I was on Hydrocodone for 7 years to help me cope with chronic back pain. The VA prescribed the opiod for me. All those years I was able to perform at a pretty normal level, including my job and social relationships. Then over 2 years ago the U.S. Government mandated that the VA no longer prescribe opiods to Veterans. Since then, I have found that alcohol is the only thing that comes close to the pain relief of Hydrocodone. Well shit, now I am a fucking alcoholic. Thanks VA.
I watched a documentary on the va dishing out methadone to Vietnam vets who came back with heroin habits,did they stop this?methadone is a full spectrum opioid
I have Multiple Sclerosis. I have been taking my medication for 15 years now, AS PRESCRIBED! While it doesn’t completely take away my pain, it improves my quality of life. Doctors tried everything on me to help with the pain, non opioids, and they did nothing but make me sleep. They tried what I currently take and I can live a better life now. I don’t abuse them, and take them as needed. I wish all these people that can talk about the problem could feel chronic pain daily. They would probably be the abusers! The problem we’re having is, there are those out there that sell their pills, and these younger kids are overdosing. The road they are taking now isn’t fair to us who take our medication as intended. This doc is another example of a know it all that knows nothing!
A friend brought this to my attention. Problem with this is I have chronic pain been on opioid for years now. Before, I had to drop out of school and had huge amounts of trouble finding work. I became physically active because doctor said it would help (it didn't and unsurprisingly made the pain worse as it is provoked by activity). Did various other treats, much to no avail. Eventually, I attempted suicide (solely to end the torment of pain). I had anger, depression and anxiety issues. I was given pain medication and guess what happened? I got better, whaaaaat? It's almost like treating the problem solves the situation. No more anger, depression, or anxiety and I have gone back to school. Also, you should review the literature again as there are lots of studies that vindicate my story as typical.
Wade, I have exactly the same experiences you cited except the suicide, so good on you! My comment is about the people that think they are medically capable, more so than the specialist I have seen, that say things like "Oh he's a Faker ", " You should throw those CRUTCHES AWAY!" and "He doesn't need that CHAIR ".....PISSES ME OFF!-but I hold my tongue. Makes me wish I could just change places with them for one hour! I am lucky, I keep my meds. in check and have been able to since 2010. Without the meds. I would be bedridden. Thank God I have a doctor who listens.
Capttomguam Buckley Im thankful ur Dr. Doesnt take them from you !!! Many many dr.s are ripping patients off thier pain meds left and right. Myself, and others i know who never abused their meds... to majority of drs it doesnt matter!
Alisa Lauzon I’m about to go through the same thing and I have so much anxiety and depression because I KNOW that I will not be able to live my life normally anymore and I have ALWAYS BEEN A GREAT PATIENT who FOLLOWED everything to the T and NEVER GOT INTO ANY TROUBLE!!! I have passed UA’s for the past 12 years and NEVER GOT MY MEDICINE EARLY! This shit is ABSOLUTELY ABSURD!!!! I’m FAR FROM A JUNKIE so I don’t understand why I’m going to be treated like one....
When they cut people with c hronic paid off from meds they WILL seek out illegal drugs and THEN they will OD or get arrested. It is only because of these ignorant temperance movement assholes that illegal drugs are fourishing.
Oh and recently in NY there have been arrests of doctors and nurses who are abusing these drugs on the job. PATIENTS should suffer? In one case, nurses were scraping off 50% of the Fentanyl, ingesting it and then giving the patch to the patient. This is compassion? You industry has some of the biggest Opioid addiction rates. Why don't you start there.
The doctors took to long to put me on an Opiod class 2. I lost my job, house, ability to walk, everything. Then I got disability, which I was so thankful, but you get such a small amount , average 1000 a month, you still can't pay your bills. Sad situation.
Fix my structure, re-inflate my discs, my bursa, regrow my nerves and then I will consider this garbage. 27 years of ongoing deterioration in my spine and increased arthritis has left me disabled and unable to work. At best the medication means I am barely able to function which living alone means everything is up to me and I get no other support from anyone.
This is absolutely true. My doctor went from being compassionate to being an outright ass. She now doesn't believe in Chronic pain conditions (go figure). I am shocked that she made a 180 degree reversal and is now removing all her patients from any pain meds whatsoever. This is hell on earth for sure.
being a retired nurse and in my senior years having a condition that has caused me chronic pain......when i reflect on many of the issues in this video.....i wonder why it is not mentioned that many doctors feel as if they are failing if the person they are treating is not getting better.....and all the opoid problems in this country i am positive have very little to do with patients who are under the care of pain management doctors....people who are addicted are always going to use narcotics in dangerous ways.. looking at patients as if they are drug seekers and the attitudes pharmacy staff have when you fill prescriptions is awful....after all we are the easiest target to punish the most visible and we are made out to be the problem ...... do you really think we can't just taper and stop using opioids? well we can and do......but being in a small agonizing world filled with pain and making it unable for you to live any other way except in bed is to many a good reason to go back to taking pain medication......yes oddly enough we chronic pain sufferers take the medication to get rid of the pain.....a real revelation i know
“Chronic pain is one of the most underestimated health care problems in the world today, causing major consequences for the quality of life of the sufferer and a major burden on the health care system in the Western world," said Professor Harald Breivik, President of EFIC. “Reasons for deficiencies in pain management include cultural, societal, religious, and political attitudes, including acceptance of torture. The biomedical model of disease, focused on pathophysiology rather than quality of life, reinforces entrenched attitudes that marginalize pain management as a priority.” - Brennan F, Carr DB, Cousins M. “Strategies currently applied for improvement include framing pain management as an ethical issue; promoting pain management as a legal right, providing constitutional guarantees and statutory regulations that span negligence law, criminal law, and elder abuse; defining pain management as a fundamental human right, categorizing failure to provide pain management as professional misconduct, and issuing guidelines and standards of practice by professional bodies.” “The artificial distinction of cancer vs. noncancer pain is more about attitudes, emotions and politics than science. Our sense of compassion should not stop at the word non.” - Lynn R Webster, MD “...there is less evidence than everybody would like on the efficacy of long-term opioids. But absence of evidence does not imply evidence of absence. There’s also less evidence that everybody would like on the risks of long-term opioid use.” - Judy Foreman, A Nation in Pain. “Ethically, the failure to manage pain better is tantamount to torture. When chronic pain is inadequately treated it undermines the body and mind. Indeed, the risk of suicide for people with chronic pain is twice that of other people.”
Wonderful letter. I have been describing my chronic pain mistreatment as torture. Now I realize it should be catigorized as a crime, on the part of the medical profession, not to treat pain.
'Sleep deprivation is classified as one of five illegal interrogation techniques practised by the British military.' Only us pain patients don't need interrogators to be tortured, we get it right in our own homes and beds.
Thank you for this Dr. Mike. I, for one have been on opioid therapy for 8-9 years now. Suddenly, because of new legislation in the pharmacy industry, the GFD (Good faith dispensing) Act, My Dr. has decided to discontinue prescribing my meds COLD TURKEY! This new legislation has had an effect on the "sticking with one pharmacy" theory as you suggested...this new legislation has given Pharmacists FAR too much power and I have been DECLINED to fill at numerous pharmacies now too! (STEER CLEAR OF WALGREENS IF YOU ARE OPIATE DEPENDENT - they will ban you from filling at ANY Walgreens nationwide!). I understand that there are "good Dr.s and bad Dr.s, but I don't agree that it should be the pharmacist who makes this determination) I too, have been living in FEAR every day for 9 years that this day would come.,,,no way to live. But since some brainiack in the FDA or DEA decided that the Pharmacists should "police" the Dr.'s (of course knowing NOTHING about the patients, long term plan, past history, combined therapies, etc.) Dr.'s now have to be ACCOUNTABLE to the pharmacists and "justify" themselves when prescribing sched 2's! This is ludicrous and my Dr. decided she wasn't going to "play" this game... I don't blame her! BUT, as the patient, I now will suffer and I am petrified! I literally cannot function without these drugs. I lost my job (in the pharmaceutical industry) through a mass-lay-off and I am raising my grandson and taking care of my elderly, wheelchair ridden parents and I cannot do it if I am bedridden. I lost my home, my retirement savings...everything. If I am unable to find help, I fear that I will have to turn my grandson over to foster care! RIDICULOUS! Now, it is difficult to find employment without drug testing, thus making it much more of a struggle to become employed if you are on medication. It's bad enough to feel the constant pain, the guilt of having to be reliant on these drugs to "function" but in addition, living with the "stigma" of friends and family around you who don't understanding what it's like to live with chronic pain...debilitating pain, and "judging" as if you are a common street drug addict! I can say that after long-term use, that YES, one does become physically and emotionally dependent on these drugs. I have never mis-used them and I don't drink, but over time, my dosage has had to increase to still be effective. You DO develop a tolerance and consequently, increased dosing. I have tried MANY alternatives...Lyrica, Cymbalta, OC, etc...all with negative side effects and little to no pain relief. I have heard that one can DIE from the withdrawals and I have been there (in the past when my meds were stolen) and believe me, I WANTED TO DIE!..What does a person do? Go to the ER? Once you tell them your dilemma, AGAIN you are judged, and most often not helped! I want to have a life, quality LIFE, and am now stuck searching for a Dr. that will either prescribe or refer me to a pain management clinic...but their job is to take you off opiates! Since losing my job, I had to go on Medicaid. That's a whole OTHER ISSUE! I must have called 50+ Dr.s to try and find one that accepts Medicaid. With the New "Affordable Healthcare Act" this is only going to get WORSE! More people than ever before are being given Medicaid, but they didn't revamp the PAY to Dr.s or increase the Dr.s that will accept Medicaid! So, since Doctors don't get adequately compensated through Medicaid, they are not participating. 100,000's of people have Medicaid now, but there are NO healthcare providers...so what good does it do? The few providers that there are, are SO OVERBOOKED that you are lucky if you can get in within a YEAR! In all, I think there needs to be a "rethinking" and "educating" nation-wide...Dr.s, pharmacists, common lay-people, patients...EVERYONE! If not misused, these drugs can mean the difference between life and death... I agree with another poster...there should be "Opiate Specialists" that can navigate the ever increasing negative stigmas and legislation and TRULY HELP PATIENTS IN CHRONIC, non-cancerous PAIN!
You do realize the job of the pharmacist is to ensure doctors are accurately prescribing medications and in my experience are overwhelmingly more qualified dealing with opiates than your run of the mill doctor. Pharmacists seem to be the only ones with a true understanding of the scale of the opiate crisis and considering the trends you are exhibiting in this post, rightfully so you were blaming the pharmacy for things out of their control and were banned from filling there. That or you have too many red flags to justify filling a prescription for.
How many overdoses were actually suicide due to under management, which is exactly what you are promoting. Long waits to see pain specialists and doctors in Ontario who are terrified of prescribing to help patients are the leading cause of suicide for pain patients. Thankfully Canada will have a law that allows assisted dying due to long term unmanageable pain.
jean sutherland I dont understand what the opioidphobes problem is, it obvious they want all pain patients dead so why do they even care if someone ods or not. since we are disabled in pain and suffering we cant contribute to the tax base so the cdc's recommended treatment is to cut patients off stigmatize us and drive us to sucidie as the olny option to end the pain.
They don't care if we die, from the pain or other treatments that sicken and harm us, as long as we don't die from opioids. They don't care if we kill ourselves, as long as we don't use opioids to die and escape our pain. Then they would only care enough to put our names on a list of tragic deaths, caused by opioid overdose. We just don't matter to these anit-opioid fanatics at all.
Do you have any studies now for 2018 ??? Ive been trying to figure out ? Are the counting any and all opoid overdose lumping it together weather street heroine, and what how many were prescription s not even perscribed for that person?? Are there studies going on that ARE counting all the suicides happening now for those cut off and now can no longer function ?? Or Studies for those who can now not work ?? Because pain mangement is now 0 opoids. Most of us have willingly tried every other option that we ARE aware of.
It really is frustrating as a chronically ill pain patient with several illnesses that takes my medicine judiciously as prescribed to be put in this category. This stigma happens now thanks to the CDC new rules that were hundreds of pages long signed off, that were " recommended" doctors follow, not a law. One being if one is a chronically ill pain patient and goes to the hospital it is 'recommended' not to treat with any opioids' . How does the doctor measure pain? If I have chronic infections that need surgery you are just going to continue cutting me open with a scalpel with no pain relief while I scream? I even have been refused lidocaine. This is barbaric and inhumane. I have had to resort to surgery at home sometimes at my own peril. Good job CDC and Trump. Shorting hospital stays and cutting meds. See how you like being bedbound most of the time because you are so ill you are fainting, or near fainting from a condiction called P.O.T.S., in a flare over 2 years on and off, with over 103 surgeries from I&D's from Staph infections, and cellulitis and a few recluse bites, and excisional biopsies. I was a Funeral Director Embalmer until 2013, but had to stop. I had 2 car accidents in a 2 year period not at fault left with hiernated discs in back and neck. So I know pain. It's only gotten worse when I did removals of deceased at that job toward the end. I loved helping families. Now, I am stuck home, fighting for my rights to get the treatment I need fighting every step of the way, because of people that abuse the system to get a high off of the drugs. That sucks. Don't lump us in with heroin users, Fentenyl users on the street, teens getting drugs from friends, that's b.s.. thats a separate report. You should do a separate report on chronic pain patients. Because doctors treat us with scorn, distrust, stigma and we are tired enough of trying to make it through another day.
CDC guidelines have killed so many people, either by killings themselves bc of the pain, or turning in desperation to the streets and receive a deadly dose!
So chronic pain management is the patients problem? It would be nice if the doctor could fix the underlying cause of the pain. Physicians frequently don't, but take your money anyway, and tell you to come back. Bottom line: chronic pain is no problem, unless its your chronic pain. Thanks Doc ( for nothing)
+Dan Seluk Study to become a doc and start "fixing the underlying causes" since you know how. We need more heroes like you to solve things like lower back pain.
Kalle, how about you find me a cure for adiposis dolorosa (Dercum's disease) and Multiple Sclerosis. Dercum's disease on top of MS has introduced me to levels of pain that make me want to "leave my body" and it never stops. If you are training to become a doctor, learn some compassion.
I have r.a. and have been on opioids for over 6 years....first Vicodin and the oxycodone and now after thowe simply stopped working I wen on suboxone because I also became dependant...and the buprenoprhine in it actually is doing better controlling my pain than the 2 most widely rxd opioids that have huge addiction stigma attached to them
Lose the idea that there is always a solution. The fact is there are more health problems to which their is NO solution, than there is problems WITH one. Sometimes what's broken cannot be fixed.
Suboxone is a nightmare to get off of. It will have the same stigma attached to it in just a matter of time. First time I was prescribed it, I had to go to the ER and had what is known as a "brain allergy" to it. It was literally causing psychosis. Anyone looking at getting on Suboxone, look at all the articles and forums with people currently taking it, so your decision to start on it will be sound. It can be great for pain, but be very informed on what the future will be with it. www.thefix.com/content/hard-to-kick-suboxone?page=all
All of this information that has been played out here is in no way news to me as I've suffered chronic pain for most of my life. I am 32 years old and have been in pain for 20 years. And when I say pain...I mean debilitating pain from chronic pancreatitis caused by an accident. Because of this I have had to be on major opiate therapy since I was about 16 years old. I always felt so so alone and self conscious about my need for opiates that I feared anyone thinking or even hinting at the fact that I might be an addict. My fears came to light very quickly. My family doctor at the the time called me a drug addict and began treating me terrible. I used to have nightmares and wake up in a panic because I was reliving experiences of being In a pancreatic attack at an emergency room where I was left to suffer...and sometimes I would lay in a hospital bed for days suffering. The doctor would say I was an addict and would refuse to give me pain medication. Many times I would crawl out of my bed and get on my knees. I would say..."Please please lord..... take my pain because I can't take anymore. And if you can't take it away then please I beg you to come and get me now. Please God please don't leave me alone." On one occasion I was life flighted from Casper Wyoming to Denver , Colorado and when I arrived in Denver my doctor thought I was an addict and refused to even come and see me. I was admitted and I was tortured there. I was at my breaking point and beginning to LOOSE touch with REALITY because it had just been too long and too much pain and no breaks. I tried to open my hospital window on the 8th floor so that.......I could jump and end my suffering. I was 5 months pregnant at the time. My poor mom was with me that night and she kept going down to the chapel at the hospital to pray for me. She knew it was bad and her herself was deeply affected by the trauma of seeing me in utter agony and knew there was not any way that she could help me. Anyway I just lost my long time doctor of 7 years who was the best pain doctor I've ever met. And I've met many. But none like him. He saved my life and I am grateful for that. For years he wrote prescriptions all the time for me and even gave me his cellphone number in case I needed him. I wish there were more like him. But when he decided to take a state JOB at a prison as there physician I couldn't find another doctor who would prescribe the amount of meds I took and I couldn't find one anywhere. I even looked so far away as 6 hours away from my home town. So when my meds ran out ....instead of going to the emergency room I thought to myself.....Well I've been pretty healthy a long time and the meds really worked so maybe I can just stop. And stop I did!!!! I quit cold turkey. It really wasn't that bad coming off of 1000mg of morphine extended release tablets each day. Yeah it was uncomfortable but I was ready. The meds had done their job and done it well so I was going to close that chapter in my life. After my doctor started really aggressively treating my pain and getting control of it my pain began to lesson over time and for about two years i really felt as if i was taking my morphine just to basically do what worked and also to not go into withdrawl. My doctor of course began slowly weaning me off about 5 years ago but everytime he asked me if i was ready to wean somemore i would say No way. I was afraid of the pain getting back to all the time and everyday instead of what was currently occurring which was just having a few attacks a month. If I had not met Dr. Kasselman I wouldn't be alive right now. I would have taken my life a long time ago. But he took me as a patient and completely sought to get me out of bed, back to work, and most importantly back to being a mom to my children with opiate medication and I don't know what I would have done if he didn't do that so many years ago.But I fear that this country is going to ban opiate medication and I don't know how people like me will survive it. But folks it is coming so be prepared for it. Ya know.....sometimes i think that the people who are drug addicts make it hard for people actually suffering. But I remind myself that they are hurting too...just in a different way. But I beg them to please stop and get help. I know they are good people that have made some bad decisions in life and I understand that because I've also made some poor choices too. WE ALL SIN AND FALL SHORT OF THE GLORY OF GOD! There is no superior human to another, we r all in this together and we all are just trying to live the best we can. And I really hope that all the physicians out there understand that. They need to understand that just because 35 people walk in their office and end up abusing their medications doesn't mean they get to turn that one person away who genuinely needs their meds and will not abuse them and go down a destructive path but actually thrive in their life. There is a solution to this so called epidemic we just have to work together. Patients, doctors, and addicts need to work together in order to make a lasting and fair for all conclusion. I hope that maybe one person will read this and be able to understand where I come from on this issue. I've lost sleep over this issue and i hope that a day will come when the experts are more knowledgeable scientifically so that no other person ever has to worry about whether their life will be over...... Just because a politician signed a document that says their pain cannot and Will not be treated anymore. The people i love would be terribly sad and life would be so different for them right now if i was not helped by pain medication. GOD bless!
I'll never forget when I hurt my back after 2 years of extreme physical labor I went to the ER after seeing stars and crying while trying to sleep. I was given a muscle relaxer and told to come back if the pain was still the same or worsened. I went back to the same ER the next day because the pain was literally making me go insane. This Female Doctor came in and said "You were just here yesterday for back pain" and then proceeded to tell me that "I was showings signs of drug seeking behavior" mind you I never went to the hospital for a damn thing back then. The female doctor then proceeded to tell me "I don't believe you are in pain, I am going to take an X-Ray of your back and when it shows nothing I want you out of the ER immediately" I said "FINE, I am not a drug seeker and feel extremely insulted by the way, There is something wrong, I have never felt pain like this before" to which she replied "What would you know about pain, you are very young, how could there be something wrong with your spine at 24 years old" Well as time went on and after 2 times of this female doctor coming in and out of the room giving me attitude and dirty looks. The female doctor then came back into the room with a totally different attitude and was very apologetic. She said "Looking at your X-Ray it showing that you completely ruptured 2 discs on your lower spine and have not only disfigured the vertebrae but have completely rounded and worn the edge of them also" She then proceeded to actually take care of me the proper way, but not after I scolded her for being such a douche in the beginning treating me like some junkie going from hospital to hospital looking for a new hand out. Best advice, stay the fuck away from pain medication that contains opioids
I've learned that the best practice for the mandatory monthly office visit is to simply say that there are no changes with me or my condition. This is given if you are on a dosage that pretty much manages your pain. Just let the doctor believe that you are a success story. If you actually talk about your pain and its management it seems to just raise red flags. Opioids are a medication that causes people to be accessed the opposite of our legal system, in that I mean people are assumed guilty until proven innocent. What the Feds and doctors don't grasp is that the regulations and practices that are now in place have resulted in drug trafficking and driven up the street value of meds. Party seeking people aside, the reason is two fold, one being that the chronic pain patient is at risk if their prescription is lost or stolen because doctors will not replace an opioid prescription. The smart people won't risk the nightmare and agony of withdrawal so they go to the street and buy an emergency cushion of pills just in case something were to happen to their meds. The other reason is that those with chronic pain that continue to suffer due to their doctor under medicating them will also go to the street to supplement their doctor's prescription. I have personally witnessed this. The fact is that the war on pain medication has effectively hurt those that suffer with chronic pain. The way I see it people with chronic pain are the ones bearing the worst affect of this war, and it's pretty much just due to a lot of young people that wanted to use these meds for a high and died from it. There is another group of people that have a prescription for opioids that are the slow-release versions and they've taken extra pills because they didn't think the med was working and died from an over dose. Over the years I've watched a cousin of mine decline because no doctor would issue him the dosages he needs for chronic pain due to injuries from a single accident. My cousin is impoverished due to the cost of street meds, he goes without food and basic things, and for the most part is still in pain because he just can't afford as much of the street meds as he needs. I helped him as long as I was able buying food and every other basic thing, also including paying his electricity, water and sewer, taxes, car insurance etcetera. I incurred thousands of dollars in debt helping. I've seen him when he has enough meds to cover his pain and it's a night and day difference. No one in the modern world should have to suffer and live like that when a damn inexpensive pill can fix their life. The Feds and doctors don't think of these things. I've driven and accompanied my cousin to a number of doctor visits. I've witnessed doctor's treat his chronic pain as though he's some kind of an addict. Doctors know what the Feds have done to other doctors so most won't issue opioids and as a result there's only about three doctors in our state that specialize in pain treatment and issue opioids. I'm pretty sure I know how this is going to for my cousin. He'll probably reach a point that after all these years of suffering he'll take his own life. And were that happen I'm sure he'll be listed as an opioid death.
this video is anti-opiate propaganda. I suffer from chronic and acute pain and opiates are the only way that I can function. without them I can't even get out of bed. I would have to say that the fact that people who are in severe pain being under medicated is more an epidemic than overdoses
Well said Chad S. Those that don't have chronic pain do not understand the plight at all. This is truly an epidemic when doctors think the easy fix is to seek other modalities and drop the treatments that actually work. Those idiots who are quick to throw accusations that chronic pain patients are addicts clearly have the lemming mentality.
I have to disagree. I have never used street drugs - not once. I needed a knee replacement at 33. They had me on 12 80mg oxycodone a day. Prescribed. I have been opiate clean for 3 years now. I was heavily dependant. There is a major flaw with prescribing opiates. You are in denial. 1 prescription is 1 too many....
Yes Chad, you're correct. The thing nobody is aware, & of course the government isn't sharing this info, is that the most deaths & overdoses from opiates are from HEROIN not prescription opioids. But, they're lumping it all into one big ball of statistics & the legitimate pain patients are unjustly suffering. I feel your pain. Good luck to you.
I hate to say it, but I think some people are so much in pain that they want to end it. It's a horrible predicament. For the people that misuse them it's irresponsible, but for those of those that have pain reduction, it has saved our lives.
In terms of treatment modalities for chronic intractable pain: I've been sold every bill of goods. My condition may be rare but my experience is anything but uncommon. It goes something like... Doc: Unfortunately after much experimentation on human beings, the evidence is insufficient for long-term benefit with high dose opioids. Therefore, I think the best way forward is to cut your medication back 'slowly' to a safer dosage (≤ 90 MME) and then reassess the efficacy of the narcotics. Pt: What's up with this magic number of 90 MME? Are you doing this with all of your patients on opiates? Doc: A lot of research shows that the risk of addiction/overdose is substantially greater when doses escalate beyond 90 MME. Actually, the CDC issued Guidelines in 2016 that every doctor is required to follow now -- it's the current standard of care outside of the treatment of patients suffering from cancer pain, palliative care, hospice, and end of life circumstances. Pt: But I've been on high dose opioids for a long time and am stable. I'm not an addict. What does the **CDC** have to do with the prescribing algorithms YOU have been following up until now? You're telling me it is NOT the FDA who are setting limits on dosages? That's insane. Doc: Do you know more than the CDC? Pt: I never insinuated I did. But I think that this forced tapering of pain medication is both dangerous and cruel. There will be a lot of people, your patients, who will be lost due to suicide...there are some of us who need 'a lot' of pain medication. Doc: Are we going to have a problem?
In the mid 1980's my mom died of an aggressive inoperable cancer, she died in considerable pain and her doctors were indifferent to her pain. In the late 1990's patients were told that "pain is a vital sign" and should be treated aggressively. By 2010 we had so called "pill mills", by 2014 no more "pill mills" (did they actually mill any pills? Nope , didn't think so!) But anyone who is undergoing opiate/opioid therapy is suddenly considered as an "addict" and any Dr who prescribes opioid analgesic medication is a "pill Dr/pusher" Unless....maybe it's for end of life/cancer pain, and we hear a lot about that now don't we, the ugly truth is that pain is fucking pain regardless of the goddamned cause! Example, if a person is driven to suicide because they can't get treatment for severe chronic (or acute) pain, is that not indeed "end of life pain? Soooo, where are we today in October of 2018? I know where I am at with it, I live with debilitating chronic pain issues that now go untreated because of the outright clusterfuck that this entire issue has become. And the icing on turd-cake? I was involved in a rather severe auto accident accident 5 months ago in which I had three broken ribs and a fractured sternum, painful? Only if breathed, I was given one light injection of morphine a prescription for 5 Percocet .5 mg tablets and the bum's rush to the goddamned door, and I have and had very good insurance coverage! After care? My "integrated medical systems" providers refused to treat me because it was due to an auto accident, I would have to travel over an hour away to the "urgent care" in there group and I could hardly move and had no transportation, In short I suffered like hells damnation for 3 months , We're in deep shit .
Regardless of the numbers, this is the most frank, informed, compassionate, and helpful I've EVER heard a medical doctor be about opiate use. The accuracy of statistics is debatable, but this Dr.'s desire to prevent the living Hell of opiate addiction is nothing short of philanthropic.
Thanks for posting, Doctor. Your testimony matched what I read where in the 80s, pain started being considered like another vital sign. So the pendulum swung too far, and now we all have a role in putting it back hopefully in the middle. I appreciate that you recognize there are some poor souls who have chronic, debilitating pain ( thankfully I'm not one ), who deserve medication and shouldn't be judged as criminals because a small separate minority abuse them.
I have been on vicaden for my back for years I have had 2 opp. For it it's all metal now I'm full of artheritis had joints.in thumbs replaced a hip replacement spinal stegnosis I can't get out of bed without my medication I have never abused them I just can move with my one in the morning I shower sitting on a chair I see my doctor every month blood work every 3 months I don't feel I'm a addict I never take more then I am prescribed so say whatever about Vicodin I am still a person with it without it I can not be a person I'm not a kid I'm 68 to me it's a lifesaver .
No one talks about acetiminophen or ibuprofen in these drugs That are toxic .Many have overdosed on these drugs that are in the opiods .Where's the talk about that?
The idea of two way communication in a treatment plan was good while it lasted but now is tossing the baby out with the bath water. stevemiller369@aol.com
Opioids can be a great drug if it's used in the right way, it's when they are used in the wrong way, that can be the big problem, Doctors have a hard job picking out the ones who want to use them to get of there heads, I think the problem with opioids and heroin is going to get much more of of a problem in the US in the next five to ten years, we are just see the start of the problem.
I feel that every patient that needs opioids be required to sit and watch videos explaining what happens when they are taken the wrong way. It is a matter of educating the public so they understand why it is important to FOLLOW DOSING INSTRUCTIONS on the label!
When one thing that works is taken away it doesn't hurt the addicts as they just move on to something else. But what do decent law-abiding people like us do? Many unfortunate folks have been chased into the arms of the street druggists who have no scruples.
@robert ward. I think you may be able to tell the future. It is now July 2021 and your gaze into the future is spot on. Patients who desperately NEED narcotic pain medication are being shut out and forced to the street. But our politicians can’t see beyond their crooked noses.
Pain management won't prescribe the medication according to the patient's condition and/or their tolerance. Most medications have a 4-5 hour effective duration period and the doctors prescribe them every 6 hours. This creates a problem.; therefore, to say people misuse their medications or the percentages of accidental overdose is misleading. Most with chronic pain probably struggle to take the medication as prescribed so the pain management doctors can't get blamed or sued. Doctor are under-prescribing medications all the time. Then they want to load you up on other medications on top of the opioids, such as muscle relaxers and antidepressants. I wonder why people are getting sick and dropping dead. I guess the safest way to treat pain and depression as well as sleep disorders, is medical marijuana. Can't overdose and die on marijuana. Oops, it interferes with profits from the Enormously Greedy Pharmaceutical Industry and their well trained doctors who are educated by the well funded Universities by the same Pharmaceutical Companies.; not to mention the funding for privatized prisons if you break their rules/laws. The FIX is on!
drs are also under performing their duties in the u.s. and violate their oath every time they allow patients to suffer...be it by not rxing pain meds or by rxing them to those who should have never been on them....
Mark Richard exactly!!! 6 a day is my ideal dose....just like the manufacturer intended at 1 every four hours....every six hours is ONLY FOR OPIATE NAIVE people which most of us aren't! It's every four hours (ok we know they only last 2-3 hours after two years) but no one should be prescribed less than 6 a day
I started with 5-325 Norco @ 3 a day (15mg) four years ago, it changed to 7.5-325 @ 3 a day as tolerance built. I moved 600 miles away a little over a year ago and still can't get continued care because of the drug addict fear the government puts on the doctors. I have to drive the 1200 mile round trip to see my pain management doctor with my prescription being 10-325 Norco @ 2 a day (2.5mg less) I did build a 50% reduction in effectiveness but seems to have stabilized. the 20mg per day only suppresses the pain with those days I want to shoot myself in the head, but it's better than nothing because without it everyday would be a living death. Been to over 10 neurologists with a laundry list of treatments, tests and medications. The binding pain starts at the C1-Atlas junction (Occipital) at the base of the skull causing Cerebral dizziness and foggy mental haze that transfers up the back of my head to the top with migraine like headaches. All the CT/MRI/X-Ray's of a Cervical study always omit the C2-C1-Atlas in the reports. Saw the next neurologist (Harvinder Birk) today and he upped my dose of Oxcarbazepine which also does nothing for me after also giving me steroid injections for Occipital Neuralgia which I already had from my pain management doctor 3 years ago. (But he had to do it for himself, so I let him. Made the back of my head numb for a week with no effect on the pain) I r3equested he put in a referral for a CT with a specific target for the Occipital junction. I am hoping we can find something pathologically wrong and it can be fixed so I don't have to hurt anymore.
What a fantastic video. I’m a chronic pain patient and I’ve been taking oxycodone for about 6 years now. It took a bunch of trial and error but I finally found the perfect pain clinic and doc AND the correct dose. I’m grateful for you pointing out the benefits because my life has improved SUBSTANTIALLY after finding my correct dose. In my humble opinion, one of the most important parts of these meds is knowledge and education. Even more important is finding a doctor that understands the benefits and doesn’t treat the patient like a horrible loser (yes I had an awful experience with a doctor) that just wants to get high. I have so much more to say, but I wanted to say “Thank you” for this video as it is a positive one for those of us suffering from horrific pain that follow the rules and work closely with our Doctor to achieve a better quality of life. There are many good people that take these responsibly that get overlooked. Thanks again for this video Dr.
His wife said he had one beer. He was at home and died in his sleep on the couch. But you are right, alcohol can also be a killer, especially when mixed with meds. I would never say that everyone would get relief from PT and a tens unit. It's been very helpful to me, but I have to keep those exercises up at home. I'm not condemning pain meds, I've definitely needed them after surgeries and they do help.They are essential to many. I just have a healthy respect and know that they can be risky.
So we walked a fine line and I think gave a mixed message but also an important message. I agree with you that the clinical relationship is paramount, but my own experience is that despite best efforts many patients have great difficulty having the same good outcomes as you. Thanks for the push back
I’m with you all, same story, ran out of meds early. Norco does nothing and he gives me 3 a day! Which I take all in the morning! I have a very high tolerance because without me asking I was on 80 mg of methadone a day , Norco for breakthrough pain, Percocet. Crazy right Then Oxy! O and I have Multiple Sclerosis it’s done it’s damage to my nerves, muscles you name it... I decided out of the blue to see what life was like without them...BIG MISTAKE!!! My Doctor was all for it...never telling me the agony I would have to go through. I was determined, I had a really great Pharmacist at the time. But Rite Aid took over his store! He begged me not to because he obviously new what was coming, and his wife has the same thing MS. But being treated with disdain , and the stink eye, smirked at, talked down , humiliated. Because my Doc who actually cared moved. I had a hard time. Spent most of my time in bed. Until recently when I ran out...I was so upset to have to go through withdrawals...I kept hearing about Kratom...I decided to try. It is totally amazing. I didn’t go through Withdrawals..a little running to the bathroom and some sneezes,,but no restless leg at all, I’ve been sleeping! I’m not pushing it but I just took some and in 10 min l’m relaxed, calm and it even helps my pain! I stopped it for a day and by night time they started, took some Kratom..All better! What can we do everyone.. stand up to them. Get a huge group and tell them we need help. To pull their heads out of their ass{ and be reasonable.. the people that are dying are the ones who buy street drugs and it either drives them crazy or they die! Sorry for rambling! I’m just very passionate about this. And they are trying to outlaw Kratom, telling lies that it’s bad! I’ve studied about Kratom a lot. No one has died from it and it is helping so many people. Ok I’m shutting up, this time I mean it ❤️ Hope this site isn’t taking names. I’m a little paranoid but for good reason! Bye for now💁 Of
You started going off the rails when you brought out the map and started giving overdose statistics. Once you take out fentanyl, heroin, and drug cocktails (mixing with alcohol/benzodiazepines) that overdose number gets very small.
the infuriating thing in this discussion is the lack of information for people with chronic lifelong painful illnesses, like crohns or ulcerative colitis or degenerative arthritis. our voices are not honored, listened too, or even part of the discussion. a lot of us need pain medication to live, to work, to have a social life, to have sex, to enjoy a walk with our dog or friends. we are not seekers, we are not users, we are not addicts. we have complicated medical conditions for which we receive lacklustre, half-assed care cobbled together from family doctors and specialists, and repeated emergency room visits. also your ideas about pain clinics and alternative treatments are great, but I live in a province that slashed healthcare budgets and shut the only chronic pain clinic while I was on its TWO YEAR waiting list. and it takes over 6 months to see a specialist and if you don't have private insurance and the funds to pay upfront you can only access physiotherapy 4 times. that's it, four. how on earth am I supposed to find alternatives with no money? I see a counsellor because I work with an addict population and know how dangerous it is to be on long term pain meds with no emotional support-but I pay for that myself, if I relied on the health region I would be lucky to see a counsellor every 6 months-maybe. all your suggestions are wonderful, but there is no education and no support system unless the patient is aware and builds one of their own. so many people end up using street drugs because they are giving dialudid with no real instructions or screening for emotional issues, they misuse, get flagged and end up in our criminal justice system when they should be in rehab or a pain clinic!!!! aarrraghh
I've been clean from meth for 14 years & proud of it! But within 4 years chronic pain kicked in. For seven years I've had multiple ESI's, Radio frequencies, MRI's, CT's, a surgery for my 2 bad discs in my cervical & drug therapies for all this time. I have a Then, because of my BiPolar & sinus issues in September, a Vicks Inhaler, Zyrtec D & Seroquel gave a false positive for methamphetamines! Now, I have to find a new Pain Management doc to take over my prescriptions?! I think I would've noticed if I'd done meth again! This "Industry" of Doctors & Lab results is a sham.
Good-day I have bad spinal pain from my head to my lower back (I take 120mg Morphine ER 3 x Daily). One day I was running a little low on medication and had the bright idea of then taking all I had left (480mg by noon) and then waiting 32 hours or until 8:00pm the next day for more meds. I told myself that this 32 hour break would lower my tolerance and make my meds work better. But really it was just an excuse to take extra meds and listen to Pink Floyd. But strangely enough it just made my pain worse and I didn't even nod. The next day at the 20 hour mark I was sweating but at the 24 hour mark I was crying from pain. I then spent the next 5 hours in hell as I couldn't lay down, sit down, or walk due to pain. Even though I knew meds were coming i almost called an ambulance (I'm a Canadian Handicapped Pensioner), thankfully it was a holiday and I got my meds earlier at 5:00pm. On top of all this I ended up taking extra meds to make up for my missing meds, and not all at once. I took 180mg and waited 3 hours, took another 120mg waited another 3 hours and incredibly took another 120mg at midnight. Around 2:00am I finally found pain relief and fell asleep. I was then short 7 pills but easily made them up over a week. I ahve never let my self get low on meds again. Point is I want to stop or at least cut down, I am now trying to taper by 10% every week.
This is PERFECT! I'm a chronic pain nurse and we are starting the conversation on a national level now. Thank you, this 11 minute video sums up what I teach in 2 hour shared medical visits for patients with chronic pain...but you did it eloquently in 11 minutes!! Wonderful!
I can only take pills about 2/3rds of the time, and then you need to withdraw some. If you keep this cycle at a low level you can use the drugs forever. If you work your way up , you will eventually have really long required withdrawal periods which are too awful. One or two days is enough to withdraw each week to keep the pills effective.
Yes. It's the only way for me to not let my tolerance get out of control. On a graph, my usage would be a wavey line. Otherwise it would be a straight line going up and up.
To begin, I absolutely love how Doctor Evans illustrates his TH-cam videos, it makes it so much more interesting than just watching a man talk for eleven and a half minutes. Anyway, after a recent tonsillectomy as an adult, I found that I was definitely slowly becoming addicted to my prescribed Norco's. Sure, I was in a great deal of pain and found them beneficial, but it came to a point that I very well could have just been taking ibuprofen but instead, found myself reaching for more Norcos (three or four a day). After taking Norco for approximately three weeks and stopping abruptly, I experienced the infamous withdrawal symptoms. After that experience, it's pretty safe to say that I will more than likely keeping a distance from any kind of Opioid medication for some time. Crazy to think after only three weeks, I found myself slowly becoming addicted, makes me wonder what it's like to be addicted for years on end?
I have chronic pain and I haven't had to up my dose from what i have at all. Before being put on pain medications I could very little, now I can go for hikes again and play with my cats and tons of other stuff. Opioid painkillers have saved my life in the sense that I'm no longer just laying in bed or sitting on the couch.
Opioid I have cronic pain I have tried everything out there and the few that did work was causing me to have more siezures then usual so because I do have siezures I can't take them but there is one that helps and that's Soma it's a muscle relaxer and pain med but because of idiots miss using I can't get them it is the only script that I can take I have been without them now for 3 months and now I am bed ridden I can't move I can't play with my grandchildren I can't even take a shower on my own anymore if anyone out there has a salutation or advice for me I greatly appreciate it
PAINKILLER SCRIPTS HAVE INCREASED BECAUSE THE GOVT NOW REQUIRES WHAT ONCE WERE 90 DAY SCRIPTS INTO 14-30 DAY SCRIPTS, WHICH TRIPLES THE AMOUNT ON IT'S OWN!!
As a pain sufferer for the past 5 years with fibro arthritis and Ms unless you have these diseases you will just not understand and anybody who says pain sufferers shouldn't be on them doesn't. Get it . until you hv this pain Again you won't get it's inhumane not to treat people of their diseases with these new strict laws People are committing suicide a true doctor a real doctor knows how to treat their patient the government should not be playing doctor at any time any doctors against it is a true quack.
I would rather be physically dependent on opiates and have a decent quality of life than refrain from taking opiates and live with pain that makes my life awful Also, 100,000 deaths in *20 years*? LOL, what about gun related deaths over the last 20 years? Talk about a moral panic.
Skram Amme *TRAMADOL the Best Available Analgesic for Medium to Severe Pain! I’ve had 5 TKR Knee Replacement Operations. The last two revisions due to deep S. Epidermidis infection. Without TRAMADOL I would have been fucked! In Sweden where I had my primary TKR OxyContin, Oxycodone, Oxynorm aka « Hillbilly Heroin » is the drug par preference not Tramadol! I wonder why? But in Thailand where I’ve undergone three major knee operations, here OxyContin only for terminally ill i.e. cancer patients. All you ADDICTS! My advice reduce to 50 mg per day. Then 25 mg (half a capsule) always with strong coffee. No sugar! Later 12,5 mg. slowly - Don’t RUSH. I repeat Tramadol is the BEST painkiller, analgesic. What’s option « Hillbilly Heroin » Fentanyl or Morphine?*
People have car accidents does that mean that we stop making cars.people.need.take responsibility for.their actions.most doctors talk to me about opoidds the times I have had to take.them Take.care
After they charge money for the medicine who actually gives the extra medicine back? I mean realistically. What if something happens and you can't afford to get to the doctor and you're in pain why would you not keep that around?
The doctors and the people regulating chronic pain care patients as a whole have never experienced the pain that we have to try to deal with unfortunately some of us get to the point that the pain is unbearable and the patient gets to the point that they feel they have no alternative, but suicide while the doctors and other regulators try to please the politicians.
Doctors and ER rooms in Toronto need to be educated! I have never seen such abuse as two recent visits to ERs where one gentleman looked in extreme pain and distress and when I asked for him to go first they laughed and said "he's ok, he's a regular." Same thing at another hospital where a woman was screaming in obvious pain and they laughed and said she's not in pain. I was horrified! I hear a LOT of this from those who suffer. Shame on you doctors where is your empathy? Disgusting!
Best advice is to take 6 a day the way they were manufactured to be taken. After 8 years I can still get relief at that dose. Too bad Doctors on prescribe 4 a day and throw in LA/ER which caused my Adrenal Insufficiency and Hypothyroidism... after I weaned myself off of Fentanyl I had more days when I could get by on less than 6 a day. Doctors should follow manufacturers instructions not CDC or DEA Guidelines.. those are not accidental overdoses! They were suicides from inadequate pain relief!
I have intractable pain, Dr Evans. And multiple comorbidites which defy all the treatments you mention. Under a palliative care umbrella using opioids, there is no addiction potential and no criminal potential. And withdrawal using opioids, not suboxone, is extremely effective. Did the CDC compensate you for this nearly word-for-word recital of their infamous and medically disastrous 2016 guideline? An extremely inaccurate propaganda piece. And if you, Mr. Evans, present with intractable pain at some point, your career and mobility is over until death- without an effective dose and dosage of opioids. Doctors need personal experience with real intractable pain with multiple comorbidities. You video should be pulled. It is now out of date and full of falsehoods.
For a chronic pain sufferer, taking opioids is really a double edged sword. The opioid does help with the pain but your body gets physically dependent on the drug. Drugs such as Oxycontin does wonders for the pain but one will find that he/she has to take the medication to keep from being sick. Even if a patient isn't hurting, he/she will have to take it to stave off the sickness of withdrawal. That's where the stink eye from a doctor comes in. They want to treat you like an addict. Well, it's because one is addicted. Not by choice, but one's body is actually addicted to the medication. And after awhile, ones body builds up a tolerance and needs more of the medication. The amount being taken might still be helping with the pain just fine but the body will go through tolerance withdrawal and need more of the medication to keep from being sick. Even if one takes the medication just as prescribed, eventually tolerance withdrawal is going to happen. And when one talks to their doctor about needing more medication, the doctor doesn't seem to understand the reasoning behind that. It's not always because the pain itself is worse but because one is staying sick from tolerance withdrawal.
Wrong. I have taken the identical perscription for 8 years. Tolerance withdrawl has not made me ill or forced me to increase dosages. The vast majority of chronic pain sufferers take their pain meds and it helps them live more normal lives. I think that the drug companies have some new class of very expensive pain meds waiting in the wings but need to demonize the existing classes of drugs to make these new driugs the only available choice. These new drugs will promise no addiction or withdrawals and only costs $1000 a month. This will be a lie but only after the damage is done. If this temerance movement succeeds thousands will commit suicide. Perhaps that is the true goal.
I have been on medication since 2014 for complex regional pain syndrome. The pain is intractable and beyond severe. I don't want to be on this class of medicine but without the medication I likely will end up killing myself just to get out of pain.
i understand ppl say use weed but weed makes ur sleepy and tired while opioids give you energy and u still can work and function without feeling tired.
Where are they in arresting big drug dealers? The opioid epidemic is a distraction. I have been on and off opioids whenever I’ve had to have surgery. They always under Medicaid me. I always go to doctors that know me and no I’m not an addict. I go way up on them and then I titrate. I am a therapist and I don’t care who knows this. In order to be an addict you have to be willing to tolerate an addicts lifestyle. There is physical addiction and then their psychological addiction. There are still doctors who know how know how to separate them; knows the difference. No one who is not an addict would remain addicted to these drugs or keep taking them past when they need them. The pills themselves do not force you to take them. I am furious about this. This guy that’s talking is a complete jerk. I would say worse but it’s profanity.
Many of us who suffer from chronic pain and find great relief from opiates, are made to feel guilty. We have to worry about a doctor taking away our meds, and with them, the ability to work and earn a living, or enjoy life. I lost a friend to suicide because of this. She had fibromyalgia, they took away her opiates (the only thing that worked). She lost her job, eventually she lost her life. I can see it being me some day. I don't know why the public health story is suddenly emerging now.
Chronic pain takes everything away from you. Some people need these medications to simply reclaim basic things in their life. On proper medication I was working and doing a lot of the normal things in life. Since this "crisis" hit, my medications were significantly reduced and now I can't work. I can't play soccer either. I wish the doctors had the balls to advocate for their patients, but all they care about now is covering their asses. They already make us jump through hoops as it is. It's also a fact that patients who get their medication from a pain management doctor and are monitored are the lowest for risk of overdose.
in CA, I can see state run offices and doctors, being the only ones who can prescribe s2 meds, and only filled at state run facilities, that is the future. or a hybrid system where your records need state approval for every re-fill. I have seen both sides of this, I was over prescribed at one point, and found a doctor that found a good balance. because the truth of it is, if you have chronic pain, you will never be pain free. I went from a very free open over medicated system to a basic police lock down to continue on the minimal levels now. not to mention now that some meds that were s3 are s2: pharmacies tend to run out faster and more often: which makes it hard to stick with one dispenser. The "WAR on DRUGS" type laws are harsh and, have we learned nothing? they do not work. because people will turn to the streets or worse heroine. Ive had the policed called on me for a legit script that, they deemed suspicious and since it was the weekend my doctor was not able to respond quick enough. this came very close to a health and safety felony charge that would have ruined my life, lucky for me they were able to verify the data in time. but I cant help but think there is some one out there who was not so lucky. with CURES and RX tasks forces all over looking to keep/validate their funding makes the whole endeavor risky. in addition if your taking these meds, its likely you know others who are too, so it best to keep it a secret from everyone, which oddly only lends itself to making you feel like your doing something wrong. I can honestly say I feel persecuted, if not outright witch hunted for my treatment. every time I see my doctor there is drama someone "going beyond the scope of their treatment" and to anyone that's taken these meds long enough knows that's not a holiday in your future.
I am a 34yr old chronic pain patient who now has terminal stress heart failure from 20+ yrs of being UNDERTREATED for pain. I have been on every painkiller under the sun at least once, and I know as well as anyone can what the difference is between ADDICTION & DEPENDENCE! I was only ever ADDICTED to Oxycontin, when I had one pain Dr in my early 20s who only pushed that & refused to let me switch meds, and yet even being honest about that with other doctors, I've been treated more like a JUNKIE & DRUG SEEKER all the other times I was not addicted than during the time that I actually WAS!!
While I agree to some extent with what the doctor said it concerns me that the website listed at the end is "my favourite medicine". That is an odd name. That being said, I have been on opioids for chronic pain for several years. I have been on the same dose for years. Some days it controls my pain and I can be fairly active and some days it doesn't. Winter is an especially difficult time for me. I know the time is coming (I live in the US) where my doctor will be forced to stop prescribing me opioids. At that point, I'm not sure what that will mean. Personally, I would like to stop taking opioid medication because I worry it is going to shorten my life. But, then again, so will being in pain 24/7.
Marie, I am in the same boat . I am in chronic pain, the winter's are the worst, and I am so bad I literally need to move to Arizona. If your state allows it, enter in to a Marijuana Program. They have strong indicas which, maybe not being able to relieve all your pain, in combination with over-the-counter pain meds and/or prescription anti-inflammatories, getting off our butts if possible and moving around, etc... unless your pain is completely off the charts, you will find relief. Best thing is as long as you don't drive or do anything dangerous, it is safe. You can even vape or now they have oral lozenges coming out. I took opioids for nearly 10 years and there are days I truly wish I still have them due to intense, chronic pain. But the weird thing is, once you completely free yourself from them, your mind will clear and you will not believe the life you have been missing and wasting! Your spirit will return! I have studied articles and read about opioid pain medication, and I have reached this conclusion and I believe it to be fact. Remember this: Opioid medication is a wonderful drug to have to use SHORT term i.e., for a medical operation, and to control pain in a patient until surgery or an injury heals. Say 2 to 3 weeks or a month or so maximum. Long term use becomes ineffective with time. Because of TOLERANCE you will need to keep increasing the dose to achieve the same effect. Where I live the state is so bad I barely receive anything as a daily dose (Morphin/Percocet). Drug testing and even urine tests performed to check the current LEVELS of the drug in your system are done monthly. One time I didn't need to use as much in the days preceeding an appointment, so they cut my working prescription down to nothing! Believe me, listen to your inner voice Marie about getting off them. Your inner voice is almost never wrong! And another peeve of mine, long term opiod users, using opiods over YEARS need to be dispensed the PURE version of their narcotic whatever is prescribed. If it is Oxycodone then that is what you should be taking. Not PERCOCET which has added acetaminophen, which has been shown to do little to nothing to reduce pain and does nothing for long term users but kill them by killing their liver. The only reason they add this in is to prevent the addicts from being able to crush and snort their pills. So because of that, we must be poisoned so our livers quit.
Thanks for your input, Dan. As I mentioned, I've been on the same dose for years. Some days, especially in the warmer months, I don't even take the full dose I'm prescribed. I live in a state where marijuana is legal so I could try different strains I suppose. The main problem is, I get anxiety when I use marijuana. I realize it's probably from the strain that I was smoking but I really don't like the overall sensation of being high. I smoked a lot of pot in my younger years. The main reason I quit using it back in the late 70s, is because I became a mother but also I was starting to have anxiety from it. I have been considering trying kratom. I've been reading about it and it sounds like it might be something that will help me and allow me to get off the opioids. However, long term I would rather just be off all of it. I'm in my sixties now so not sure if it will be possible but I'm going to try because I do worry about my liver.
Hey Marie, I was really hoping you would be able to get a chance to see what I replied to you, but I will tell you, I was the same way. I smoked lots of pot in the 70's and 80's, and quit pot in the early '90's due to it making me anxious, tired, etc...that was then this is now. I literally quit all drugs for 20 years(no lie) except for alcohol which I had quit for ten and have now quit permanently. I don't know what is considered the exact source of your pain, but my back is extremely bad and I have shooting sciatica down both legs in the front and back, my whole spine from my neck down to my tailbone is damaged, and I get in such pain, especially the cold, wet, weather, I feel like I can't go on at times. Marie, you are correct. Today there are marijuana strains, tried, tested and proved to help. The strain that works the very best for me so far, with minimal anxiety, is OG KUSH. The trick is you only use a little till you see how it makes you feel. I urge you to read reviews on it! This strain is not always easy to find, and I haven't tried any other Kush strains, but this WORKS. The taste of this is not the best, described as Piney, kinda harsh, but oh boy, it will melt your pain away. The high is not the type of sativa strain high (known to cause anxiety in some) but like a heavy Indica high, which is not an anxious high but a mellow, can be what they call a "couch lock" type high if you are tired, but it can be used in the day too, and is great for people hanging out, to talk and socialize! Marie, this will relax you SO MUCH, your muscles will relax, you will sleep through the night, and the anti-inflammatory properties will kick your pains ass! See the thing with the medical marijuana (that's what you want!) the THC levels in the "High Potency" versions, at least where I am obtaining my Medical Cannabis, are testing around 25% THC! This is significant as it can be costly so you want the most powerful version/strain you can get. Other strains to try which are super potent are Bubblegum and East Coast Sour Diesel. These are daytime Sativas which I have found out that so far, these two are great daytime strains if you do not want to be tired during the day. Golden Goat is another. You will become creative and energized. Just use more caution and use sparingly till you achieve your desired effect. And DO NOT ever drive or do anything dangerous on these. Remember, these are HIGH POTENCY! Remember Marie the trick is only try a hit or two at first, let it effect you, you can always ingest more if necessary. Also, with these types of strains, I literally do not even get the munchies. The exact opposite occurs. I don't even want to eat! The weed from yesterday is not the "organically grown by a master grower under perfect conditions weed of today". Marie, from one human being to another, do yourself a favor and AT LEAST give OG Kush a try. When you see how it can melt your pain away, your eyes are going to be opened. Take Care
A lot of these statistics , actually most of them are out dated. The problem is that things change faster than evidence can be gathered. Even pain management doctors are operating with old information. The epidemic for lack of a better term of people overdosing on prescription medicines is over. It was addressed and supplies and practitioners curtailed prescriptions to ther point where even people who need these medicines can barely get them. Patients playing by the rules are the ones hurt. The black market still manages to thrive although prices have skyrocketed while in the same time heroin and illicit fentanyl have flooded the country. With these really dangerous drugs the prices have dropped substantially. 85 percent of opioid overdoses currently are because of heroin and fentanyl.
Denying those with Intractable pain where only one opioid has worked and now delisted SUDDENLY by ODB for those who are poor is insane. The misuse of these drugs by persons who make themselves addicts by self-medicating is a psychiatric issue. To deny people who desperately need them but cannot now use them borders on criminal. ABOVE ALL ELSE DO NO HARM. What do you think is happening right now to the people DENIED their rights because of poverty? Tried EVERYTHING. ONE opiod worked - now what?
Going to tell you right now exactly what happens with opioids yes your brain does adapt and it took me a few years to realize you can beat this by changing to a different opioid and keep this process going in that’s how you combat that I can’t believe doctors don’t know this
You make a great point and this was our challenge. There are lots of people like you that are on stable doses that have improved function. It is not surprising to me that you feel the message was a bit too negative given your experience. At the same time, there is an emerging public health story that is very concerning.
Make sure to ALWAYS research what you take, even if Dr prescribed. I know for a fact that there's at least one "dietary supplement" out there that has withdrawals WORSE than heroin. AND its legal in the US... Research. Google " withdrawal", and read the stories before you dose.
This presentation is very informative. I started seeing kids using Vicodin and other pills at parties when I was a teenager but never used them myself. I have seen them use them to just get high and I have a lot of patients that use them for pain management as well. I personally have experience with someone very close to me becoming addicted to Vicodin. This lead to an addiction to Oxycontin and he is now a Heroin addict. He was never prescribed these medications. He was sold them by friends. He is now living in and out of jail, is a thief and has been in and out of rehab more times than I can count on my fingers. He is my son's father. There are so many people that truly use Opiods as only a pain reliever but seeing addiction first hand shows how easily it can control someone's life. I see how it would be hard for doctor's to prescribe such drugs and would like patients to seek alternative methods of pain relief first. Like he said, there are many good and bad things about opiods but the good are clouded so heavily by the bad, they are sometimes hard to see.
I have been off and on large, HUGE! dose's of opiates and have gone off many times but the pain won out. I have gone as long as as two years off but always came back due to my quality of life. The big issue was I needed more and more, so much more that doctors would no long go past the "guidelines" lucky for me I searched "safer opioid medications" and came upon a trial of buprenorphine for paint patients who struggled with taking the correct dose. Bupe worked for my pain and when I decided to taper to see where my baseline pain was, the withdrawal was nothing compared to pure agonist opioid's. I cut down super, super slowly and went from 16mg down to "crumbs" over several months which was the key to a proper withdrawal taper. After a year off I did come back but had no worries about it. Why? I did not worry because while over time i needed more, it was no where like the tolarance I had with regular opioid med's plus I do not feel dull and "out of it" in fact, I feel on an even keel and pretty much the same I feel without it. So yeah buprenorphine saved my butt.
Same goes for government. Job of gov is to require labeling of drug and amount, and prosecute criminally drug sellers who mislabel drugs as to the drug, and the amount. If label says maple syrup and jar contains cane sugar syrup and artificial maple flavoring - you go to jail. Secondarily it is to support research as to the pros and cons, and education. Job of gov is not to decide what drug a person puts in their body. Ultimate decision should belong to person whose body it is.
I’ve NEVER had a doctor or pharmacist describe the addiction risk of opioids when they prescribe them. It’s a huge issue with Codeine and OxyContin both. They don’t tell you if you take these for a few days straight, on that fourth day when you don’t, it’s gonna hurt. A lot. And you’ll probably get sick:
I have had chronic back pain since the age of 22 and am now 54. I take slow release morphine (MST Continus 20 mg twice a day). I work for myself so I can't take time off sick otherwise I don't get paid. I also take 3 x 300 mg of Gabapentin to prevent muscle seizures and 100 mg of amitriptyline for nerve pain from frayed nerve endings and to cope with sciatica. If I had to give this medication up I would not be able to function. The amitriptylines knock me out, I've never got used to them, so I have to take them two hours before I go to bed, but they leave me feeling hungover without the headache for the rest of the day. I am dulled by all the medication but at least I can still function.
Thanks for the advice but still doctors don't seem to understand people who really need pain medication. They need to go through some experience themselves to really understand.
/2 aspect of it), & I experience significant distress when faced with the prospect of losing that crutch. I WANT to stop taking them, but I'm terrified of the constant, unending, grinding pain in my head. Luckily, I don't drink.
Yet seems to me that among all the discussions of pros and cons of taking a drug and the issues of how decide what to take or not to take, based on limited knowledge of all the consequences, this issue of choice and responsibility, and who it belongs to, is being overlooked.
You just said most people don't become addicted to smoking. Yet it seems to me that most people who start smoking, continue smoking despite being harmed by smoking, and knowing it. That is, they fit your definition of being addicted.
Using Michael Jackson as an example of a person who uses opioids without needing them is misleading. He had a third degree burn on his scalp and was in pain his whole life. He might've gotten addicted to morphine but without intention. Like I said, he intended into using the pain reliever to treat the pain he was going through.
How long do I have to suffer and live in my bed at 49 years old before I can actually trust a doctor to not be afraid do no harm am right? I’ll tell you this when I was getting the medicine I needed I was able to support my family and now I have stopped cooking I barely do anything and I can’t even get out of bed most days
Nicely done DocMike - this is a wildly complex and deeply emotional issue. I often wonder how much difference we would find if, as you eluded to, the primary consideration for continuing to take opioids is whether it lets people move better. When a patient receives the medication from the doctor, it could come with a clear message - "This is to help you move better. If it decreases your pain but you cannot move better, we need to change things up."
Nurse practitioners and Dr's do not give a crap about your quality of life. I'm a paraplegic with cuada equina syndrome. I am in pain 24 hr/7days a week. They profiled me as an addict. Ummmm no. I have a legit injury, but the Dr I had put me on 1300mg of codiene a day, I tapered myself down to 600mg. I asked the Dr to put me on a different med, but she refused. Then she ditched me as a patient, so a nurse practitioner took over. She put me on suboxone, I didn't want to be on it. Besides that, the side effects were very bad. She didn't care. So she put me on gabapentin. I hated that drug, mixing the 2 drugs was terrible. But she still kept me on them. NEITHER ONE OF THESE DRUGS ARE TO BE USED FOR CHRONIC PAIN!!!!! I basically had no pain relief for 6 months. It was terrible.
Ever hear the expression, "if your only tool is a hammer, then every problem looks like a nail"? Well, DocMikeEvans works for the Centre for Addiction and Mental Health of Canada. Not for the treatment institute of chronic pain. So, all he sees is a "nail". No help to anyone except those who make their living treating addiction whether is real or not.
Didn't I see this in "Blazzing Saddles" where Mel Brooks goes "bullshit, bullshit, bullshit, bullshit, bullshit, bullshit, bullshit, bullshit, bullshit, bullshit"?
It's very easy to get addicted to opioids without realizing it. Usually by the time you do realize you've got a problem, it's already too late. So be VERY careful when it comes to these medications. Even if you use it for legitimate purposes, it's easy to use that as a rationalization to use more than is necessary, or to use in a way which negatively affects your life. A lot of people don't like to think that they are putting themselves at risk of such a fate, but the truth is that it can happen to anyone, and it's not always immediately obvious when it does. Be vigilant about it. The best thing you can do to avoid it is take as little as you can get by on and take it as seldom as possible as well. Obviously not to the point where you're torturing yourself from the pain of whatever affliction you've been taking them for. And most importantly, be honest with yourself. If you think it may be causing you more harm than good, reevaluate your situation, talk to people who know you well and ask what they think, and most importantly, talk to your doctor about alternative or supplemental treatments.
They said that tramadol and gabapentin are now opioid when they never were before. Tramadol helps patients who can't take Nsaids. And gabapentin helps with nerve damage and neuropathy. Take it away and there is never ending pain and misery.
Hey, good post. I am going thru the "chronic pain-RXmeds reducing Testosterone-need for more Low-T treatment-and-more Opioid treatment effect. Basically, long-term pain, whether acute or chronic, lowers testosterone big-time AND it is now showing that this affects the ability of RX opiate-opioid meds to work. You will need more pain meds because the lack of testosterone affects the axis of the Endocrine system and this affects the capability of meds to work in the 'strength' they are prescribed. A double-edged sword and then if the pain is not controlled? A vicious cycle - you basically need more more more of the CORRECT Low-T + HCG + an estrogen blocker to get your endocrine system to not burn out. So, ppl have died from over-stimulation from the lack of enough pain medication to keep 1. The pain down 2. enough to not over-work the endocrine system, and 3. enough to cause ATTENTION by Physician to pay attention to the effects of this balance. So, a chronic pain patient sees a GP and if that GP doesn't understand how this works, the right blood-tests to show SBHG and FREE testosterone? Then, patient runs the risk of not having ANY of his CNS, Respiratory, Sympathetic Nervous systems and brain function to work properly. The very best study on this is the following link: www.practicalpainmanagement.com/treatments/hormone-therapy/hormone-replacements-treatments-chronic-pain-update-2010 Read this and it gives you all you need - and it is written mainly for Physicians to get a grasp of how important getting this balance between pain treatment, Low-T and a healthy CNS + Endocrine system ALL working to keep a pain patient healthy for the long-term. It literally takes every one of these systems and a good control on the pain for it to work. If the patient is not getting relief? Then there is a very good reason, which can - and most likely will - be found in this study. This is five years old and I can tell you - most of the PROBLEM is getting your different Specialists to work together to get you, not only pain relief, but in doing so - a healthy overall body while RXing the meds - and an understanding that these narcotic meds affect other parts, other systems of the body and they, too, need to be addressed. One affects the other and vice-versa. So, if you are having issues, your answer could be right here - print it off and hand it to your Specialists. It's up to you to show them as many of them get tunnel-vision and can't see the big-picture. It is complicated, but not enough to keep your 'team' from keeping you pain free and addressing the other possible affects from chronic pain treatment. A great read, and useful to give to your physicians - so they can get on the same page. Good luck - glad I found this and they will read it and understand how it all fits.
Well, mixed - he is compassionate, but fast. Unless you have an issue, and just say hello? It's in, then out, pretty fast after they check your vitals. Office works 1/2 days. Only two days a week is he there. So, mixed, I would say.
I am so sorry for your loss. I agree - Oxycontin should NEVER be prescribed for surgery or any normal surgical pain UNLESS there is mostly intractable pain.
Klausmki hmmm. Hopefully I am interpreting this right, but my point regarding "90 days" was that,unfortunately, there is very little research following patients on opioids with Chronic Non-Cancer Pain for more than 90 days- and i think people should know this. To your point we dont want people to live in pain, so we continue the pain control... but I really wish we had quality data and research beyond 3-4 months to inform best practice. Especially as chronic use is so common. Hope this helps.
Yes.. where is the studies?? As far as my research goes... seems they lummped all opiate over doses wrather it be from heroin or perscribed... how many overdoses from prescription were not even there medicene??? WHERE is the differentials of illegal use, to actual perscribed. Who was who overdosing ??? And what percentage s were taking dr. Perscribed that took meds correctly??? How do people overdose when taking as perscribed ?????
i believe you are not looking at studies that showed the risk of addiction in chronic pain sufferers using opioids is very low...i understand there are many of them
My original Dr. died and I was so stable and balanced with my opioids and pain levels under control. The Dr. that took over for him has been reducing me every two months since he took over, my pain levels have crushed my life. I'm not active at all now and I realized my muscle mass has been going down over the last year since he took over my case. I don't know what to do now, because he keeps taking me down on meds but has not given me a single thing to help with the pain that has always been there. Now, I'm not able to hardly do anything and my Dr. just doesn't seem to care and I don't know what to do! Most of the Dr.s in my area will not prescribe pain medicine at all. Please if you have any suggestions I would love to hear them, it seems to me like he just doesn't care at all. :(
hey try kratom. it really helped me with the withdrawals and i take it everyday to help with my pain. i get my kratom from the golden monk website and it actually works. i pray for u people in ruff situations tend to do rough things.. 🙏
When I was started having pain issues I went to an orthopedic doctor.best decision I could.have made.take.alot.of.primary care doctors will not prescribed opoids.take care
Hello, everyone tyty for answering my post here. Just an update, I have since basically left my regular dr. and now see a pain specialist dr. I'm so glad because she is awesome and also young so she won't retire till long after I'm gone lol. My pain is now under control and I still function minimally but at least I can do that. I do store shopping but only on very super short trips. Either way, I'm 100 times better than before. :) TY all for your advice. :) and posting replies. :)
@@criptcrum2865 Hello, everyone tyty for answering my post here. Just an update, I have since basically left my regular dr. and now see a pain specialist dr. I'm so glad because she is awesome and also young so she won't retire till long after I'm gone lol. My pain is now under control and I still function minimally but at least I can do that. I do store shopping but only on very super short trips. Either way, I'm 100 times better than before. :) TY all for your advice. :) and posting replies. :)
I know its not for everyone but I have been on opioid therapy for 13 years and now have a intrathecal pump with hydromorphone and fentanyl along with 120 mg of oral morphine a day. After 13 years no problems other than constipation which is moderately managed. Its a shame so much negativity from abuse and diversion make it difficult for those who are truly suffering and legit.
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I was on Hydrocodone for 7 years to help me cope with chronic back pain. The VA prescribed the opiod for me. All those years I was able to perform at a pretty normal level, including my job and social relationships. Then over 2 years ago the U.S. Government mandated that the VA no longer prescribe opiods to Veterans. Since then, I have found that alcohol is the only thing that comes close to the pain relief of Hydrocodone. Well shit, now I am a fucking alcoholic. Thanks VA.
I watched a documentary on the va dishing out methadone to Vietnam vets who came back with heroin habits,did they stop this?methadone is a full spectrum opioid
I have Multiple Sclerosis. I have been taking my medication for 15 years now, AS PRESCRIBED! While it doesn’t completely take away my pain, it improves my quality of life. Doctors tried everything on me to help with the pain, non opioids, and they did nothing but make me sleep. They tried what I currently take and I can live a better life now. I don’t abuse them, and take them as needed.
I wish all these people that can talk about the problem could feel chronic pain daily. They would probably be the abusers!
The problem we’re having is, there are those out there that sell their pills, and these younger kids are overdosing.
The road they are taking now isn’t fair to us who take our medication as intended.
This doc is another example of a know it all that knows nothing!
Ron Mullen 6
A friend brought this to my attention. Problem with this is I have chronic pain been on opioid for years now. Before, I had to drop out of school and had huge amounts of trouble finding work. I became physically active because doctor said it would help (it didn't and unsurprisingly made the pain worse as it is provoked by activity). Did various other treats, much to no avail. Eventually, I attempted suicide (solely to end the torment of pain). I had anger, depression and anxiety issues. I was given pain medication and guess what happened? I got better, whaaaaat? It's almost like treating the problem solves the situation. No more anger, depression, or anxiety and I have gone back to school. Also, you should review the literature again as there are lots of studies that vindicate my story as typical.
Wade Schipprack your story is the archetype for most all true pain patients.
Wade, I have exactly the same experiences you cited except the suicide, so good on you! My comment is about the people that think they are medically capable, more so than the specialist I have seen, that say things like "Oh he's a Faker ", " You should throw those CRUTCHES AWAY!" and "He doesn't need that CHAIR ".....PISSES ME OFF!-but I hold my tongue. Makes me wish I could just change places with them for one hour! I am lucky, I keep my meds. in check and have been able to since 2010. Without the meds. I would be bedridden. Thank God I have a doctor who listens.
Capttomguam Buckley Im thankful ur Dr. Doesnt take them from you !!! Many many dr.s are ripping patients off thier pain meds left and right. Myself, and others i know who never abused their meds... to majority of drs it doesnt matter!
Alisa Lauzon I’m about to go through the same thing and I have so much anxiety and depression because I KNOW that I will not be able to live my life normally anymore and I have ALWAYS BEEN A GREAT PATIENT who FOLLOWED everything to the T and NEVER GOT INTO ANY TROUBLE!!! I have passed UA’s for the past 12 years and NEVER GOT MY MEDICINE EARLY! This shit is ABSOLUTELY ABSURD!!!! I’m FAR FROM A JUNKIE so I don’t understand why I’m going to be treated like one....
When they cut people with c hronic paid off from meds they WILL seek out illegal drugs and THEN they will OD or get arrested. It is only because of these ignorant temperance movement assholes that illegal drugs are fourishing.
Oh and recently in NY there have been arrests of doctors and nurses who are abusing these drugs on the job. PATIENTS should suffer? In one case, nurses were scraping off 50% of the Fentanyl, ingesting it and then giving the patch to the patient. This is compassion? You industry has some of the biggest Opioid addiction rates. Why don't you start there.
Peg Moore-Maioreillo, Peg you are 100% correct.
The doctors took to long to put me on an Opiod class 2. I lost my job, house, ability to walk, everything. Then I got disability, which I was so thankful, but you get such a small amount , average 1000 a month, you still can't pay your bills. Sad situation.
Dependence and addiction are completely different!
Fix my structure, re-inflate my discs, my bursa, regrow my nerves and then I will consider this garbage. 27 years of ongoing deterioration in my spine and increased arthritis has left me disabled and unable to work. At best the medication means I am barely able to function which living alone means everything is up to me and I get no other support from anyone.
Doctors now days are more concerned about getting patients to stop opioids then treating and relieving pain .
This is absolutely true. My doctor went from being compassionate to being an outright ass. She now doesn't believe in Chronic pain conditions (go figure). I am shocked that she made a 180 degree reversal and is now removing all her patients from any pain meds whatsoever. This is hell on earth for sure.
pretend you are an IV heroin user and you'll be put on the strong opioid methadone daily.. its a last resort but would definitely work.
Yea it's hilariously obvious hearing some of these doctors just blatantly act in their own interests
@@stancurry6265 Doctors are scared to death of politicians.
stevemiller369@aol.com
being a retired nurse and in my senior years having a condition that has caused me chronic pain......when i reflect on many of the issues in this video.....i wonder why it is not mentioned that many doctors feel as if they are failing if the person they are treating is not getting better.....and all the opoid problems in this country i am positive have very little to do with patients who are under the care of pain management doctors....people who are addicted are always going to use narcotics in dangerous ways.. looking at patients as if they are drug seekers and the attitudes pharmacy staff have when you fill prescriptions is awful....after all we are the easiest target to punish the most visible and we are made out to be the problem ...... do you really think we can't just taper and stop using opioids? well we can and do......but being in a small agonizing world filled with pain and making it unable for you to live any other way except in bed is to many a good reason to go back to taking pain medication......yes oddly enough we chronic pain sufferers take the medication to get rid of the pain.....a real revelation i know
“Chronic pain is one of the most underestimated health care problems in the world today, causing major consequences for the quality of life of the sufferer and a major burden on the health care system in the Western world," said Professor Harald Breivik, President of EFIC.
“Reasons for deficiencies in pain management include cultural, societal, religious, and political attitudes, including acceptance of torture. The biomedical model of disease, focused on pathophysiology rather than quality of life, reinforces entrenched attitudes that marginalize pain management as a priority.” - Brennan F, Carr DB, Cousins M. “Strategies currently applied for improvement include framing pain management as an ethical issue; promoting pain management as a legal right, providing constitutional guarantees and statutory regulations that span negligence law, criminal law, and elder abuse; defining pain management as a fundamental human right, categorizing failure to provide pain management as professional misconduct, and issuing guidelines and standards of practice by professional bodies.”
“The artificial distinction of cancer vs. noncancer pain is more about attitudes, emotions and politics than science. Our sense of compassion should not stop at the word non.” - Lynn R Webster, MD
“...there is less evidence than everybody would like on the efficacy of long-term opioids. But absence of evidence does not imply evidence of absence. There’s also less evidence that everybody would like on the risks of long-term opioid use.” - Judy Foreman, A Nation in Pain. “Ethically, the failure to manage pain better is tantamount to torture. When chronic pain is inadequately treated it undermines the body and mind. Indeed, the risk of suicide for people with chronic pain is twice that of other people.”
Wonderful letter. I have been describing my chronic pain mistreatment as torture. Now I realize it should be catigorized as a crime, on the part of the medical profession, not to treat pain.
@@stephenmiller2590 Absolutely!
'Sleep deprivation is classified as one of five illegal interrogation techniques practised by the British military.' Only us pain patients don't need interrogators to be tortured, we get it right in our own homes and beds.
Thank you for this Dr. Mike. I, for one have been on opioid therapy for 8-9 years now. Suddenly, because of new legislation in the pharmacy industry, the GFD (Good faith dispensing) Act, My Dr. has decided to discontinue prescribing my meds COLD TURKEY! This new legislation has had an effect on the "sticking with one pharmacy" theory as you suggested...this new legislation has given Pharmacists FAR too much power and I have been DECLINED to fill at numerous pharmacies now too! (STEER CLEAR OF WALGREENS IF YOU ARE OPIATE DEPENDENT - they will ban you from filling at ANY Walgreens nationwide!). I understand that there are "good Dr.s and bad Dr.s, but I don't agree that it should be the pharmacist who makes this determination) I too, have been living in FEAR every day for 9 years that this day would come.,,,no way to live. But since some brainiack in the FDA or DEA decided that the Pharmacists should "police" the Dr.'s (of course knowing NOTHING about the patients, long term plan, past history, combined therapies, etc.) Dr.'s now have to be ACCOUNTABLE to the pharmacists and "justify" themselves when prescribing sched 2's! This is ludicrous and my Dr. decided she wasn't going to "play" this game... I don't blame her! BUT, as the patient, I now will suffer and I am petrified! I literally cannot function without these drugs. I lost my job (in the pharmaceutical industry) through a mass-lay-off and I am raising my grandson and taking care of my elderly, wheelchair ridden parents and I cannot do it if I am bedridden. I lost my home, my retirement savings...everything. If I am unable to find help, I fear that I will have to turn my grandson over to foster care! RIDICULOUS! Now, it is difficult to find employment without drug testing, thus making it much more of a struggle to become employed if you are on medication. It's bad enough to feel the constant pain, the guilt of having to be reliant on these drugs to "function" but in addition, living with the "stigma" of friends and family around you who don't understanding what it's like to live with chronic pain...debilitating pain, and "judging" as if you are a common street drug addict! I can say that after long-term use, that YES, one does become physically and emotionally dependent on these drugs. I have never mis-used them and I don't drink, but over time, my dosage has had to increase to still be effective. You DO develop a tolerance and consequently, increased dosing. I have tried MANY alternatives...Lyrica, Cymbalta, OC, etc...all with negative side effects and little to no pain relief. I have heard that one can DIE from the withdrawals and I have been there (in the past when my meds were stolen) and believe me, I WANTED TO DIE!..What does a person do? Go to the ER? Once you tell them your dilemma, AGAIN you are judged, and most often not helped! I want to have a life, quality LIFE, and am now stuck searching for a Dr. that will either prescribe or refer me to a pain management clinic...but their job is to take you off opiates! Since losing my job, I had to go on Medicaid. That's a whole OTHER ISSUE! I must have called 50+ Dr.s to try and find one that accepts Medicaid. With the New "Affordable Healthcare Act" this is only going to get WORSE! More people than ever before are being given Medicaid, but they didn't revamp the PAY to Dr.s or increase the Dr.s that will accept Medicaid! So, since Doctors don't get adequately compensated through Medicaid, they are not participating. 100,000's of people have Medicaid now, but there are NO healthcare providers...so what good does it do? The few providers that there are, are SO OVERBOOKED that you are lucky if you can get in within a YEAR! In all, I think there needs to be a "rethinking" and "educating" nation-wide...Dr.s, pharmacists, common lay-people, patients...EVERYONE! If not misused, these drugs can mean the difference between life and death... I agree with another poster...there should be "Opiate Specialists" that can navigate the ever increasing negative stigmas and legislation and TRULY HELP PATIENTS IN CHRONIC, non-cancerous PAIN!
I agree with you and have posted.
You do realize the job of the pharmacist is to ensure doctors are accurately prescribing medications and in my experience are overwhelmingly more qualified dealing with opiates than your run of the mill doctor. Pharmacists seem to be the only ones with a true understanding of the scale of the opiate crisis and considering the trends you are exhibiting in this post, rightfully so you were blaming the pharmacy for things out of their control and were banned from filling there. That or you have too many red flags to justify filling a prescription for.
How many overdoses were actually suicide due to under management, which is exactly what you are promoting. Long waits to see pain specialists and doctors in Ontario who are terrified of prescribing to help patients are the leading cause of suicide for pain patients. Thankfully Canada will have a law that allows assisted dying due to long term unmanageable pain.
jean sutherland I dont understand what the opioidphobes problem is, it obvious they want all pain patients dead so why do they even care if someone ods or not. since we are disabled in pain and suffering we cant contribute to the tax base so the cdc's recommended treatment is to cut patients off stigmatize us and drive us to sucidie as the olny option to end the pain.
They don't care if we die, from the pain or other treatments that sicken and harm us, as long as we don't die from opioids. They don't care if we kill ourselves, as long as we don't use opioids to die and escape our pain. Then they would only care enough to put our names on a list of tragic deaths, caused by opioid overdose. We just don't matter to these anit-opioid fanatics at all.
I live in Ontario Canada PREACH its sickening what they're doing to us.
Yes I almost became a statistic of tbi headaches...89% commit suicide...this dose not help..there needs to be a path for real pain people
Jean Sutherland You are so right! This was 3 years ago and it’s only gotten worse!
Do you have any studies now for 2018 ??? Ive been trying to figure out ? Are the counting any and all opoid overdose lumping it together weather street heroine, and what how many were prescription s not even perscribed for that person?? Are there studies going on that ARE counting all the suicides happening now for those cut off and now can no longer function ?? Or Studies for those who can now not work ?? Because pain mangement is now 0 opoids. Most of us have willingly tried every other option that we ARE aware of.
It really is frustrating as a chronically ill pain patient with several illnesses that takes my medicine judiciously as prescribed to be put in this category. This stigma happens now thanks to the CDC new rules that were hundreds of pages long signed off, that were " recommended" doctors follow, not a law. One being if one is a chronically ill pain patient and goes to the hospital it is 'recommended' not to treat with any opioids' . How does the doctor measure pain? If I have chronic infections that need surgery you are just going to continue cutting me open with a scalpel with no pain relief while I scream? I even have been refused lidocaine. This is barbaric and inhumane. I have had to resort to surgery at home sometimes at my own peril. Good job CDC and Trump. Shorting hospital stays and cutting meds. See how you like being bedbound most of the time because you are so ill you are fainting, or near fainting from a condiction called P.O.T.S., in a flare over 2 years on and off, with over 103 surgeries from I&D's from Staph infections, and cellulitis and a few recluse bites, and excisional biopsies. I was a Funeral Director Embalmer until 2013, but had to stop. I had 2 car accidents in a 2 year period not at fault left with hiernated discs in back and neck. So I know pain. It's only gotten worse when I did removals of deceased at that job toward the end. I loved helping families. Now, I am stuck home, fighting for my rights to get the treatment I need fighting every step of the way, because of people that abuse the system to get a high off of the drugs. That sucks. Don't lump us in with heroin users, Fentenyl users on the street, teens getting drugs from friends, that's b.s.. thats a separate report. You should do a separate report on chronic pain patients. Because doctors treat us with scorn, distrust, stigma and we are tired enough of trying to make it through another day.
CDC guidelines have killed so many people, either by killings themselves bc of the pain, or turning in desperation to the streets and receive a deadly dose!
So chronic pain management is the patients problem? It would be nice if the doctor could fix the underlying cause of the pain. Physicians frequently don't, but take your money anyway, and tell you to come back.
Bottom line: chronic pain is no problem, unless its your chronic pain.
Thanks Doc ( for nothing)
+Dan Seluk Study to become a doc and start "fixing the underlying causes" since you know how. We need more heroes like you to solve things like lower back pain.
Kalle, how about you find me a cure for adiposis dolorosa (Dercum's disease) and Multiple Sclerosis. Dercum's disease on top of MS has introduced me to levels of pain that make me want to "leave my body" and it never stops. If you are training to become a doctor, learn some compassion.
I have r.a. and have been on opioids for over 6 years....first Vicodin and the oxycodone and now after thowe simply stopped working I wen on suboxone because I also became dependant...and the buprenoprhine in it actually is doing better controlling my pain than the 2 most widely rxd opioids that have huge addiction stigma attached to them
Lose the idea that there is always a solution. The fact is there are more health problems to which their is NO solution, than there is problems WITH one. Sometimes what's broken cannot be fixed.
Suboxone is a nightmare to get off of. It will have the same stigma attached to it in just a matter of time. First time I was prescribed it, I had to go to the ER and had what is known as a "brain allergy" to it. It was literally causing psychosis. Anyone looking at getting on Suboxone, look at all the articles and forums with people currently taking it, so your decision to start on it will be sound. It can be great for pain, but be very informed on what the future will be with it. www.thefix.com/content/hard-to-kick-suboxone?page=all
All of this information that has been played out here is in no way news to me as I've suffered chronic pain for most of my life. I am 32 years old and have been in pain for 20 years. And when I say pain...I mean debilitating pain from chronic pancreatitis caused by an accident. Because of this I have had to be on major opiate therapy since I was about 16 years old. I always felt so so alone and self conscious about my need for opiates that I feared anyone thinking or even hinting at the fact that I might be an addict. My fears came to light very quickly. My family doctor at the the time called me a drug addict and began treating me terrible. I used to have nightmares and wake up in a panic because I was reliving experiences of being In a pancreatic attack at an emergency room where I was left to suffer...and sometimes I would lay in a hospital bed for days suffering. The doctor would say I was an addict and would refuse to give me pain medication. Many times I would crawl out of my bed and get on my knees. I would say..."Please please lord..... take my pain because I can't take anymore. And if you can't take it away then please I beg you to come and get me now. Please God please don't leave me alone." On one occasion I was life flighted from Casper Wyoming to Denver , Colorado and when I arrived in Denver my doctor thought I was an addict and refused to even come and see me. I was admitted and I was tortured there. I was at my breaking point and beginning to LOOSE touch with REALITY because it had just been too long and too much pain and no breaks. I tried to open my hospital window on the 8th floor so that.......I could jump and end my suffering. I was 5 months pregnant at the time. My poor mom was with me that night and she kept going down to the chapel at the hospital to pray for me. She knew it was bad and her herself was deeply affected by the trauma of seeing me in utter agony and knew there was not any way that she could help me. Anyway I just lost my long time doctor of 7 years who was the best pain doctor I've ever met. And I've met many. But none like him. He saved my life and I am grateful for that. For years he wrote prescriptions all the time for me and even gave me his cellphone number in case I needed him. I wish there were more like him. But when he decided to take a state JOB at a prison as there physician I couldn't find another doctor who would prescribe the amount of meds I took and I couldn't find one anywhere. I even looked so far away as 6 hours away from my home town. So when my meds ran out ....instead of going to the emergency room I thought to myself.....Well I've been pretty healthy a long time and the meds really worked so maybe I can just stop. And stop I did!!!! I quit cold turkey. It really wasn't that bad coming off of 1000mg of morphine extended release tablets each day. Yeah it was uncomfortable but I was ready. The meds had done their job and done it well so I was going to close that chapter in my life. After my doctor started really aggressively treating my pain and getting control of it my pain began to lesson over time and for about two years i really felt as if i was taking my morphine just to basically do what worked and also to not go into withdrawl. My doctor of course began slowly weaning me off about 5 years ago but everytime he asked me if i was ready to wean somemore i would say No way. I was afraid of the pain getting back to all the time and everyday instead of what was currently occurring which was just having a few attacks a month. If I had not met Dr. Kasselman I wouldn't be alive right now. I would have taken my life a long time ago. But he took me as a patient and completely sought to get me out of bed, back to work, and most importantly back to being a mom to my children with opiate medication and I don't know what I would have done if he didn't do that so many years ago.But I fear that this country is going to ban opiate medication and I don't know how people like me will survive it. But folks it is coming so be prepared for it. Ya know.....sometimes i think that the people who are drug addicts make it hard for people actually suffering. But I remind myself that they are hurting too...just in a different way. But I beg them to please stop and get help. I know they are good people that have made some bad decisions in life and I understand that because I've also made some poor choices too. WE ALL SIN AND FALL SHORT OF THE GLORY OF GOD! There is no superior human to another, we r all in this together and we all are just trying to live the best we can. And I really hope that all the physicians out there understand that. They need to understand that just because 35 people walk in their office and end up abusing their medications doesn't mean they get to turn that one person away who genuinely needs their meds and will not abuse them and go down a destructive path but actually thrive in their life. There is a solution to this so called epidemic we just have to work together. Patients, doctors, and addicts need to work together in order to make a lasting and fair for all conclusion. I hope that maybe one person will read this and be able to understand where I come from on this issue. I've lost sleep over this issue and i hope that a day will come when the experts are more knowledgeable scientifically so that no other person ever has to worry about whether their life will be over...... Just because a politician signed a document that says their pain cannot and Will not be treated anymore. The people i love would be terribly sad and life would be so different for them right now if i was not helped by pain medication. GOD bless!
I'll never forget when I hurt my back after 2 years of extreme physical labor I went to the ER after seeing stars and crying while trying to sleep. I was given a muscle relaxer and told to come back if the pain was still the same or worsened. I went back to the same ER the next day because the pain was literally making me go insane. This Female Doctor came in and said "You were just here yesterday for back pain" and then proceeded to tell me that "I was showings signs of drug seeking behavior" mind you I never went to the hospital for a damn thing back then. The female doctor then proceeded to tell me "I don't believe you are in pain, I am going to take an X-Ray of your back and when it shows nothing I want you out of the ER immediately" I said "FINE, I am not a drug seeker and feel extremely insulted by the way, There is something wrong, I have never felt pain like this before" to which she replied "What would you know about pain, you are very young, how could there be something wrong with your spine at 24 years old" Well as time went on and after 2 times of this female doctor coming in and out of the room giving me attitude and dirty looks. The female doctor then came back into the room with a totally different attitude and was very apologetic. She said "Looking at your X-Ray it showing that you completely ruptured 2 discs on your lower spine and have not only disfigured the vertebrae but have completely rounded and worn the edge of them also" She then proceeded to actually take care of me the proper way, but not after I scolded her for being such a douche in the beginning treating me like some junkie going from hospital to hospital looking for a new hand out. Best advice, stay the fuck away from pain medication that contains opioids
Damn sorry to hear! I can relate. I’m glad you priced that dr wrong and also pointed out her ignorance in her judgemental ways
I've learned that the best practice for the mandatory monthly office visit is to simply say that there are no changes with me or my condition. This is given if you are on a dosage that pretty much manages your pain. Just let the doctor believe that you are a success story. If you actually talk about your pain and its management it seems to just raise red flags. Opioids are a medication that causes people to be accessed the opposite of our legal system, in that I mean people are assumed guilty until proven innocent.
What the Feds and doctors don't grasp is that the regulations and practices that are now in place have resulted in drug trafficking and driven up the street value of meds. Party seeking people aside, the reason is two fold, one being that the chronic pain patient is at risk if their prescription is lost or stolen because doctors will not replace an opioid prescription. The smart people won't risk the nightmare and agony of withdrawal so they go to the street and buy an emergency cushion of pills just in case something were to happen to their meds. The other reason is that those with chronic pain that continue to suffer due to their doctor under medicating them will also go to the street to supplement their doctor's prescription. I have personally witnessed this.
The fact is that the war on pain medication has effectively hurt those that suffer with chronic pain. The way I see it people with chronic pain are the ones bearing the worst affect of this war, and it's pretty much just due to a lot of young people that wanted to use these meds for a high and died from it. There is another group of people that have a prescription for opioids that are the slow-release versions and they've taken extra pills because they didn't think the med was working and died from an over dose.
Over the years I've watched a cousin of mine decline because no doctor would issue him the dosages he needs for chronic pain due to injuries from a single accident. My cousin is impoverished due to the cost of street meds, he goes without food and basic things, and for the most part is still in pain because he just can't afford as much of the street meds as he needs. I helped him as long as I was able buying food and every other basic thing, also including paying his electricity, water and sewer, taxes, car insurance etcetera. I incurred thousands of dollars in debt helping. I've seen him when he has enough meds to cover his pain and it's a night and day difference. No one in the modern world should have to suffer and live like that when a damn inexpensive pill can fix their life.
The Feds and doctors don't think of these things. I've driven and accompanied my cousin to a number of doctor visits. I've witnessed doctor's treat his chronic pain as though he's some kind of an addict. Doctors know what the Feds have done to other doctors so most won't issue opioids and as a result there's only about three doctors in our state that specialize in pain treatment and issue opioids.
I'm pretty sure I know how this is going to for my cousin. He'll probably reach a point that after all these years of suffering he'll take his own life. And were that happen I'm sure he'll be listed as an opioid death.
this video is anti-opiate propaganda. I suffer from chronic and acute pain and opiates are the only way that I can function. without them I can't even get out of bed. I would have to say that the fact that people who are in severe pain being under medicated is more an epidemic than overdoses
Chad S that's because you are addicted at this point.
Well said Chad S. Those that don't have chronic pain do not understand the plight at all. This is truly an epidemic when doctors think the easy fix is to seek other modalities and drop the treatments that actually work. Those idiots who are quick to throw accusations that chronic pain patients are addicts clearly have the lemming mentality.
I have to disagree. I have never used street drugs - not once. I needed a knee replacement at 33. They had me on 12 80mg oxycodone a day. Prescribed. I have been opiate clean for 3 years now. I was heavily dependant. There is a major flaw with prescribing opiates. You are in denial. 1 prescription is 1 too many....
@@Slideyslide You are so wrong.... Do some research before you comment on things you don't k ow about. You sound ignorant.
Yes Chad, you're correct. The thing nobody is aware, & of course the government isn't sharing this info, is that the most deaths & overdoses from opiates are from HEROIN not prescription opioids. But, they're lumping it all into one big ball of statistics & the legitimate pain patients are unjustly suffering. I feel your pain. Good luck to you.
I hate to say it, but I think some people are so much in pain that they want to end it. It's a horrible predicament. For the people that misuse them it's irresponsible, but for those of those that have pain reduction, it has saved our lives.
In terms of treatment modalities for chronic intractable pain: I've been sold every bill of goods. My condition may be rare but my experience is anything but uncommon. It goes something like...
Doc: Unfortunately after much experimentation on human beings, the evidence is insufficient for long-term benefit with high dose opioids. Therefore, I think the best way forward is to cut your medication back 'slowly' to a safer dosage (≤ 90 MME) and then reassess the efficacy of the narcotics.
Pt: What's up with this magic number of 90 MME? Are you doing this with all of your patients on opiates?
Doc: A lot of research shows that the risk of addiction/overdose is substantially greater when doses escalate beyond 90 MME. Actually, the CDC issued Guidelines in 2016 that every doctor is required to follow now -- it's the current standard of care outside of the treatment of patients suffering from cancer pain, palliative care, hospice, and end of life circumstances.
Pt: But I've been on high dose opioids for a long time and am stable. I'm not an addict. What does the **CDC** have to do with the prescribing algorithms YOU have been following up until now? You're telling me it is NOT the FDA who are setting limits on dosages? That's insane.
Doc: Do you know more than the CDC?
Pt: I never insinuated I did. But I think that this forced tapering of pain medication is both dangerous and cruel. There will be a lot of people, your patients, who will be lost due to suicide...there are some of us who need 'a lot' of pain medication.
Doc: Are we going to have a problem?
In the mid 1980's my mom died of an aggressive inoperable cancer, she died in considerable pain and her doctors were indifferent to her pain.
In the late 1990's patients were told that "pain is a vital sign" and should be treated aggressively.
By 2010 we had so called "pill mills", by 2014 no more "pill mills" (did they actually mill any pills? Nope , didn't think so!) But anyone who is undergoing opiate/opioid therapy is suddenly considered as an "addict" and any Dr who prescribes opioid analgesic medication is a "pill Dr/pusher"
Unless....maybe it's for end of life/cancer pain, and we hear a lot about that now don't we, the ugly truth is that pain is fucking pain regardless of the goddamned cause!
Example, if a person is driven to suicide because they can't get treatment for severe chronic (or acute) pain, is that not indeed "end of life pain?
Soooo, where are we today in October of 2018? I know where I am at with it, I live with debilitating chronic pain issues that now go untreated because of the outright clusterfuck that this entire issue has become.
And the icing on turd-cake? I was involved in a rather severe auto accident accident 5 months ago in which I had three broken ribs and a fractured sternum, painful? Only if breathed, I was given one light injection of morphine a prescription for 5 Percocet .5 mg tablets and the bum's rush to the goddamned door, and I have and had very good insurance coverage! After care? My "integrated medical systems" providers refused to treat me because it was due to an auto accident, I would have to travel over an hour away to the "urgent care" in there group and I could hardly move and had no transportation,
In short I suffered like hells damnation for 3 months ,
We're in deep shit .
It appears to be more beneficial for the medical profession to keep me on medication that to fix my problem.
Regardless of the numbers, this is the most frank, informed, compassionate, and helpful I've EVER heard a medical doctor be about opiate use. The accuracy of statistics is debatable, but this Dr.'s desire to prevent the living Hell of opiate addiction is nothing short of philanthropic.
Thanks for posting, Doctor. Your testimony matched what I read where in the 80s, pain started being considered like another vital sign. So the pendulum swung too far, and now we all have a role in putting it back hopefully in the middle.
I appreciate that you recognize there are some poor souls who have chronic, debilitating pain ( thankfully I'm not one ), who deserve medication and shouldn't be judged as criminals because a small separate minority abuse them.
Their money is more important than your pain! They need you to stay in pain to protect their profits....bottom line!
I think they will lose money most will not go to doctors that won't treat their pain it is a waste.of money.
Opiods work wonders.
I have been on vicaden for my back for years I have had 2 opp. For it it's all metal now I'm full of artheritis had joints.in thumbs replaced a hip replacement spinal stegnosis I can't get out of bed without my medication I have never abused them I just can move with my one in the morning I shower sitting on a chair I see my doctor every month blood work every 3 months I don't feel I'm a addict I never take more then I am prescribed so say whatever about Vicodin I am still a person with it without it I can not be a person I'm not a kid I'm 68 to me it's a lifesaver .
No one talks about acetiminophen or ibuprofen in these drugs That are toxic .Many have overdosed on these drugs that are in the opiods .Where's the talk about that?
8:58 You left out titrating to relief, increasing the meds, until you see relief.
Its very common to be undermedicated nowadays.
The idea of two way communication in a treatment plan was good while it lasted but now is tossing the baby out with the bath water.
stevemiller369@aol.com
Opioids can be a great drug if it's used in the right way, it's when they are used in the wrong way, that can be the big problem, Doctors have a hard job picking out the ones who want to use them to get of there heads, I think the problem with opioids and heroin is going to get much more of of a problem in the US in the next five to ten years, we are just see the start of the problem.
I feel that every patient that needs opioids be required to sit and watch videos explaining what happens when they are taken the wrong way. It is a matter of educating the public so they understand why it is important to FOLLOW DOSING INSTRUCTIONS on the label!
When one thing that works is taken away it doesn't hurt the addicts as they just move on to something else. But what do decent law-abiding people like us do? Many unfortunate folks have been chased into the arms of the street druggists who have no scruples.
@robert ward. I think you may be able to tell the future. It is now July 2021 and your gaze into the future is spot on.
Patients who desperately NEED narcotic pain medication are being shut out and forced to the street. But our politicians can’t see beyond their crooked noses.
@@lunasgma7546 You are 100% correct.
robert ward,
YES
Pain management won't prescribe the medication according to the patient's condition and/or their tolerance. Most medications have a 4-5 hour effective duration period and the doctors prescribe them every 6 hours. This creates a problem.; therefore, to say people misuse their medications or the percentages of accidental overdose is misleading. Most with chronic pain probably struggle to take the medication as prescribed so the pain management doctors can't get blamed or sued. Doctor are under-prescribing medications all the time. Then they want to load you up on other medications on top of the opioids, such as muscle relaxers and antidepressants. I wonder why people are getting sick and dropping dead.
I guess the safest way to treat pain and depression as well as sleep disorders, is medical marijuana. Can't overdose and die on marijuana. Oops, it interferes with profits from the Enormously Greedy Pharmaceutical Industry and their well trained doctors who are educated by the well funded Universities by the same Pharmaceutical Companies.; not to mention the funding for privatized prisons if you break their rules/laws. The FIX is on!
drs are also under performing their duties in the u.s. and violate their oath every time they allow patients to suffer...be it by not rxing pain meds or by rxing them to those who should have never been on them....
Mark Richard exactly!!! 6 a day is my ideal dose....just like the manufacturer intended at 1 every four hours....every six hours is ONLY FOR OPIATE NAIVE people which most of us aren't! It's every four hours (ok we know they only last 2-3 hours after two years) but no one should be prescribed less than 6 a day
well said
8 years later and these statistics are still mind blowing
I started with 5-325 Norco @ 3 a day (15mg) four years ago, it changed to 7.5-325 @ 3 a day as tolerance built. I moved 600 miles away a little over a year ago and still can't get continued care because of the drug addict fear the government puts on the doctors. I have to drive the 1200 mile round trip to see my pain management doctor with my prescription being 10-325 Norco @ 2 a day (2.5mg less) I did build a 50% reduction in effectiveness but seems to have stabilized. the 20mg per day only suppresses the pain with those days I want to shoot myself in the head, but it's better than nothing because without it everyday would be a living death. Been to over 10 neurologists with a laundry list of treatments, tests and medications.
The binding pain starts at the C1-Atlas junction (Occipital) at the base of the skull causing Cerebral dizziness and foggy mental haze that transfers up the back of my head to the top with migraine like headaches. All the CT/MRI/X-Ray's of a Cervical study always omit the C2-C1-Atlas in the reports. Saw the next neurologist (Harvinder Birk) today and he upped my dose of Oxcarbazepine which also does nothing for me after also giving me steroid injections for Occipital Neuralgia which I already had from my pain management doctor 3 years ago. (But he had to do it for himself, so I let him. Made the back of my head numb for a week with no effect on the pain) I r3equested he put in a referral for a CT with a specific target for the Occipital junction. I am hoping we can find something pathologically wrong and it can be fixed so I don't have to hurt anymore.
What a fantastic video. I’m a chronic pain patient and I’ve been taking oxycodone for about 6 years now. It took a bunch of trial and error but I finally found the perfect pain clinic and doc AND the correct dose. I’m grateful for you pointing out the benefits because my life has improved SUBSTANTIALLY after finding my correct dose. In my humble opinion, one of the most important parts of these meds is knowledge and education. Even more important is finding a doctor that understands the benefits and doesn’t treat the patient like a horrible loser (yes I had an awful experience with a doctor) that just wants to get high. I have so much more to say, but I wanted to say “Thank you” for this video as it is a positive one for those of us suffering from horrific pain that follow the rules and work closely with our Doctor to achieve a better quality of life. There are many good people that take these responsibly that get overlooked. Thanks again for this video Dr.
His wife said he had one beer. He was at home and died in his sleep on the couch. But you are right, alcohol can also be a killer, especially when mixed with meds. I would never say that everyone would get relief from PT and a tens unit. It's been very helpful to me, but I have to keep those exercises up at home. I'm not condemning pain meds, I've definitely needed them after surgeries and they do help.They are essential to many. I just have a healthy respect and know that they can be risky.
So we walked a fine line and I think gave a mixed message but also an important message. I agree with you that the clinical relationship is paramount, but my own experience is that despite best efforts many patients have great difficulty having the same good outcomes as you. Thanks for the push back
I’m with you all, same story, ran out of meds early. Norco does nothing and he gives me 3 a day! Which I take all in the morning! I have a very high tolerance because without me asking I was on 80 mg of methadone a day , Norco for breakthrough pain, Percocet. Crazy right
Then Oxy!
O and I have Multiple Sclerosis it’s done it’s damage to my nerves, muscles you name it...
I decided out of the blue to see what life was like without them...BIG MISTAKE!!! My Doctor was all for it...never telling me the agony I would have to go through. I was determined, I had a really great Pharmacist at the time. But Rite Aid took over his store! He begged me not to because he obviously new what was coming, and his wife has the same thing MS. But being treated with disdain , and the stink eye, smirked at, talked down , humiliated. Because my Doc who actually cared moved. I had a hard time. Spent most of my time in bed. Until recently when I ran out...I was so upset to have to go through withdrawals...I kept hearing about Kratom...I decided to try. It is totally amazing. I didn’t go through Withdrawals..a little running to the bathroom and some sneezes,,but no restless leg at all, I’ve been sleeping! I’m not pushing it but I just took some and in 10 min l’m relaxed, calm and it even helps my pain!
I stopped it for a day and by night time they started, took some Kratom..All better!
What can we do everyone.. stand up to them. Get a huge group and tell them we need help. To pull their heads out of their ass{ and be reasonable.. the people that are dying are the ones who buy street drugs and it either drives them crazy or they die!
Sorry for rambling! I’m just very passionate about this. And they are trying to outlaw Kratom, telling lies that it’s bad! I’ve studied about Kratom a lot. No one has died from it and it is helping so many people. Ok I’m shutting up, this time I mean it ❤️
Hope this site isn’t taking names. I’m a little paranoid but for good reason! Bye for now💁
Of
You started going off the rails when you brought out the map and started giving overdose statistics. Once you take out fentanyl, heroin, and drug cocktails (mixing with alcohol/benzodiazepines) that overdose number gets very small.
the infuriating thing in this discussion is the lack of information for people with chronic lifelong painful illnesses, like crohns or ulcerative colitis or degenerative arthritis. our voices are not honored, listened too, or even part of the discussion. a lot of us need pain medication to live, to work, to have a social life, to have sex, to enjoy a walk with our dog or friends. we are not seekers, we are not users, we are not addicts. we have complicated medical conditions for which we receive lacklustre, half-assed care cobbled together from family doctors and specialists, and repeated emergency room visits.
also your ideas about pain clinics and alternative treatments are great, but I live in a province that slashed healthcare budgets and shut the only chronic pain clinic while I was on its TWO YEAR waiting list. and it takes over 6 months to see a specialist and if you don't have private insurance and the funds to pay upfront you can only access physiotherapy 4 times. that's it, four. how on earth am I supposed to find alternatives with no money? I see a counsellor because I work with an addict population and know how dangerous it is to be on long term pain meds with no emotional support-but I pay for that myself, if I relied on the health region I would be lucky to see a counsellor every 6 months-maybe.
all your suggestions are wonderful, but there is no education and no support system unless the patient is aware and builds one of their own. so many people end up using street drugs because they are giving dialudid with no real instructions or screening for emotional issues, they misuse, get flagged and end up in our criminal justice system when they should be in rehab or a pain clinic!!!! aarrraghh
I've been clean from meth for 14 years & proud of it! But within 4 years chronic pain kicked in. For seven years I've had multiple ESI's, Radio frequencies, MRI's, CT's, a surgery for my 2 bad discs in my cervical & drug therapies for all this time. I have a Then, because of my BiPolar & sinus issues in September, a Vicks Inhaler, Zyrtec D & Seroquel gave a false positive for methamphetamines! Now, I have to find a new Pain Management doc to take over my prescriptions?! I think I would've noticed if I'd done meth again! This "Industry" of Doctors & Lab results is a sham.
Good-day I have bad spinal pain from my head to my lower back (I take 120mg Morphine ER 3 x Daily). One day I was running a little low on medication and had the bright idea of then taking all I had left (480mg by noon) and then waiting 32 hours or until 8:00pm the next day for more meds. I told myself that this 32 hour break would lower my tolerance and make my meds work better. But really it was just an excuse to take extra meds and listen to Pink Floyd. But strangely enough it just made my pain worse and I didn't even nod. The next day at the 20 hour mark I was sweating but at the 24 hour mark I was crying from pain. I then spent the next 5 hours in hell as I couldn't lay down, sit down, or walk due to pain. Even though I knew meds were coming i almost called an ambulance (I'm a Canadian Handicapped Pensioner), thankfully it was a holiday and I got my meds earlier at 5:00pm. On top of all this I ended up taking extra meds to make up for my missing meds, and not all at once. I took 180mg and waited 3 hours, took another 120mg waited another 3 hours and incredibly took another 120mg at midnight. Around 2:00am I finally found pain relief and fell asleep. I was then short 7 pills but easily made them up over a week. I ahve never let my self get low on meds again. Point is I want to stop or at least cut down, I am now trying to taper by 10% every week.
This is PERFECT! I'm a chronic pain nurse and we are starting the conversation on a national level now. Thank you, this 11 minute video sums up what I teach in 2 hour shared medical visits for patients with chronic pain...but you did it eloquently in 11 minutes!! Wonderful!
First do no harm. Remember that? Too many doctors don't
I can only take pills about 2/3rds of the time, and then you need to withdraw some. If you keep this cycle at a low level you can use the drugs forever. If you work your way up , you will eventually have really long required withdrawal periods which are too awful. One or two days is enough to withdraw each week to keep the pills effective.
Yes. It's the only way for me to not let my tolerance get out of control. On a graph, my usage would be a wavey line. Otherwise it would be a straight line going up and up.
To begin, I absolutely love how Doctor Evans illustrates his TH-cam videos, it makes it so much more interesting than just watching a man talk for eleven and a half minutes. Anyway, after a recent tonsillectomy as an adult, I found that I was definitely slowly becoming addicted to my prescribed Norco's. Sure, I was in a great deal of pain and found them beneficial, but it came to a point that I very well could have just been taking ibuprofen but instead, found myself reaching for more Norcos (three or four a day). After taking Norco for approximately three weeks and stopping abruptly, I experienced the infamous withdrawal symptoms. After that experience, it's pretty safe to say that I will more than likely keeping a distance from any kind of Opioid medication for some time. Crazy to think after only three weeks, I found myself slowly becoming addicted, makes me wonder what it's like to be addicted for years on end?
I have chronic pain and I haven't had to up my dose from what i have at all. Before being put on pain medications I could very little, now I can go for hikes again and play with my cats and tons of other stuff. Opioid painkillers have saved my life in the sense that I'm no longer just laying in bed or sitting on the couch.
Opioid I have cronic pain I have tried everything out there and the few that did work was causing me to have more siezures then usual so because I do have siezures I can't take them but there is one that helps and that's Soma it's a muscle relaxer and pain med but because of idiots miss using I can't get them it is the only script that I can take I have been without them now for 3 months and now I am bed ridden I can't move I can't play with my grandchildren I can't even take a shower on my own anymore if anyone out there has a salutation or advice for me I greatly appreciate it
Try kratom. It will work( acts on opiate receptors)
PAINKILLER SCRIPTS HAVE INCREASED BECAUSE THE GOVT NOW REQUIRES WHAT ONCE WERE 90 DAY SCRIPTS INTO 14-30 DAY SCRIPTS, WHICH TRIPLES THE AMOUNT ON IT'S OWN!!
As a pain sufferer for the past 5 years with fibro arthritis and Ms unless you have these diseases you will just not understand and anybody who says pain sufferers shouldn't be on them doesn't. Get it .
until you hv this pain
Again you won't get
it's inhumane not to treat people of their diseases with these new strict laws
People are committing suicide
a true doctor a real doctor knows how to treat their patient
the government should not be playing doctor at any time
any doctors against it is a true quack.
I would rather be physically dependent on opiates and have a decent quality of life than refrain from taking opiates and live with pain that makes my life awful
Also, 100,000 deaths in *20 years*? LOL, what about gun related deaths over the last 20 years? Talk about a moral panic.
Skram Amme *TRAMADOL the Best Available Analgesic for Medium to Severe Pain! I’ve had 5 TKR Knee Replacement Operations. The last two revisions due to deep S. Epidermidis infection. Without TRAMADOL I would have been fucked! In Sweden where I had my primary TKR OxyContin, Oxycodone, Oxynorm aka « Hillbilly Heroin » is the drug par preference not Tramadol! I wonder why? But in Thailand where I’ve undergone three major knee operations, here OxyContin only for terminally ill i.e. cancer patients. All you ADDICTS! My advice reduce to 50 mg per day. Then 25 mg (half a capsule) always with strong coffee. No sugar! Later 12,5 mg. slowly - Don’t RUSH. I repeat Tramadol is the BEST painkiller, analgesic. What’s option « Hillbilly Heroin » Fentanyl or Morphine?*
People have car accidents does that mean that we stop making cars.people.need.take responsibility for.their actions.most doctors talk to me about opoidds the times I have had to take.them
Take.care
After they charge money for the medicine who actually gives the extra medicine back? I mean realistically. What if something happens and you can't afford to get to the doctor and you're in pain why would you not keep that around?
Absolutely true. Yet I am told that keeping extra meds is abuse and violation of the pain contract.
The doctors and the people regulating chronic pain care patients as a whole have never experienced the pain that we have to try to deal with unfortunately some of us get to the point that the pain is unbearable and the patient gets to the point that they feel they have no alternative, but suicide while the doctors and other regulators try to please the politicians.
Doctors and ER rooms in Toronto need to be educated! I have never seen such abuse as two recent visits to ERs where one gentleman looked in extreme pain and distress and when I asked for him to go first they laughed and said "he's ok, he's a regular." Same thing at another hospital where a woman was screaming in obvious pain and they laughed and said she's not in pain. I was horrified! I hear a LOT of this from those who suffer. Shame on you doctors where is your empathy? Disgusting!
Best advice is to take 6 a day the way they were manufactured to be taken. After 8 years I can still get relief at that dose. Too bad Doctors on prescribe 4 a day and throw in LA/ER which caused my Adrenal Insufficiency and Hypothyroidism... after I weaned myself off of Fentanyl I had more days when I could get by on less than 6 a day. Doctors should follow manufacturers instructions not CDC or DEA Guidelines.. those are not accidental overdoses! They were suicides from inadequate pain relief!
The area of opioid addiction is a mine field! However, I think this is a very balanced and nonjudgmental approach. Nice work!
I have intractable pain, Dr Evans. And multiple comorbidites which defy all the treatments you mention. Under a palliative care umbrella using opioids, there is no addiction potential and no criminal potential. And withdrawal using opioids, not suboxone, is extremely effective. Did the CDC compensate you for this nearly word-for-word recital of their infamous and medically disastrous 2016 guideline?
An extremely inaccurate propaganda piece. And if you, Mr. Evans, present with intractable pain at some point, your career and mobility is over until death- without an effective dose and dosage of opioids. Doctors need personal experience with real intractable pain with multiple comorbidities.
You video should be pulled. It is now out of date and full of falsehoods.
For a chronic pain sufferer, taking opioids is really a double edged sword. The opioid does help with the pain but your body gets physically dependent on the drug. Drugs such as Oxycontin does wonders for the pain but one will find that he/she has to take the medication to keep from being sick. Even if a patient isn't hurting, he/she will have to take it to stave off the sickness of withdrawal. That's where the stink eye from a doctor comes in. They want to treat you like an addict. Well, it's because one is addicted. Not by choice, but one's body is actually addicted to the medication. And after awhile, ones body builds up a tolerance and needs more of the medication. The amount being taken might still be helping with the pain just fine but the body will go through tolerance withdrawal and need more of the medication to keep from being sick. Even if one takes the medication just as prescribed, eventually tolerance withdrawal is going to happen. And when one talks to their doctor about needing more medication, the doctor doesn't seem to understand the reasoning behind that. It's not always because the pain itself is worse but because one is staying sick from tolerance withdrawal.
Wrong. I have taken the identical perscription for 8 years. Tolerance withdrawl has not made me ill or forced me to increase dosages. The vast majority of chronic pain sufferers take their pain meds and it helps them live more normal lives. I think that the drug companies have some new class of very expensive pain meds waiting in the wings but need to demonize the existing classes of drugs to make these new driugs the only available choice. These new drugs will promise no addiction or withdrawals and only costs $1000 a month. This will be a lie but only after the damage is done. If this temerance movement succeeds thousands will commit suicide. Perhaps that is the true goal.
I have been on medication since 2014 for complex regional pain syndrome. The pain is intractable and beyond severe. I don't want to be on this class of medicine but without the medication I likely will end up killing myself just to get out of pain.
i understand ppl say use weed but weed makes ur sleepy and tired while opioids give you energy and u still can work and function without feeling tired.
Where are they in arresting big drug dealers? The opioid epidemic is a distraction. I have been on and off opioids whenever I’ve had to have surgery. They always under Medicaid me. I always go to doctors that know me and no I’m not an addict. I go way up on them and then I titrate. I am a therapist and I don’t care who knows this. In order to be an addict you have to be willing to tolerate an addicts lifestyle. There is physical addiction and then their psychological addiction. There are still doctors who know how know how to separate them; knows the difference. No one who is not an addict would remain addicted to these drugs or keep taking them past when they need them. The pills themselves do not force you to take them. I am furious about this.
This guy that’s talking is a complete jerk. I would say worse but it’s profanity.
Many of us who suffer from chronic pain and find great relief from opiates, are made to feel guilty. We have to worry about a doctor taking away our meds, and with them, the ability to work and earn a living, or enjoy life. I lost a friend to suicide because of this. She had fibromyalgia, they took away her opiates (the only thing that worked). She lost her job, eventually she lost her life. I can see it being me some day. I don't know why the public health story is suddenly emerging now.
"Most people don't become addicted to nicotine". Really doctor? The addiction rate is approaching 100%.
Most addictive substance on earth
Chronic pain takes everything away from you. Some people need these medications to simply reclaim basic things in their life. On proper medication I was working and doing a lot of the normal things in life. Since this "crisis" hit, my medications were significantly reduced and now I can't work. I can't play soccer either. I wish the doctors had the balls to advocate for their patients, but all they care about now is covering their asses. They already make us jump through hoops as it is. It's also a fact that patients who get their medication from a pain management doctor and are monitored are the lowest for risk of overdose.
guy probably has never taken any pain killers... But he has read a book about it... well i am gonna listen to him.. he's smart...
in CA, I can see state run offices and doctors, being the only ones who can prescribe s2 meds, and only filled at state run facilities, that is the future. or a hybrid system where your records need state approval for every re-fill. I have seen both sides of this, I was over prescribed at one point, and found a doctor that found a good balance. because the truth of it is, if you have chronic pain, you will never be pain free. I went from a very free open over medicated system to a basic police lock down to continue on the minimal levels now. not to mention now that some meds that were s3 are s2: pharmacies tend to run out faster and more often: which makes it hard to stick with one dispenser. The "WAR on DRUGS" type laws are harsh and, have we learned nothing? they do not work. because people will turn to the streets or worse heroine. Ive had the policed called on me for a legit script that, they deemed suspicious and since it was the weekend my doctor was not able to respond quick enough. this came very close to a health and safety felony charge that would have ruined my life, lucky for me they were able to verify the data in time. but I cant help but think there is some one out there who was not so lucky. with CURES and RX tasks forces all over looking to keep/validate their funding makes the whole endeavor risky. in addition if your taking these meds, its likely you know others who are too, so it best to keep it a secret from everyone, which oddly only lends itself to making you feel like your doing something wrong. I can honestly say I feel persecuted, if not outright witch hunted for my treatment. every time I see my doctor there is drama someone "going beyond the scope of their treatment" and to anyone that's taken these meds long enough knows that's not a holiday in your future.
I am a 34yr old chronic pain patient who now has terminal stress heart failure from 20+ yrs of being UNDERTREATED for pain. I have been on every painkiller under the sun at least once, and I know as well as anyone can what the difference is between ADDICTION & DEPENDENCE!
I was only ever ADDICTED to Oxycontin, when I had one pain Dr in my early 20s who only pushed that & refused to let me switch meds, and yet even being honest about that with other doctors, I've been treated more like a JUNKIE & DRUG SEEKER all the other times I was not addicted than during the time that I actually WAS!!
While I agree to some extent with what the doctor said it concerns me that the website listed at the end is "my favourite medicine". That is an odd name.
That being said, I have been on opioids for chronic pain for several years. I have been on the same dose for years. Some days it controls my pain and I can be fairly active and some days it doesn't. Winter is an especially difficult time for me. I know the time is coming (I live in the US) where my doctor will be forced to stop prescribing me opioids. At that point, I'm not sure what that will mean. Personally, I would like to stop taking opioid medication because I worry it is going to shorten my life. But, then again, so will being in pain 24/7.
Marie, I am in the same boat . I am in chronic pain, the winter's are the worst, and I am so bad I literally need to move to Arizona. If your state allows it, enter in to a Marijuana Program. They have strong indicas which, maybe not being able to relieve all your pain, in combination with over-the-counter pain meds and/or prescription anti-inflammatories, getting off our butts if possible and moving around, etc... unless your pain is completely off the charts, you will find relief.
Best thing is as long as you don't drive or do anything dangerous, it is safe. You can even vape or now they have oral lozenges coming out. I took opioids for nearly 10 years and there are days I truly wish I still have them due to intense, chronic pain. But the weird thing is, once you completely free yourself from them, your mind will clear and you will not believe the life you have been missing and wasting! Your spirit will return!
I have studied articles and read about opioid pain medication, and I have reached this conclusion and I believe it to be fact. Remember this: Opioid medication is a wonderful drug to have to use SHORT term i.e., for a medical operation, and to control pain in a patient until surgery or an injury heals. Say 2 to 3 weeks or a month or so maximum.
Long term use becomes ineffective with time. Because of TOLERANCE you will need to keep increasing the dose to achieve the same effect. Where I live the state is so bad I barely receive anything as a daily dose (Morphin/Percocet). Drug testing and even urine tests performed to check the current LEVELS of the drug in your system are done monthly.
One time I didn't need to use as much in the days preceeding an appointment, so they cut my working prescription down to nothing! Believe me, listen to your inner voice Marie about getting off them. Your inner voice is almost never wrong!
And another peeve of mine, long term opiod users, using opiods over YEARS need to be dispensed the PURE version of their narcotic whatever is prescribed. If it is Oxycodone then that is what you should be taking. Not PERCOCET which has added acetaminophen, which has been shown to do little to nothing to reduce pain and does nothing for long term users but kill them by killing their liver. The only reason they add this in is to prevent the addicts from being able to crush and snort their pills. So because of that, we must be poisoned so our livers quit.
Thanks for your input, Dan. As I mentioned, I've been on the same dose for years. Some days, especially in the warmer months, I don't even take the full dose I'm prescribed. I live in a state where marijuana is legal so I could try different strains I suppose. The main problem is, I get anxiety when I use marijuana. I realize it's probably from the strain that I was smoking but I really don't like the overall sensation of being high. I smoked a lot of pot in my younger years. The main reason I quit using it back in the late 70s, is because I became a mother but also I was starting to have anxiety from it.
I have been considering trying kratom. I've been reading about it and it sounds like it might be something that will help me and allow me to get off the opioids. However, long term I would rather just be off all of it. I'm in my sixties now so not sure if it will be possible but I'm going to try because I do worry about my liver.
Hey Marie, I was really hoping you would be able to get a chance to see what I replied to you, but I will tell you, I was the same way. I smoked lots of pot in the 70's and 80's, and quit pot in the early '90's due to it making me anxious, tired, etc...that was then this is now. I literally quit all drugs for 20 years(no lie) except for alcohol which I had quit for ten and have now quit permanently.
I don't know what is considered the exact source of your pain, but my back is extremely bad and I have shooting sciatica down both legs in the front and back, my whole spine from my neck down to my tailbone is damaged, and I get in such pain, especially the cold, wet, weather, I feel like I can't go on at times.
Marie, you are correct. Today there are marijuana strains, tried, tested and proved to help. The strain that works the very best for me so far, with minimal anxiety, is OG KUSH. The trick is you only use a little till you see how it makes you feel. I urge you to read reviews on it!
This strain is not always easy to find, and I haven't tried any other Kush strains, but this WORKS. The taste of this is not the best, described as Piney, kinda harsh, but oh boy, it will melt your pain away. The high is not the type of sativa strain high (known to cause anxiety in some) but like a heavy Indica high, which is not an anxious high but a mellow, can be what they call a "couch lock" type high if you are tired, but it can be used in the day too, and is great for people hanging out, to talk and socialize! Marie, this will relax you SO MUCH, your muscles will relax, you will sleep through the night, and the anti-inflammatory properties will kick your pains ass!
See the thing with the medical marijuana (that's what you want!) the THC levels in the "High Potency" versions, at least where I am obtaining my Medical Cannabis, are testing around 25% THC! This is significant as it can be costly so you want the most powerful version/strain you can get.
Other strains to try which are super potent are Bubblegum and East Coast Sour Diesel. These are daytime Sativas which I have found out that so far, these two are great daytime strains if you do not want to be tired during the day. Golden Goat is another. You will become creative and energized. Just use more caution and use sparingly till you achieve your desired effect. And DO NOT ever drive or do anything dangerous on these. Remember, these are HIGH POTENCY!
Remember Marie the trick is only try a hit or two at first, let it effect you, you can always ingest more if necessary. Also, with these types of strains, I literally do not even get the munchies. The exact opposite occurs. I don't even want to eat! The weed from yesterday is not the "organically grown by a master grower under perfect conditions weed of today".
Marie, from one human being to another, do yourself a favor and AT LEAST give OG Kush a try. When you see how it can melt your pain away, your eyes are going to be opened. Take Care
A lot of these statistics , actually most of them are out dated. The problem is that things change faster than evidence can be gathered. Even pain management doctors are operating with old information. The epidemic for lack of a better term of people overdosing on prescription medicines is over. It was addressed and supplies and practitioners curtailed prescriptions to ther point where even people who need these medicines can barely get them. Patients playing by the rules are the ones hurt. The black market still manages to thrive although prices have skyrocketed while in the same time heroin and illicit fentanyl have flooded the country. With these really dangerous drugs the prices have dropped substantially. 85 percent of opioid overdoses currently are because of heroin and fentanyl.
All of that being said, your video is one of of the better ones I've seen, Thank you.
Denying those with Intractable pain where only one opioid has worked and now delisted SUDDENLY by ODB for those who are poor is insane. The misuse of these drugs by persons who make themselves addicts by self-medicating is a psychiatric issue. To deny people who desperately need them but cannot now use them borders on criminal. ABOVE ALL ELSE DO NO HARM. What do you think is happening right now to the people DENIED their rights because of poverty? Tried EVERYTHING. ONE opiod worked - now what?
Going to tell you right now exactly what happens with opioids yes your brain does adapt and it took me a few years to realize you can beat this by changing to a different opioid and keep this process going in that’s how you combat that I can’t believe doctors don’t know this
Mine knows but she gives a shit
You make a great point and this was our challenge. There are lots of people like you that are on stable doses that have improved function. It is not surprising to me that you feel the message was a bit too negative given your experience. At the same time, there is an emerging public health story that is very concerning.
Make sure to ALWAYS research what you take, even if Dr prescribed.
I know for a fact that there's at least one "dietary supplement" out there that has withdrawals WORSE than heroin. AND its legal in the US...
Research. Google " withdrawal", and read the stories before you dose.
Oh, and NEVER take more than you have to. Youll only end up paying for it later in pain.
This presentation is very informative. I started seeing kids using Vicodin and other pills at parties when I was a teenager but never used them myself. I have seen them use them to just get high and I have a lot of patients that use them for pain management as well. I personally have experience with someone very close to me becoming addicted to Vicodin. This lead to an addiction to Oxycontin and he is now a Heroin addict. He was never prescribed these medications. He was sold them by friends. He is now living in and out of jail, is a thief and has been in and out of rehab more times than I can count on my fingers. He is my son's father. There are so many people that truly use Opiods as only a pain reliever but seeing addiction first hand shows how easily it can control someone's life. I see how it would be hard for doctor's to prescribe such drugs and would like patients to seek alternative methods of pain relief first. Like he said, there are many good and bad things about opiods but the good are clouded so heavily by the bad, they are sometimes hard to see.
I have been off and on large, HUGE! dose's of opiates and have gone off many times but the pain won out. I have gone as long as as two years off but always came back due to my quality of life. The big issue was I needed more and more, so much more that doctors would no long go past the "guidelines" lucky for me I searched "safer opioid medications" and came upon a trial of buprenorphine for paint patients who struggled with taking the correct dose. Bupe worked for my pain and when I decided to taper to see where my baseline pain was, the withdrawal was nothing compared to pure agonist opioid's. I cut down super, super slowly and went from 16mg down to "crumbs" over several months which was the key to a proper withdrawal taper. After a year off I did come back but had no worries about it. Why? I did not worry because while over time i needed more, it was no where like the tolarance I had with regular opioid med's plus I do not feel dull and "out of it" in fact, I feel on an even keel and pretty much the same I feel without it. So yeah buprenorphine saved my butt.
Same goes for government. Job of gov is to require labeling of drug and amount, and prosecute criminally drug sellers who mislabel drugs as to the drug, and the amount. If label says maple syrup and jar contains cane sugar syrup and artificial maple flavoring - you go to jail. Secondarily it is to support research as to the pros and cons, and education. Job of gov is not to decide what drug a person puts in their body. Ultimate decision should belong to person whose body it is.
Thanks Dr. Evans for making this video and posting it. Lack of common sense and evil greed was a big part of the opioid epidemic.
it's NOT the pill's that People O.D, it's Stupidity.
I’ve NEVER had a doctor or pharmacist describe the addiction risk of opioids when they prescribe them. It’s a huge issue with Codeine and OxyContin both. They don’t tell you if you take these for a few days straight, on that fourth day when you don’t, it’s gonna hurt. A lot. And you’ll probably get sick:
I have had chronic back pain since the age of 22 and am now 54. I take slow release morphine (MST Continus 20 mg twice a day). I work for myself so I can't take time off sick otherwise I don't get paid.
I also take 3 x 300 mg of Gabapentin to prevent muscle seizures and 100 mg of amitriptyline for nerve pain from frayed nerve endings and to cope with sciatica.
If I had to give this medication up I would not be able to function. The amitriptylines knock me out, I've never got used to them, so I have to take them two hours before I go to bed, but they leave me feeling hungover without the headache for the rest of the day. I am dulled by all the medication but at least I can still function.
Thanks for the advice but still doctors don't seem to understand people who really need pain medication. They need to go through some experience themselves to really understand.
/2 aspect of it), & I experience significant distress when faced with the prospect of losing that crutch. I WANT to stop taking them, but I'm terrified of the constant, unending, grinding pain in my head. Luckily, I don't drink.
Yet seems to me that among all the discussions of pros and cons of taking a drug and the issues of how decide what to take or not to take, based on limited knowledge of all the consequences, this issue of choice and responsibility, and who it belongs to, is being overlooked.
You just said most people don't become addicted to smoking. Yet it seems to me that most people who start smoking, continue smoking despite being harmed by smoking, and knowing it. That is, they fit your definition of being addicted.
Using Michael Jackson as an example of a person who uses opioids without needing them is misleading. He had a third degree burn on his scalp and was in pain his whole life. He might've gotten addicted to morphine but without intention. Like I said, he intended into using the pain reliever to treat the pain he was going through.
How long do I have to suffer and live in my bed at 49 years old before I can actually trust a doctor to not be afraid do no harm am right?
I’ll tell you this when I was getting the medicine I needed I was able to support my family and now I have stopped cooking I barely do anything and I can’t even get out of bed most days
Nicely done DocMike - this is a wildly complex and deeply emotional issue. I often wonder how much difference we would find if, as you eluded to, the primary consideration for continuing to take opioids is whether it lets people move better. When a patient receives the medication from the doctor, it could come with a clear message - "This is to help you move better. If it decreases your pain but you cannot move better, we need to change things up."
Nurse practitioners and Dr's do not give a crap about your quality of life. I'm a paraplegic with cuada equina syndrome. I am in pain 24 hr/7days a week. They profiled me as an addict. Ummmm no. I have a legit injury, but the Dr I had put me on 1300mg of codiene a day, I tapered myself down to 600mg. I asked the Dr to put me on a different med, but she refused. Then she ditched me as a patient, so a nurse practitioner took over. She put me on suboxone, I didn't want to be on it. Besides that, the side effects were very bad. She didn't care. So she put me on gabapentin. I hated that drug, mixing the 2 drugs was terrible. But she still kept me on them. NEITHER ONE OF THESE DRUGS ARE TO BE USED FOR CHRONIC PAIN!!!!!
I basically had no pain relief for 6 months. It was terrible.
Ever hear the expression, "if your only tool is a hammer, then every problem looks like a nail"? Well, DocMikeEvans works for the Centre for Addiction and Mental Health of Canada. Not for the treatment institute of chronic pain. So, all he sees is a "nail". No help to anyone except those who make their living treating addiction whether is real or not.
Didn't I see this in "Blazzing Saddles" where Mel Brooks goes "bullshit, bullshit, bullshit, bullshit, bullshit, bullshit, bullshit, bullshit, bullshit, bullshit"?
Hi Kjartan, you're welcome to link to the TH-cam video, or even embed it directly onto you page using the TH-cam Embed codes.
It's very easy to get addicted to opioids without realizing it. Usually by the time you do realize you've got a problem, it's already too late. So be VERY careful when it comes to these medications. Even if you use it for legitimate purposes, it's easy to use that as a rationalization to use more than is necessary, or to use in a way which negatively affects your life. A lot of people don't like to think that they are putting themselves at risk of such a fate, but the truth is that it can happen to anyone, and it's not always immediately obvious when it does. Be vigilant about it. The best thing you can do to avoid it is take as little as you can get by on and take it as seldom as possible as well. Obviously not to the point where you're torturing yourself from the pain of whatever affliction you've been taking them for. And most importantly, be honest with yourself. If you think it may be causing you more harm than good, reevaluate your situation, talk to people who know you well and ask what they think, and most importantly, talk to your doctor about alternative or supplemental treatments.
They said that tramadol and gabapentin are now opioid when they never were before. Tramadol helps patients who can't take Nsaids. And gabapentin helps with nerve damage and neuropathy. Take it away and there is never ending pain and misery.
What a great artist doing the illustrations..wow. :)
Very well done. Should be shared with all patients on opioids
Hey, good post. I am going thru the "chronic pain-RXmeds reducing Testosterone-need for more Low-T treatment-and-more Opioid treatment effect. Basically, long-term pain, whether acute or chronic, lowers testosterone big-time AND it is now showing that this affects the ability of RX opiate-opioid meds to work. You will need more pain meds because the lack of testosterone affects the axis of the Endocrine system and this affects the capability of meds to work in the 'strength' they are prescribed. A double-edged sword and then if the pain is not controlled? A vicious cycle - you basically need more more more of the CORRECT Low-T + HCG + an estrogen blocker to get your endocrine system to not burn out. So, ppl have died from over-stimulation from the lack of enough pain medication to keep 1. The pain down 2. enough to not over-work the endocrine system, and 3. enough to cause ATTENTION by Physician to pay attention to the effects of this balance. So, a chronic pain patient sees a GP and if that GP doesn't understand how this works, the right blood-tests to show SBHG and FREE testosterone? Then, patient runs the risk of not having ANY of his CNS, Respiratory, Sympathetic Nervous systems and brain function to work properly. The very best study on this is the following link: www.practicalpainmanagement.com/treatments/hormone-therapy/hormone-replacements-treatments-chronic-pain-update-2010
Read this and it gives you all you need - and it is written mainly for Physicians to get a grasp of how important getting this balance between pain treatment, Low-T and a healthy CNS + Endocrine system ALL working to keep a pain patient healthy for the long-term. It literally takes every one of these systems and a good control on the pain for it to work. If the patient is not getting relief? Then there is a very good reason, which can - and most likely will - be found in this study. This is five years old and I can tell you - most of the PROBLEM is getting your different Specialists to work together to get you, not only pain relief, but in doing so - a healthy overall body while RXing the meds - and an understanding that these narcotic meds affect other parts, other systems of the body and they, too, need to be addressed. One affects the other and vice-versa. So, if you are having issues, your answer could be right here - print it off and hand it to your Specialists. It's up to you to show them as many of them get tunnel-vision and can't see the big-picture. It is complicated, but not enough to keep your 'team' from keeping you pain free and addressing the other possible affects from chronic pain treatment. A great read, and useful to give to your physicians - so they can get on the same page. Good luck - glad I found this and they will read it and understand how it all fits.
You must have real dr. and not one that says,next.
Well, mixed - he is compassionate, but fast. Unless you have an issue, and just say hello? It's in, then out, pretty fast after they check your vitals. Office works 1/2 days. Only two days a week is he there. So, mixed, I would say.
I am so sorry for your loss. I agree - Oxycontin should NEVER be prescribed for surgery or any normal surgical pain UNLESS there is mostly intractable pain.
Klausmki
hmmm. Hopefully I am interpreting this right, but my point regarding "90 days" was that,unfortunately, there is very little research following patients on opioids with Chronic Non-Cancer Pain for more than 90 days- and i think people should know this. To your point we dont want people to live in pain, so we continue the pain control... but I really wish we had quality data and research beyond 3-4 months to inform best practice. Especially as chronic use is so common. Hope this helps.
DocMikeEvans Go away on your summer vacation that was probably paid for by the pharm. Reps
Yes.. where is the studies?? As far as my research goes... seems they lummped all opiate over doses wrather it be from heroin or perscribed... how many overdoses from prescription were not even there medicene??? WHERE is the differentials of illegal use, to actual perscribed. Who was who overdosing ??? And what percentage s were taking dr. Perscribed that took meds correctly??? How do people overdose when taking as perscribed ?????
i believe you are not looking at studies that showed the risk of addiction in chronic pain sufferers using opioids is very low...i understand there are many of them
My original Dr. died and I was so stable and balanced with my opioids and pain levels under control. The Dr. that took over for him has been reducing me every two months since he took over, my pain levels have crushed my life. I'm not active at all now and I realized my muscle mass has been going down over the last year since he took over my case. I don't know what to do now, because he keeps taking me down on meds but has not given me a single thing to help with the pain that has always been there. Now, I'm not able to hardly do anything and my Dr. just doesn't seem to care and I don't know what to do! Most of the Dr.s in my area will not prescribe pain medicine at all. Please if you have any suggestions I would love to hear them, it seems to me like he just doesn't care at all. :(
hey try kratom. it really helped me with the withdrawals and i take it everyday to help with my pain. i get my kratom from the golden monk website and it actually works. i pray for u people in ruff situations tend to do rough things.. 🙏
Thank God all doctors aren't doing that.if It is a state that has a lot of drug addiction problems.that is where it is happening.
When I was started having pain issues I went to an orthopedic doctor.best decision I could.have made.take.alot.of.primary care doctors will not prescribed opoids.take care
Hello, everyone tyty for answering my post here. Just an update, I have since basically left my regular dr. and now see a pain specialist dr. I'm so glad because she is awesome and also young so she won't retire till long after I'm gone lol. My pain is now under control and I still function minimally but at least I can do that. I do store shopping but only on very super short trips. Either way, I'm 100 times better than before. :) TY all for your advice. :) and posting replies. :)
@@criptcrum2865 Hello, everyone tyty for answering my post here. Just an update, I have since basically left my regular dr. and now see a pain specialist dr. I'm so glad because she is awesome and also young so she won't retire till long after I'm gone lol. My pain is now under control and I still function minimally but at least I can do that. I do store shopping but only on very super short trips. Either way, I'm 100 times better than before. :) TY all for your advice. :) and posting replies. :)
I know its not for everyone but I have been on opioid therapy for 13 years and now have a intrathecal pump with hydromorphone and fentanyl along with 120 mg of oral morphine a day. After 13 years no problems other than constipation which is moderately managed. Its a shame so much negativity from abuse and diversion make it difficult for those who are truly suffering and legit.