Friday, June 28, 2013

Chronic Pain? You're Hosed

     No, even more than you were already.

     --Blame it on the War On (some) Drugs.  If you're on meds for chronic pain, expect delays: one big drugstore chain has started double-checking prescriptions for often-abused medications and doctor's offices -- already in a paperwork crunch, already being "run lean" by the P.C.s and hospitals that operate most of them -- can't keep up.  Result?  Both addicted talk-show hosts and chronic pain patients are having to wait a longer time, days in some cases, for prescription refills.

     If you have chronic pain, better get refills while you still have a couple day's supply -- and get ready for one more entity all up in your business, asking personal questions of you and your doc.

     As someone who has (comparatively mild) chronic pain, and who has had worse and been on the stronger stuff for it, I will once more point out the obvious: in general, these drugs are not addictive when they are taken for pain; it's after the pain is gone and the patient has some left that the trouble can start: without pain to dull, a Vicodin (etc.) has pretty much the effect of a couple of highballs, a nice warm glow.  (The stuff'll stop you up worse than a block of government cheese, too, a side-effect rarely mentioned).  It can be insidious.

     Is it so dire a threat that making your great-Aunt with trigeminal neuralgia writhe in pain for two-three days is an okay price?  As it turns out, neither the pharmacy nor the drug warriors much care.  Caring isn't their job.

     Naturally,  the news report managed to dig up one (1) case of an actual abuser being actually caught by an actually suspicious pharmacy -- and what's the modern mantra, class?  "We all have to be punished for the bad acts of individuals."  Guns, drugs, impoliteness, doesn't matter; somehow Paula Deen, Adam Lanza and Rush Limbaugh are everybody's fault and we have to stay after and write "I will do as I'm told by my leaders" on the blackboard  five thousand times to keep it from happening even more. Hasn't worked in the past but hope springs eternal in the shriveled hearts and tiny minds of social engineers.

     (Me, I gave up the prescription stuff long years ago; I didn't like being mentally fuzzy or the other effect and OTC stuff worked almost as well.  Recent developments have me swapping ibuprofen for acetaminophen, which is not quite as effective; I keep a log of how much/when and take it very sparingly, which means, yeah, I'm hurtin' rather more than I'm used to.  Seems to be a lot of that goin' around, all of a sudden, but at least mine's by choice.)


perlhaqr said...

If you have chronic pain, better get refills while you still have a couple day's supply

Ha ha ha! If you can! Talk about a catch-22, Schedule II drugs often can't be refilled early, to crack down on abuse!

As it turns out, neither the pharmacy nor the drug warriors much care. Caring isn't their job.

The pharmacy, as an entity, certainly doesn't care. The pharmacist, as a human being, most likely does. But she's not likely to endanger her license, either. (Fuck the DEA!)

I realise that it probably makes me a bad person in the end, but I hope every higher up in the DEA and Congress who pushes for this shit gets stomach cancer, and can't get pain meds.

plblark said...

completely unrelated but should lift your spirits: A Big Wheel race!

Anonymous said...

I have chronic pain.
I've a good friend with TGN, Psoriatic Arthritis,
and a host of other pain issues.
It's obvious - in the so-called 'War' on Drugs, the gov't wants the peons to suffer.
Less ability to come after them!


Rob K said...

A million Aunt Betsys or Grandpa Clems having to suffer a couple of days of unbearable pain is a small price to pay if it keeps just one mook from getting high. We have to have our priorities straight!

Anonymous said...

I have cancer. At the moment I don't need a lot of prescription pain meds but I will before this ends. My oncologist tells me that she can't call in a prescription to a pharmacy, it must be a paper script. Since she gives me the script while I am in her office at the cancer center I fill it at the hospital pharmacy before I leave. Its been working out fine so far.

The Freeholder said...

It isn't just pain meds. I've had the same problems with migraine meds.

Jeffro said...

Another side effect of those pain meds is how itchy I'd get. Stoned, itchy and still in some pain - what a life. Glad I don't need that crap these days.

DJ said...

I take slight issue with the statement:

"... in general, these drugs are not addictive when they are taken for pain; it's after the pain is gone and the patient has some left that the trouble can start ..."

I don't ignore the "in general" qualifier, I simply know my own experience in the matter.

Two years ago, my two chronic herniated disks in my neck became quite acute. An MRI showed the pressure they were exerting on the nerves which served my right arm and shoulder, and did so clearly enough that a blind man could read it. The pain rated a 7 to 8, usually an 8, on my 1-10 pain-o-meter. It was calibrated back in 1978 by a kidney stone.

To make a long story short, I lived on Lortabs from May 20 until about July 20, 5 mg every six hours. It was not excessive, rather it kept the pain down to a tolerable level. Spinal fusion surgery fixed the problem instantly on June 28, causing very little pain (relatively speaking) at the incision, and no pain whatever internally.

Stopping the Lortabs cold-turkey didn't work. It caused pain of its own that was worse than what the disks caused, a spider web of horror that crackled across my whole back and down into my legs. But I (sort of) invented a simply way off them. I used my loading scale to cut and file tablets to reduced dosage, such that I kept on the same schedule but reduced the dosage over time. It was still one dose every six hours, but I reduced the dose by 0.5 mg every other day. When the dose reached 1 mg, I simply stopped. The process involved no withdrawal symptoms whatever.

Filing the tablets to reduced dosage was easy. A 10 mg tablet weighed 10.0 grains, exactly. They are physically hard but not brittle and are easy to file.

So, I had severe pain, I took just enough hydrocodone to make it tolerable, and I had severe withdrawal pains when I quit cold-turkey. All that means is, be careful when you try to stop such pain meds. You might think you're not addicted, but you might be surprised.

Roberta X said...

Interesting, and perhaps it is way more "YMMV" than I ever suspected.

At one point (20-some years ago), I had what was effectively an unlimited prescription for Vicodin. I had severe pain and I took as much as I needed to get a decent night's sleep and get through the day. When the problem was finally resolved, I stopped taking them. No withdrawal, no nothin'.

DJ said...

Yesterday was the two year anniversary of the surgery that finally gave me relief from that pain. "Taking your hand out of a vice" can't hold a candle to it. I've been smiling for two days now.

perlhaqr said...

DJ: I am amused by your "calibrated" comment, only because I myself had my pain scale "calibrated" similarly, by crushing a fingerpad in a jack stand.

I'm glad the surgery stopped your problem. Chronic pain sucks.

DaddyBear said...

I only had the hard stuff around when I had surgery a few years ago, and ejected them from the house as soon as I didn't need them. There are too many people willing to break into homes to get at stuff like that for me to want it around.

I was on prescription NSAIDS for years for my arthritis, and while they worked wonderfully, I eventually gave them up in favor of daily aspirin with augmentation with acetaminophen for bad days. Yeah, I'm still sore and achy by the end of the day, but the cost is a lot less and the cardiac risks are a lot less.

I can't imagine being in dire need of pain management in order to get on with life and having some bureaucratic twit make you wait a few days because some people can't handle their meds.