James W.D. Stewart

James W.D. Stewart

Embrace "The Suck"


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People in chronic pain, such as myself, are feeling the impact of the legal changes regarding the use of opioid analgesics for severe pain.  I used to detest pain medications.  I did all that I could to avoid making use of opioids — relying upon 8–10+G of Ibuprofen each day instead.  As I age though, I'm finding that the effects of the extreme abuse which I'd put my body through is fast catching up with my gimp-ass.

/blog/2017/05/15/severe-pain-what-to-do/

https://forces.army/blog/2017/05/15/severe-pain-what-to-do/

Severe Pain, What to Do

Count Words — Reading Time
by James Stewart
Published: 
Updated:    Removed Image
Location:  Tim Hortons, 1373 Martindale Rd., Sudbury, Ontario, P3E 4J7, Canada
 

 

People in chronic pain, such as myself, are feeling the impact of the legal changes regarding the use of opioid analgesics for severe pain.  I used to detest pain medications.  I did all that I could to avoid making use of opioids — relying upon 8–10+G of Ibuprofen each day instead.  As I age though, I'm finding that the effects of the extreme abuse which I'd put my body through is fast catching up with my gimp-ass.

I hurt every-fucking-where and it's become quite miserable when I'm off of my pain management medications.  Trust me — I don't wish to be on them — but, I need them all the same.  While I do somewhat understand the changes in law, all that the lawmakers are accomplishing is to make people like me live in absolute fucking Hell — the addicts and/or abusers, they simply turn to more heroin.  You'll never be able to control the addicts.  To punish those whom don't abuse it, and require them to live a relatively normal life, is abso-fucking-lutely unjust.

I'm living in a constant pain that I'd not wish upon my worst enemy.  The pain is excrutiating most times and my mobility is drastically decreasing with each passing month.  The new laws, in combination with the severe lack of family doctors, has caused significant damage to countless lives across the nation — more damage than one could, possibly, fatham.

I can't remember the last time that I actually had a regular family doctor — it's been quite a long time anyhow.  The closest that I can get is to visit the same clinic and utilize the same pharmacy.  I've been going to Northwood Medical Clinics, on a fairly regular basis, for several years now.  WTF is one to do, when they have no family doctor nor can they readily obtain one, and clinics refuse to refill their prescrition(s)?

I try to go to the same clinic, so that they have a medical history/record for me, and I need not have to re-explain my entire fucking life's story to each new doctor with each visit each month.  With that said, there's a single doctor at this clinic — whom we'll call Dr. Armani Sarabia — that's ignorant, degrades his patients, disrespects his patients, and makes you feel as though you're a drug addict for simply wanting a refill on your already existing/prescribed long-term medication(s) for clear and visible injuries…  Fuck, I had to fight with him last year, after stripping down in the office for him see my legs along with their visible wounds and my custom designed/manufactured orthosis — for a simple refill of my Arthrotec, FFS!

 

The government had issued new guidelines which strongly urge doctors to stop prescribing narcotics to patients with chronic pain.  While I believe its mandate may reduce deaths from opioid overdose, what the feds haven't considered is the impact on people with long-standing severe pain, especially if they're disabled.

 

Changing the Rules

In the last couple of years, there's been a huge effort to make it harder for doctors to prescribe opioid pain relievers.  The government's made it much harder for patients to obtain hydrocodone combination (i.e. Lortab, Norco, Vicodin, etc.) pain relievers.  Previously, prescribers could call-in and/or send-in an electronic prescription to a pharmacy and could give a pain patient several refills.  Now, patients typically only get a 30-day supply and must visit the doctor's office each time that they're in need of a refill prescription.

The new laws have made it much more challenging for a patient who's disabled and/or in severe pain to access an opioid medication.

 

New Guidelines

In essence, the new opioid guidelines state that narcotics shouldn't be prescribed for chronic pain patients.  Rather, doctors should recommend acetaminophen (i.e. Tylenol) or NSAIDs (i.e. aspirin, ibuprofen, etc.).  Other suggestions include antidepressants, cognitive behavioral therapy, and/or exercise therapy.  I'd suspect that there are many patients, like myself, for whom such suggestions won't be met with much enthusiasm.

For acute pain, such as after surgery or an accident, it's recommended that doctors prescribe opioids for no more than three days.  Really?  Some "acute" pain lasts substantially longer than three damn days!

The government acknowledges that cancer treatment may require opioid medication during the active phase of therapy.  However, what they've not taken into account, is that cancer survivors may have to deal with chronic pain.  The president of the American Cancer Society Cancer Action Network said:

Pain does not end when an individual completes treatment.  Most often, cancer patients deal with lasting effects from their disease or treatment including pain for a significant period of time or indefinitely.

The guidelines fail to take that into account.

 

Walking the Tightrope

I recognize that there's tremendous abuse of narcotics within this country, but I'm uncertain that the new guidelines will help to reduce the problem though.  I've not seen convincing evidence, that making it harder for chronic pain patients to access drugs like hydrocodone, will make a huge difference in abuse and/or overdose deaths.

I also believe that it's, virtually impossible, to generalize about the most appropriate treatment for people with severe chronic pain.  Some people will do well with cognitive behavioral therapy, while others, can only function on opioid medications.  These drugs allow them to work and/or function with some dignity.  They don't abuse the pain medicine, don't increase the dose, and don't sell their medicine to drug abusers.  They've now become vulnerable to a huge federal mandate┬áthat impacts how physicians practice medicine.

It's my belief that the government shouldn't tell physicians how to practice medicine.  Especially, when it comes to something as complex as chronic pain.  Each patient needs to be evaluated individually and treated with respect.  The new guidelines scare many doctors away from prescribing potent pain killers for longer than a few days or weeks.  That means┬áthat some patients will live in agony, with no acceptable treatment, through no fault of their own.

 
Categories:  Health, Law, Medical, Political, Science  
Tags:  Opinionated, Self, The Stupid, The Suck

 
Syndicated to:

 
References:

  1. Final CDC Opioid Prescribing Guideline Could Have Unintended Consequences for Cancer Survivors Living with Chronic Pain
    by Chris Hansen Published: 
    Referenced: 
  2. Northwood Medical Clinics
    by Innominate Referenced: 

 

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Creative Commons Licence :: BY-NC-SA James W.D. Stewart by James Stewart is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.  Based on a work at https://github.com/jwds1978/jwds1978.github.io.