This is something I don’t understand. Back when I had legitimate chronic pain from endometriosis and adenomyosis, my docs would barely prescribe 20 of the lowest mg hydrocodone a month. And I was in daily, exhausting abdominal pain. If ever I had a real reason for heavy pain meds, this was it, but no amount of proof of my condition would convince them to prescribe me anything. It was like they were super paranoid about the DEA coming down on them.
This led me to go out and find my own sources, which is part of why I think I got addicted (that and unfortunate genetics). I really believe that a lot of addicts start out as desperate pain patients who can’t get the medication they actually need. You’ll do anything when you have pain like that. And those pill docs know it, which is why they can charge you $200 for an appointment every two weeks. And they know you’ll get addicted, which keeps you going even once your pain is gone.
Anyway, there are at least two doctors in Indianapolis who have been busted multiple times for unscrupulous prescription writing. We’re talking cash only docs that have waiting rooms full of junkies. They make the news and then two months later you hear that they are back in business. How the heck do they get away with it?
In case it was keeping anyone up nights, ladyfoxfyre and I discovered via IM we are in fact two separate people who happen to work right down the street from each other.
I hear you, and I don’t quite get it, either. I have back pain that has been growing steadily worse over the past few years. It got worse after I got rear ended in my car(twice!) by a hit and run driver. So after the accident I finally told my doc about the problem. Was told to use Aleve and a heating pad. Didn’t help. Got prescribed Soma, finished the prescription and refill. Didn’t help. Put me to sleep, mostly. Got prescribed Diclofenac, finished the presciption. Didn’t help.
I finally stopped mentioning the pain because I didn’t want my doctor to think I was a drug seeker. I guess it’s just a matter of finding the right doctor. Some prescribe it only as a last resort, others hand it out left and right. And I certainly don’t want 30 mgs of oxycodone. That shit is wayyy stronger than I could stomach. Just something to dull the pain, especially after a 10 hour workday with a throbbing back. Ugh.
I wish I had some of your docs. I had multiple surgeries on my right foot a few years back, and now I have severe nerve damage in all the major nerves in my right lower leg. Anything that touches my foot causes pain, anything. My doctor wouldn’t give me anything for pain after he determined that it had healed. He assured me it would get better. Well, it’s been three years, and putting on a sock still hurts like hell. I could definitely use something, if just to help me get to sleep at night.
Nerve pain often responds to such meds as gabapentin, pregabalin, amitriptylene, and others. People with nerve pain issues should ask their physicians if they might benefit from such therapies.
I live in a very small town, and the pharmacy was broken into Sunday afternoon.
The perp, in a very long and convoluted story, fled the scene in a car, abandoned it south of town, crossed a very dangerous swamp wearing only blue jeans, and wound up at the house of the pharmacist’s brother in law, asking for a ride home north of town, which he got. Drove right past the sheriff’s deputies investigating the break-in, too. :rolleyes:
He’s still at large, but the perp is known, several witnesses saw the break-in, and the amount of blood he left behind at the scene will be hard to beat for DNA evidence. If he doesn’t die from the infections he’ll get from swimming the swamp with all those lacerations…
See, this is interesting, because the doctor who performed the surgeries told me that there was nothing that could be done for it except waiting. I saw a podiatrist for an ingrown toenail last year, and when I told him the whole story he gave me cortisone shots (ouch) and put me first on neurontin(?) and then lyrica, when the side effects of neurontin proved to be too strong. Unfortunately they really didn’t do anything.
The big thing that bugs me about this is that I had to argue with my doctor to give me something for pain, just so that I could relax a bit after I went out shopping or whatever. He kept saying ‘We don’t want to treat this with drugs’. I don’t want to be on pain pills for the rest of my life, but holy shit 10 fucking minutes without pain would really be nice right about now. And I hear about doctors that throw narcotics at people who can spell their name right 2 out of 3 tries, and I wonder what the hell I’m doing wrong.
The drugs that you named, are they different or the same as the ones I named?
Everyone seems to want to give me hydrocodone. I can’t process this stuff, so all it does is make me somewhat woozy and nauseous. Fortunately, I can take Darvocet.
Can you go to another doctor? I think that pain management is given more priority these days, and it seems that your current doctor isn’t with the program. I take Cymbalta, primarily as an antidepressant, but it also helps with my neuropathy. Of course, living with chronic pain is liable to depress anyone.
Gabapentin is Neurontin, Pregabalin is Lyrica, so yes you’ve been on those.
Amitriptyline is Elavil, a tricyclic. And if you haven’t tried a class of tricyclics to see if they help nerve pain, you might want to discuss that with your doc.
Darvocet is my drug of choice too. Percocet makes me constipated, naseous, and hallucinate. The week after surgery was interesting.
One thing I’ve found, is that when I ask for Darvocet by name in a pain medication situation (like when I had a kidney stone a few months ago), I get eyeballed by the physician. I understand that they’re supposed to look out for people who want a fix, but cmon, I’ve got a rock in my urinary tract. I think it’s time to make with the good stuff.
Yeah, it sucks. I’m about to move to a different city, so I’m really tight on money right now. I’ll have to look into after I get a new doctor there. Maybe I can ask my family doctor about it before I go, though. Moving is going to be a whole adventure in pain, and I sure could use a bit of relief.
Sorry to hear of your troubles, hotflungwok, and that just reinforces my feelings on the subject that much more. It’s not fair. Some people have to suffer through chronic pain because of doctors who are wary about giving out pain meds, yet others easily obtain pills that they then crush and snort or inject to obtain a heroin-like high(so I’ve heard), or sell to other junkies and make thousands of dollars. (Literally. As I mentioned in a previous post, Roxicodones go for $15 and up on the streets. A scrip for, say, 240 of these pills, if sold, is worth at least $3600). Amazing.
Thanks for the answer re: docs QtM, and I have another question for you or anyone who cares to answer. I see “pain management clinics” all over town, and most of the scrips for narcotics I get presented with at work come from one of these places. Are these types of places generally known for being quick to prescribe controlled substances, or are some of them legitimate? (I suspect it’s a bit of both.) How are they generally regarded by the medical community, by MDs who do not work in such places? What is your opinion on them? (Again, I suspect there are varied answers and opinions as there are with most things.) Thanks in advance for any answers.
I have a close relative who has chronic pain issues and let me tell you the pain management clinic she goes to is totally on the up-and-up. They have a lot of rules about how they prescribe and they do not hesitate to boot your ass if you break them or try to get around them in some way.
I love my dads surgeon - she was adamant about his pain control. She said that at the age of 84, after having an illiotomy, a PIC and a PEG installed, they would worry about withdrawl after he got out of surgical ICU. Unfortunately he didnt live, but he did not have to deal with inordinate pain while trying to survive [he picked up a secondary infection and just was not able to fight it and heal…but the care in the hospital was amazing.]
A bit of both, in my experience. The more reputable ones I’ve dealt with tend to make their pain patients sign contracts requiring them to go only to that clinic for their pain meds, and some even require the use of a certain pharmacy so that use can be appropriately monitored. It’s basically one of those things you just learn through the grapevine and experience in your area. Oftentimes, your PCP will have a good idea of which places are reputable.
My opinion is that they perform a vital function and I wish there were more qualified pain specialists, given the incredibly long wait times for the few that exist now.
And some must themselves be addicts, who of course often love to enable other addicts. I was once, without having mentioned pain, unexpectedly given an oxy script for a condition which I’d always treated with OTC advil before. Based on this as well as some visual and verbal clues, I’m certain the doctor was on something.
Some are run by docs who think all pain is the result of an opiate deficiency, and that it’s reasonable to give enough opiates to make the patient stop complaining of pain.
Some are quite legit, recognize that opiates are only one of many tools in the toolbox for treating chronic non-malignant pain, and usually they’re not the first tool to be reached for. These places use and abide by patient contracts regarding opiate use, and they don’t hesitate to tell a patient: “Sorry, you violated the agreement, you’ll need to find another doctor”.
I find that (painting with an overly broad brush here) pain clinics run by anesthesiologists are pretty good for doing injections for trigger points, facet pain, nerve impingements and similar, but tend to be rather too liberal with opiates and not use enough physical therapy, home exercise, meditation, relaxation, & non-opiate meds.
Conversely, those pain clinics run by physiatrists (doctors specialisting in physical medicine and rehabilitation) tend to be better with non-opiate therapies, and tend to use the opiates more circumspectly. Just IMHO, of course. But I do have some experience with chronic pain treatment and its various philosophies.
Thanks for the answers, all. It’s good to hear there are some good ones out there. I became suspicious of them after one of our regular patients came to us for advice. He had gone to his appointment for his pain management and found the place closed up, apparently deserted. No cars in the lot, nothing. They evidently closed up shop in a hurry. He’s been on oxycodone for some time and would have suffered withdrawal if he abruptly stopped taking it. He did manage to get a scrip for it someplace else.
aruvqan, sorry to hear of your dad’s passing.
