That’s more or less my experience (aside from the puke). After gall bladder surgery, I asked for a mild pain killer to just take the edge off and help me sleep. The nurse gave me morphine. While it did make me sleepy and remove the tiniest sensation of pain, it also removed the tiniest sensation of anything else, and left me unable to sustain a coherent thought. Not pleasant at all.
At other times I’ve been prescribed Vicodin. While not nearly as strong an effect as the morphine, it still gave me a fuzzy feeling. Like some other posters, I’ve had several scrips and used maybe 2 pills worth, with zero desire to use the rest.
I wonder if there’s some detectable difference (say, genetic) between opioid-seekers and the unimpressed remainder.
I feel like you’ve missed the point of the ad. The point was that you wouldn’t give a powerful, addictive, mind-altering drug to your child if she broke her bone, so why give her Oxy, a powerful, addictive, mind-altering drug?
I’ve had the broken ankle mentioned above (along with a torn deltoid ligament) that required surgery, and two broken collarbones, and breaking those bones was definitely not the worst pain I’ve experienced. My son broke his arms a couple of times when he was young, cried, fell asleep in the ER, and woke up smiling. I remember hearing that nothing hurts like a broken bone, but I no longer believe that. I’ve had headaches way worse.
I don’t know how you square the idea that short-term use doesn’t lead to addiction with the whole crisis thing happening. Some people won’t get addicted even with longish term use (see the anecdote above), but obviously some people are getting addicted more easily. And, giving out prescriptions like candy, even when the patient doesn’t want it, has to be one reason for the crisis.
I agree with you that people who need opioids should get them. I question whether many people who get them, need them, and use my own anecdotes as a shred of evidence. That was my point to Beck above – did she really need the hard stuff for a dog bite? Did her kid really need them for her wisdom teeth? It seems to me that a couple of days of discomfort, even real discomfort, doesn’t justify such a powerful drug, and using them is leading to people with chronic cancer pain, etc., having trouble getting them.
Is there really evidence that people who used opiates for 3-5 days end up addicted? I always wondered if part of the problem is that because of insurance or something, they always write the script for 30. Always 30. I don’t know why they couldn’t write scripts for 5 or 10: enough to get you through those first couple days of acute pain, to let you sleep so that your body can heal. I’ve had some cases where that would have made all the difference in the world–an ear infection so bad that blood and pus were running out of my ear, a particularly painful tooth infection, an amazingly bad bladder infection – and couldn’t get anything. In none of those cases did I need strong pain management more than 3 days. But other times, I’ve had doctors prescribe me 30 or 60 based on much less painful conditions.
[raise my hand]
I wasn’t on another planet, but I was out-of-touch in an Asian jungle. Last I remembered from circa 1990 were complaints that doctors were far too reluctant to treat pain. I distinctly remember the claim “Pain killers are not addictive when used to treat pain.” (Was that propaganda from Big Pharma, eager to sell drugs like OxyContin?) When I got back in-touch a decade ago, partly due to joining SDMB, I was rather shocked to read about the opioid crisis.
I had an American friend in Thailand, who started vacationing here in part because heroin was very cheap. But after the big War on Drugs here made the price skyrocket, he reported that heroin then became far cheaper in the U.S. than in Thailand!
Funny, when I had a tooth pulled all I got was a couple codeine (I took all of two). The dentist prescribed 5 total. No requirement to get 30. Is that really an insurance requirement with some companies or something else?
Also - I have to say dislocating my knee was a LOT more painful than the broken ribs I had once. But this is no doubt an area with mileage varies widely depending on the break and where, exactly, it’s located.
When discussing heroin addition, it is very common for people to blame pain meds. It is often asserted, “People get prescribed opiate-based pain medications, get addicted, and then move on to heroin when they can no longer get their meds.” While this does happen, studies have concluded most heroin addicts were never prescribed pain meds. (It’s true many may have been addicted to opiate-based pain meds before they moved on to heroin. But there is a difference between buying pain meds on the street and being prescribed them by a doctor.)
They have 5 different colors. Looks like thay adjust the percentages from year to year so that one-fifth (10) of the states are in each color. Basically it’s grading on the curve. Not the best way to present the info.
On something that was mentioned before: alas, because of what are the realities of the world, a patient directly soliciting a narcotic script by name is considered a major red flag. (You may notice pharma ads say “ask your doctor if Inagaddadapuminab is right for you”, rather than “ask your doctor to give you Innagadadapuminab”)
In some cases there is a confluence of factors: the Pharma Corps prepackage a lot of products in 30-day count factory-sealed bottles (which IMO makes sense for maintenance medication(*) but not for acute pain narcotics, but it’s easier for the factory to just bottle everything up the same way) so that the drugstore can just scan the code on the bottle and slap on a label. Insurers meanwhile may not necessarily mandate a month’s supply but, depending on how lousy is your plan, may only cover one script a month for one same thing; or else cover as needed but will Ask Many Questions about it and hassle the doctors who first do a script for 10 days, then 5 more if that wasn’t quite enough, more than the ones who just go for 30 to begin with.
Pain meds are tricky since being self-perceived, a lot of the protocol is “PRN”, i.e. “as needed”.
(*My BP medication these days already comes in 90-day factory-bottled batches)
Heck, when in 2016 I was at hospital for kidney stones and the professional choice was just let them pass, the most powerful thing I got was a powerful NSAID (Toradol) IV then more Rx-strength NSAIDs to take home. Same with my dental surgeries save for one major one in the early 00s that got me an opiate-type script most of which eventually got thrown away after mouldering for years since the way it made me feel was mighty unpleasant.
Why am I giving opiates to my child with a broken bone? Because she is in a lot of pain. If I wasn’t able to obtain legal opiates via a doctor, I might have to consider giving her heroin if the pain is bad enough.
One of my friends in 1974 was told that opiates “don’t cause addiction when used for pain”, so the idea is at least that old.
She was given a button to press when she woke up in pain, providing intravenous pain medication. As she recovered, the frequency with which she pressed the button increased, rather than decreasing. Eventually they took it away.
My doctor didn’t normally prescribe opiates. She didn’t prescribe /anything/ unless there was a very good reason. It wasn’t that there was a fear of addiction in particular: she just came from a generation that assumed all effective drugs had noxious side effects. She would have been distinctly unimpressed by the idea that it was ok to prescribe pain killers just because “they aren’t addictive”.
OF COURSE an active addict is going to blame anyone and anything but themselves; that’s one of the natures of addiction.
Melbourne, that push-button thing your friend had is called a PCA, or patient-controlled analgesia. They hook up a syringe of (from what I’ve seen) morphine, fentanyl, or meperidine and there may be others into the IV line, and the patient can push a button to deliver a small dose whenever they want it, within the lockout limits of course.
For example, a morphine PCA would be 1mg/ml (people with terminal cancer often had 5mg/ml) and the allowed dose would be 1mg every 5 minutes up to 4 doses per hour and 10 doses in a 4-hour period. Not only does this make life much easier for the nurse, because s/he isn’t constantly having to address pain issues, research has shown that MOST people use considerably less on a PCA than those who don’t. Most people would be on them for a very short time, often less than a day, and those who weren’t would have the dose gradually reduced until they didn’t need it any more. Epidural analgesia is also someone done this way.
It could be worse. My wife is allergic to acetaminophen.
Stop and think of that for a moment. Damm near everything has it in it, everything that ends in -cet does, the number of -dan drugs is very limited. When she drags herself into the ER with Gall Bladder flareups, or kidney stones, it’s Toradol or Morphine.
Try educating the ER intern and not being labelled drug seeking. The number of interns that had even heard about acetaminophen allergy was vanishingly small
My own experience has been that taking opiates as prescribed means you will not get addicted, which is what you are told when you go into the hospital. Last year I had a knee replacement and was given a supply of oxycodone while I recovered. I did not become a slavering addict and I did not go running around looking for illegal street drugs when my prescription was done. I definitely needed the pain relief but I hated the nightmares I often had while taking it so it was fine with me when I no longer took it.
The problem is that people are not taking these drugs according to instructions and are looking for drugs on the street which is never a good idea. That is where the supposed “opioid explosion” is taking place. I have never had a doctor who handed out opioids like candy. That is not going to happen if you are going to a legitimate physician.
Addiction is not dependence. Addiction is a psychological thing that not everyone falls victim to. Taking opiates for extended periods pretty much will cause physical dependence on most people, with some exceptions. To say that no one would also or alternately get addicted to legitimate opiate prescriptions is ridiculous. How can anyone say beforehand if a legit opiod prescription, if prescribed long enough, wouldn’t cause addiction as well as dependence in some people? No one does in depth psychiatric screening for potential addiction (if there even could be such a thing) prior to prescribing narcotics.
I have been prescribed tramadol (a weak opiod) for almost 14 years due to tears in both rotator cuffs in my shoulders. In this time, I have been a model patient. I have kept all my prescription records, as well as the doctor info who prescribed it (basically one doctor), which includes the dosages levels. Well, for succinctness, I will skip the whole story of why my long time doc disappeared but that is what happened. And it happened without ANY forewarning or accomodation for any of his patients, many of whom were on pretty strong medications that were both needed and couldn’t be simply stopped cold turkey. Yet that is exactly the position all of his patients were put in, without any other doc put in a position to temporarily accomodate these patients while more permanent situations could be worked out.
With all that being said, I had been recently attempting to tough out my tramadol withdrawal symptoms because I had found a new doc who I had a appt with in Jan (this was in Dec). But after a few days of the most profound agony I have ever experienced (and that is saying something right there), I quickly realized I needed help from a professional. So, given my dearth of options, I headed to the ER. And I have never in my life experienced a colder, less compassionate, less willing to help group of medical professionals IN MY LIFE. And it was simply and ONLY because it involved opiod painkillers.
Despite the fact that I came with more than ample information that validated my story, I was treated NO DIFFERENTLY than if I had been a strung out junkie looking to get high. I was offered nothing but tylenol. Tylenol and the door. I left the ER in tears. My faith in humanity had reached a new low.
(i may have shared this story already as it is a few months old from Dec 2017, but I don’t think so. Either way, it seems relevant to this thread).
I missed the edit window. The most ironic thing about that whole experience was the fact that despite me being in a medical institution, supposedly where understanding for my physical condition (paraplegia) would be deepest, this was the ONE AND ONLY FUCKING PLACE where some Good Samaritan didn’t rush (or do anything) to open the door for me when I left. All the RN did was point to it. And this is when I was shivering, shaking, sweating profusely and crying my eyes out.
