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Discussion Opiate Panic

RUC4

Bluelighter
Joined
Oct 26, 2018
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646
Congratulations to the winner of the War on Drugs: Drugs.

After spending a little over 5 weeks in the hospital for malnutrition, sepsis, and surgery, I can tell you that the current policy on the administration and use of opiates has mutated to a level of pretzel logic I didn't even know existed. I was in the hospital essentially for a mass on my intestines and other endometriosis deposits. The end goal was a bowel resection (cutting pieces from my intestines and putting them back together) and total hysterectomy. I was too malnourished for surgery, so I had to receive IV nutrition for close to a month so that I would have a better chance of surviving the surgery and healing appropriately.

The main rule for receiving opioid pain medicine is they have to counter it with non-opioid treatments as well. I didn't realize that the non-opioid treatments didn't have to even make sense. They are just doing what looks good on paper. That has become the focus instead of your pain relief. They actually admittedly don't intend to relieve ALL of my pain. The current theory is that you should have some pain. It's "normal". The moment you ask for pain relief, they bring you non-opioid medication without explaining it to you. I was brought Toradol, which is an NSAID (non-steroidal anti-inflammatory drug) that's a bit stronger than ibuprofen. I asked for more/other medicine and was brought Morphine AND Gabapentin. Then was brought lidocaine patches for my belly. I have intestinal pain. Lidocaine is a topical (meaning applied to skin) medication. It can be used for muscle pain and soreness. There is no way in the universe it would EVER go through my skin and tissue and fat and abdominal wall, etc. all the way to my guts and help. It's not possible, but this is part of the charade. I was then given a regimen of OTC aids like Tylenol to help as well. I was getting the pain medication through IV and the Tylenol by mouth. Because of my intestinal issues, I was vomiting the Tylenol, which the doctors and nurses referred to as "refusing alternative treatments" and the opiates were taken away from me. I asked for pain meds again and was then referred to pain management.

Pain management came and gave me Dilaudid by mouth and once again I puked and told the attending that I'm not tolerating medication by mouth. I was then flagged for "repeatedly requesting IV pain medicine" and not cooperating with my treatment. I had to jump through some more hoops and eventually got the Dilaudid back (by mouth so I wasn't really getting relief). A few days later I became septic and the doctors came in to evaluate me. I was dripping in sweat and vomiting and SUPER tired. They woke me up when they came in the room. After I talked to them, my pain medicine was discontinued because I was "falling asleep" while they were talking to me because of "all the pain meds" I was on. Of course, I argued with them saying the obvious things like I was septic and thus really tired. That night a nurse reported that I was acting "suspicious" and she suspected I was doing something with my medication. They came in and talked to me about my 2 options: I was to be moved to a room with cameras so I can be watched or security would have to check my bags.
(Dead serious)

Skip ahead to me leaving the hospital. Following the major surgery I got 1 week of meds. Gabapentin was one of those meds, and Dilaudid 2mg (same as when I was in-patient). Not only was it a pain in the ass to get and continue taking opiates, but I was given ZERO instruction or education about withdrawals. After a week at home, I had been on Gabapentin and some opiate for 6 weeks, long enough to develop a tolerance and dependance on both. Luckily, I have the education I need to know about hese things, but many people/most people do not. They put me on a regimen of medications that will cause dependance, and neglected to explain anything about it. I should have been presented with information about Gabapentin, withdrawals are very uncomfortable and I'm sure surprising to some. With all the effort the healthcare industry is taking in prescribing non-opiates and creating a pain management team and everything, they don't provide the most important thing of all: education/harm reduction. A dietician and multiple surgical teams and a social worker came to see me before I left the hospital so I knew what to expect and what was expected of me when I went home. I think an addiction specialist should have been one of those people to check in and educate me of the symptoms of withdrawal and when to expect it and how to minimize it, etc. Why is that topic so completely neglected?

Share your experiences with recent opiate policy and healthcare workers. How can this be improved? What are your thoughts?
 
I got morphine shots for a chest tube but they switched me to toradol pretty soon. I was surprised because I told them I was an addict but I definitely wasn't free of pain. I left the hospital on a sublocade shot but it was Yale .. one of the best hospitals in the country.
 
I got morphine shots for a chest tube but they switched me to toradol pretty soon. I was surprised because I told them I was an addict but I definitely wasn't free of pain. I left the hospital on a sublocade shot but it was Yale .. one of the best hospitals in the country.
All of this happened at Tampa General Hospital, which is the leading gastrointestinal hospital in the country. I went there for the team of surgical specialists.

That’s awesome that they gave you the shot of sublocade before you left.
 
All of this happened at Tampa General Hospital, which is the leading gastrointestinal hospital in the country. I went there for the team of surgical specialists.

That’s awesome that they gave you the shot of sublocade before you left.

I just drove by this hospital today lol. Small world. I moved to Tampa last month
 
We are seeing major disease in the medical community and they need to be studied and treated. I say the next DSM lists Paranoid Scheduled Substance Obsession (PSSO) and Paranoid Scheduled Substance with Drug Seeker Delusional Diagnoses Obsession Disorder (DSDDOD) and also often seen together are Substance Abuse and Addiction Ignorance and Competence Delusion(SAAICD) and Negative Unintended Policy Consequence Aptitude Disorder (NUPCAD).
 
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I was getting opiates as well as neurontin when I was in the hospital for cancer treatment. One hospital gave me IV Dilaudid on request, the other hospital only gave me IV Dilaudid twice, on very special occasions. But it a completely different approach to using the central line--the one hospital did everything possible IV, the other did as little as possible. Both gave me 150mg+/day of oxy, and then sent me home on methadone and oxy 15s when I was discharged. Lots of neurontin too. No NSAIDS because of prior stomach issues and possibly the type of cancer, though I did take Tylenol a couple times.
 
I was getting opiates as well as neurontin when I was in the hospital for cancer treatment. One hospital gave me IV Dilaudid on request, the other hospital only gave me IV Dilaudid twice, on very special occasions. But it a completely different approach to using the central line--the one hospital did everything possible IV, the other did as little as possible. Both gave me 150mg+/day of oxy, and then sent me home on methadone and oxy 15s when I was discharged. Lots of neurontin too. No NSAIDS because of prior stomach issues and possibly the type of cancer, though I did take Tylenol a couple times.
If you don’t mind me asking, which state? I’m assuming by your language you’re in the US.
 
As an aside I realize ibuprofen isn't an opiate but I almost died when I got ulcers that bled heavily and later my stomach acid literally was seeping into my body, from a hole from ibuprofen. Be cautious with NSAIDS. I got lucky that I lived.
 
As an aside I realize ibuprofen isn't an opiate but I almost died when I got ulcers that bled heavily and later my stomach acid literally was seeping into my body, from a hole from ibuprofen. Be cautious with NSAIDS. I got lucky that I lived.
Yeah NSAIDs are horrible for your stomach and guts. After any kind of surgery, especially bowel surgery, you can’t take NSAIDs. I’ve heard stories of people presenting to the ER vomiting gallons of blood, and some needing emergency surgery to stop the bleeding.

A quick google search yields this, “NSAIDs such as ibuprofen may cause ulcers, bleeding, or holes in the stomach or intestine. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death.”
 
I got morphine shots for a chest tube but they switched me to toradol pretty soon. I was surprised because I told them I was an addict but I definitely wasn't free of pain. I left the hospital on a sublocade shot but it was Yale .. one of the best hospitals in the country.
I’ve never heard of morphine for a chest tube. Usually they just topically numb the skin. Was it for pneumothorax?
 
I’ve never heard of morphine for a chest tube. Usually they just topically numb the skin. Was it for pneumothorax?
They gave me something for the placement of my Hickman line. Not nearly enough though, that part was some of the worst of the entire cancer experience. At a different time I had 2 PICC line placements (one in each arm) and those were done bedside with just some prn IV Dilaudid and oral Ativan right before, under my normal PRN orders.
 
They gave me something for the placement of my Hickman line. Not nearly enough though, that part was some of the worst of the entire cancer experience. At a different time I had 2 PICC line placements (one in each arm) and those were done bedside with just some prn IV Dilaudid and oral Ativan right before, under my normal PRN orders.
I had my PICC line put in twice and never had any pain meds for it, besides a shot of Novocain where the line went in. I didn’t feel any pain, just some pressure when he was pushing the spacer thing in.
 
Yeah NSAIDs are horrible for your stomach and guts. After any kind of surgery, especially bowel surgery, you can’t take NSAIDs. I’ve heard stories of people presenting to the ER vomiting gallons of blood, and some needing emergency surgery to stop the bleeding.

A quick google search yields this, “NSAIDs such as ibuprofen may cause ulcers, bleeding, or holes in the stomach or intestine. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death.”
It's ironic I injected the wost , dirtiest street dope no problem yet ibuprofen almost killed me... God's got some sense of humor I guess
 
They gave me something for the placement of my Hickman line. Not nearly enough though, that part was some of the worst of the entire cancer experience. At a different time I had 2 PICC line placements (one in each arm) and those were done bedside with just some prn IV Dilaudid and oral Ativan right before, under my normal PRN orders.
I hope you are doing ok now
 
As an aside I realize ibuprofen isn't an opiate but I almost died when I got ulcers that bled heavily and later my stomach acid literally was seeping into my body, from a hole from ibuprofen. Be cautious with NSAIDS. I got lucky that I lived.
And isn't it ironic that you can legally buy an ibuprofen-codeine combo, or a paracetamol combo which isn't the greatest for your liver in great quantity, but you can't just buy the fucking codeine on its own when that has ZERO bad effects on any organ in your body.
 
And isn't it ironic that you can legally buy an ibuprofen-codeine combo, or a paracetamol combo which isn't the greatest for your liver in great quantity, but you can't just buy the fucking codeine on its own when that has ZERO bad effects on any organ in your body.
Exactly 🤦‍♀️
 
We are seeing major disease in the medical community and they need to be studied and treated. I say the next DSM lists Paranoid Scheduled Substance Obsession (PSSO) and Paranoid Scheduled Substance with Drug Seeker Delusional Diagnoses Obsession Disorder (DSDDOD) and also often seen together are Substance Abuse and Addiction Ignorance and Competence Delusion(SAAICD) and Negative Unintended Policy Consequence Aptitude Disorder
I laughed so hard at this. When I worked at Psychiatric Emergency Department I swear every clinician, nurse, tech (besides me), or doctor suffered from one or more of these serious illnesses.
 
And isn't it ironic that you can legally buy an ibuprofen-codeine combo, or a paracetamol combo which isn't the greatest for your liver in great quantity, but you can't just buy the fucking codeine on its own when that has ZERO bad effects on any organ in your body.
Where do you live that you can buy codeine? Heck even with tylenol or motrin, I still wish we could buy codeine. There's always kratom I guess but its not the same.... but whenever I have a cough the doctors never give hydrocodone or codeine anymore, when I was really young I'd get one or the other, hydro if really bad, codeine if it was just a cough.
 
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