 2004 & one in 2007. Back this past year I was taking 4 of the 10/325 Norcos or hydrocodones a day. My pain doc who was a staff anesth. at the hospital said he was under increasing scrutiny over pain med scripts and that he had to cut me back to 3 per day in two months. He suggested that I break them in half and start tapering down to 3 a day.

So I did this, but every 3 or 4 days I kept reducing my doses. Long story short is that I completely quit the meds in just over three weeks. I jonesed a bit at night but nothing severe. So after stopping my pain meds I still have pain but surprisingly have less than when I was on the meds. I still take Gabapentin and a muscle relaxer at night but if I start hurting really bad I take a Tylenol.

The thought of going cold turkey if I showed up to my doc's office and he stopped being able to write scripts was not a pleasant thought. I think I was blessed to be able to come off those meds so easily. I can't use cannabis due to my position doing defense contract work. If that should change you bet I'll go that route.

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Not to be a negative Nancy, but gabapentin can catch up with you long term. Muscle relaxers may be next on the chopping block, lots of screeching about how addictive it is. Finally, Tylenol is hard on the liver in high doses. Just an fyi in case this info wasn't relayed to you.

Posted: 2/26/2019 9:00:02 AM EST

[#31]

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It's really not that. Half the population has a decent pain tolerance. The other half are whiney, cranky, sniveling children who expect to never feel pain even after an open heart surgery. Of this second half we have about 15% that absolutely refuse to even have a slight twinge of pain. Usually they are absurdly anxious and are unable to tolerate even small deviations from their expectations! That is the population who gets hooked, and thanks to patients bill of rights we are unable to adequately nitrate their pain meds down.

Believe it or not the pain seekers are a small percentage. Super-users, but we'll surpassed by Suzy housewife who can't take the excruciating pain of a hangnail removal.

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If that is true......it is MUCH worse than I thought.

Posted: 2/26/2019 9:01:37 AM EST

[#32]

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More people die annually from alcohol abuse and obesity. It's not really a crisis. Like every other "war on drugs" it wil punish the good people. War on meth can't get cold medecine worth a shit. Can still get meth. "War on opioid" law enforcement telling doctors what the can and can't do.....it is almost as if they are trying to drive pain patients to using illegal narcotics to manufacture a crisis.

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The whole "opioid crisis" is another stupid left-wing manufactured propaganda piece foisted on the ill-informed and dimwitted by the Democrat Party. It's no different than them focusing on firearms instead of the underlying problem (bad people doing bad stuff). The underlying problem [in the "opioid crisis"] is addiction. If you eliminated all opioids today the addicts would just transition to something else (more than likely meth, cocaine, alcohol, etc.). People need to stop being so gullible and focusing on the inanimate "thing" and instead focus on the underlying behavior.

More people die annually from alcohol abuse and obesity. It's not really a crisis. Like every other "war on drugs" it wil punish the good people. War on meth can't get cold medecine worth a shit. Can still get meth. "War on opioid" law enforcement telling doctors what the can and can't do.....it is almost as if they are trying to drive pain patients to using illegal narcotics to manufacture a crisis.

Although many people in this thread want to make it about prescription drugs and evil big pharma companies and doctors prescribing them, here are some facts...

The CDC estimates that 72,287 people died from overdoses in 2017, an increase of about 10% from the year before. A majority of the deaths nearly 49,000 was caused by opioids, according to the new data. And the biggest driver was the dangerous synthetic opioid fentanyl, which killed more than 29,000 people, followed by heroin and other drugs.

So, 40 percent of drug overdoses were caused by one opioid, Fentanyl. So, where is all this Fentanyl coming from? The pharma companies? Grandma's medicine cabinet? No, it's predominantly being produced illegally by Mexican drug cartels.

Flowing in one direction, this fentanyl pipeline runs through Mexican cartel strongholds and heads north on well-established drug trafficking routes. It funnels 80 percent of the drug through the San Diego border before dispersing throughout the U.S. The pipeline flows in another direction, as well, direct from Chinese laboratories to U.S. customers through the mail, bringing small, hard-to-detect packages of extremely pure fentanyl to suburban doorsteps.

Sealing the fentanyl pipeline, however, has proven to be thus far an insurmountable challenge. The effort involves navigating delicate political relations with China and Mexico, addressing weaknesses at U.S. borders and within international mail systems that continue to allow narcotics to slip through unnoticed, battling nimble and powerful drug traffickers, and trying to keep up with enterprising chemists who constantly skirt drug controls with new formulations.

Sounds like [another] supporting case for building Trump's wall along the U.S./Mexico border. If you want to curb the opioid crisis, then build the wall to curtail the massive influx of synthetic Fentanyl from Mexican drug cartels!

Posted: 2/26/2019 9:04:41 AM EST

[#33]

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It isn’t just that group of people though, it’s a large percentage of construction/trade workers as well. Messed up backs, knees, sore all over from an injury. There are a couple options, the best being rest up and let the body heal. Unfortunately that means limited income, or sometimes and often, no income. What do you do? Go to the dr. and get pain meds. So much better. Then you keep going to work and your body doesn’t heal. Then you need more pain meds, and more and more and more. You get hooked on them, even if they aren’t truly helping your pain, and they damn sure aren’t treating the problem. You drink with them, mix other drugs to take the edge off, and when the dr cuts you off, you move to illicit drugs, often the same drugs you have been taken but now with no dr oversight or management plan at all.

Yes, I see it a lot. I’m in the trades and anyone that thinks this scenario isn’t real needs to take the blinders off.

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Just "resting up" is a very general answer. What I've noticed is that the hesitancy to really figure out the problem is causing more problems. Mris are great, but they are very expensive and doctors often use them as a last resort if nothing else works. This is the only area I've seen where it's treat first, diagnose later. Physical therapy may be contraindicated, but how can you know without an MRI. Just "resting" and doing nothing about it can cause problematic healing patterns. If doctors are gonna virtue signalling against opioids, they need to make damn sure they do a good job of early diagnosis, and I'm just not seeing it.

Posted: 2/26/2019 9:04:56 AM EST

[#34]

Question: Which opioid is the strongest at relieving pain...….I assume Fentanyl but is that correct?

Or does Fentanyl give people a high they like and other opioids stop pain just as well?

Posted: 2/26/2019 9:06:27 AM EST

[#35]

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It isn’t just that group of people though, it’s a large percentage of construction/trade workers as well. Messed up backs, knees, sore all over from an injury. There are a couple options, the best being rest up and let the body heal. Unfortunately that means limited income, or sometimes and often, no income. What do you do? Go to the dr. and get pain meds. So much better. Then you keep going to work and your body doesn’t heal. Then you need more pain meds, and more and more and more. You get hooked on them, even if they aren’t truly helping your pain, and they damn sure aren’t treating the problem. You drink with them, mix other drugs to take the edge off, and when the dr cuts you off, you move to illicit drugs, often the same drugs you have been taken but now with no dr oversight or management plan at all.

Yes, I see it a lot. I’m in the trades and anyone that thinks this scenario isn’t real needs to take the blinders off.

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With the people like that you gotta let them have opioids IMHO.

It is the abusers and "fakers of chronic" pain who are the problem.

It's really not that. Half the population has a decent pain tolerance. The other half are whiney, cranky, sniveling children who expect to never feel pain even after an open heart surgery. Of this second half we have about 15% that absolutely refuse to even have a slight twinge of pain. Usually they are absurdly anxious and are unable to tolerate even small deviations from their expectations! That is the population who gets hooked, and thanks to patients bill of rights we are unable to adequately nitrate their pain meds down.

Believe it or not the pain seekers are a small percentage. Super-users, but we'll surpassed by Suzy housewife who can't take the excruciating pain of a hangnail removal.

It isn’t just that group of people though, it’s a large percentage of construction/trade workers as well. Messed up backs, knees, sore all over from an injury. There are a couple options, the best being rest up and let the body heal. Unfortunately that means limited income, or sometimes and often, no income. What do you do? Go to the dr. and get pain meds. So much better. Then you keep going to work and your body doesn’t heal. Then you need more pain meds, and more and more and more. You get hooked on them, even if they aren’t truly helping your pain, and they damn sure aren’t treating the problem. You drink with them, mix other drugs to take the edge off, and when the dr cuts you off, you move to illicit drugs, often the same drugs you have been taken but now with no dr oversight or management plan at all.

Yes, I see it a lot. I’m in the trades and anyone that thinks this scenario isn’t real needs to take the blinders off.

Finally something I can agree with you on. As you can tell from my screen name I'm in the trades and have been for over 25 years. One of the hardest physically at that which is Roofing. Illicit drug use among construction workers is HUGE, borderline epidemic levels. Even the younger guys who haven't been beat up for decades are getting high at work. If they aren't getting high at work they are getting drunk as hell at the end of the day and show up to sites still drunk or worthless for the first few hours of the day.

Posted: 2/26/2019 9:06:44 AM EST

[#36]

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Just "resting up" is a very general answer. What I've noticed is that the hesitancy to really figure out the problem is causing more problems. Mris are great, but they are very expensive and doctors often use them as a last resort if nothing else works. This is the only area I've seen where it's treat first, diagnose later. Physical therapy may be contraindicated, but how can you know without an MRI. Just "resting" and doing nothing about it can cause problematic healing patterns. If doctors are gonna virtue signalling against opioids, they need to make damn sure they do a good job of early diagnosis, and I'm just not seeing it.

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It isn’t just that group of people though, it’s a large percentage of construction/trade workers as well. Messed up backs, knees, sore all over from an injury. There are a couple options, the best being rest up and let the body heal. Unfortunately that means limited income, or sometimes and often, no income. What do you do? Go to the dr. and get pain meds. So much better. Then you keep going to work and your body doesn’t heal. Then you need more pain meds, and more and more and more. You get hooked on them, even if they aren’t truly helping your pain, and they damn sure aren’t treating the problem. You drink with them, mix other drugs to take the edge off, and when the dr cuts you off, you move to illicit drugs, often the same drugs you have been taken but now with no dr oversight or management plan at all.

Yes, I see it a lot. I’m in the trades and anyone that thinks this scenario isn’t real needs to take the blinders off.

Just "resting up" is a very general answer. What I've noticed is that the hesitancy to really figure out the problem is causing more problems. Mris are great, but they are very expensive and doctors often use them as a last resort if nothing else works. This is the only area I've seen where it's treat first, diagnose later. Physical therapy may be contraindicated, but how can you know without an MRI. Just "resting" and doing nothing about it can cause problematic healing patterns. If doctors are gonna virtue signalling against opioids, they need to make damn sure they do a good job of early diagnosis, and I'm just not seeing it.

Sorry, I should have went in to detail but the treatment would generally be different for each. Letting the body heal and not just giving pain meds to cover the problem was the point. I've made numerous posts on arfcom about how an awesome physical therapist has completely changed my viewpoint on my herniated discs.

Posted: 2/26/2019 9:21:12 AM EST

[#37]

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Thats fine, but i dont want someone with 5 whole hours of pain management training prescribing my 10 year old opiotes for a broken bone.

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You're the adult. You make decisions for your child. If you don't want your kid on opiates, you have that right...

No need to defacto ban opiates because you don't want your 10 year old on them. Always better to have options, right?

Posted: 2/26/2019 11:41:46 AM EST

[#38]

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Sounds like bone marrow edema. MRI will make the diagnosis.

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@ar15lizard thanks very much as well for your reply. Off to google what the hell that is. If the soaking, and heel support don't help...it'll be off to the MRI I guess.

Posted: 2/26/2019 6:48:35 PM EST

[#39]

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I don't get it, what does the benadryl do?

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This wasn't the norm, but was a common enough occurrence that we were all checking previous admits for telltale signs of drug seeking behavior. It wasn't just me, it was all of the newer residents noticing a shift in the way that patients reacted to questions and their willingness to tell us they would negatively rate the hospital for pain management satisfaction Becca of the weight placed on pain management satisfaction scores for Medicare reimbursement.

A neighbor of mine is a pharmacist, and says that a not-insignificant portion of every single day is spent dealing with drug-seekers. "Oh, someone stole your freshly-filled bottle of narcotics for the third time this year? Sure, just get us a police report for the theft, and we'll replace it."

Yep, I have diverticulitis, IBS, Crohns, I'm 10/10 pain, but I'm allergic to narcotics. The only thing I can tolerate is IV dilauadid, but it makes me itch so bad, I also need Benadryl.

I don't get it, what does the benadryl do?

IV Benadryl will potentiate the euphoric feeling from the dilaudid and make the feeling last a bit longer. Oral Benadryl won't do anything to increase the high, so it's pretty easy to figure out the pro's when then decline oral Benadryl for the hives they claim they are getting.

Posted: 2/26/2019 7:56:31 PM EST

[#40]

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It's really not that. Half the population has a decent pain tolerance. The other half are whiney, cranky, sniveling children who expect to never feel pain even after an open heart surgery. Of this second half we have about 15% that absolutely refuse to even have a slight twinge of pain. Usually they are absurdly anxious and are unable to tolerate even small deviations from their expectations! That is the population who gets hooked, and thanks to patients bill of rights we are unable to adequately nitrate their pain meds down.

Believe it or not the pain seekers are a small percentage. Super-users, but we'll surpassed by Suzy housewife who can't take the excruciating pain of a hangnail removal.

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Quoted:

With the people like that you gotta let them have opioids IMHO.

It is the abusers and "fakers of chronic" pain who are the problem.

It's really not that. Half the population has a decent pain tolerance. The other half are whiney, cranky, sniveling children who expect to never feel pain even after an open heart surgery. Of this second half we have about 15% that absolutely refuse to even have a slight twinge of pain. Usually they are absurdly anxious and are unable to tolerate even small deviations from their expectations! That is the population who gets hooked, and thanks to patients bill of rights we are unable to adequately nitrate their pain meds down.

Believe it or not the pain seekers are a small percentage. Super-users, but we'll surpassed by Suzy housewife who can't take the excruciating pain of a hangnail removal.

Who are you to tell someone how much pain they must tolerate?

If I can walk on a broken leg, should I be able to tell you that you must endure your kidney stones with ibuprofen?

Your argument is absurd.

Posted: 2/26/2019 9:30:37 PM EST

[#41]

60 Minutes' forte is corporate hit pieces. That's their bread and butter. The lefties eat it up. There have been a handful of times in my life when I had inside knowledge of a company or issue they presented and the news piece was completely wrong. Not minor mistakes, mind you, but glaring mistakes at the core of the issue that invalidated their position completely. With that in mind, I have absolutely no faith in anything they say.

Posted: 2/26/2019 9:41:05 PM EST

[#42]

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Finally something I can agree with you on. As you can tell from my screen name I'm in the trades and have been for over 25 years. One of the hardest physically at that which is Roofing. Illicit drug use among construction workers is HUGE, borderline epidemic levels. Even the younger guys who haven't been beat up for decades are getting high at work. If they aren't getting high at work they are getting drunk as hell at the end of the day and show up to sites still drunk or worthless for the first few hours of the day.

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Quoted:

Quoted:

With the people like that you gotta let them have opioids IMHO.

It is the abusers and "fakers of chronic" pain who are the problem.

It's really not that. Half the population has a decent pain tolerance. The other half are whiney, cranky, sniveling children who expect to never feel pain even after an open heart surgery. Of this second half we have about 15% that absolutely refuse to even have a slight twinge of pain. Usually they are absurdly anxious and are unable to tolerate even small deviations from their expectations! That is the population who gets hooked, and thanks to patients bill of rights we are unable to adequately nitrate their pain meds down.

Believe it or not the pain seekers are a small percentage. Super-users, but we'll surpassed by Suzy housewife who can't take the excruciating pain of a hangnail removal.

It isn’t just that group of people though, it’s a large percentage of construction/trade workers as well. Messed up backs, knees, sore all over from an injury. There are a couple options, the best being rest up and let the body heal. Unfortunately that means limited income, or sometimes and often, no income. What do you do? Go to the dr. and get pain meds. So much better. Then you keep going to work and your body doesn’t heal. Then you need more pain meds, and more and more and more. You get hooked on them, even if they aren’t truly helping your pain, and they damn sure aren’t treating the problem. You drink with them, mix other drugs to take the edge off, and when the dr cuts you off, you move to illicit drugs, often the same drugs you have been taken but now with no dr oversight or management plan at all.

Yes, I see it a lot. I’m in the trades and anyone that thinks this scenario isn’t real needs to take the blinders off.

Finally something I can agree with you on. As you can tell from my screen name I'm in the trades and have been for over 25 years. One of the hardest physically at that which is Roofing. Illicit drug use among construction workers is HUGE, borderline epidemic levels. Even the younger guys who haven't been beat up for decades are getting high at work. If they aren't getting high at work they are getting drunk as hell at the end of the day and show up to sites still drunk or worthless for the first few hours of the day.

I don't see a connection with taking pain meds and getting high at work and drunk after. The two latter are more a condition of the young who would be getting high and drunk during and after any job, not just the trades.

Posted: 2/26/2019 9:43:07 PM EST

[#43]

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So, what would you have someone who is in excruciating pain and has found an opioid that works for them, take?

Just tough it out with some ibuprofen?

"Oh, you have 5 crushed disks and constant nerve pain? Well, we can't have you taking an opioid. You might get addicted. Much better for you to live in agonizing pain so we feel better about ourselves".

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Doesn't work anyway. You become resistant to the pain reducing effects, need more and more to the point it's toxic / deadly and now you have your pain, your addiction and your toxicity as well.

Posted: 2/26/2019 9:56:05 PM EST

[#44]

Well as an example.

Lets say you have had in your life a compound fracture of your right leg. Both tibia and fibula broken on your right leg as well. Hip surgery with a rod inserted then another surgery to remove remove rod from your femur.

A discectomy and laminectomy on L5-S1.

Fractures of the L1 thru L5 traverse processes.

Right knee also had torn meniscus.

You have nerve damage from injuries.

You have arthritis from above injuries.

And now you can't get any pain meds.

Does that seem reasonable?

Sometimes you cant walk.

Sometimes you cant stand.

Sometimes you're ok.

What qualifies as "reasonable"?

Who decides how much pain qualifies??

Posted: 2/26/2019 10:00:20 PM EST

[#45]

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Dr's prescribe them based on the labeling though, so as noted with posters above, they are told, "keep shoveling these pills in your mouth".

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lol

The opiod crisis, just like the obesity crisis, is the result of human nature, nothing else. It's not the government's "fault" it's not the FDA's "fault" - it the fault of peoples' choices.

Dr's prescribe them based on the labeling though, so as noted with posters above, they are told, "keep shoveling these pills in your mouth".

Posted: 2/27/2019 9:56:01 AM EST

[#46]

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In my short time here, I've learned that arfcom is very passionate about the pain pill topic.

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Have I been missing these kind of threads? This is better than an abortion/taylor swift thread

In my short time here, I've learned that arfcom is very passionate about the pain pill topic.

Nope. That is incorrect.

Some are very passionate about freedom and liberty and keeping the .gov nose out of our business.

Others are very passionate about controlling what other people do. Many times based on ignorance or false data and lack of critical thinking ability.

Posted: 2/27/2019 8:02:41 PM EST

[#47]

Quoted:
I know that there are a lot of opioid users on this forum for long term chronic pain who feel as though they need their meds for every day functioning, which may very well be true, but that is a byproduct of using a drug which should not have been approved for long term use.

This was on 60 Minutes last night and the facts around the case are rather frank. The gist is that big Pharma bought their way in to the FDA and had the labeling changed from short term use to long term use, where there is no scientific testing or data to support the long term use of drugs like Oxycontin as being safe or effective. On the contrary, the testing has proven the exact opposite.

Is The FDA at Fault?

These lawsuits are quite different than the other class action lawsuits across the country in that it is going after the FDA, rather than just trying to get a payout from big Pharm

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I wish we could trade for a week. you take my pain and I'll sit on the internet and be self righteous. it will be a long week for one of us.

Posted: 2/27/2019 8:12:46 PM EST

[#48]

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Nope. That is incorrect.

Some are very passionate about freedom and liberty and keeping the .gov nose out of our business.

Others are very passionate about controlling what other people do. Many times based on ignorance or false data and lack of critical thinking ability.

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Quoted:

Quoted:
Have I been missing these kind of threads? This is better than an abortion/taylor swift thread

In my short time here, I've learned that arfcom is very passionate about the pain pill topic.

Nope. That is incorrect.

Some are very passionate about freedom and liberty and keeping the .gov nose out of our business.

Others are very passionate about controlling what other people do. Many times based on ignorance or false data and lack of critical thinking ability.

Posted: 2/27/2019 8:14:45 PM EST

[#49]

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Just so long as you admit you wish to enforce your ideals and values on everyone else because of your experiences and opinions.

Reminds me of a couple other groups we deal with.

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Posted: 2/27/2019 8:18:46 PM EST

[#50]

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I wish we could trade for a week. you take my pain and I'll sit on the internet and be self righteous. it will be a long week for one of us.

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I know that there are a lot of opioid users on this forum for long term chronic pain who feel as though they need their meds for every day functioning, which may very well be true, but that is a byproduct of using a drug which should not have been approved for long term use.

This was on 60 Minutes last night and the facts around the case are rather frank. The gist is that big Pharma bought their way in to the FDA and had the labeling changed from short term use to long term use, where there is no scientific testing or data to support the long term use of drugs like Oxycontin as being safe or effective. On the contrary, the testing has proven the exact opposite.

Is The FDA at Fault?

These lawsuits are quite different than the other class action lawsuits across the country in that it is going after the FDA, rather than just trying to get a payout from big Pharm

I wish we could trade for a week. you take my pain and I'll sit on the internet and be self righteous. it will be a long week for one of us.

I’m sorry that you are in the position that you are, and I imagine that you go to a good pain management dr with a good pain management plan and have exhausted all options. Some times, there is no fix.

In this case, corruption inside the FDA made a money maker out of addictive pain meds instead of finding the right fix.

[ARCHIVED THREAD] - FDA And the Opioid Crisis (Page 6 of 6)

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