I live in chronic pain too and don’t want to use opioids. I have found that marijuana does help, especially on the mental end of things, but that’s me, and other people don’t have the same experiences.
I honestly prefer Flexeril when I do have meds. My previous doctor questioned how it could possibly relieve my pain and I said it loosened the muscles, which tightened up and caused additional pain because of the existing pain and the stress of it.
I’ve been three doctors for my arthritis in the last year. It’s gotten very bad in a very short time and I’d kind of like to know what the future holds. They take x-rays, tell me it all due to old age and there’s nothing they can do, then they offer ‘something for the pain’, meaning opioids. The last doctor misunderstood and asked if I needed something more powerful. Doctors don’t even try to diagnose or fix problems anymore - just write a script and take the profit.
Esquire magazine had great article a few months ago about the Shackler family, the folks who managed to the create the notion that oxycodone was non-addictive. They aren’t done yet.
I imagine there’s no good answer for chronic pain sufferers, since there appears to be no medication that’s right for it.
I think I’ll have to find a different board to understand how to use mj correctly for this. 
Thank you for expressing it so well. I’m a non-practicing pharmacist and I pretty much agree with everything you say. The “Candy Man” doctors and the pharmacies that will fill those prescriptions without question are known to every addict in the region, whatever that region may be, and that’s always been true.
I was working at a grocery store when the Oxycodone “blitz” was going on, and we were skeptical ourselves about the “non-addictive” characteristics of this drug. Like I’ve said here many times before, and probably will again, the difference between addiction and dependence is this: If you are addicted to drugs, your quality of life goes down, and if you are dependent on drugs, it goes up. I had many customers who took opiates as they were intended to be used, and if and when the pain went away, they had absolutely no desire to stay on them after they were weaned off.
Many posters here disagree with me about this, but I also wonder how many people have, in recent years, started using drugs with the hope of becoming addicted because the media has made it seem glamorous and fun. :dubious: I mean, really, if I never turn on the TV and see a young white person, usually a woman who is very physically attractive, say, “Oh, yeah, I used to be a drug addict and now I’m clean, and life is so wonderful now”, it will be too soon. It will also be too soon when the update after her death says that she got high in the bathroom prior to the interview. :o Believe me, none of the drug-seekers I ever encountered when I was practicing enjoyed what they were doing, although it may have been part of a good time at one time.
I also believe that a lot of the publicity is because it’s mostly striking white middle-class people.
Your BIL probably got tied up with a pill mill. Is he the type who would do that?
I’m not aware of gender bias with these crooked businesspeople, as long as the money is green.
Are there drastically different reactions to opiates between different people? I mean, I’ve had IV Dilaudid, IV Demerol, morphine (I think; whatever they gave you in those dose-yourself gizmos in 1989) and several variants of the acetaminophen/opiate medications (Norco, Vicodin, Percocet, etc…) for a couple of knee surgeries and when I got my wisdom teeth removed.
I don’t recall there being ANY particularly pleasant sensations associated with any except Demerol, except for the obvious relief of pain, and a lot of drowsiness. Demerol definitely gave me a euphoric rush, but that was pretty limited- I got one dose of it in the post-op recovery room after a MCL reconstruction and exploratory ACL scope (wasn’t torn!), and was on cloud nine for a few minutes, then fell back to sleep.
But the rest? Just kind of sleepy and not in pain. Nothing pleasant about it, and the morphine made me nauseated enough to puke like the girl from the Exorcist. So I’m kind of baffled by this whole drug-seeking behavior for stuff like Vicodin or the like.
If you’re right, and it’s a few bad Dr’s, known by addicts, pumping out scripts how is it not THE easiest thing to curtail? Wouldn’t those Dr’s stand out to every pharmacist in town? And be easy to crack down on?
How are there controls on Joe Public buying OTC meds but none on over prescribing Dr’s? How is every Dr writing scripts for movie stars NOT under constant supervision? Why aren’t pharmacies not gate keepers to Drs instead of harassing all the patients including those with legitimate needS? Why make more restrictive rules for all Drs, instead of identifying the abusive prescribers?
How can a simple data base not identify such Drs pretty easily? Wouldn’t that be cheaper than treating addicts?
What am I missing here?
Apparently, opioids are no more effective for arthritis and back pain than even Tylenol:
So, I guess if they prescribe you opioids, they are doing you a disservice.
As I mentioned, two of my kids had their wisdom teeth removed, and one even got infected. Sure, they were in a fair amount of pain, but it was only for a couple of days and they dealt with it. There’s an ad on the trains around here that says, “you wouldn’t give your child heroin for a broken bone. Why are you giving her opioids?”
Was your child in really unbearable pain? Were you in unbearable pain that you needed Oxy to get through it?
Not to pick on you, but it seems like you’re representative of the problem – people get these pills if they are in any amount of pain, even short term, and that leads to addiction. The addiction epidemic and overdose epidemic makes it harder and harder for people who need real pain management to get proper treatment.
I’m glad you and your daughter didn’t get addicted, of course. I guess I don’t understand where the attitude that life should have zero pain came from.
Nitpick : it’s Sackler.
Egad, what a screwup. Changing what percentage range a color means for each year.
That’s some fine graph work there, Lou.
Because different drugs work differently on different people. I don’t care for alcohol. I don’t like the taste, the effects or how it feels inside me (since I have this rather strange ability to ‘taste’ stuff in my blood stream.) I tried cocaine once when I was 19. Just a very very small amount, and it had a huge effect on me that scared the shit out of me and I’ve never touched it again because I know it would likely kill me.
CBD works for me, but as they say, having THC along with it helps. For me, 90% of the time it absolutely blows away the depression that comes with the pain. I can go from sitting at my desk in pain to singing and dancing. Now I’m sure some people will go :eek: and go on about using drugs to make you feel happy, but those people are also rather ignorant of the entire point of anti-depression drugs and I don’t need the lecture. That’s their opinion, not mine.
Some studies do indicate a gender bias.
And, of course, we know for the sake of simplicity early studies are often carried out men or male mice, but that’s a separate issue.
What a stupid ad. The reason I wouldn’t give them heroin is because heroin would be an uncontrolled street drug, and it would be hard to know exactly what’s in it or to give the right amount. If it were controlled and what the doctor prescribed, I would give it to them just like any other opiate.
The thing about broken bone pain is that it is initially some of the worst pain you can have. I admit I’ve not ever broken a bone, but I’ve heard this from other people, including both people who felt it and doctors. The pain is generally acute, and acute pain responds well to opioids. And it is long term use that has the greatest risk of dependency, not short term.
Then again, I don’t see avoiding addiction as a legitimate reason for not providing pain medicine in general. The bulk of the problems with opioid addiction is due to their illegal status, not the drugs themselves. If we focused on managing addiction when it did occur, I think we’d be a lot better off.
Not all pain is bad, but it is when it is above a certain threshold. I’d rather have living addicts and people living with tolerable pain than few addicts and people who suffer in severe pain. Even some level of death from addicts is better than living people in chronic, intolerable pain–though I honestly think we could get it a lot lower if they were allowed to manage their addiction rather than either have to quit or keep using illegally.
Is there evidence that opiates are a good choice for the treatment of any chronic pain, though? I ask this having come up empty after doing a brief amount of research. The only thing I’ve seen about it is the recent study linked above saying they’re not any better than OTC drugs for chronic back pain and arthritis. I’m genuinely curious to see a study proving their effectiveness, but intuitively the speed with which one builds a tolerance to them makes that seem unlikely.
Lacking such studies, prescribing such potentially life altering, addictive drugs long term should be unsupportable.
I’ve been doing research on this too. I believe the perception is now that opioids are not a good choice for long term treatment of chronic pain. The interesting thing is that as you start digging for information on who gets addicted, when, and why, the data doesn’t support the story we all hear. We hear that millions of people are prescribed drugs, get addicted, and move on to heroin, and then die. It turns out that almost all of that is untrue. Here are a few quotes from a good overview article I found:
On the rate of addiction among long term users for chronic pain management
One number that is frequently mentioned as the addiction rate for opioids is 26%. The article points out that:
The article covers several other interesting areas, such as the fact that many people who become addicted are not users who were prescribed the drugs in the first place. There are other risk factors as well, such as prior addictive behavior. This means that prescription management makes sense. We also see that the pendulum has swung too far, and people in genuine need are feeling the brunt of it. They live with chronic pain, and those who are addicted simply shift to other sources.
I found the article an interesting read (and a refreshingly rational one). I’d like to see society come back to a point where the actual medical science was governing how these drugs are used, and where addicts could be monitored and assisted, as opposed to driven to illegal drugs.
Because investigations can often take months, even years, to build an airtight case.
Stripping someone of their professional license is comparable to a prison sentence; the disciplinary websites I’ve seen almost invariably have the action taken many months after the offense(s) occurred.
No obvious relationship between this map:
And this one (more detailed than the one that HurricaneDitka posted):
https://www.thefix.com/communities-overlooked-government-response-opioid-overdose-crisis
Or worse yet, the doctor gets a negative Press-Ganey score for refusing to write scripts to addicts while working in the emergency room, and is asked not to come back.
The Pharmacy Times link is from 2014, when hydrocodone was reclassified into schedule II, which cannot be refilled under any circumstances, and shows what pharmacists in each state could legally do with HC prescriptions that still had refills on them. And that map from the link from The Fix does not necessarily mean that the people OD’d on prescribed drugs.
I’ve wondered about this myself. Obviously I can’t use my own medical history as data but I am an anecdote. About ten years ago, I was hospitalized for a period for almost two months and I was on pretty much constant opiates. They worked just fine for me; if I was in pain and took the meds, the pain stopped. I usually fell asleep for about a half an hour or so after taking the meds but that was the only effect I experienced other than the relief of pain. I didn’t feel any “rush” or euphoria or anything like that.
After several weeks, I finally got stabilized and treated and then I was able to go home. They gave me a thirty day prescription of Oxycontin and an order for refills. I took one pill the day I got home. After that, I didn’t take anymore. The pain was mostly gone and, as far as I was concerned, that meant I had no reason or desire to take the pills. The only thing the drugs had done for me was eliminate the pain and once that pain stopped, the drugs did nothing. It took no effort to stop taking them.