Or the feeling they can just self diagnose and not bother going to the doctor for more.
In regards to the OP, would the fact that 4 times in 6 months she’s had some sort of accident/procedure that required Vicodin set off alarm bells for her MD? ie Does that add in to “drug seeking behaviour”? I assume her MD was involved in at least a couple of them so knows the validity of those earlier prescriptions.
Since I’ve never been prescribed any pain meds, no, I don’t. I actually don’t know anyone who does have some stashed in the med cabinet, but they might not share that information.
People who have suffered from chronic pain for decades, as has my spouse, usually have some notion of when it’s the chronic pain problem which they’ve had some experience dealing with vs. something new and acute.
Really, you can’t manage chronic pain without some input and effort on the part of the patient any more than you can manage something like diabetes without patient knowledge and cooperation.
When I’ve been prescribed Vicodin (always an acute situation), it has always been at a level that would put me on another planet if I actually took the amount as prescribed.
Once I had an accident (@ 2 tons of hay fell on me while I was standing up) and the ER gave me six Vicodin for severely sprained neck. I was amazed at what they could do. I went from unable to move without tears to fifteen minutes of amazing pain free floating, to flat out unconscious for the next 8 hours. (Without them, I couldn’t have slept until exhaustion over ruled the pain). At that point, they became “those happy pills” because I could never remember their name. I took only 4 of the six because that kept me unconscious for about three days after which the pain was tolerable and I had to go back to work. So, I guess I hoarded the other two.
Years later I ended up in ER again for what turned out to be my first migraine. Again, they gave me Vicodin. I ended replacing my stash because sleep/dark took care of the migraine.
Years later I had a sever tooth problem and went to the dentist. I needed to take anti-biotics for 10 days before they could pull the tooth. The dentist gave me a prescription for 3 Vicodin/day for five days (OMG, I would have never even been on planet earth if I took that much!) So, I used that prescription to update my stash because the anti-biotic took care of the pain after the first day.
So why do I hoard these happy pills? Because I don’t have insurance and something as simple as a broken toe would cost me nearly a thousand dollars if I went to a doctor over it (I can get 3 radiograph angles on a horse’s joint for $45, but our local people xrays start out around $500 for one shot + readings + admin + you name it, we’ll tack it on!) . I strongly suspect I’ve broken at least two toes on different occasions. Also, it isn’t totally impossible to get a severe body strain (e.g. a 1000 pound horse suddenly goes left when you thought we were going right). So, I have them ‘in case’ of those things. I’ve never actually used them because I have other solutions that work just as well without knocking me out. But it still gives me peace of mind to know that those happy pills are there just in case.
Also there are many people who self-diagnose and self-treat because some medications that are prescription only for humans are available OTC for other uses. (And, yes, some people accidentally kill themselves this way)
I’m fortunate that despite the may ways that I’ve beaten my body up, I don’t have a chronic pain issue. I couldn’t imagine what it would be like to deal with extreme pain on a daily basis. But I can totally understand people who “hoard” excess prescriptions.
At one point, my mother was on a boat load of prescribed medications. They had her so spaced out that she would have “out of body experiences” and call me from across the US to tell me good bye. She was utterly loopy for most of the time. She ended up this way because each of her doctors prescribed their stuff and didn’t want to mess with what the other doctors were giving her, so it all became additive.
Fortunately, she finally went to a doctor who took control of the situation and went through all her prescriptions and why they’d been prescribed (literally, one doctor gave her a med that another doctor was counteracting with another med!).
It took months to migrate her into a comprehensive medication program, but she finally came back to earth and was ‘normal’ again and that was a relief because we had begin talking about institutionalizing her. But even when she was sitting in front of these doctors, clearly not coherent, they didn’t think twice about keeping up “their meds” or looking at the big picture. Thank God for the one doctor who did finally say, hey wait, maybe 2/3rds of your problem is that you’re doped up to the gills.
Maybe it’s just that all my friends are lowlifes.
If I’m at someone’s home and say, “Boy, my back is killing me”, having a friend offer something from their stash is sorta expected.
As I posted above, I haven’t dealt with joint issues like you’re going through personally. I’ve had heel spurs in the past, I’m not sure if they are the same as instep spurs, but when i had them, it was like a metal spike was poking up through my heel on each step that was so bad that I walked on the front of my feet. I got rid of them by increasing my calcium (I drink whole milk and eat a lot of spinach) and doing gentle (because that is all I could stand) stretching exercises on my feet. It took a couple months, but I’ve never had them since (and I have really crappy shoes).
Also, I’ve dealt with joint issues in horses who’ve had pretty much no joint space left. You may have already tried these things, but just didn’t list them. If not, some of these might give you some level of relief.
Hyaluronic Acid - Horse can get an IM injection and you can see a difference in their gate within hours (definitely by the next day). If doctors can’t provide IM injections to humans, there are OTC supplements. They take a little longer, but this is the best/fastest relief that I’ve seen for deteriorated joints.
Glucosamine Sulfate - When I’ve had horses come in who were on daily NASIDs, I can always swap them out for Glucosamine and they no longer need the NASIDs. I buy bulk, food grade Glucosamine at www.herbalcom.com because I’ve found that stuff you buy in stores seems to be less effective (maybe old, maybe not mixed as strong as claimed?). I personally also take this in winter months (I just sprinkle it over food). It isn’t supposed to have a toxic level, but I won’t post the amount that I take here because I’m not sure if that would be high or not compared to what products on the market provide. (I’d have to sit down and weight it all out again to double check).
Methylsulfonylmethane (MSM) - I’m not sure how much this helps or not, but some horses seem to do better with MSM added. I get it at the same place as above. It doesn’t do much for me, but it is a sulfur type compound and I eat a lot of onions and other sulfer type veggies already.
Finally, a friend of mine had horrible all-over body pain. After weeks of trying to figure it out, the doctors finally tested her Vitamin D level through a blood test and it was extremely low. She was provided some sort of Vitamin D supplement and within a week felt a whole lot better. (She literally had trouble getting in and out of her truck because her entire body hurt so bad that this woman who is NO WHINER would cry at the thought of lifting her body up into the truck seat). I’m out in the sun for hours each day, so that may be part of why at my age, I don’t have a chronic pain issue yet. (Plus low Vit D is supposed to interfer with Calcium – see bone spurs above).
I wish you the best of luck.
The fact that this med list even raises an eyebrow is proof that I practice on a different planet from most people. Having two different forms of oxycodone/acetaminophen is a little weird, but not unheard of, especially if someone has been to more than one doc. I see the oxy and hydrocodone combination fairly often–usually they write it as a scheduled q6h or q4h dose of the oxy with the hydro for “breakthrough pain”, even though they take a set number of the hydros every single day as well. Otherwise this is a perfectly bog-standard med list for new patients that show up in my clinic.
Oh, wait, no, I see one thing that would definitely stand out to us: where’s the benzodiazepine?
Oh I’m sure he just forgot to mention that one (slipped his mind, what with all the other meds coursing through his system,and all).
That line is way, WAY more blurry than you portray it to be. At best, you’re describing two extreme ends of a spectrum. And there’s nothing about the pain-relieving qualities of narcotics that takes anything away from the “high”. There’s nothing about having real chronic pain that prevents someone from becoming an addict.
There’s a trap people fall into (not that you are) where they believe that addicts are bad people and good people won’t become addicts. The nurse practitioners I used to work with would come and ask me to prescribe chronic pain meds for a patient and say, “She’s a good person, she goes to church, she’s got a good family…” But I can sit here and name a dozen people who I know either personally or professionally who started out as productive and well-adjusted people who lost everything because doctors were willing to give them all the narcs they wanted along with endless benefit of the doubt.
And addiction isn’t the only problem. The people I mentioned before who we caught selling their pills in the parking lot? It happened a few times a year. Most of the people who did it sure as hell didn’t look like people who would go and sell their pills. I personally don’t believe that a lot of them intended to sell them, but if everybody in the family is out of work and they’re about to come and turn the lights off and somebody is offering $800 for your bottle of Lorcet, you might decide that you can live with the pain for another month.
And I’ve seen plenty of people who have chronic pain from objectively verifiable causes who have (to their credit) learned to live with the pain through other means, but who still get their monthly supply and sell it. If they’re smart enough to keep enough pills around to be able to come in for a pill count and to pop one the day before they come in to the doc to fool the drug test, they could probably do it indefinitely without being caught. And I still caught people doing just that all the time.
I hate that things are the way they are, and I don’t like the alternative of pain clinics either. (As others have pointed out, a lot of them are scams.) I wish there were a better way to do things.
This. This this this.
Yes. Which is why I said in an ideal world we’d have clinics for addicts, clinics for those with chronic pain, and clinics for those who are both.
And I also agree with the moralizing attitude regarding addiction - “Oh, she’s not an addict, she’s a good person!”. It just adds to the mess.
Update:
So he turned out to be a perfectly coherent and lovely gentleman (yes, yes, I know that perfectly coherent and lovely gentlemen can be addicts, but it’s at least a sign that he isn’t overmedicated, which is my primary concern at this point), and there’s a reason that his previous nurse was let go from the company - she sucked at med reconciliation and paperwork. He’s got the Percocets from a back surgery back in December - still 6 of them left in the original bottle of 30 - and takes one every once in a while when things get really terrible. Doc said it’s okay to hang on to them at the rate he’s using them and I’m inclined to agree.
The hydrocodone and Cyclobenzaprine were also from that surgery, and the Endocet from a surgery 18 months ago and none of them refilled ever (confirmed by the pharmacy) and no longer in use. He had several left in each bottle which he gladly handed over to me to take to the pharmacy for safe disposal (and that is a pretty strong indication he’s not an addict). He’s got severe arthritis, some congenital bone malformations in some joints and several bullets lodged in his body for going on 8 years now, including one pressing on the sciatic nerve (ow!) which do cause chronic pain, but his breakthrough pain medication of choice is…well…chronic. IfyouknowwhatImean.
So it was the nurse who was an idiot, and the doctor who signed that medication list without reading it, but the patient does not appear to be a drug seeker or an abuser of opiods. First words out of his mouth were begging me to arrange Physical Therapy, which helps with the pain more than meds. Thank goodness!
What’s the point of ibuprofen 800mgs? You could just take four 200mg tablets, and you can get those over the counter.
Good luck, kittenblue. I hope you find something that works. (I was given vicodin a few years ago for a toothache and all it did was upset my stomach. Fortunately I only needed it for a couple of days)
Not that I’m doubting that your friend has problems, but are you sure it’s not something else? Because hemophilia only effects males. Women are carriers of the gene, but they aren’t affected by it. (You’d have to have a male hemophiliac marry a female hemophiac carrier for that to happen). So I’m guessing your friend has some other clotting disorder, NOT hemophilia.
Pain sucks. Good luck.
I’m sure. Note that I said, “rare”. Women are usually carriers but can suffer symptoms of hemophilia.
First of all you mention he uses marijuana from a non-medicinal source, it is great to see a doctor NOT freakout about that but that isn’t a given at all. Some doctors treat it like a black stain on a person, I know people who have said they have been asked have you EVER used marijuana.:rolleyes:
Second you should be careful about judging someone on how easily they part with pills, if they have no insurance those pills were damn expensive! I certainly would not throw muscle relaxants or pain killers in the trash I paid $$$ for, I’d hold on to them in case I need them and are in rougher financial shape etc. With the experiences shared in this very thread it seems like it is random on whether you get pain relief, so having a stockpile sounds wise.
You tell me, it is a common RX for some mysterious reason.
Yeah, that is pretty damned stupid. It’s a complete waste of money, for one.
True, carriers can suffer some mild symptoms of hemophilia. Reportely the daughters of Nicholas the II also tended to bleed more than usual when they had an injury, although they weren’t actually in danger like their brother, the Tsarevich. (Note: I’m not challenging you – I learned a LOT about hemophilia and the way it’s passed down due to the fact that I have a major interest in royalty history, especially the Romanovs)
There IS a type women can inherit – hemeophilia C, which mostly affects Jews of Ashkenazi descent.
I’m a nurse, not a doctor, but thanks.
I think this is one of those cases where judgement (in the sense of discernment, not prejudice) works one way, but not the other.
That is, Person A hands over the pills with no hesitation and thanks you for helping them clear the clutter in their medicine chest and seeing that they’re safely destroyed…probably not an addict.*
Person B hesitates, hands you the pills, takes them back, says maybe they’ll just keep a couple, no, wait, they better hold onto the whole bottle…maybe an addict, maybe not. More information is needed. As you say, they could just be concerned about needing them later and having them at hand, whether it’s due to financial reasons or the pharmacy being an hour away or fear they won’t get a doctor to prescribe them later. Or they could be loathe to give up the drugs because they’re addicted to them. No way of knowing from that behavior alone, but it’s a signal to look into other behaviors that might suggest addiction, like using more than one pharmacy or having scrips for percocet and vicodin and hydrocodone and benzos.
*Or is a very clever one with another source of painkillers, if I’m being honest and cynical. That’s the biggest problem at the root of this thread, if you ask me - dealing with addicts makes nurses and doctors cynical and suspicious.