This is not even remotely true. The doctor knows the number is approximate. It is one of many factors used to diagnose and decide treatment, including which medicine for pain. Drug seeking is presumed because of a constellation of many factors and flags and this question is only a small part of that.
Even drug-seeking is not an excuse not to treat pain since users are more susceptible to pain (having fewer endogenous defences) and often need relief - but one must be more careful with the choice of medicine. Anyone in pain should be offered reasonable relief, as possible, and doctors have a moral duty to treat pain when practical.
It is absolutely true in my experience. And the experience of others I know.
In my case, I expect my appearance has something to do with it.
I have read that Black patients are often denied pain medication. For example:
That’s an example I just dug up, and you can assign whatever weight you want to it. I’m not exactly up on the medical literature. I am up on what I’ve heard from Black motorcyclists in the motorcycle world. No painkillers for them.
I agree that doctors have a moral duty to treat pain. Nonetheless, I remember all too well being sent home after a smash-up that hospitalized me for two weeks and which had life-long consequences with the advice to take Tylenol as needed and trying breathing exercises.
Urgent care facilities in NYC, which are fast becoming the primary care points for many New Yorkers (since more and more doctors are absorbed into practice groups practicing assembly line medicine under the banner of one of the big hospital chains (NYU Langone or Mount Sinai)) have an explicit policy of not prescribing pain medication at all, ever. The big group practices are very nearly the same.
ERs will usually give a patient medication in the ER. They will almost never send a patient home with a prescription, no matter what the injury.
Your experiences are your experiences. It is unfortunate you were treated that way, if it is so. ER doctors may not give out huge quantities of strong pain medicines, but when called for, it is reasonable to give enough for a week or two pending further follow up (or more in certain circumstances). But if you went to a doctor who knew you every two years and asked for something because you were in severe pain, receiving Tylenol would usually be far from ideal and from good practice.
I do not agree with a blanket policy of not giving pain medicine. There may be reason not to choose narcotics. But these certainly have their place too in many cases. There are ways of prescribing them responsibly. In practice, it may be a policy to discourage people who go to the ER on a daily basis, honoured in the breech. No prescription at all? For anything? I don’t believe it.
I wasn’t prescribed any pain meds, until I asked for them. The doc said “We’re really scared of patients getting addicted, or even taking too much. Tell you what, I’ll call your local pharmacy with a prescription, but with a note not to fill it unless you call them in the next two weeks. But try to manage your pain without it.”
I thought that was fair, and I swear, I toughed it out as if I’d been dared to go without meds.
Most unexpected? I ski better now than I did at a third of my age. My knees are a Wonder of Nature, and I can hammer the moguls all day, and better form than when I was in High School. All on wood core 204’s from the 80’s. Sadly, today was Season End.
I asked Michaela to order one on Sunday, it arrived Monday, and I’ve just finished installing one and taking it for a test drive. Even with cold water, it was NOT an unpleasant experience.
So now I’ma go to Amazon, have one delivered to my gf’s house tomorrow, and I’ll install it then.
ETA: It’s not a musical bidet, so I’ll have to ask Alexa to play the song for me.
My doctor said that he was tightly monitored on his pain medication prescriptions.
From what I’ve read, a tiny subset of doctors prescribed tons of pain medication spurred on by incentives from the Sacklers. (Like big speaking fees to audiences of under a dozen.) I doubt they would have done this without incentives, and it screwed things up for the rest of us.
I have read the thread, but not recently, so this might have come up before but I just got hit with something unexpected, which is friends dying. A good friend and neighbor, only a year older than me was found to have cancer and was gone in six weeks. Another good friend is dying. And I can just see more of this happening.
Until it happens to me. I’m reading a book of poems from Billy Collins and in one, “Life Expectancy,” he notes that the robin hopping on the lawn outside his window might outlive him, and maybe even the worm the robin is chasing. I’m not there yet. But, as George Burns said when he neared 100, and that point he didn’t buy unripe bananas.
As a gay man who survived NYC in the '80s, I can relate to this. I once had three funerals at the same time. By the time I left the city, there was virtually nobody left of my former friends and lovers.
One thing I can’t recall seeing mentioned is the new awareness of the risk and implications of falling. I’m 56 now (and in much better shape than I was 20 years ago), but I notice now how careful I am getting in or out of the shower, and how easily I can imagine the feeling of a simple slip, and what would happen if I did.
Men tend to have fewer wrinkles then women, due to thicker skin. (IIRC, this is also why men are more prone to acne as teenagers.)
I myself have a lot more equanimity about death than I used to. But I think it’s just acceptance of the inevitable, and the fact that it looms a lot larger than it used to.
I think the fear of death is mostly about not wanting to die, but if you know and accept that you’re going to die anyway and it’s only a matter of when, then it’s not as big of a deal.
The thing is that most people do know they’re going to die but put it out of their minds, and manage thereby to view their death as “if” rather than “when”. But I think increasing exposure to other people dying as one ages, and the knowledge that it’s a lot closer than it once was makes for a lot more acceptance.
I worry less about dying and more about the suffering that so often precedes it. My mom suffered from a terrible progressive condition for two years before her death, and my dad’s mind and body have been hammered by Parkinson’s disease for about a decade now. Falls, shitty sleep as a matter of routine, severe cognitive decline, medical crises that land you in the ER once or twice a year, inability to do the things that used to give your life great meaning. Yikes.
I’m 61. I had my first child when I was 53. I’ve had the opposite reaction. I now have an intense fear of dying. Not because I’m afraid of death (I’m not – I really don’t care. I fear pain, and physical deterioration, but actual death? No, no fear of death), but because I fear not being around for my children, and because I fear the hurt my death might cause them.
I have to make it into my 70s. In good shape. If my kids are in their twenties, they can handle my death. I was in my twenties when my mother died. I was devastated, but I could handle it.
Hah! Yeah - I’ve become very aware of this risk. Not so much with the shower, but with general walking. I was never coordinated, and this has not improved with age; falls and other injuries are too common. Broken toe just 2 weeks ago (not entirely my fault; household member left a box of detergent in an unusual spot, and I slammed a toe into it); broken tailbone 2 summers ago slipping while walking downstairs; broken foot 9 years ago on those same stairs… frequent rolled ankles leading to anything from embarassment to sprained ankle to broken elbow…
When I saw the podiatrist about the broken toe, I offhandedly quipped about the number of broken bones and she looked worried, I did confirm that I panic if I need to go down stairs and there’s no railing.
If I ever get asked the “do you feel safe at home?” question by a medical professional, I’d have to answer “well, no, but it’s nothing anyone is doing to me, I’m just too klutzy”.
So while we love this house, another thing that surprised me about aging is that now, I REALLY want to downsize to a one-level house or condo. Unfortunately, hereabouts (DC metro) one-story houses are extremely rare, and condos are pretty darned spendy.
The unpredictability of my body’s elimination processes. 'Nuff said."
My eyebrows. Individual hairs go rogue and stick up such that I have to trim them with scissors. I’m afraid I’ll wind up looking like one of those Southern movie lawyers with unkempt hedges above each eye.
This has been a problem for me since childhood. I suffer from vertigo and have had some drastic falls as a result. But now, it’s other things that send me to the ground such as my knee not being there for me, possibly related to worsening sciatica. At age 60, I’m already looking into getting a fall-alert bracelet.
I’m 42. I often like to sleep on my side. Every so often, I wake up with a sore shoulder. As best as I can figure out, it’s from nothing more than my body weight resting on my shoulder for several hours.
But those doctors that are incentivized are known as “thought leaders” and they helped the drug companies convince other doctors that opiates weren’t really that addictive. The pharmaceutical companies found a letter written to the NEJM in the ‘80’s from doctor that observed that patients receiving opiate pain meds in a hospital inpatient setting didn’t typically seek drugs and become addicted after release, and conflated that into a “landmark study that proved opiates weren’t inherently addictive.” They funded advocacy groups for pain patients, those groups promoted opioid medications and sometimes threatened doctors with legal action for withholding sufficient pain relief.
The wrongdoing around OxyContin was deeper than just overprescribing.
The big selling point of OxyContin was that it allegedly provided pain relief that lasted 12 hours. The problem was, it didn’t. But when doctors reported that their patients were experiencing breakthrough pain in hours 8-12, Purdue told them to increase the dosage rather than the frequency - I believe they even searched out prescriptions where the doctor instructed 8 hour intervals, and came down on those doctors.
Then there was the whole “targeting addicted communities” thing,
Purdue’s wrongdoing was way deeper than just pressuring a few doctors to overprescribe - no matter how they try to whitewash it,
