Medicare Is Cracking Down on Opioids. Doctors Fear Pain Patients Will Suffer.

[RKP5637]

So, what are those with severely chronic pain supposed to do. My hunch is the black market will flourish. IMO these decisions are outrageous!

https://www.nytimes.com/2018/03/27/health/opioids-medicare-limits.html

Critics say the rule would inject the government into the doctor-patient relationship and could throw patients who lost access to the drugs into withdrawal or even provoke them to buy dangerous street drugs. Although the number of opioid prescriptions has been declining since 2011, they noted, the rate of overdoses attributed to the painkillers and, increasingly, illegal fentanyl and heroin, has escalated.

The rule means Medicare would deny coverage for more than seven days of prescriptions equivalent to 90 milligrams or more of morphine daily, except for patients with cancer or in hospice.

Trump Offers Tough Talk but Few Details in Unveiling Plan to Combat Opioids.

“The decision to taper opioids should be based on whether the benefits for pain and function outweigh the harm for that patient,” said Dr. Joanna L. Starrels, an opioid researcher and associate professor at Albert Einstein College of Medicine. “That takes a lot of clinical judgment. It’s individualized and nuanced. We can’t codify it with an arbitrary threshold.”

[Ms. Toad]

1. My grandmother with crippling pain from arthritis

wore a morphine patch for at least the last decade of her life, until she died at 101. She was neither living with cancer nor in hospice, and morphine made her life bearable.

After decades of being stingy with pain meds, the lack of which got in the way of both healing from surgery and living with chronic pain, people like my grandmother were finally permitted the medication needed to make life bearable.

And now we're reversing course - again letting the fear of drug abuse tail wag the medical care dog. I hate this knee-jerk reaction that makes life more difficult (and costly) for people who need pain medication (and before that allergy medication).

[RKP5637]

5. As often happens in the US, they go after the majority than focusing on where the problem is and

taking corrective action. It's a cop-out decision. I've had friends similar to your mother and they only survived with pain medication. I think they would have considered suicide to escape the pain if something like this had happened.

Same here, "I hate this knee-jerk reaction that makes life more difficult (and costly) for people who need pain medication ...)"

We often have very little control over our lives and destiny in the US. This, is yet another example.

[riverbendviewgal]

10. My 80 plus friend was taking morphine for arthritic pain.

It wasn't working after awhile. Her daughters convinced the doctor to prescribe medical marjiuana, pill form,. It worked. The only side effect was she had the munchies.

[TheFrenchRazor]

105. MM should absolutely be available nationwide; of course, it isn't. nt

[quartz007]

180. I am nearing 80

but my medication is rapid walking 10-12 miles every week. Been doing it since age 58.

Knock on wood, no arthritis or pain anywhere.

[riverbendviewgal]

189. Wonderful.

I wish i could have been so fortunate, i have hypothyroidism. Off shoots are anemia, arthritis, depression, fibromyalgia. It seems my health went downhill in the late 90s when my husband and son were diagnosed with cancers. 3 years of fighting cancer until they died. Prozac saved me.

[quartz007]

199. thank you

for sharing your situation. I hop you can look forward to less problematic years.

If at all possible, begin a walk routine. Start small and gradually increase over 3 months. There is nothing better for humn body ovre age 50 than exercise such as just walking.

[Crunchy Frog]

2. Kratom or unwashed poppy seeds.

Depending on the severity of the pain. There's always alcohol too.

[blake2012]

3. There are other ways to manage through pain than narcotics

Last edited Tue Mar 27, 2018, 04:13 PM - Edit history (1)

This is an epidemic that needs to be battled fiercely. I am all for making doctors more overtly prescribe smaller quantities more frequently for those with chronic pain rather than continue with over medication and addiction of our country.

[Aristus]

7. I'm never that blunt about it.

But that's essentially what I tell my patients with chronic pain of non-traumatic etiology.

It's happened fairly often that I will evaluate a patient, and then say:"I can get you something for the pain."

Then when I prescribe something like naproxen or meloxicam, the patient will say: "No, I need, you know, you know, pain medication!"

[blake2012]

11. We need a bunch just like you helping ramp down this addiction

And an irrational belief we should never experience pain.

[MicaelS]

37. Sure you're on the right website? n/t

[blake2012]

43. Yes. How is it that my desire to see medical community reverse opioid epidemic

Is not in line with Democratic values and platform? Have you listened to any of the many NPR interviews on the subject? For instance, dentists are some of the worst at overprescribing. Their licensing bodies are moving to make continuing education on pain management and opioids mandatory.

[CountAllVotes]

87. +1,000 !!

No kidding!

[Ms. Toad]

12. Naproxen

Created ulcers from mouth to anus when I was required to take it for pain for months. Ibuprofen raised my blood pressure from its normally low-normal range to the dangerously high range when I had to take it for a couple of months to minimize inflammation. Although I have not taken meloxicam, it has the same high blood pressure risk that ibuprofen carries when taken for chronic pain. With the number of diabetics with comorbid hypertension, most of the NSAIDS are not a reasonable solution. Acetominophen does nothing for any pain other than a sore throat.

I doubt there is anything that my grandmother could have tolerated for over a decade that would make her crippling arthritis pain manageable, without creating painful or dangerous side effects.

There is no reason, particularly among the elderly, to sacrifice relief from chronic pain in favor of fighting an opioid epidemic that largely does not involve them.

[kcr]

18. Thank you. Internet doctors, particularly ones who tout drug warrior propaganda

should be roundly ignored.

[CountAllVotes]

80. Naproxen's cousin Ibuprofen almost killed me

I lost half of my intestines due to that sh*t and they don't try pawning anything close to it to me now (listed as a "allergy" now after they had me taking 2400 mg. of ibuprofen a day for YEARS which is a big no-no!).

The bill after three horrific surgeries was $800,000+ !

I agree, they are trying to off the lot of us!

[BobTheSubgenius]

88. After surgery and massive antibiotics for Staph A in my heart,

I had to attend little seminars about this and that before I could be released with their blessing. I had nothing better to do, and like learning things, so....I went.

During the one on pain management, a fellow post-op patient brought up ibuprofen. The person doing the in-house - the head pharmacist, as it happened - said this:

"When you go home, take your bottle of ibuprofen and throw it in the garbage."

[CountAllVotes]

117. I wish I'd known

Since it almost killed me I can't keep on any weight much & I am weak as a kitten most days.
They don't ask me any questions any more. That is the "reward" I got after almost dying from that sh*t.

It never helped w/the pain, never, but I had to play their game. I dumped that doctor 2+ years ago luckily even though I knew I was taking a huge risk.

Today I go to a community health center. They look at my chart and see my carved up stomach and don't ask me a hell of a lot any longer.

I am certain it took at least 10+ years off of my life and yes, I still have the 'effin pain BUT it IS being dealt with properly now. To think this is what it took for that to occur is sickening to me. No one should have to go through such a thing esp. when they have a diagnosis and written history going back 35 years that backs them up!

[dhol82]

150. Ibuprofen is the only OTC pain med that works for me

I have taken it for years with no adverse effects.
Acetaminophen does nothing - it’s like taking a sugar pill.
Aspirin irritates my stomach.

I will just ignore any warnings and continue with what works for me.

[Ms. Toad]

154. I still take it ocassionally -

even though I have experienced the consequences of hypertension.

I just can't take it (as suggested) on a regular basis for chronic pain.

Not everyone experiences adverse effects. It's still my go-to-drug for headaches.

On the other hand, the side effects I experienced taking naprosyn (for a shorter period of time) scare me more - and it did nothing for pain relief. So it's on my permanent do-not-touch list.

You might try acetaminophen for sore throats. I always treated it as a sugar pill, as well. But for some reason I took one when I had a sore throat - and it allowed me to sleep through the night. I've experimented since then, expecting it to be a fluke - since nothing else touched my sore throats - and it continued to kill sore throat pain.

[dhol82]

158. Thanks for the tip

However, whenever I have a sore throat I just drink tea and use a nasal spray - post nasal drip is usually what has precipitated the soreness.
If the soreness is from coughing with a cold, then I get a cough suppressant.

[Ms. Toad]

160. For me the soreness is associated with a cold -

but not from coughing, since it precedes any coughing by a couple of days. It's the first sign of the arrival of a cold.

[RKP5637]

208. Acetaminophen gives me extremely high blood pressure despite my medication. It gets

damn scary.

[quartz007]

186. Thank you..I just tossed bottle of Naproxen

in garbage. It has been sitting in my cabinet since 2013.
Still Mostly full. I can't believe the Doc had given 12 refills of 60 tablets !! I am doing exercise instead of popping pain pills, and it works!

[csziggy]

32. For years I used naproxen and piroxicam to control the pain from my knees

Piroxicam I believe is related to meloxicam and it reduced the inflammation from my bone on bone knees better than opioids.

Now I can't take either - being down one kidney reduces your drug choices a lot. So rather than take acetaminophen which does not reduce the pain and inflammation from my osteo-arthritis now in my hands, I just hurt. In a month I will see my hand doctor to see if his injections will help.

[Eliot Rosewater]

46. It absolutely makes my head EXPLODE that we would under medicate people with

pain from cancer, post op, etc.

No physician would want to limit pain killers in certain situations, I would hope.

[Aristus]

51. No. Absolutely not. Cancer patients, post-operative patients,

any patient for whom opioid treatment is appropriate will receive the appropriate prescription.

My cross to bear is the twenty year-old kid, in no acute distress, no past medical history of trauma, blood pressure, pulse and respiration all within normal limits, complaining of 10-out-of-10 pain and demanding Percocet.

His reasons:

1. It's the only thing that works!.
2. "I have a high pain-tolerance".
3. I just need a little until I can get in with a pain specialist.
4. I lost my previous prescription.
5. "They're not addictive".
6. The guy down the street precribes them.
7. I'm allergic to everything else.

[Eliot Rosewater]

56. Been there, done that. I know what you mean. How do you gauge when they have an injury

you cant see or confirm?

BTW, this person is likely addicted to street or RX and needs your help, dont you wish we had on demand rehab at no cost? In patient, etc.?

[Aristus]

59. I do an appropriate workup to assess injury or any etiology for chronic pain.

And my clinic does have a substance abuse department, whose head is very good about getting patients into treatment.

[TheFrenchRazor]

61. what gives you the right to decide who will or won't be allowed to stop their own suffering? you mus

must have an extremely high opinion of yourself, or a very low opinion of others, or both.

[Aristus]

76. Well, state regulators, for one thing.

I like my medical license. I'm not going to lose it because I deliberately refused to follow standard of care.

And when it comes to clinical medicine, yeah, I got some game. I'm good at what I do. And I intend to stay that way.

[TheFrenchRazor]

81. like i said, conscienceless. "saying it's your job don't make it right." yeah, you keep your licen

keep your license; i'll keep my conscience.

[Aristus]

90. Your indignation would be a lot sexier

if I thought it wasn't tied to a trolling operation.

So go ahead, tell your supervisor you got some digs in. Then tell him that I admitted that we medical providers are all monsters who relish watching people die in agony.

[blake2012]

92. Lol

[Aristus]

98. Wow. This just gets better and better.

Do you get bonuses for this kind of thing?

[blake2012]

106. I think you nailed it

[TheFrenchRazor]

114. i think you need to work on your bedside manner, or move to the morgue. nt

[Skittles]

119. he better not

he's not very good

[Aristus]

120. HA!

[phylny]

164. I, too, work under a license (not medical, speech-language pathology)

and I would never, under any circumstances, do something against the law or my code of ethics. Thank you for being a smart provider!

[Skittles]

116. LOL

or maybe he just understands addiction and is trained to see the warning signs

[Eliot Rosewater]

62. Sounds like you know what you are doing.

I predicted a long time ago this would happen, what I did not anticipate is complete moronic fools like rump and whoever he appoints would be at the helm certainly making it even worse than it needs to be.

RX companies manufacturing Oxycontin and Fentanly purposely got physicians to addict patients for profits. That is what happened.

That we go from there to under-medicating people in pain, sigh

For instance I had a broken or cracked rib once, could barely breathe and I simply CANT describe the pain. As a man who obviously has not gone thru childbirth, I suspect it is one of the most painful things a man can have.

My doc tells me joint replacements are the most painful thing ever, does that include hips?

[TheFrenchRazor]

64. well remember, laws are for the little people; when doctors or other big-shots have pain, severe or

or otherwise, no doubt they will have plenty of meds available, so what do they care about the rest of us?

[Eliot Rosewater]

65. UNFAIR, most docs are great people who do care ...this is not their fault

they were in the middle

People crying for meds who didnt need them for pain but for addiction, how is the doc supposed to know that and solve that problem, cant

[TheFrenchRazor]

70. to be honest, i would err on the side of believing the patient. and while i understand that doctors

are subject to existing legislation/regulations, in my experience most of them really don't give a sh*t. they're kind of like cops; they just want to pick up their paycheck and go home. and i really don't mean to insult the good ones, but there are far too many bad ones.

[Eliot Rosewater]

77. Vast majority of docs I have dealt with are just fine.

Dont know where you are experiencing this, sounds like the opposite of my experience.

[TheFrenchRazor]

83. not going to disagree, but my experience has been different; i have a weird auto-immune thing

that is hard to diagnose/treat, but it leaves me in constant pain and other unpleasant symptoms, and doctors basically just tell me to F-off. i think that if your condition is very straightforward, your experience is probably a lot better.

[Demsrule86]

239. Oh really how nice that you can crawl into another's body and experience their pain. How does that

Happen?

[TheFrenchRazor]

72. so if a person is days away from death, you will "allow" them to have relief from their pain? that's

that's mighty big of you; give yourself a pat on the back, why don't you.

[Aristus]

78. I don't work in palliative care.

n/t.

[TheFrenchRazor]

84. i'm not sure if that's good or bad; maybe you should go into pathology, or some other field

where you don't have to deal with actual, live human beings.

[Aristus]

100. Kharosho. Spaseeba, tovarisch.

Say hello to Mother Russia for me.

[Ms. Toad]

126. So you extend your experience with one person who is clearly drug-seeking

to a near-blanket practice that excludes the use of opioids for people with chronic pain.

How about treating the exception as an exception, rather than treating the exception as if it was the rule.

[blake2012]

137. because national health statistics show it's not enough of an exception

33,000 per year dying from OD on opioids/opiates.

[TheFrenchRazor]

140. the people ODing are not the ones complaining about this government over-reach; those people are

out on the street finding their next fix. nothing you're doing is going to help them one iota.

[Ms. Toad]

151. So my grandmother should suffer, and bear the cost

of monthly copays and visits to the doctor for the last decade of her life, just to maintain some level of comfort?

I agree that opioid overdose is a problem, but the solution is not to micromanaging the doctor-patient relationships of people already burdened with living in chronic pain, requiring them to pay for a dozen office visits a year, and to physically visit the doctor each month when chronic pain already makes living and moving around so much harder.

Address the problem on someone else's back.

[questionseverything]

222. that is already not true...people with chronic pain are already denied prescription pain pills in il

my daughter,a cancer survivor that breaks her bones if the wind blows too hard

lives in constant pain now because of monsters like you

[fescuerescue]

249. I'll never forget how I was treated when I lost (half) prescription

Mind you, I'm clean cut, have absolutely no issues with addiction, nor do I take pills on a regular basis. But I was recovering from gall bladder surgery, and half my script went missing (maybe stolen, maybe lost, I don't know)

That way the pharmacy treated me, you would have through I was a stinky street bum, strung out with needle marks...all for an early refiil request of about 7 to 10 pills.

I'll NEVER forget they way they made me feel.

[GusBob]

149. Are you an MD?

[Crunchy Frog]

213. No. He isn't. n/t

[Dave Starsky]

178. As a healthcare provider, you can appreciate...

How we desperately need to understand the chronic pain syndrome, and how to treat that in this country.

That treatment should not involve opiates/oids. Those drugs generate their own demand. People who are hooked on those drugs are mostly trying to eliminate the pain of withdrawal from them.

[spanone]

16. tough shit? goodbye

[RussBLib]

21. tough shit, eh?

Some day you will likely experience some intense pain and I hope your doctor says "tough shit".

what a dick. I think the Ignore feature was made for people like you.

[spanone]

25. I'm with you.

[RKP5637]

30. K&R!!! n/t

[CountAllVotes]

42. +1,000 !!

n/t !!!!!!!

[TheFrenchRazor]

60. yep; STFU and suffer until you die, so that i can feel smugly self-righteous in my anti-drug purity.

can't believe the number of people here who think telling other people what they can and can not do with their own body is a good thing.

[TheFrenchRazor]

57. with all due respect, mind you own f-in business. nt

[blake2012]

58. This affects us all. Try hearing stories of husbands who lost wives or

Mothers who lost children because they became chronically addicted to pain killers.

[TheFrenchRazor]

63. so what about the people who have loved ones suffering without adequate pain relief? find a way to

to help these people you mention that does not hurt other innocent people. is that really too much to ask? i hope not.

[blake2012]

67. No it is not. Any rules put in place in April wint Kick in until Jan 2019

Maybe this news and associated debate will result in a more balanced response by Medicare.

Medicare does lag behind many private insurers whilo’ve already put similar limits in place.

[TheFrenchRazor]

75. other regs have already gone into place, that are affecting non-medicare patients; don't their lives

don't their lives matter? like i said, find a better way to help people.

[LanternWaste]

220. Physician... heal thyself.

"mind you own f-in business..."

Physician... heal thyself.

[pazzyanne]

103. As a person with chronic pain

I would just like to say that my doctor took me off all non-steroidal pain medication 15 years ago. I had to go cold turkey and learn to live with the pain and using pain relief management techniques that have isolated me from the community and my family. I am not a believer in using more medication than is necessary, but I am also at the point where I cannot live with the pain I am in any longer. So, with the new guidelines in place, will I be unable to receive even the smallest amount of narcotic pain relief? What about people like my brother who died in extreme pain from advanced cancer because his doctor would not prescribe the level of pain relief he needed because "he might become addicted". For gods sake, he was dying. Sorry but I cannot support you idea unless you are a person who deals with extreme pain on a daily basis. When you do, we will talk.

[TheFrenchRazor]

108. i feel you. unfortunately, our Masters couldn't care less. nt

[MuseRider]

135. These medicines have a place in our treatment protocols.

To take them away from people who need them because a bunch of doctors or people on the street could not stop themselves from selling it to people who should not have it is stupid.

As a former health care person I have to tell you that the first thing you learn is that people do not heal when they are in pain. It is impossible to not include pain relief in the group of items needed for a person to recover.

None of this has anything to do with the macho or out dated "tough it out" attitude. That is ridiculous and not a way to help someone heal. You fall down and skin your knee, sure no big deal, but if you have cancer or if you have major surgery or honest chronic pain you need the medicine and there is nothing wrong with someone expecting it and using it.

Please stop. If you are not a medical professional please stop with this. If you are there needs to be more rational than we should not expect to always be without pain.

Of course there are other ways to manage pain and I have helped people learn how to do that, I think most nurses do this just routinely or we used to anyway. Still, most people will never have enough training or ability to handle their pain solely with this and some aspirin.

I had a small surgery. My problem, really not a problem but could be if I was inclined to over do, was that I came home with enough pain meds (one of the oxy groups) to last me a month. It was certainly overkill. I kept them, I will use them if I ever need them. It has been 3 years and I think I have 40 of them tucked away. This is stupid yet they sent me home with them.

[blake2012]

139. I think you and I are in more agreement than you may realize

[Cattledog]

155. What an uninformed post.

I'm sure a cancer patient would love going to the pharmacy every couple of days.

[Betty88]

161. Smaller quantities more frequently

Why does it always come down to making it harder on the people with real life long, it ain't going to be prayed away, pain.

[riverbendviewgal]

4. I found pain relief much better using Tylenol for arthritis

I was given octecon or hydromorhin after having my quadruple bypass after my heart attack. It did not relieve my pain. The hospital put me on Tylenol for arthritis. Much better. I am not addicted.

Hospitals and doctors really push opioids.
Also in another pain experience, gum infection, marijuana worked wonders killing the pain. This was years ago.

[RKP5637]

6. Did you have rheumatoid arthritis? n/t

[riverbendviewgal]

8. I did before my heart attack.

I have sciatica too. Pool exercises and cardiac rehabilitation exercises also help.

[RKP5637]

9. Thanks!

[Demsrule86]

240. My niece has long term lyme disease and this has caused terrible arthritis. She is without a doubt

ad addict but she would die without it. The paid would be too much. People take insulin for diabetes because if you don't , it will kill you...enough pain will kill you also. kevorkian(mercy killing) killed people who were not terminal but were experiencing a great deal of pain...they preferred death.

[RKP5637]

252. I worked in a hospital once a long time ago where some drs. prescribed shock therapy for

Last edited Thu Mar 29, 2018, 05:32 PM - Edit history (1)

patients with severe arthritis because they were depressed. FFS, why wouldn't they be depressed, and pain medication was minimal. Some of this crap is just horrific. They should have been given all of the pain medication they needed.

[Demsrule86]

254. She would die without pain medication.

[RKP5637]

255. Yes, definitely she would. It was ridiculous the patients where I worked were not given all of the

pain medication they needed.

[Demsrule86]

256. It is inhumane.

[TheFrenchRazor]

54. not everyone's pain is the same; some pain is not inflammatory, so NSAIDs do nothing, except give

give people stomach problems. seriously, let doctors and patients decide which kind of pain relief is best.

[Demsrule86]

235. And tylenol kills your liver if you take it regularly.

[spanone]

13. goddamn it. I occasionally need them for kidney stones.

that's the republican way..make everyone suffer for the few

I've been taking them for over ten years as needed.

[Ms. Toad]

15. My spouse is in that situation as well.

We hoard them, since when she gets a kidney stone her only options are to wait weeks for an appointment with her urologist or to pay 4 times the copay and go the ER, because her doctor can no longer prescribe her opioids without an office visit.

So whenever we get a supply and don't use them all, we tuck them away for the next kidney stone attack. I think we're up to 5, three of which ultimately required surgery or lithotrypsy to resolve.

[spanone]

17. same way. i'm having lithotripsy next monday kidney 1 - following monday kidney 2

[Ms. Toad]

22. Good luck.

Amazing how much pain those little buggers cause.

[spanone]

24. it is amazing.

first time i thought i was dying.

[Eliot Rosewater]

48. If they withheld them from you in the case of a kidney stone I would be furious

[Ms. Toad]

159. They don't generally withhold them -

They make you go to the ER (at 4x the cost of a drs visit copay) to get a prescription for them, since the current law prohibits dispensing them without an office visit and the urologists are generally booked out a couple of weeks.

This is true even when you are established patient with chronic kidney stones which happen frequently.

[Eliot Rosewater]

171. what do they normally prescribe? they give you a shot on site also, right?

[Ms. Toad]

176. The first time, they hooked her up to a morphine drip

and admitted her. That was before we knew what had making her sick for days, so she didn't leave the hospital until after surgery to remove it.

Since then, we have yet to run out of my personal cache of oxycodone, so we haven't had to find out. We almost went to the ER the last time, since my spouse was uneasy about taking oxy without being seen by a doctor. So I made her call the doctor and ask - he told her to take it. According to the doc, the ER could do two things, unless she was in bad enough shape to be admitted (she wasn't): give her a prescription for opioids and take an X-ray to confirm it was a kidney stone.

From my experience post-surgery, I would be very surprised if an ER would administer morphine, and then let you leave. The next-to-last surgery I had, my doctor "had to"** administer Narcan to wake me up - that meant that I was without the pain relief from the anesthesia and they refused to give me any pain meds until (1) I had moved from post-op and was settled in my room and (2) had eaten. Specifically, they had to wait until anything they gave me wore of before they could transport me. I imagine similar concerns would apply to releasing a patient from the ER while still high on pain meds.

Completely off topic, but it was hours before they met the criteria for giving me pain meds, since they had forgotten to order food for me. In the mean time they rolled me bouncing along through the uneven halls from the OR to my room, rolled me up in the sheet, rather than dragging it flat, to move me from the gurney to the bed, folding my shoulder in on the nub of the rib they had just removed. About an 11 on a scale of 1-10. I've always believed in adequate pain management, but that experience is one of the reasons I'm so insistent that if a doctor is not on board for post-surgical narcotics for an ordinarily painful surgery (bone surgery, joint replacement, rotator cuff, to name a few) I'll find a new doctor.

**Doc was an old-school anesthesiologist & over-anesthetized me, then panicked when I was breathing primarily in response to a suggestion that I breathe, rather than as quickly or without prompting as he would have liked. (I tracked down the gory details in advance of the last surgery - totally screwed up the initial administration; using Narcan was, at least, less obviously malpractice - but every anesthesiologist I've described the OR scenario to (half dozen or so) said they would have waited since I was breathing in response to "breathe.&quot Still pissed at the trauma I experienced, and that it created for my mother (who genuinely has problems with experiencing pain before anyone realizes she's awake, and who later had to have surgery in the same facility).

[Eliot Rosewater]

179. My doc told me joint replacement is the most painful, would that include hip surgery?

What did you have in that area?

[Ms. Toad]

181. No joint surgery

appendectomy (not bad, except they tried to do it while I was awake b/c I was 5 months pregnant), C-section (not bad), and rib removal (x2) - initial intense pain, but I didn't need narcotics for more than a day

Both my parents have had rotator cuff surgery, and I'm afraid I'm headed that direction. From their description, it's very intense pain, but relatively brief.

A neighbor had a knee replacement - definitely extremely painful surgery.

My former boss had a hip replaced - but I didn't know her at the time. So no direct info.

[Eliot Rosewater]

183. Rib removal? Wow

have not heard of that one before.

What or why did that happen, if I can ask?

[Ms. Toad]

192. Thoracic outlet syndrome

The top rib, collarbone, and sternum create a small opening that veins, muscles, arteries, and nerves run though. Most people with TOS get nerve damage from the pinch. I got blood clots - and an eggplant for an arm for about a month in the 80s (the clot blocked all blood return through the outlet back to the heart). In that era, they had no treatment - and since they failed at busting up the clot - I was not expected to have full use of my arm. Thankfully, I had humble doctors who were willing to share everything they knew with me and - at my suggestion - we devised an exercise plan that leveraged the body's need to get that blood out of my arm. I'm one of the few from that era with full recovery.

Fast forward to 2009 - they now have better tools in their toolbox - and the solution when it popped up on the other side is to remove the top rib and open up the outlet to eliminate the pinch.

Post-mortem studies indicate that most people with my version have a birth defect - cartilage that extends too far into the outlet, combined with arm rotation (swimmers & pitchers) or upper body weightlifters. My vice was swimming - and for a brief relapse in the late 90s, since I didn't yet know any better, upper body weightlifting.

[Heartstrings]

195. Had my sternum fractured in a car accident

Pain was worse than giving birth to my 2 children combined!

Pain is pain.....who are we to judge tolerance?

[Crunchy Frog]

214. They withheld them from me when I had a kidney stone.

I was left screaming in an ER cubicle for hours until the stone finally shifted position and the pain went down to a 4 from a 10. Then they gave me 10 mg of hydrocodone, and a prescription for high dose ibuprophen that did nothing at all for the subsequent painful episodes for a stone that took 8 weeks to finally pass. It was two weeks before I managed to get a tiny prescription of hydrocodone from my regular doctor, but not until after she threw a tantrum and accused me of being a drug seeker.

This was a horrific experience, and I am fanatically anti drug war because of it.

If I get another kidney stone, I will stay home and self treat.

[Eliot Rosewater]

221. The very idea this happened to you makes me want to scream.

[Kittycow]

14. I'm afraid of what's going to happen to me...

I'm a severe chronic pain patient completely disabled by it, so bad that I got SSDI on my first try. Dr Government has already whittled my opioids therapy down so far that my quality of life sucks. I've spent so many sleepless nights/weeks pacing the floor with tears in my eyes and fantasizing about putting a bullet in my brain.

No, I'm not going to do that; it was just a mental release at the time. But some desperate people actually follow through.

I can't try medical marijuana or Kratom or else I'll be going against my pain contract and get kicked out of the pain clinic. I go through the motions of other therapies such as PT and injections just to keep the government off my back.

As I told my pain practioner the other day, I know the government is coming for me and I'm going to get screwed. The elderly and the disabled aren't running the streets and selling their pills, but we are the ones paying the price with our increased physical suffering.

There's gotta be some way to crack down on the importation of Chinese fentanyl causing a lot of the deaths. Maybe put a tariff on it... that's the ticket! And crack down on the pill mills in the red States, but that's trump's base .They might get mad.

[blake2012]

19. I deaths are caused when people become addicted, cannot renew prescription

And they turn to heroin. Much of our heroin crisis stems from over prescribed pain meds.

[Ms. Toad]

23. I rarely say things like this -

but i wish a year of chronic pain for you, and a doctor whose philosophy matches yours.

Not the decade my grandmother lived with crippling pain, but a year. I think that long might give you a bit more compassion about what it is like to actually live with pain for which there is no relief, other than medication the government (not your doctor) says you don't need.

[blake2012]

29. I am rethinking the way I expressed it. I lost 2 close relatives to cancer

And pain management/relief for them was an invaluable part of hospice care.

I do like the idea of having doctors overtly step in and keep
Prescribing refills for cases like yours or
Your grandmothers. Defaulting to large quantities of pills in each prescription is what led to all of the tragic overdoses we’ll continue to see.

[Eliot Rosewater]

52. No, making someone get a new Triplicate scrip every week , that they have to physically pick up

and deliver, someone in great pain, nonsense.

Fucking republicans, and I dont mean anyone on this thread or you, I mean the stupid FUCKS who will OVERNIGHT change this rule when it happens to THEM

You see, to get a strong painkiller it is called a triplicate or whatever it is called now, it CANT be called in or faxed or emailed in and it must be hand delivered by patient to pharmacy.

Trying doing that every week when you can barely walk.

[TheFrenchRazor]

99. thank you; the current situation is criminal, and i'm not talking about the "addicts." nt

[RKP5637]

209. TPTB and rich fucks will get their medication. The little people of America, the majority, will

suffer. It's just the American way under GOP control.

[Ms. Toad]

144. The challenge is that imposing draconian limitations and barriers to needed pain meds

is costly in both time and money to people, often who can least afford it.

My spouse has chronic kidney stones. I believe 5 bouts in the last 10 years. When she develops a stone, her choices are:

wait 2 weeks or more to see the doctor OR go to the emergency room for a non-emergent situation because her doctor cannot prescribe opioids without a physical visit - and he never has openings.

Going to the emergency room costs us 4x what it would cost for an office visit - and infinitely more than it cost for him to call in a prescription before a law designed to fight drug abuse prevented him from being able to appropriately manage pain for a known chronic disease. There is absolutely no reason for her to go to the emergency room. We all know what it is, we all know the protocol. If it doesn't pass in a few days, we blast or cut it out. But at the time of the initial acute pain, there is nothing an ER physician will do for her beyond charging her $150 to write a prescription for $10 worth of oxycodone. It is a waste of both our family and ER resources.

As for my grandmother, with chronic crippling pain from arthritis, requiring her to go to her doctor every few days, or at most every 30 days, means a co-pay every month for more than a decade, plus the hassle of transporting a woman in her 90s to the doctor for each of her visits.

Once a patient is established as having chronic pain for which opioid treatment is appropriate, there is no reason related to her care to require her to show up in person to get her next prescription.

In practices like urology, in which acute pain is a predictable side effect of a prominent condition, for established patients (like my spouse who gets a kidney stone every 1-2 years), doctors ought to be able to prescribe narcotics by phone.

[CountAllVotes]

38. +1

People do not have a clue unless they have experienced chronic intractable pain. To know it is to hate it! Living in pain is not an option for many. I can understand why many would simply give up!

[TheFrenchRazor]

69. so your solution is to never allow people to have pain relief, so they won't get "addicted?" or to

give them only 7 days worth, even though their pain may be lifelong? that's bound to stop people from turning to street heroin... NOT.

[blake2012]

73. I think there should be a bit more flexibility

For doctors and patients who are currently managing long term chronic pain with opioids, but I also believe doctors should investigate with every patient whether doses can be ramped down and/or provide non opioid alternatives and free pain management counseling about all of these efforts.

Think about it. Up until mid-90’s (not exactly the Stone Age of medicine) we were dealing with chronic pain in this country with Much, much, much less opioid in our medical system.

Maybe like with mist hotly debated issues, more education and compromise for all involved is needed.

[TheFrenchRazor]

79. that train has already left the station; people are suffering NOW, and this latest move is a step in

the wrong direction, beyond belief. i mean these are poor, elderly people, who probably have multiple health conditions, and the government is going take away medication which could give them some reasonable quality of life??? and btw; drug usage always goes through cycles and fads; and a lot of it is caused precisely *by the government crackdowns.* if drug X becomes less available, people switch to drug Y; that's economics 101. if the demand does not go away (which it won't), a supply will be found.

[blake2012]

89. This epidemic was caused by medical negligence or at least wrong thinking

As well as Pharmaceutical corporate greed. Nothing like it occurred in our recent medical history.

[TheFrenchRazor]

96. so what has caused every other drug "epidemic" this country has experienced? whatever the cause,

prohibition is probably not the answer.

[Demsrule86]

236. Here in Ohio...the addicts don't have prescriptions...they make the shit used.

So, that is not really true...and five years ago my sis in law's doctor refuse her pain meds...he stopped prescribing them because of the paperwork for all his patients...she went to pain management which was expensive and honestly stupid. She can't survive with her arthritis and circulatory issues without pain medication...and they want to make it harder to get over the counter too because of the side effects like killing your liver...face it the plan is to kill the elderly as efficiently as possible or so it seems.

[Ms. Toad]

162. It was the stone age as far as pain relief.

The wife of a friend, who was living with chronic pain, killed herself because in that era she was denied pain relief. We should not be going back to that particular stone age.

[tazkcmo]

94. My oldest son

Committed suicide due to chronic pain and no treatment. What I have to say to you you will get me banned and I don't care enough about you to tell you what I think of you.

[blake2012]

101. Im sorry for your loss. No one is prescribing no treatment for chronic pain

Least of all me. I was on short course of Percocet in 2008 and I saw first hand how quickly one can not only become addicted but lose quality of life on these types of pain killers. No one should have to go without pain medication for chronic pain, but I am also glad the pendulum is swinging quickly back away from overleliance in opioids.

[TheFrenchRazor]

118. YES THEY ARE!!!! what planet are you living on??? and gee, despite your run-in with percocet, you'

you're apparently still alive and well, and here to lecture us about it. how evangelical of you.

[pazzyanne]

132. I strongly support what you said.

I would also get banned if I spoke my true feelings about the attitude toward chronic pain by some on this thread. I also agree with whoever said that they wish a year of chronic pain on people who think that a Tylenol will take care of this level of pain. I HAVE been using non-medication to address my chronic pain, and life is not worth living most days.

[WyattKansas]

122. Really? I still have morphine pills from the 90s...

I kept my last prescription as a trophy, because everyone assumed that I would become addicted. People do not know the hell a stretched and torn sciatic nerve can be in their pelvis. I was finally diagnosed then with Causalgia, but nobody knows what it is today. 23 years ago, I switched from the morphine pills to the maximum dosage of Tramadol and have been on that up to now. If anyone wants to know how Tramadol effects a person, I can tell them... I'm amazed that the Defense Department/CIA hasn't done studies on it to use to their advantage. It helped me a lot to present to keep going with excruciating pain for years, and there is no way that I could tolerate the nerve pain and withdrawal effects from that.

[Demsrule86]

241. I don't think that happens that much, but the answer is not to end

the ability to get pain pills for the majority and allow people to experience terrible suffering.

[blake2012]

250. We need balance. Doctors should be able to do brief write ups for waivers

We need to continue fighting the quantity of these drugs—one way is to ramp down drugs available through pain prescriptions that are so highly addictive.

I understand the many concerns about chronic pain management. I just know there are many weapons against pain besides an unquestioned endless supply of opioids even to people currently on high doses for arthritis and the like.

[RKP5637]

20. As usual in the US with some of the idiots that make decisions, millions will suffer. n/t

[kcr]

31. Yep. They will suffer because of puritanical moralizing bullshit.

Addicts must be punished for their sin and if there is collateral damage, so be it. You're not a cancer patient? Suck it up, cupcake. Stop crying over that compound fracture. Stop whimpering over your Rheumatoid Arthritis. We're meant to feel pain. Suffering is good for the soul.

[RKP5637]

35. Feeling pain is the godly thing to do. Pray the pain away. We often live in a bullshit society! n/t

[CountAllVotes]

39. Try those thoughts & prayers

& Jesus will make it all better!

[smirkymonkey]

172. Mother Teresa thought that letting her patients suffer in pain with nothing to relieve it brought

them closer to god. They got to experience the "suffering of Jesus".

She was a sick, sadistic woman. Of course, when it came for her time to suffer, she availed her self of the best care money could buy and bore her illness in relative comfort.

[Crunchy Frog]

216. Suffering is such a wonderful thing when it's someone else's.

[TheFrenchRazor]

86. couldn't have said it better!!! ain't the Land Of The Free great? nt

[CountAllVotes]

33. They tried to cut my 90 year old aunt off

She fought them and after a few three page letters, she was able to keep her script.

She needs it. She's had more spinal surgeries than I can count and osteoporosis as well. She is not a fraud, she is in a boatload of pain.

Shame of these people! They sicken me so!

They need to quit trying to finish off people like my old auntie! She would be in a nursing home without the pain meds that allow her to live independently and care for herself without the need for home health care!

[RussBLib]

28. it's so stupid and cold-hearted

Take away our opioids and many will turn to the black market, or worse. The last pain doc I went to said he expected hydrocodone and some others to be totally phased out in a few years. WTF?

When I start thinking about the insane pain that I have experienced in my feet, which is ameliorated by hydrocodone and nothing else (so far) it actually makes me choke up and start to cry. When I told this to a doctor's assistant recently, and started choking up, he said, "You have PTSD". I'd never thought about it that way, but I think it's true. Reliving that just brings back a visceral reaction that I cannot control. If all that comes back, a bullet is the only way. I've lived a pretty good life till now.

I live close to Mexico, and that might be an answer for me.

[TheFrenchRazor]

113. Mexico; i'm seriously considering it. how messed up is it when people in america have to literally

consider leaving the country to get basic, necessary pain medication? pretty damn f-ed up, if you ask me.

[suffragette]

26. Last fall I read an article about a study finding increased alcohol use by elderly.

It was striking that the researchers and article basically threw up their hands as to why this is occurring.

I have been wondering if there is a connection between reduced access to effective pain medication and increased alcohol use.

People do have a tendency to turn to what is available and this age group would likely turn to legal and readily available alcohol rather than to street drugs.

[RKP5637]

34. Researchers are often not too bright. To me it's obvious why some older people drink.

There's a lot of depression and pain with old age ... and often horrible financial situations, and homelessness. The US can often be a brutal country IMO.

[TheFrenchRazor]

50. "research" is often driven by politics and dollars. nt

[RKP5637]

107. Yep, sadly quite true. n/t

[OldHippieChick]

66. If "old" people can't get the pain

medications they need, they will also turn to alcohol - an age-old painkiller.

[TheFrenchRazor]

85. i wish i could turn to alcohol, but it makes me sick, so i'm just screwed. nt

[RKP5637]

110. I wish we could try pot, but illegal as hell here. n/t

[TheFrenchRazor]

121. yep; the government tools will throw you in jail without a second thought, for having the audacity

to think you had the right to relieve your own suffering.

[RKP5637]

141. And it's my fucken body. Damn, I am so fed up with this shit in the US. n/t

[Lee-Lee]

27. Given what a high percentage of opioids on the black market originated

with Medicaid and Medicare funded prescriptions this is a move I saw coming long ago.

When I was a deputy when we found pills still in the labeled bottle or when we were able to backtrack where they came from around 65-75% of the time it was a prescription paid for by one of those two programs.

Usually Medicare ones it was either a parent or grandparent getting them for a family member either because they were intimidated or abused into it, or just to sell because they wanted or needed the money.

In Medicaid cases it was about a 50/50 mix of the drug seekers trying to get the drugs fraudulently or getting the drugs to sell because they needed the money and it was easy to go tell the doctor the right things to get what you needed to get the pills.

I had one family where the parents (well, Mom and not the kids dad but live in boyfriend) had managed to get a diagnosis of adult ADHD and then they coached all 4 kids on the right answers to get diagnosed and they were filling 6 scripts for Ritalin monthly and selling it. Good scam until the college kid they were moving it too got drunk and drove with about 400 pills in his console. He was quick to tell where he got them trying to avoid going to jail. He still went to jail.

[blake2012]

45. Thank you! Was starting to feel out of sorts like reversing a negative trend is a bad thing

[TheFrenchRazor]

49. which negative trend do you think has been reversed? as this article noted, OD deaths continue to ri

to rise. the only difference is that now you have a whole lot of other people literally suffering because they can not get adequate pain relief. you think that's a good thing? well, i hope you get to experience it some day soon.

[blake2012]

55. Please read more deeply on the subject

Heroin OD’s are a lagging symptom of overprescription of opioids. I am not saying this has been solved. Nowhere near. I have a HS classmate in West Virginia who I recently spoke to. He and his fiancée are RN’s in ER. They see the sad reality of deaths almost daily.

This epidemic I’ll only stay the same or get worse if nothing changes with physicians and pharma

[TheFrenchRazor]

47. i hope you get an excruciatingly painful chronic disease, and can get absolutely no pain relief.

sorry, but that's what i think of the conscienceless tools who enforce the "war on drugs."

[Lee-Lee]

53. Well I hope your never lose someone you love to opioid abuse

And I mean that, I hope you never do and won’t wish evil upon those I disagree with.

[TheFrenchRazor]

91. like i said, what about all the other people whose lives are ruined, ended, or diminished by the

War on Drugs, in all it's manifestations? i guess they just don't matter. my life is expendable, so that some dumb-ass doesn't OD? gee thanks. and unfortunately, some people never learn until it happens to them. btw, i have a brother who ruined his life with alcohol, but i hardly think that the solution to that would be alcohol prohibition; maybe you do.

[blake2012]

95. Were not discussing prohibiting opioids. Straw man argument

[TheFrenchRazor]

97. oh yes you are; you aren't fooling anybody. if you have to literally be dying to be "entitled" to pa

pain relief, that's prohibition.

[blake2012]

104. No one made that claim either

[Demsrule86]

243. That is what the ultimate outcome will be. Only those with influence and power will get medication

and others will have to die screaming in pain...ah the war on drugs so wonderful. Catch and punish those who abuse the system...not innocent people.

[blake2012]

245. What you said is not true. Shorter duration of prescription

More frequent follow up for chronic pain. Not prohibition on the meds.

[Demsrule86]

246. My sister in law was forced into pain management...and if the rules tighten more, she won't get it

and will die a painful death. Why should she pay the ultimate price for the stupid who use heroin? And don't kid yourself. They don't need pills, they can make their own.

[Lee-Lee]

125. Nobody is saying ban all opioids for those in true need

If your attitude is that it’s fine that as many “dumb-asses” as needed can overdose as long as your not inconvenienced in getting your drugs well then I guess we just have different perspectives.

[Demsrule86]

233. Why should elderly folks , many who have pain issues, pay the price for opioid addiction hysteria.

It won't do anything except kill those in true pain. And it will make it more expensive so many can't afford it...stupid to attack the most vulnerable so you can claim falsely that you 'are doing something'. It is my opinion that untreated pain of all sorts led to this crisis... that and a lack of mental health care and affordable health care especially areas that did not expand Medicaid also contributed to this ' 'crisis'.

[NutmegYankee]

109. Yeah sure, because suicide is so much better than an overdose.

And that’s what people in excruciating pain are now doing - they are killing themselves in droves. I’ve seen that effect.

But hey, as long as you get civil asset forfeitures from the new drug war to get you a nice cruiser, eh Deputy?

[blake2012]

112. Huh? Are you not acknowledging the high death toll due to opioid OD?

[NutmegYankee]

123. People arent dying from prescribed pain pills.

They die from using heroin and synthetics when cut off from pills. And yes, heavy medical use can cause dependency, but that isn’t the same as addiction. A diabetic is dependent on insulin, but they aren’t addicted.

Studies show Most people addicted to opiates didn’t get hooked by pain medicine, they intentionally sought it to get high. And yet the myth continues.

[TheFrenchRazor]

127. correct; nobody OD's on 2-3 tramadols/day. now we still have the OD deaths, and we've got people suf

suffering from chronic pain, etc. on top of that. some of the people here apparently think that's a victory.

[blake2012]

128. you are wrong. please read through this to become better informed as to cause of opioid epidemic

and the numbers who are OD'ing. I'm being accused as a puritan but now you're telling me only the WEAK and BAD people on opioids go out and get hooked and die.

https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis

[TheFrenchRazor]

145. really? people OD on 2-3 tramadols/day? or do they take a handful, get street heroin, and mix it wi

with a 5th of vodka and some sleeping pills? seriously, why should the rest of us be punished for this? and don you care about all the people dying from alcohol and cigarettes? don't their lives matter?

[NutmegYankee]

153. No I'm Right, and Research backs me up.

The majority of pain users took the pills they needed and stopped when the pain stopped. The scientifically established rate is roughly 1% go on to misuse drugs. For comparison, alcohol misuse rate is ten fold higher. Research shows that many heroin users got addicted by misusing pills for "highs" or got hold of someone else's pain pills and only switched when the pill access was cut off. Were pain pills flowing to easily feed a culture of abuse, especially in economically depressed areas, absolutely. Oxycontin didn't get the nickname in 2003 as "Hillbilly Heroin" for nothing. And yet, nearly every person using wasn't using them for a chronic pain condition, nor had they acquired them in most cases for a pain issue.

They used drugs for the same reason many communities with a lack of hope use drugs. With similar effects.

[blake2012]

163. another quick article from drugabuse.gov

https://www.drugabuse.gov/publications/research-reports/heroin/how-heroin-linked-to-prescription-drug-abuse

OD deaths from prescription opioids has actually outpaced deaths from heroin and cocaine combined.

just about half of young people on heroin have said they were taking prescription opioids prior to heroin. Many cited cost as a reason they switched to heroin.

Supply is the main reason this problem spiked along with subsequent deaths. I agree with working on other aspects of treating the epidemic, but supply is the clearest causal to go after.

[TheFrenchRazor]

124. what about alcohol, cigarettes, car crashes, etc.? apparently nobody cares about those people. nt

[blake2012]

130. they do. were you someone who groused about laws forcing you to war a seat belt?

this is not a minor uptick. 33,000 people in 2015 died just opioid overdoses. This is an epidemic and should be treated as such.

[TheFrenchRazor]

148. FAR MORE people die due to alcohol and cigs; should we have to get gov't/doctor approval before

consuming those things? it's a simple question. you can't have a country that is both free and drug-free. i choose free, and yes i opposed seat belt laws; if i want to kill myself that's my business. i also ride a motorcycle with no helmet, and i enjoy the hell out of it!!

[NutmegYankee]

156. They're not dying from taking pain medication - it's black tar heroin mixed with synthetic opiates

They're dying because a black market doesn't regulate dosage and society can't cure the reason they sought drugs in the first place.

[blake2012]

165. wrong

https://www.drugabuse.gov/publications/research-reports/heroin/how-heroin-linked-to-prescription-drug-abuse

[NutmegYankee]

173. *Yawn* Did they pay you to post this?

Or did you really fall for it on your own?

[blake2012]

174. why would you say that?

[NutmegYankee]

177. I'm tired of propaganda. I'm tired of moral panics.

Imagine having an illness where pain flares up from time to time to unbelievable levels and you can't even get out of bed. You can't think, or scream, only moan in agony. You might cry since nothing else works.

Now, There are pills that you can take that temporarily allow you to function like a normal person, and once the condition goes to remission, you stop taking them. They aren't perfect, but it knocks the pain down substantially.

Now, imagine hysteria caused by misuse by others has ensured that your next flare up will be agonizing and merciless. Imagine now that medical doctors who completely understand the pain have only chosen to leave you to suffer because they fear draconian laws passed due to the adventures of people who wanted to get away from their depressing but non physically painful lives. But that's OK, you can "take an aspirin and tough it out". Said a fucking psychopath* whose never had the misfortune to be in agony...


*Who I might add, looks like a Keebler elf.

[blake2012]

182. you're really linking to Reason magazine?

From Wikipedia:

Funding and partners[edit]

Reason Foundation is a 501(c)(3) nonprofit organization supported by donations and sale of its publications.[15] Its largest donors are the David H. Koch Charitable Foundation ($1,522,212) and the Sarah Scaife Foundation ($2,016,000), according to disclosures.[16] Other major donors are Donors Trust and Donors Capitol Fund, which in turn do not reveal their donors.[17] The Reason Foundation is part of the libertarian Atlas Network,[17][18], the State Policy Network and ALEC.[17]

NO THANKS!

[NutmegYankee]

184. And you're linking to the Trump Regime. I figured it fit right in. nt

[blake2012]

185. now all of the rank and file departments within federal government are Trump?

apparently you didn't like their statistics.

[NutmegYankee]

188. It didn't go unnoticed that the rest of that previous post was ignored.

I'm not surprised at all. Those with chronic pain have no place in this society anymore.

[Eliot Rosewater]

68. The folks who want to prevent you from getting your needed drugs arent in pain

and dont know shit.

When they are in pain, they will change their tunes.

If they had any clue what they were talking about they would NEVER conflate someone who died from abusing RX to someone in pain.

[TheFrenchRazor]

102. see #64. nt

[Demsrule86]

242. Oh my the horror, we must of course stop all pain medication and ADD medication.

Punish everyone.

[Eliot Rosewater]

36. I knew it, I knew this FUCKER would kill people eventually, pain kills.

[CountAllVotes]

40. Pain prevents healing

That is why they give you an RX for pain medication after surgery. It is so you will heal faster!

Shame on anyone that embraces such idiocy! There are some people that DO REALLY NEED THE HELP that opiates provide!

[Eliot Rosewater]

41. We are under attack, we are at war. The right is trying to kill us, not just liberals but all of us

[TheFrenchRazor]

44. people are ALREADY suffering from this. the War on Drugs is a war on people. it's BS.

chronic pain suffers are considering killing themselves or leaving the country, due to the inability to get necessary, appropriate pain relief. i'm sure that many have already done one or the other. it is complete bullshit and governmental over-reach.

[CountAllVotes]

74. A true story here

Was at the hospital waiting to have some blood tests run. This woman was sitting there that had neuropathy from diabetes.

I mentioned they are trying to cut people off from pain meds. She said she did not know how she could manage w/o them due to the pain she has.

This man was sitting there and he said to her, "You might try heroin if you cannot get your pain RX filled."


I couldn't believe that a stranger would come right out with it like that! And they wonder why there is a problem?

[TheFrenchRazor]

136. guarantee you that person is not the only one who thought of that. heroin is cheaper on the black

market than pills; more bang for the buck, anyway, apparently.

[RKP5637]

115. I would be out of the US in an instant, but I have no options. The US is crazy in so many ways. n/t

[TheFrenchRazor]

131. i hear you. stay strong, as much as possible. nt

[RKP5637]

142. It's never ending in the US. One damn punitive thing after another. Greatest place to live?

Definitely NOT!

[CountAllVotes]

147. I am sick of it

I agree, what kind of country has this become. Every person that has pain is an addicted criminal is the new rule it seems!

I want out of here too!

[TheFrenchRazor]

152. unfortunately, it looks like it's only going to get worse. the War on Drugs has been a fabulous

fabulous success from the POV of government and law enforcement. it is a useful tool to control and terrorize the masses, while providing themselves with an almost unlimited source of untraceable drug money for their slush-funds, and all the goodies from asset forfeitures.

[Le Gaucher]

71. Good. Opiods are rarely used elsewhere in the world.

Time to crack on it abuse

[RKP5637]

111. What do they use, for example, after a major operation? n/t

[Le Gaucher]

170. See reply below .. My cousin got nothing more than a Tylenol after the anesthesia wore off

That after a c section

My wife here got Percocet / Hydrocodone

[Demsrule86]

244. And you think that is a good thing? Percocet and hydrocodone are pain drugs and would

be limited as well.

[TheFrenchRazor]

134. you're kidding, right? they might not use pharm. pills, but the opium is quite popular around the wo

world.

[Le Gaucher]

169. No .. my cousin in Germany did not get an opiod after C-SECTION

Doctors asked her to feel the pain and take a Tylenol if needed. My cousin thought the doctor was crazy .. but she recovered very quickly and now thinks that pain helps you listen to your body.

[Ms. Toad]

198. C-sections are not especially painful surgeries.

Don't recall if I used narcotics or not, Other surgeries are far more painful, so don't extend tylenol as sufficient pain relief for a C-section to it being sufficient pain relief for other surgeries.

[Le Gaucher]

200. My wife got a Percocet and hydrocodone for a C-section recovery

Same surgery and narcotics were given as a standard operating procedure

[Demsrule86]

247. That is not true...if they open the abdomen, it is one of the most painful surgeries there are...the

old fashioned c-sections still used for emergencies are very painful. They have surgeries now where they don't cut as much. You have the vertical cut and the horizontal cut.

[Demsrule86]

234. Link because I don't believe that and lets concentrate on places where health care is available.

My daughter broke both her ankle and was sent home with tylenol...she was in agony. This is unconscionable.

[BobTheSubgenius]

82. The threat of withdrawal is a serious issue.

My wife had a knee replacement, and was given a scrip for Dilaudid when she was sent home. It worked a treat, but I was a bit concerned. We talked it over, and with the Dr's blessing a second fortnight's supply was changed to a non-narcotic.

At first, she hated the new med because of its side-effects, and not just the lowered efficacy. It made her feel anxious and uncomfortable in her own skin, and a sensation that had a dollop of itchiness about it, but wasn't that, exactly. Sort of "crawly." The worst was the feeling that she would eventually erupt through her own skin, like Alien.

She persevered, and it got better. Fast forward almost 2 weeks to her next appt. "Oh yes. A lot of people experience that. It's a mild withdrawal."

After TWO WEEKS!

[Shrike47]

138. I am having rotator cuff surgery in a coupe weeks, apparently without prescription painkillers.

I had the other shoulder repaired a year and a half ago. Very painful but manageable with opioids. I took them only as prescribed. Same doctor but different approach now. I am really not looking forward to the surgery and curse the federal government on this subject.

I can’t take naproxen due to my heart/medication.

May they all get untreatable gout.

[CountAllVotes]

143. I wish you luck

I am living with a torn rotator cuff (35 years now).

The pain and the spasms that go with it are horrible.

I cannot sleep or lay on that side as the pain is out the window when it is touched by anything.

As for no help w/the pain ... I think I'd look for another surgeon as you HEAL when the pain level is controlled. Shame on this physician if the new approach is to use no pain medication for such an intense surgery!

I wish you the best of luck and I understand if that helps at all!

[RKP5637]

146. I've had some major surgery that hurt like hell with ample pain medication. I can't imagine going

under major surgery without post-operative pain medication. What are we supposed to do, drink ourselves into oblivion. Damn, I am so fed up with all of this.

[Ms. Toad]

157. I'd be finding another doctor.

My understanding is that rotator cuff surgery is particularly painful for a very brief period. There is no reason not to have adequate pain relief.

[blake2012]

166. the other poster said "non opioid" pain relief would not be used

not "no pain relief".

[Ms. Toad]

168. I'd still be finding another doctor.

Last edited Tue Mar 27, 2018, 07:34 PM - Edit history (1)

Best practices, ignoring regulations imposed for non-medial reasons, address two things:

Pain relief is crucial to healing
Staying ahead of the pain is far easier than driving it back once it is present.

From my contacts with people who have had rotator cuff surgery, it is an extremely painful surgery for a brief period. I am not aware of any pain medication other than opioids, in the face of acute pain that is capable of shutting it down quickly enough to stay ahead of that kind of pain. /And trying something else first leads to entrenched pain when it is insufficient, countering the two elements of post-surgical pain relief.

Opioids should not be needed for an extended period of time - but I would not consent to rotator cuff surgery with a doctor who refused to provide adequate pain relief, up to an including opioids. (And since I've been dealing with rotator cuff pain since July that is not a theoretical response.)

ETA: The other poster said non-prescription. While that includes no opioids, it is a lot broader than just no opioids.

[Demsrule86]

237. Like what? There is no effective pain relief without opioids for many.

And at the same time they want to make people get prescriptions for over the counter paid drugs because of their side effects like killing your liver or bleeding ulcers.

[raven mad]

167. I'd love for the opioid fear-mongers to break their pelis

in not one but three areas. All 4 of my docs, 2 ER, 2orthopedic specialists have put, in writing, that I'll heal IF I adhere to their regimen: lots of rest, very mild physical therapy to start, and pain meds.

Dare you, Medicare!

[WestwardWind]

175. More reason we need to legalize marijuana ASAP

[GaYellowDawg]

187. I wanted to weigh in on this

As someone who's had an ongoing pain condition recently.

Back in December, I started having a tingling feeling on the front of my thighs and around my waist that graduated into pain. It was skin hypersensitivity. The pain level ratcheted up and up until it was unbearable. It felt like I was on fire. And it spread, too. You know the day after you've had a terrible sunburn? When you can't even abide the touch of the softest cotton sheets on your skin? Imagine that, on the front of your legs and the back of your arms, and all over your entire torso. Imagine not being able to shower because even a gentle shower causes you pain. I've been hospitalized for diverticulitis, and I had 3 major coronary blockages leading to 2 stents being placed. The pain that I've suffered has been at times comparable to a perforated bowel and angina. The kind of pain that makes you curl into it, and get nauseous and sweaty just from the pain. I'm not kidding. I'm talking gas bubble stretching an intestinal perforation and severe angina resulting from a mostly-blocked LAD. This pain has been comparable to those at its worst. I've cried and howled from this pain, and I'm not a crier.

I tried OTC painkillers. Aspirin, ibuprofen, acetaminophen, naproxen. None of them even put a dent in the pain. Then, following my doctor's advice, I tried gabapentin. Tried Lyrica. Tried tramadol. Tried tramadol in combination with gabapentin. Then with Lyrica. Then I had an oral surgeon prescribe hydrocodone/acetaminophen and that took the pain away for a couple of days. Then it came back. And then I was on oxycodone. 20mg per day. Then 30. Then 40. Then 40 with 900mg gabapentin. Each time, the pain would subside for 2-3 days and then come straight back. I went to a pain clinic. It was the most useless experience ever. They tried a couple of desultory tests and then said they didn't know what was going on, so they weren't going to diagnose and weren't going to prescribe any painkillers. Back to the primary care physician. Then I finally got in to see a rheumatologist and apparently I have an autoimmune disorder that is sending some histamine receptors crazy. Antihistamines have worked very well, and I am now tapering off the oxycodone, and profoundly grateful to do so.

I don't know what I would have done if all the different painkiller routes hadn't been available to me. Most likely lost my job (so many days when I could barely push through) and might have been pushed to suicide. They weren't ultimately the solution, but they gave me enough of a bridge to keep going. Unless you have been through it, you can't imagine what unrelenting, unremitting pain will do to you. When the pain won't let up, ever. When you can't find a posture or a palliative for it. It will drive you crazy. In my case, fortunately, there was finally a diagnosis and a solution that didn't involve painkillers. It might not have been that way. If the opioids had been the solution, and there were time limits placed on that kind of chronic pain, it would end my life. When you're in that kind of pain, you'll do just about anything to get rid of it. And you - the reader, you - have no clue how you will react to ongoing pain until you've been through it. You may think you're tough, you may think you could rise above it, but you just don't know.

To deny any and all available routes for getting rid of pain is to be either an unthinking, uncaring ideologue, or a masochist. I realize what drug dependencies are, and I realize what the risks are. I went into the opioid prescriptions with my eyes wide open, accepting the risks. They were well worth it for me to feel some relief. I wasn't even asking for complete relief. I just wanted manageable pain. Just manageable. Most days for the past 3 months, I haven't had that. Don't you dare judge until you've walked in someone's pain. Screw someone's shoes. Walk in their pain and you will come out of it thinking differently.

Instead of cracking down on patients, how about cracking down on abuse? More severe penalties for doctor shopping, and more severe penalties for drug distribution, combined with free and available detox and rehab centers. This thing to set time limits on painkillers will end up being a killer.

[blake2012]

191. how long were you on the oxycodone if I may ask prior to finding out antihistamine was the solution?

[GaYellowDawg]

215. Close to 2 months.

I got a little shaky and weepy when I cut back from 40 mg to 30 mg per day. Now I'm cutting the dosage by 25%, and things seem to be going well. I understand that my dependency is not what it would be if I have been on the oxycodone for years, but 8 weeks at 40 mg per day he is more than enough to develop a dependency. I would hate to have tried to go cold turkey.

[blake2012]

217. Wow. Definitely understand. Pain is unbelievable to deal with. Only limited experience for me

[RKP5637]

202. Very well said. I really think those professing they are not needed have never been subjected to

seriously prolonged pain.

[blake2012]

210. Ive not seen one person claiming pain meds arent needed

Or even that opioids specifically aren’t needed

[RKP5637]

211. Someway, there needs to be a dividing line. Is it the pharmaceutical companies pushing drugs and/or

lax doctors. I've had pain killers several times for some operations I've had and I did not even become remotely addicted. My dr's monitored how I was doing very closely, and then toward the end had me take the pain medication every other day, and Naproxen on the other day. And then eventually stop everything. Now, I just take Naproxen everyday.

I had a friend that had constant pain from a number of diseases in her 90's. The drs. gave her a lot of pain medication and said at her age, it made little difference if she were addicted. I think you agree, one size does not fit all.

One concern I have is the black market will just increase. The problem is how to consistently distinguish those with legitimate needs and those that can do well with alternatives. And those who abuse the system.

[blake2012]

212. I wholeheartedly agree with your post

[MaryMagdaline]

190. I'm Libertarian on this issue

People should have liberal access to pain medication. Some people will choose to die rather than live in pain. Some people will become non-functioning addicts. Who am I to judge?

[blake2012]

193. wow

[MicaelS]

196. Agree completely. n/t

[RKP5637]

203. I agree. People should be in control of their own bodies. The gov. should go after the abusers, not

pigeon hole everyone into the same box.

[tymorial]

194. The black market has been alive and well for a while

The crack down doesn't stop abuse it just causes death as people turn to alternative methods to get their fix. They will go to the street or the deep web of they are savvy. I am on the front lines, these laws do little to halt abuse.

[RKP5637]

204. They are stupid laws that TPTB enact to say see, we did something. It's stupid and absurd. n/t

[aikoaiko]

197. I stand with the people who will be denied pain meds for legit pain.

Its just damn cruel.

[RKP5637]

206. K&R!!! n/t

[tammywammy]

201. Hasnt there been multiple studies recently

Indicating that opioids are no more effective than non-opioid pain medication?

[kcr]

205. One study

And it was limited to one type of pain. ETA it was a flawed study in that the doses of OTC were maximum, while the dosages of opioids were minimum.

[RKP5637]

207. I think it depends on the type of pain. I take prescription Naproxen for arthritis, twice a day,

4 pills a day. So, I will possibly end up with ulcers and potentially a fatal heart attack.

[Crunchy Frog]

218. No. n/t

[enid602]

219. opiods

And yet, on a per capita basis, doctors in the UK only prescribe 1 1/16th of the opioids that are prescribed in the US. Do Americans have greater pain issues, or are they just hooked on the opioids.

[Crunchy Frog]

223. Until very recently, codeine was an OTC medication there.

So people could take opioids without being prescribed them.

Also, heroin is a legitimate drug, manufactured and used for pain management there.

I don't know where your statistics come from, or how accurate they really are.

[enid602]

224. opioid use

per https://qz.com/1198965/the-surprising-geography-of-opioid-use-around-the-world/

daily doses of Opiods per million people, 2013 to 2015.

US 47,580
Japan 1,220

[Crunchy Frog]

225. Nothing in there about the UK.

[enid602]

226. UK

I heard that from another source, but this source did not mention the U.K.. I wish we would adopt the U.K. policy regarding distributing heroin to addicts, but I think we should end the incentives made to doctors to get new people hooked on opioids.

[Crunchy Frog]

227. They don't use it for addicts. They use it in hospitals for management of severe pain.

https://patient.info/medicine/diamorphine-for-pain-relief

(Diamorphine is a "nice" word for heroin.) There are other countries using pharmaceutical grade heroin for addicts.

[enid602]

228. UK

In England the Gov't distributes heroin laced cigs to addicts. They have for years, and there's not much drug related crime. They prescribe just a tiny fraction of the opioids prescribed here. They know how dangerous they are.

[Crunchy Frog]

230. And they sometimes administer heroin to children, and codeine has been freely available OTC. n/t

[radius777]

229. Some people are just addictive; everyone else shouldn't pay price.

This is your typical moral panic (like with porn, pot, video games, music, etc) that punishes the many for the bad actions of a few. It's why even with the gun issue I tend to be wary of overreach, because once a society becomes based upon the moral panic-restriction dynamic, it radiates outward to every other issue.

Most of these drugs that get demonized - from benzos to stimulants to painkillers to medical marijuana - are perfectly safe, effective and affordable (generic or soon to be) medications that are used properly by most doctors/patients. The suffering they solve is exponentially greater than the suffering their misuse causes.

Outlawing or severely restricting these meds (that are essential for many) will mean that only outlaws and the elites will have access to them.

[RKP5637]

231. Well said!!! Exactly!!! We see this crap all the time, the moral crusaders to punish all because of

the abusers.

[Demsrule86]

238. Exactly, the abusers will find it somewhere and the innocent will suffer needlessly.

[alarimer]

232. This is going to do the opposite of what is intended.

Reducing legal access to pain medication will only lead desperate people in serious pain to less than legal methods. How is this not going to result in MORE opioid deaths, not fewer?

This is a public health crisis, but one that is not going to be solved with more prohibition (which, as we know, never works anyway). It also has the effect of demonizing people who are genuinely in pain. Lately, I've been hearing or reading that Americans are too afraid of a little pain and life shouldn't be pain-free. Well, why not? Is there some nobility in suffering needlessly?

Couple this short-sighted plan with Sessions' crackdown on pot and we will have the perfect storm of even more people dying needlessly, from people self-medicating in some other way or ending up in prison with a small amount of pot (which I understand works pretty well a lot of the time without the risk of overdosing. Not that scientists are even allowed to study it to prove, but still).

I am not in any kind of situation that requires serious medication, but if I were, I would certainly do WHATEVER IT TOOK to end pain. I think, unfortunately, that too many people, including physicians and elected officials, lack empathy for those individuals.

I do recognize that we need more tools to deal with pain. Big Pharma makes a shit ton of money on opioids that they would lose if pot, say, were legal everywhere. But telling someone to take a Tylenol (which has its own drawbacks) is just fucking insulting.

[RKP5637]

251. K&R !!!!! n/t

[fescuerescue]

248. And then we wonder why Heroin addiction rates are sky rocketing

[RKP5637]

253. Often the US is void of intelligence. The US fuels black market things and then wonders why. n/t