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Posted on 9/27/17 at 11:35 pm to 3lsu3
Yes and quarterly visits for all controlled medications are crushing those of us who work in primary care. We have more documentation and assessment/care duties to perform b/c patients are coming in so often. Of course we still have to see our same day/sick visits.
I do not envy PCP's and the shite they have to deal with daily.
I do not envy PCP's and the shite they have to deal with daily.
Posted on 9/27/17 at 11:37 pm to VaBamaMan
quote:
VaBamaMan
I have to go to bed, but I want to leave you with this...
Opioids are NOT the treatment for your father's condition, or any neuropathic pain condition for that matter.
Either your father is simply addicted to opioids and you or he won't admit it to yourselves. Or, he has a really shitty doctor and needs to find a new one.
I hope it's the latter, and he can find someone who can actually treat him and improve his quality of life.
Posted on 9/27/17 at 11:38 pm to HailHailtoMichigan!
Just from a glance at headlines over the past year and a handful of first hand stories from a few different regions of the country I think heroin is on its way to crippling rural/small town white communities the same way crack destroyed low income black communities.
And the government has played a key role in its growth (Afghan war facilitating production, lack of regs for Big Pharma) just as they did with crack.
And the government has played a key role in its growth (Afghan war facilitating production, lack of regs for Big Pharma) just as they did with crack.
Posted on 9/27/17 at 11:50 pm to GEAUXT
quote:
Is there a reason your father hasn't actually been treated, and is instead just being fed pain pills?
Because Trigeminal Neuralgia basically cant be treated. He has already had a 6 hour long, highly invasive brain surgery to lighten some of the symptoms. They can cut the nerve completely, but you could lose your hearing, sight, potentially speech...etc, if they do. And it still wouldn't stop the burning. Only the stabbing pain where it feels like someone is sticking a white hot needle through your eye, another through your temple, and into your brain.
quote:
Enlighten us
a) Legalize weed. Yesterday. A solid discussion about ending opioid addiction begins there.
b) Limiting scripts to 7 days is great. If they have never had a script before. You can't just cut off those who have already been on it long term. You can't. 7 days is not long enough to ween off of it. I know, I've tried. I've been on opioids for 4.5 years after having a shoulder surgery that went bad. I didn't become physically addicted until the summer of 2015. Since then, the longest I was able to stay off was 25 days, and I still couldn't sleep without a tall glass of vodka, ambien, melatonin, and ZZZZquil. Longest I've been awake because of withdrawals was something like 62 hours. I slept a grand total of 4.5 hours when I finally was able to sleep. And I've only been taken Norco 10mg 4x a day. People who are on stronger for longer, are seriously screwed if this 7 day plan is implemented.
c) We need to actually help people. Support addicts instead of dragging them down. Change the dynamic regarding addicts. They aren't bad people. They are your neighbors, your family. Many of them go to work every day, and do so because these meds make it possible to work. We need support and help to get over this. Not derision, hate, and judgement. Also, we need to make meds such as suboxone easier to obtain. The stuff produces no analgesia or euphoria to users outside of the first day.
d) better alternatives. The best thing I've ever taken for pain is Toradol. It is a non addictive NSAID. But you can't take it daily. It will kill you. Diclofenac is another strong NSAID, but it doesn't even come close to Toradol for really bad pain. My shoulder has been in so much pain I couldn't breath and toradol knocked it out. Diclofenac is like tickling an elephant with a BB gun by comparison.
c) Develop opioid strains that are almost purely analgesic, and provide no "euphoria" to a segment of the population. Which is normally around 20%-25%. I am admittedly one of these. Opioids are an upper for me. It gets me up, feeling good, and ready to attack the day. There are many like me. While I have never taken heroin, I have taken a purer form more akin to mother opium once, and it was more analgesic and didn't give me this high. I found this curious, so I researched it. It's because many of the drugs we use are made from the alkaloid Thebaine, which has more stimulating effects than the other alkaloids produced by the poppy. Yes, our body metabolizes stuff like Norco into Morphine, but its made via Thebaine rather than the route we use to make morphine.
I'm tired of typing for the night. But I could say more. Those are just the main points of how I would go about doing it.
This post was edited on 9/27/17 at 11:58 pm
Posted on 9/27/17 at 11:56 pm to GEAUXT
quote:
I have to go to bed, but I want to leave you with this...
Opioids are NOT the treatment for your father's condition, or any neuropathic pain condition for that matter.
Either your father is simply addicted to opioids and you or he won't admit it to yourselves. Or, he has a really shitty doctor and needs to find a new one.
I hope it's the latter, and he can find someone who can actually treat him and improve his quality of life.
No, they aren't. He started out taking them because of a degenerative back, and a knee that is missing its ACL, MCL, and PCL. But he can't take the pain of TN and go through withdrawals, and his doctorS(plural) have all tried everything. Including a long and seriously invasive brain surgery. They are not relying solely on opioids.
He is absolutely physically addicted to them.
And that is the thing people don't seem to understand. Addiction isn't necessarily a mental thing. Our bodies get used to these things and addiction becomes physical.
The list of medicines he takes to try to mitigate the pain, as well as the mini strokes, and raised blood pressure from the pain, is long than an elephant's dick. Oh, and he is only taking 4, 10mg Norco a day as well.
Posted on 9/28/17 at 12:01 am to BamaFan365
quote:
Haven't really been around either
Posted on 9/28/17 at 12:35 am to NCNurse
Oh here come the nurses...NPs haven’t written as many opioid Rxs for two reasons 1) there aren’t as many of them 2) the DEA and states rightfully prevented them from being able to write schedule II substances for a long time.
The ANA, for years, had been beating the pain is undertreated drum and teaching mid levels that it’s ok to treat a subjective finding with opioids. Their publications regularly alluded to the brutality of 19th century wartime medicine, to promote/inflate their own role in dealing with pain management. They also influenced hospital policy (along with patient satisfaction BS) to the point where providers could get “written up” for not adequately addressing a patient’s 10/10 pain. I know because I had a floor nurse report me for not giving a completely neuropathic patient pain medicine in the middle of the night. The patient had dementia and was sundowning...the nurse demanded pain medication for the patient basically because he was flustered and couldn’t handle the patient, saw the metal on her leg and figured I was going to make his life easier.
As for the guy whose dad has TN and said “trigeminal neuralgia can’t be treated.” Um, it can be treated and it is actually treated successfully in a large majority of patients who develop it. And that’s with non opioid medication alone...before you even get to surgical procedures that involve various means of decompression.
The ANA, for years, had been beating the pain is undertreated drum and teaching mid levels that it’s ok to treat a subjective finding with opioids. Their publications regularly alluded to the brutality of 19th century wartime medicine, to promote/inflate their own role in dealing with pain management. They also influenced hospital policy (along with patient satisfaction BS) to the point where providers could get “written up” for not adequately addressing a patient’s 10/10 pain. I know because I had a floor nurse report me for not giving a completely neuropathic patient pain medicine in the middle of the night. The patient had dementia and was sundowning...the nurse demanded pain medication for the patient basically because he was flustered and couldn’t handle the patient, saw the metal on her leg and figured I was going to make his life easier.
As for the guy whose dad has TN and said “trigeminal neuralgia can’t be treated.” Um, it can be treated and it is actually treated successfully in a large majority of patients who develop it. And that’s with non opioid medication alone...before you even get to surgical procedures that involve various means of decompression.
Posted on 9/28/17 at 12:39 am to genro
Are you a health care provider?
Posted on 9/28/17 at 1:07 am to HailHailtoMichigan!
For sober, educated people, they just don't get it... prescription pills are not fueling this round of the epidemic. It is full blown heroin, everywhere. Now fentanyl is way easier to source and carfentanil not particularly much harder... so we're dealing with that delight of prohibition now.
Got stuck working with a junkie crew the other day... about wet myself listening to the stories of their suboxone melting in the hurricane outage and being less active/potent.
And chris christie would still be fat if limited to an 8 hour supply of food... so there's that.
Got stuck working with a junkie crew the other day... about wet myself listening to the stories of their suboxone melting in the hurricane outage and being less active/potent.
And chris christie would still be fat if limited to an 8 hour supply of food... so there's that.
Posted on 9/28/17 at 1:11 am to MoarKilometers
quote:
prescription pills are not fueling this round of the epidemic. It is full blown heroin, everywhere
Uh what? You do realize people jump from pills to heroin... Because heroin is so much easier and cheaper to get?
The pill mills are absolutely to blame for the rise in heroin usage.
Why spend $100 a day on oxys when you can spend $20 on heroin and get a longer, "cleaner" High?
Posted on 9/28/17 at 1:47 am to beerJeep
quote:
The pill mills are absolutely to blame for the rise in heroin usage.
Were... as in it is not the biggest current issue we face. Cracking down further on legit doctors is as useful as pissing on the great chicago fire. The problem has expanded to beyond what they are addressing here.
Posted on 9/28/17 at 1:56 am to HailHailtoMichigan!
All this is going to do is make it harder to give legitimate patients the medicine they need while pushing druggies to illicit substances, which will of course necessitate the expansion of the police state.
Posted on 9/28/17 at 5:04 am to HailHailtoMichigan!
In this land of freedom we spend far to much time trying to force compliance from others on far too many issues.
Want to resolve the opiod "crisis", give all consenting adults all the opiods they want, 18-24 months later the problem will be resolved and the rest of us can carry on as normal.
How did we get to where we are constantly restricting all people because a few are frickups, not just on this topic but so many more.
Want to resolve the opiod "crisis", give all consenting adults all the opiods they want, 18-24 months later the problem will be resolved and the rest of us can carry on as normal.
How did we get to where we are constantly restricting all people because a few are frickups, not just on this topic but so many more.
Posted on 9/28/17 at 5:07 am to HailHailtoMichigan!
I don't need the government restricting my prescription power. I know the patient, the government doesn't know the patient.
Posted on 9/28/17 at 5:20 am to HailHailtoMichigan!
quote:
Looks like decent progress being made
Great progress! Drug dealers everywhere are rejoicing.
Except the ones in white coats. This is going to piss them off, and cost the rest of us a lot of money.
Posted on 9/28/17 at 5:23 am to YipSkiddlyDooo
quote:
As for the guy whose dad has TN and said “trigeminal neuralgia can’t be treated.” Um, it can be treated and it is actually treated successfully in a large majority of patients who develop it. And that’s with non opioid medication alone...before you even get to surgical procedures that involve various means of decompression.
So? It wasn't treated successfully in his case. Now he's stuck on prescription pills, issued by his doctor. That's the situation.
Posted on 9/28/17 at 7:14 am to HailHailtoMichigan!
So stupid.
More heroin overdoses soon to come.
Larger black market
People who really need them getting screwed.
The right wants to repeal Obamacare but wants three Feds telling doctors how to do their jobs.
More heroin overdoses soon to come.
Larger black market
People who really need them getting screwed.
The right wants to repeal Obamacare but wants three Feds telling doctors how to do their jobs.
Posted on 9/28/17 at 7:26 am to HailHailtoMichigan!
quote:
recommending new treatments for pain management without the use of addictive substances
Posted on 9/28/17 at 7:42 am to YipSkiddlyDooo
There are many debilitating diseases that can only be treated with pain pills. Migraines, fibromyalgia, back disease etc. hell my cousins fibromyalgia is so bad that he starts developing flu like symptoms if he misses a day of his medicine for it
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