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Pain Medicine: Pain Relief Network Sues State of Washington Over Narcotic Prescribing Guidelines

The Pain Relief Network (PRN), a nonprofit organization waging a lonely battle to protect the rights of doctors who prescribe opioid pain relievers and patients who receive them, has filed a lawsuit against the state of Washington over prescribing guidelines promulgated in March 2007 by the state Department of Health.

The guidelines are designed to guide physicians through the minefields of narcotic prescribing in a time where they face a rising clamor for the relief of pain at the same time they face the threat of arrest and prosecution by federal or state agents intent on stopping narcotic drug abuse. But PRN alleges that Washington's guidelines deter doctors from prescribing opiates and have had an undue negative influence on prescribing practices across the country.

The guidelines, which only apply to the treatment of chronic pain -- not cancer pain, acute pain or hospice care -- recommend that daily opioid doses not exceed 120 milligrams of morphine or the equivalent if both pain and physical function are not improving. PRN argues that the guidelines are inflexible and fail to account for the needs of real patients.

According to the complaint filed late last month on behalf of a Washington state doctor and a group of Washington state pain patients, plaintiffs seek an injunction blocking the guidelines from being used. The complaint argues that the Washington guidelines violate both state laws and federal civil rights laws.

Permission to Reprint: This article is licensed under a modified Creative Commons Attribution license.
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Prescribing Opiate Pain Relievers

We don't have that problem in Iowa. With 2 methadone programs in Des Moines, a town of only 225,000 people, anyone who has even a mild addiction to pain pills can get on Methadone a much more addictive narcotic. I also know of to opiate addicts who take 110mgs of Methadone every day plus they get 225 Dilaudid a month, legally! While, in Iowa, Marijuana/ Medical Marijuana is considered as addictive as heroin yet it is outlawed, but you can become a legal opiate junkie. Where is the sense in this?!?! This is just another example of the "War On Drugs" working in reverse.

STIGMA

Anonymous

Shame on you for comparing patients with legal perscriptions of opiates to street junkies.

Methadone is a wonderful medication for chronic pain. It has many advantages for long term chronic pain patients.

As far as addiction managment is concerned, methadone is highly regulated and considered the gold standard treatment for opiate addiction managment.
It is no party beinging a patient at a methadone clinic since most of the anonymous joes out there like you don't know anything about the treatment so they just keep up the same stigma you exhibit.

Shame on you.

KK

Pain Medication

I have been in chronic pain related to damage to my kidney from a lifetime of kidney stones. This pain feels as though I have a stone and I would have no quality of life without my medication. When this first started 12 years ago it was virtually impossible to get a doctor to prescribe pain medication. After being insistent and consistent in my symptoms I finally found a doctor who believed that I was in pain. Now there is a question about my ability to perform my job after 12 years of performing my job competently. Because of people who are addicts and who do abuse narcotics we chronic pain sufferers are paying the price. If someone is truly in pain the medication goes directly to the pain and if taken responsibly does not impair performance or judgment. I recently read an article that was referenced to my particular occupation that indicated an employee would be most beneficial if they were being treated for the pain than they would if they were suffering all day. People who do suffer from chronic pain can relate to this because the pain controls every aspect of your life. In regard to ADDICTION that is completely different than DEPENDENCY. Addiction is a behavior where a person is seeking drugs, often gets prescriptions from different doctors, is clearly impaired and calls his doctor for refills before its due. Like my doctor says, "people don't call and say they lost their antibiotic." its hard for an addict to hide his addiction because of the nature of the disease and its progressive nature. Dependent. however, is merely the bodies need for the medication which is why withdrawals occur. If not an addict and merely dependent there should be no problem weaning off. Too many people confuse addiction with dependency. That is the stigma of our society based on ignorance (meaning not educated on the subject).

Prescribing Opiate Pain Relievers

It is not the DEA that has to go to school to learn how people tolerate a drug. A peak and trough test is usually the correct way of knowing what a persons body needs to fight off pain. I do not feel it is the DEA's job to do what a trained doctor is taught to do.
Granted there are probably a few crooked doctors just in it for the MONEY but most actually care about a persons pain and try their best to help the person in need. Each persons body has different tollerances and the DEA needs to learn this. Again I dont feel the DEA has the right to make the decision on how much of a drug a person needs. Let the test show the truth.
I have seen some people that do quite well on a low dose and some that do require alot more because each persons body absorbs differently. In my feelings I say the peak and trough test should be done because it shows the actual tollerances that ones body needs to combat the pain. It is not a guessing game as the DEA is doing it now. I say leave prescribing to trained proffesionals that have the means to actually know what a body needs to ward off pain.
Also it has been proven that IF medical cannabis was legal a person can cut their dose by quite a bit. Cannabis has not once killed ANYONE, unlike the narcotics have and do.
So I would have to go with a trained doctor and NOT a DEA person that is guessing. maybe one day that DEA person may need an opiate drug to fight off pain, would their feeling still be the same if it was their child or a loved one, would they choos to let them suffer when ther is a way to relieve the pain? I say they would not and would want proper treatment just as I do.
I can understand both sides to this story but I still feel its a doctors choice on what to give a person and not the DEA.
It was fine to medicate John Kennedy when he was our president with opiates, most people did not even know the man was that bad and took tons of medication just to function daily. Our government hides what it wants hid but sooner or later the truth will prevail.
Do old people in nursing homes know they are given Marinol to make them hungry? My guess is most dont even know what the pill is or what it is. If you asked them if they ever did cannabis they would most lkely say, "no, I never have when all along they are getting it daily, but yet the government claims there is NO medical use. That myth is being disproven each day with research. So I say if medical cannabis was made legal a doctor would not have to prescribe as much of a narcotic for their pain, I know this from first had experience.
Our laws need a drastic change,
Thank you for your time ,,,,,,Dave

your alll rude

To automatically assume opiates is something demonizing is GOD awful dark ages....so i'll repeat!!!!! We that suffer from injuries that are not cancer like mine broken ankle dead Talus excrutiating pain and you want to say go to a drug treatnment center you frickkein idiot..... please let me break everyone of your ankles with a metal bat and you tell me if you believe you need a drug prevention center.....Stupid FFFFFF idioiots yea you spell it.........

[email protected]
Richard Shane

helping doctors

can,t we all sign our names to show we support the doctors people who need it are suffering because drs are afraid to give it because thr dea go to the drs offices and threaten the that if they prescribe it the they will go after the dr and my dr is a surgon and told me him self that he can give a little but i would have to suffer after so many pain meds are given or the dea will come and shut him down and he is a surgon that did a operation and feels bad because he know that the pain meds are needed hes the one who went to school for 7 yrs and done over 6000 surgurys we need to help doctors to protect our rights and his no person should be treat with creul and unusual punish ment lad

6 years of chronic pain and now, no doctor

I had a horrble car accident in 2003 and it left me immobile due to extreme pain. I refused any narcotics in the begining, because I didn't want to be imapired. A week later, I had reached a point with the pain that I really didn't want to live anymore. I went from being "super-mom" to not being able to get to the bathroom on time. I began on a low dose and tried everything from massage thereapy to physical therapy and nerve blocks. Until a week ago, I was finally at a point where I could do some normal daily things and had received my degree in Criminal Justice on my medications. Because of the Washington State Laws on Opiates, my doctor of 8 years, was raided and is being accused of being "Dr. Feel-Good". I had to do blood work and UA's to get non-refillable medications and see my doctor monthly. I didn't start out on the levels I am now, it has been a slow up-hill climb. I know people were trying to use my doctor for meds and he was figuring out those people and refusing to help them unless they went into a treatment program. The problem is, until further notice, my doctor is closed and NO_ONE will take his patients where I live. We are being forced out of our own community and most of us, have true non-stop chronic pain that cannot be treated by surgery. I have been stuck in my bed for days due to the pain of not being able to even go to the ER. It has cripled me and my family is suffering from my pain too. I have perminent straightening of my cervical spine and two herniated discs, with two more that have spurs and I've lost mobility in my arms and legs. I have nerve root exposure and chronic migraines and I have never felt more alone or discriminated against in my life. While I am stuck waiting to find out whats going to happen to my doctor, whats going to happen to me? I feel like I'm going to have a heart attack from the pain and I don't want to wake up sometimes. My doctor is a good man and I believe in him, he saved my life, gave me some quality of life and now?

Feel For You

Hi,

I just came across your article and I know what you're going through. I just recently moved here from Hawaii and am about to run out of my meds which I have been on for 4 yrs. I have 2 herniated disks which doing the operation did nothing to alleviate the pain. Before the operation the pain was on a scale from 1-10; 9-10. After the operation; 8-9. I was told by my doctor in Hawaii that I would be in this condition until I die and that my cane will be my constant companion. From the looks of things,without my meds, I will soon die. I cannot imagine a day without my meds. Just because I am on meds does not mean that the pain is completely gone. I take my meds as perscribed and the pain is still there. Without it, I don't think I could walk 10 steps.

Mahalo

that's horrible, hang in there....

When you feel better, I would email your congressmen/women and senators.  You can also at least try some searches for Pain Management practices in your state (yes state).  Start will State and you can find cities from there.  You would probably benefit from nerve blocks and other treatments as well --- which BTW, means you would be given a higher priority at these practices because A. it further proves your legitimacy B. they make more money C. they are trained to use both (and other) methods to treat pain with a number of different approaches (including long term Class 2 narcotics).

 

Hang in there.   You may also find serious relief from Lyrica. Celebrex and Cymbalta.  I have known people who have gotten significant relief from Lyrica and Cymbalta (one of the only SSRI's to work on pain) and moderate relief from Celebrex.  Used together and/or with narcotics, they can bring people back from situations like yours.  Everyone is different and doctors have samples so these meds should be easy to try for free...until you see how well they work.  Neurontin is another alternative to Lyrica for nerve pain.  Some studies also suggest it helps enhance the pain relieving aspect of narcotics.

 

Try also to find a (or another) Pain Management doctor.  If you were going to a PM doc, then look for spine surgeons.  Your situation is severe enough that they will likely prescribe some narcotic meds, but I would also consider some of their (surgical and nonsurgical) recommendations on top of the pills.  Most any good doc will prescribe the Lyrica etc. without any issues, but spine docs would be the way to go if other Pain Management practices are too far away.  BTW, if the PM office doesn't take insurance, they are generally not a legit Pain Management practice -- most of the real ones will be run by anesthesiologist s (as the main doc) and will certainly take insurance, work with hospitals, perform nerve blocks etc.  Look for those. 

sorry for your troubles

I live in Washington as well, have u found a doc yet?

Found a physician

Hi, I know that you commented on a post and also asked a question back in feb 2013 and I am hoping you are still using this email address still. I am located in WA state and I had an amazing doctor for 12 years who believed me when I said I was in a lot of pain all the time he did an MRI on me back in June of 2000 or 2001 which showed I have DDD L5 S1 and also abusing disc. I started out on Vicodin then Percy's etc I ended up being on MS Contin 100 mgs 1 pill 3times a day plus I had 90 30mg immediate release morphine for break through pain which worked great. Anyways everything was great till he retired in Nov 2012. So now I CANNOT finda doctor who will even see me at all. Now I take suboxene (which doesn't relieve my pain at all) and I'm at a pain clinic that is just about making money etc. Anyways I'm wondering if you ever found a doctor?? I'm not looking to get back on high level morphine again I'm just looking for a dr who will at least listen to me believe me and be willing to work with me. Ever since all the negative shit in the headlines popped up doctors are paranoid to even see you let alone prescribe a narcotic. If you have found a doctor or omething PLEASE LET ME KNOW ASAP. I never had a bad UA never said I was robbed nothing like that at all. I can explain everything in more detail it's just that i already had a lot written here already. So PLMK and get back to me ASAP Liz fishel

DEA cowards

It is my fondest wish that each and every DEA agent suffers intractable pain and cannot find a doctor who will treat their pain thanks to their sadistic policies. The DEA would rather thousands suffer than one addict deceive a doctor. The DEA is a great example of a rogue government agency that needs to be shut down. The DEA seems to have become a repository for cowards, sadists, and right wing sociopaths!

i need a n west docter whos not afraid to help someone

in 1989 i fell on a glass coke bottle that some idiot left on a side walk in the winter ice and as i put my hand down it ran right smack up into my hand cutting my 3 tendons and i had to have surgery and in 2001 some idiot back stabber who demanded 25 cents stuck me in the back with a sharp object and took off running when i told him i didnt have money only credit cards on me, now as i get older and yearsof being a ironcraftsmen im in chronic pain in and near i was stabbed by my spine and upper lower neck area and my hand I was for 3 years getting ms contin for my pain at 3 a day never evr increasing the dose as at 3 a day i could function pain free and if i increased the dose id be too tired and couldnt function . now thanks to Mr Right wing Bush man new law id have to go al the way to florida to get what works so well for me and my pain I cant afford to got there and in search for a pain clinic in the n west states area of wash state, orgegon or Idaho or Montana. I havent found a dr here yet whos not a paranoid schztzo to prescribe whats legal to be prescribed in the 1st place talk about selfish people and cowards. If anyone knows of a open minded docter whos not afriad to prescribe meds to people with legit reasons for taking em please email me at [email protected] i and please dont think im some kid looking for ahigh im a 47 yr old man whos very sucessfull and has worked hard his whole life whos raising afamily and has legitimate reasons for taking opiates Sure im tolerant i dont deny it but im not a addict and i know im not as i would never increase the dose to get thartwhat evr feeling people look for for me it kills the pain and i live abetter life and can function with out being irratbale and uncomfortable from the pain If you know somweone let me know it would defenilty be along term relation ship not a one night stand hahahahalol

reply

I'm putting together a book and an ebook by late Dec/early Jan that will have every doc in every state....among other treatments, ways to cut med costs, new treatments (that few know about).  I'll put up a YouTube video with links in a couple months.  There are doctors out there, but its important to also be proactive in your approach to pain.  Most docs are often more willing to help those patients who get nerve blocks, PT, or any number of therapies.  Those that just take meds often have a harder time finding and keeping good empathetic docs.  I used to get injections about every 6-9 months and stayed on a PM program for 4 years without any issues.

On a another note, I had a very hard time reading your response because there were no periods etc. Basically, I couldn't tell where one sentence began and another ended.  It's even more important for pain patients to go out of their way when communicating with doctors and the public.  We all must be (or at least appear to be) professional, well-spoken, and educated.  I see people getting different treatment from docs based on these factors.  If someone shows up in a Metallica or Budweiser shirt to their doctors appointment smelling like cigarettes, they will often experience some discrimination. 

The point is:  think about every e-post, appointment, etc. as something you are being judged on.  Is it fair?  No, but it is accurate.  Who's judging?  The uniformed average joe, doctors, nurses, pharmacies, the voting public, congressmen etc.  I'm not picking on any one person, but it seems like 60% of the posts I read from those who use/need narcotics often look like a stoned 5 year old hijacked their computer.  We need to work together to change the inaccurate perception while helping to weed out those who ruin it for others by abusing drugs for fun, escape etc. 

 

Thanks.

S

Chronic Pain/Physicians who refuse to treat patients properly

I am 49 years old, live in southeastern Kansas and have a Primary Care Physician (Kimberly Wood, MD.) Since 2004 I have had 4 back surgeries, I suffer from advanced arthritis, have scoliosis - needless to say I live with daily chronic pain.
Will someone please tell me why this physician and many more for that fact, hesitate or even refuse to treat a patient with a narcotic analgesic, when the use of these medications have been proven to provide relief? I no longer work outside the home. Performing even the simplist of tasks around my home has become almost unbearable. I do not use mediications recreationally, however that is the impression she seems to have and has therefore stopped all medications containing a narcotic. Also, I was cut off "cold turkey" and spent 5 days of hell in withdrawal.
I know there are many people like me, who suffer on a daily basis. Does anyone have information on pain relief methods, other than the one method that did work?
Gratefully,
C. Beckley

reply

I feel your pain.  See my reply above.  You have to get referred to a Pain Management doc.  They are generally the only docs that are set-up to treat chronic pain with opiates long-term (years, decades, life).

These practices have specific rules etc. but they also expect patients to try to leverage other therapies (in addition to opiates) to help reduce pain.

Hang in there.

 

S

please help

i have been in pain for 3 years now, because its a stomach pain that has to do with the nerves there is no test that shows what i'm suffering so doctors wont perscribe me pain meds.. i have been so close to suicide almost every month for the past 3 years i cry at night and during the day my pain is so bad it makes me vomit and not be able to eat.. i have been hospitalized for 2 weeks in Sacramento and 3 days in Washington and another 3 days and then another 3 days then i was turned away .. when i cried in the emergency room that my pain was so bad and they wouldn't give me anything for it so i started to freek out .. so they put me in a phyc room without my current meds and no extra meds for over 10 hours.. so i had bruises all up and down my legs from kicking the sides of the bed i was in horrendous pain i was just hurting so bad and screaming help me , help me, no one cared finally a psychiatrists came at his leazure and said why are you like this i explained my situation and he apologized to me and had me immediately released.. i luckily found a doc that would prescribe me 16 oxycodones a day and some methadone about 20 methadone which is very low when others are talking 120 methadone.. form the beginning this did not stop the pain and for 2 years i always ended up short with the drugs and spent weeks without any meds cus i finished them early because the pain was so bad.. the doctor will not prescribe me anymore in fear the DEA with arrest him.. please god help me i will be dead from suicide sometime in the next year if things dont change .. please i'm not crazy before this pain came on i was a pilot and in college and doing very well .. i want my life back but i need more pain meds to get ontop of the pain to finally be at peace then i can come off of them slowly.. please god help .. please someone read this and tell a doctor who is willing to help i have documentation i have been in pain for 3 years i have tryed acupuncture pain program retreats everything.. i'm crying as i type this because i have lost faith my country calls me a drug addict and wont help me .. i'm in pain lord help me survive i dont want to die but i dont see any other way out but suicide if i dont get some help soon.. please god help me anyone help me please .....please my soul is dead my pain is so bad i go delirious sometimes .. i don't have enough meds ... i will be dead soon.. i havent found the courage to cut my wrists yet but every time i try i get closer and closer .... please i pray and i'm not even religious i'm just on my last leg of hope here that maybe someone will here me and save me .. please please, pleas, pleas, save me all i need is 30 oxycodone 5's a day and then i can detox off the methadone and then come down slowly off the codone and see if i can make it without drugs.. but right now nothing is happening the right way .. its been 3 years and almost 30 doctors, who have accused my parents of rapeing me and also telling me i need antidepressants that they prescribe like candy .. but when it comes to pain they do nothing..please some one help me please. i will move anywre canada, or any state, anywere.. just help me .. help save my life .. i'm in so much pain i need help .. please please help me!

Pain pain pain : Erg!

Dearest Karl : i hope you see this post!! I'm so tired & in a lot of pain so I can't begin to tell about my 28 year plight with pain, dumba** Dr's & the ruthless dea stick'n their nose into my very salvation.
However, you make my soul cry out for you!!! I oh so know exactly where you are and what it is like to be there! But what makes me even more sad is that you're suffering so much you're feeling as if someone would be kind enough to allow you a respite that you would be willing to give up the meds forever at some point!! You should be able to be on the meds you need for the rest of your life if need be w/out feeling like your do'n something wrong!!
I so wish i had the power to help you!!! If you were back east here in Maine or NH i could help you!! My clinic does help some better than nothing.
Actually i feel like crap now cuz i just got into a fight w/my dr cuz he won't give me a pain pill for night time so i can sleep more than 1/2 hrs at a time.
I hate how i have to be thankful for what i do have. No one should have to feel like that - but worse than that no one should ever have to feel like you feel!!!!!!! My heart goes out to you!!
I dunno where you live but try a University Dr! Or if you can come to Maine - i'll let you use my physical address as a residence. Then get you to my doc ASAP - sorry that's the best i can do. A flight on Expedia.com should be cheap. PLEASE email me!!! [email protected] maybe i can find a way to help you where you are!! I dunno. Please go get some pot or some'n till you can get a dr!!
We pain patients are what they call "Calateral damage" of the tons of $$ our "War on Drugs" !!!! And like any victims we will go unnoticed till we are medicated enough to stand up for ourselves. See the irony?? Bites big time huh?? Dude i gotta get to sleep - ya "sleep" please email me soon as you see this ..... I'll be looking for ya!! I will pray for you too! Ur new friend Kara

Chronic pain sufferer

you sound nice to want to help that Karl guy out. I, too suffer from chronic back pain, permanent tissue damage and fibromyalgic arthritis. I'm right in NH, not too bad of a drive to travel up to Maine if i knew I could get proper pain management. Ever since my primary care doc retired over a year ago, I've been having the hardest time getting a doc as compassionate to my pain needs as he was. Went to the pain clinic, they helped but they didn't accept my disability insurance so I was paying out of pocket and ending up flat broke every month b/c of it and had to stop going there. Perhaps u could help me out w/ the place and dr. u see. It sounds like he is understanding to the needs of chronic pain patients. I have my medical records and everything. I do have a high tolerance to opiates since I've been on them since a bad car accident over 8 yrs ago so that has to be considered as well. Well any help u could offer would be great. Right now I have to buy them off people who rip me off and charge me an arm and a leg for just a few pills to get me by on my really bad days when I'm on the couch in the fetal position in tears b/c it feels like someones stabbing my back b/c the spasms are so severe. Thanks for listening, hope to hear from you soon. If you want to e-mail me, my e-address in [email protected] and my name is Shana. I live in Nashua, NH. I hope u get this and thanks again :)

Karl

Karl - i cannot urge you enough to email me!! I don't care who sees my address if it means you will contact me! I am so very very worried and concerned for you!!!!! Please don't give up!! Have faith!! I know it's hard but please keep trying to find help!! My friends husband has stomach pain and he gets oxycodone from his dr! Soooo you Can & Will find help. I dunno how i got to this web site - by accident - maybe to find you!!! Please write ASAP!!! Kara

help

i'm crying so much i didn't think anyone would understand.. the pain is so bad i need to talk to you i need help.. if you couldn't believe it, someone calling me a junkie on this post and it emtyed my heart i couldn't believe the hate i encountered.. please i will contact you i dont know if it will do any good but my pain is ruining my life.. im only 24 and my last 3 years have ruined my career.. i pray everyday for help i hope i have found someone now .. the idea i has caused me to cry.. excuse me for a min while i cry i can't even type at the moment ,,,,,,,,,,,,,,,,,,,,,,, they call call me a junkie i feel so hopeless .. please god help me

i dont see your email .. please respond soon.. i dont mean to threaten my live i'm just be honest about the terrible thought that go through my head.. please . please help me..

thankyou for even tryiong to help it makes me cry so much .. i cant type anymore im just a mess ... please my email is [email protected] please send me a message please help me

thankyou

thank you so much for understanding... i didn't think anyone would .. i'm crying so heavy ... i didn't know there were people out there still willing ti help.. bless you .. bless you so much.. contact me if i have not already contacted you [email protected]..

bless you so much!!!!

thankyou

several people called me a junkie.. but i'd like to make sure that they know wat a junkie is.. its a person who goes onto the illegal market and buys drugs to get high! i find people who will give me pain medication so i can live my life normally.. you dont get hi when you have heavy pain .. its just takes away the pain.. i have never gotten high once and on top of that a junkie wants to stay high for the rest of his life.. i need meds to build on so i can get rid of the low does of methadone im on and then if i can get rid of the does of oxycodone i'm on (itis not oxycotin at all) my goal is to be drug free to see how the pain reacts to herbal medicines not prescriptions meds.. but until then i need the medications to be able to eat dinner with my family go out and enjoy the life.. i cant even drive a car right now.. its a bad life but the pain holds me back from doin anything... so for those who call me a drug addict or junkie.. you are sadly mistaken and do not understand .. your hate is whats causing the dEA to be able to not serve people who are really suffering and its sad.. just wait until you are in my position .. you deserve it to be in my position

Pain/addiction

Hello : just a brief message as i am too uncomfortale to go into everything. For those who do not know or understand : Chronic pain, Addiction & depression All run on the Exact Same Neuropathways!! Therefore, it is very unlikely that a person who is in pain will become an "addict" and people in pain do not get or feel "High" when taking narcotics! Because each neuropathway can do only one job at a time! When there is a constant signal of pain - the brain becomes unable to shut that signal down on its own. Our bodies under normal circumstances - such as a broken leg - send neurochemicals related to the same chemical found in the Poppy plant - to help us fight the pain of the broken leg and to tell us to get help!! When pain continues due to disease which does not heal within the time limit set by our primative (sp?) brains then pain becomes Chronic and our supply of Natural pain relief runs out!! So, a suppliment is needed! Such as a prescribed medication from a doctor. Drugs such as oxycodone are needed because they replace the Missing neurotransmitter the body uses naturally to stop pain. The pill is digested, absorbed by the bloodstream and sent to the brain - saying : hey, i'm here!! You can stop now! It is just like diabeties! People whose bodies do not make or process insulin at all or correctly must take insulin in order to function - in order to live. Yes. Pain can kill! When not treated - pain causes depression which can cause death. In fact suicide has risen by 16% amoung chronic pain people since the National Drug War began - then failed and then went aftet easy targets such as dr's and people with legit needs. It is not a good or easy life! I know no one who would choose a life of pain and pain meds!! I would give up every pill to have my construction business back, to be working on my Masters degree, to help my mother who has early onset dementia better and to just be able to persue happiness on my terms not the terms of my dr or his fears! Try some compassion you nay sayers! You could end up in a car accident, develope a painful disease yourselves or worse a loved one may someday need pain medication! There are millions of people in pain. Do you believe we all could be junkies? In fact my dr. was in pain for 11 yrs! If he was a junkie - do you think he would be a dr? Ok, l went on a bit more than i expected. Though, when i read that someone called an other person a junkie - it bothered me. Try educateing yourself before making comments that are hurtful and ignorant! It could be you someday! : )

Ps

I just wanted to add something : when i mentioned a broken leg as an example of pain which is not chronic .... I meant as it happens ... Not while it's healing or the aftermath of pain which can occur when the leg is healed ... Our bodies are still such a huge mystery ... That is our brains - because our brains control every aspect of our bodies ... And some people after an injury can develop certain medical conditions which continue to cause pain. The central nervous system can malfunction and cause the other nervous systems to break down as well - then people develop pain which is chronic and very much as real as any other cause of pain. So, i'm sorry - i did not intend to say that someone who broke their leg shouldn't or couldn't possibly be in pain long after the injury heals because it happens every single day. Thank you : ) - Kara

No Easy Answers

I've prescribed plenty of narcotics/opiates over my 18 years of practice. My own experience tells me that, unfortunately, trying to treat chronic pain with opiates simply does not improve most patients' lives and has many, many untoward consequences. I have read and heard all of the public patient testimonials and also heard hundreds of the same from my own patients. If you want to see what the pain experts believe and recommend, go to www.jpain.org and read the "Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain". These guidelines are a good source for everyone about what chronic opiates can (and can't) do.

Several issues are severely under-appreciated by many chronic pain patients (and doctors and the lay public for that matter). The relief that chronic opiates give when treating chronic pain is mild - averaging less than 2-3 points on a 10 point pain scale. The majority of patients become physically dependent on opiates after several months of regular dosing. Addiction certainly can and does occur, although it is hard to say how frequently. Many patients, 25% or so, will overuse their medicines, use illegal drugs in addition to their legal opiates, obtain opiates from multiple sources, or sell their medicines on the street. For the man patient taking chronic opiates, sexual dysfunction and low testosterone levels are possible side effects. There is also evidence that chronic use of opiates actually makes some people more sensitive to pain after long-term use.

It is no accident that the large increase in legal opiates being prescribed has coincided with a similar large increase in overdose deaths. There are more and more of these medicines available in the community and people are abusing them with lethal consequences at times. Doctors are obligated to prescribe responsibly and this means using well-accepted screening guidelines to limit chronic opiates to patients at high risk for abuse as well as the diligent use of ongoing patient monitoring.

chronic pain patient

I understand drs need to prescribe responsibly but, the problem is with screening guidlines. I was on opiate meds for 3 years until last week, when the "so-called" pain management dr I recently started going to treated me like an addict before taking the time to know me, and even if he thought I had an addiction problem, why didn't he offer help for that instead of just denying me refills and abandoning me altogether?
I failed my urine test because this dr switched me from hydrocodone to oxycodone, and I had hydrocodone in my urine along with the oxycodone. The dr knew I still had some left and had the nurse write on my injection discharge instructions to continue both meds. I even asked her if that was right and she said yes the dr said continue hydrocodone too. Of course I didn't take it as extra but, rather took one in place of the oxycodone dose some days. After all, I paid my money for it and knew it to be ok as long I wasn't doubling up doses.
During the last 3 years of being on opiates, I always took the lowest dose possible, never sold them, never went above 4 ten mg's per day on worst unbearable pain days, and most days able to stay at 2 ten mgs or less. I don't do illegal drugs or drink. I never went to the ER for opiates( have suffered in my bed because of drs misjudgment a couple times and didn't get refills when due), and never tried to get scripts early, and never got opiates from more than 1 dr. I have always used honesty as my best policy and felt I had nothing to hide. I've tried hard to everything to please drs while taking pain meds.
What makes things worse is that I've heard of people selling their high powered opiates a lot, and from what I read and heard the dealers always pass the screening because they just take their prescribed med a day or 2 before each appointment so as to pass urine tests, they sell all but a few pills every month! Also, I'm sure people that aren't in true pain seem more stable to drs which would make them seem more likely candidates for meds, because as someone in pain, I know I hurt so bad at times, that I can't help what I'm sure appears to drs to be odd behavior.
Now for the first time in my life I hate drs, even tho the Dea has drs scared, drs are suppose to offer some type of help, even if it's a referral to someone else. In the last year I've been let down, made to feel like scum, felt abandoned, and a victim in this "so called" land of the free that everyone is suppose to love and wake up happy in. I have an 11 yr old daughter, husband, and 2 elderly parents who need me, and I'm helpless, unless I do something illegal, like buy pills off the street or something!!! I'm suffering in my bed!!!!!!! Thanks to people who obviously don't care or have a clue!!

i'm so sorry!!

hello depressed: I wish I could help you!! I am so sorry for your suffering! I have no idea what it is going to take for those of us that live with chronic pain to be treated like decent people. There are so many different opinions and research data that's set against us and doctors whose opinions are based upon such research that it makes it nearly impossible to be treated as an individual.

 

I have read a lot of information about chronic pain. I have read a lot of studies for and against using narcotics for the treatment of pain. But when it comes down to it all that ought to really matter is how the drugs affects each individual person. But doctors are too busy (or lazy, or cheap) to treat each person as an individual and therefore base their thoughts upon data which more than likely is not relevant to the person sitting in front of them (imho).

 

I understand the risk. However, there are many illnesses, diseases, medical conditions where the "cure" or treatment causes Many harmful side effects! Should this mean we ought to stop giving radiation & chemo treatments to cancer patients? Certainly not. If or when a person becomes actually addicted then deal with that side effect when it occurs. In the interim don't let someone suffer because addiction may or may not occur.

 

depressed: I could not begin to tell you how many times I have suffered beyond the imagination of most people because a doctor has had a negative opinion about pain and the use of narcotics. I can relate to everything you said and i hear what you're saying and you are right. I have read in my medical file: "She has odd behavior" - what?! Was this physicians assistant serious? I get very agitated when I am in pain. I get grumpy, moody, depressed, angry, sad, irritable and so forth. I don't feel any of these emotions could be construed as "odd".

 

I like what you said about how those who are abusing the system are probably looked at as being "stable". It is true - you are so right! I am unable to sit still through my appointment and often have trouble concentrating. The chair in the office is as comfortable as a bed of nails and would make someone w/out pain uncomfortable.

 

Any way, I am sorry to rant on and on. I just wish I knew how to contact you so that I could at least be an ear to listen. You hang in there! Keep looking for a doctor who will treat you with compassion and the respect that you deserve! Be well and take care!

chronic pain patient

Oh, and I also want to add that I've decided to give up getting treatment for this disabling pain(who cares if I can't get a shower or bath more than once a month, or if I haven't been able to attend some of my daughter's school activities, and broken promises to her, or never feel like being a fulfilling wife, or go see or help my elderly parents,or if I exist even if for my child ). I also give up asking for more medical tests to better treat my pain so I could possibly have found something other than opiates, something I'm missing perhaps, because the dr I went to the last 8 mths(that sent me to pain dr), treated me like an addict as well. Everytime I would ask for blood tests or scans,etc for possible causes of my pain he gave me weird looks and would say it's probably just fibromyalgia!! And he would follow by saying we're suppose to be tapering you off your pain meds(like I was hinting for more or something), even tho I wouldn't even mention those!! I wasted my time, my money, my trust, my spec of energy I didn't have to spare,to go to these drs that I thought went to school so I could pay them to help me. I finally went to an ortho dr on my own a couple mths ago and got an mri and found out I have a central bulging disc, bone spurs, and foraminal stenosis at L5-S1. I pray for the many people that are way worse than me, and going thru the same or worse!!!

All of you that start these

All of you that start these ridiculous organizations.... Drugs will be around forever just as guns will be. They make them faster than people take them and it will continue to grow... You are just making harder for the people who actually need them. Wait until you have some chronic pain someday and all the doctors you see think you're making it up like some of us. It takes several months and fate to find that one good doctor that will find treat and cure you these days. All these doctors have their heads wrapped around the idea of addiction, its causing much more pain to the people with chronic pain than it is helping keep stupid people from dying. So your kid died from an overdose.... your kid was stupid. I injured my back at 15 and had surgery. I will never be the same again and have been taking pain killers since. I am now 27  !!! Hey I'm still alive because I don't fuck around for the fun of it. I take my dosage to help me get through my daily life. Now I have certain periods where I have to go without for a week so... because of you idiot parents that lost for idiot child and thinking standing up will make a difference....   pphhfffff....

i understand

Hi:

I just wanted to say I understand your anger!! It is awful that because so many misuse and abuse what is life saving for people like us that this "war on drugs" has made our suffering worse than it ought to be! As if any of us would choose this life!

I wish I knew what it was going to take to stop the senseless suffering! Until science finds a better way to treat pain what we have is narcotics. Rather some suggest there are too many "side effects" should not matter because they do indeed help. I know I would not be alive today if it were not for Oxycodone! Oxy is a little miracle! I thank god every single day that "he" put the poppy plant on this planet. I am so tired of suffering because of what a very low minority of people may or may not do with their medication.

 

I wish for you many many pain free days!!

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