My father was recently admitted to a local hospital because of severe back pain. He was subsequently diagnosed as having a compression fracture of one of his lower vertabrae. He was initially given morphine for relief of the pain. When the pain was under control, the medication was changed to Percodan on the order of his doctor. His doctor, I should say, has been his doctor for the past ten years and knows my father well. This doctor’s orders called for Percodan to be administered as needed. However, the doctor in question had announced his intention to retire, and did retire the second week my father was in the hospital. The doctor who assumed control of the case immediately changed the Percodan from “as required” to “twice daily.” His reason: “I don’t want him to get addicted.” My father, I should say, had his 92nd birthday while in the hospital and I maintain that addicting a 92 year old man who is now dealing with severe pain is about the last thing the doctor should be concerned with. I would appreciate the opinion of any folks in the medical field–of course, other opinions are welcome.
I agree.
Many docs who aren’t used to prescribing to treat chronic pain notoriously undermedicate their patients. Physical dependence and addiction are 2 different things. You may want to consider looking into a pain management specialist. (often times anaesthesiologist).
Also, Percodan may not even be the drug of choice for his condition and age, especially considering that it contains aspirin.
This may be a fear of some doctors, but if the patient is assessed and managed appropriately by someone w/ some expertise in the area, there should be no reason for concern. If a doc is concerned about potential o-d based on his prescription, then he clearly needs to pass the hat to someone else willing to manage the case and meet the pt’s needs. Point being, if he is still having pain, then he should be treated for it.
There are some pretty well-established guildelines to follow–“Large doses” are relative to how tolerant the pt. is to the medication over time. Start small, work your way up if you need to.
I work as a nurse in a neurosurgical ward. I see plenty of patients with the same condition/symptoms and VERY rarely does narcotic addiction become a problem with people in acute pain. Addiction tends to occur when not enough different options are offered as the pain begins to decrease and therefore the patient continues to be given narcotics even for mild pain. This is unnecessary as there are a huge variety of analgesics available.
I am unfamiliar with the drug ‘Percodan’ - it is not used here but I doubt a twice daily dose of ANY medication is sufficient. I agree that a pain specialist might be a good option. However, is it worth requesting a 2nd opinion?
It is very easy for a Doctor to write an analgesia order that is safe, and gives nursing staff room for adjusting the dosage according to the patient’s current pain status. I do not think this Doctor is a sympathetic practitioner. He is taking the easy way out. I’ll bet the nurses don’t like him either.
As has already been said, the fear of physical addiction should not be a significant concern at all when treating acute pain. Caution must be used when prescribing narcotic pain killers, but a competent physician should know how to reach a dosage which reflects the minimum amount of medication necessary to achieve adequate pain control.
Second opinions in matters like this are good things. A competent Family Practitioner or Internist should be able to come up with a plan. If goals of pain control are not met, one can consider consulting a pain management specialist.
Oh LouisB, your poor dad. I don’t really have anything to add aside from what others have said about getting a pain management specialist but I just felt so bad reading your OP. No 92-year-old should have to be in pain like that. Please press his doctor to up the meds - insist on it - or demand to see the department chief and keep pushing until you get a satisfactory response.
Thanks for the input. As far as I can see, it really doesn’t matter if a 92 year old person is addicted or not–he hasn’t driven for years, doesn’t own a car or have a drivers license. He is barely mobile, must use a cane and/or a walker to get around and isn’t likely to be a menace to anyone. I would prefer to see him addicted to a prescription medication than to live the rest of his life in pain. But thats just me.
