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Doctors told (by CDC) to avoid prescribing opiates for chronic pain

^I think you hit the nail on the head there.

It would be an interesting experiment to take 10 anti-opioid crusaders, smash their spine with a crowbar 2 or 3 times, then see how like bouncing between Doctors and being denied treatment.
 
Felonious Monk said:
^I think you hit the nail on the head there.

It would be an interesting experiment to take 10 anti-opioid crusaders, smash their spine with a crowbar 2 or 3 times, then see how like bouncing between Doctors and being denied treatment.
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Instead of actually disabling people, why not just seek out doctors that already have injuries that cause chronic pain and then take their meds away. That way they start of with a healthy dose of withdrawal followed by unending pain. I guarantee you some medical findings in favor of prescribing opiates will be published post haste.
 
manboychef said:
Instead of actually disabling people, why not just seek out doctors that already have injuries that cause chronic pain and then take their meds away. That way they start of with a healthy dose of withdrawal followed by unending pain. I guarantee you some medical findings in favor of prescribing opiates will be published post haste.
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I think it's important that the experiment be done with people who have previously crusaded against opioid access, to see how long they are personally willing to suffer before admitting they were wrong or just buying heroin from a friend/relative. To do it to people who already have injurious would just be cruel.
 
Felonious Monk said:
^I think you hit the nail on the head there.

It would be an interesting experiment to take 10 anti-opioid crusaders, smash their spine with a crowbar 2 or 3 times, then see how like bouncing between Doctors and being denied treatment.
Click to expand...

I am laughing so hard that I just spit my drink out onto my keyboard. Bravo.
 
I have severe non-cancer pain and if it weren't for opiates I would be totally fucked. What people don't seem to understand is that severe chronic pain will destroy your life way more than potential opiate-related dependence will. It turns you angry, bitter, resentful, distorted. Everything gets a negative tint. Your blood pressure skyrockets, you can't eat, you just sit there all day groaning and screaming. You turn on loved ones. You lash out. You can't function enough to go to work, your hopes and dreams get dashed. Pain becomes an evil specter and your entire life becomes a task in anticipating it and avoiding it.

I mean, it's not like my life is so wonderful because I have opiate access. I actually hate how morphine makes me feel. I get some relief and some functionality, but my life will never be normal. I am stuck with a condition for which there is no cure, no end game, no true relief. If it weren't for opiates I guarantee you 100% I would have killed myself over a year ago. Try living with severe, stabbing bowel colic 24/7 in addition to internal bleeding. You will be begging for drugs or death in no time.

The policy makers are working hand in hand with the war on drugs, but their recommendations are ridiculous. If I didn't have access to RX opiates, I would consider street heroin. And that's what a lot of people are going to end up doing if doctors seriously listen to the CDC. They just don't understand what pain is like... they're all bureaucrats looking at the situation ideologically. It's not fair that cancer patients get to basically passively euthanize with the amount of opiates they get, but people who are in crippling, non-fatal pain just get told to deal with it. Well, I will deal with it, by blowing my fucking brains out one day.
 
Captain.Heroin said:
Other drugs.

Eventually more people will end up on heroin. Which won't be a good thing. It's sad the CDC is advising this.
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What other drugs? NSAIDS? Ibuprofen, Relafen, etc? Pregabalin? What other painkillers are available?

It seems to me that if they're going to phase out a class of drugs, a credible alternative needs to be available that demonstrates efficacy at dealing with the problem (for example, barbiturates being phased out in favor of benzodiazepines). I just don't see an alternative to opioids for the relief of serious pain.
 
Burnt Offerings said:
What other drugs? NSAIDS? Ibuprofen, Relafen, etc? Pregabalin? What other painkillers are available?

It seems to me that if they're going to phase out a class of drugs, a credible alternative needs to be available that demonstrates efficacy at dealing with the problem (for example, barbiturates being phased out in favor of benzodiazepines). I just don't see an alternative to opioids for the relief of serious pain.
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My pain management doctor recommended Lyrica (pregbalin). When I said I wasn't willing to take something that was likely to increase my fatigue, she responded with "Oh, well, it only reduces pain for about one in ten people anyway."

And that's considered the best non-opioid option for neuropathic pain.
 
SixBuckets said:
My pain management doctor recommended Lyrica (pregbalin). When I said I wasn't willing to take something that was likely to increase my fatigue, she responded with "Oh, well, it only reduces pain for about one in ten people anyway."

And that's considered the best non-opioid option for neuropathic pain.
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This may be true, but in my experience gabapentin and TCAs are definitely in the same league when it comes to treating neuropathic pain. The thing is, these drugs don't act directly on the pain as much as they promote the body's pathways for nerve repair, which indirectly, long term, reduces neuropathic pain. Which brings me to my next point: the best treatment for neuropathic pain is to remove the insult to the affected nerve, whatever it is. No treatment for neuropathy is effective long term without this piece in place.

Do opioids have a role in the treatment of neuropathic pain? Yes, but typically short term. Damaged nerves, after all, can take weeks to months to heal, even after the source of damage is completely removed and the body optimized for maximum nerve repair. While drugs like gabapentin or amitriptyline do their thing at getting this healing process underway, I find it appropriate to mask the residual pain with opioids as needed. But unless there is no end in sight to the nerve damage the person is likely to suffer, I don't see a role for daily opioids for years and years in most patients.
 
These articles scare me as I know someone in chronic pain and they get treated like SHIT at their clinic( place is always counting pillls, the NP had been getting snippy with her and saying she should have more pills, so she of course snapped back...low and behold two weeks later a pill count, which was passed) ANYWAY, my point is this person is REALLY TRULLY in PAIN and sits around MISERABLE all fucking day because she is scared to take an extra percocet if they need it. She sits around looking slightly sucicidal(thought doesn't or trys not to complain) from the pain she is in. My point being this is all this damn thing is gonna do, make doctors TOO SCARED to TREAT pattients from fear of loosing their licensce...cats already outta the bag, after 10 years of people banging oxys/heroin, well "lets just make it harder for people to get a script of 120 percocets a month, with a low dose of something time released on the side, that will solve shit"... Like really, we have a generation of junkies on our hand, me being one of them, I just see more people relaspeing, more methadone/suboxone clinics opening, and this making if fucking impossible for somebody to get pain meds who really needs them, and turns to the street for treatment...but thats already been said..And I don't see this solving a problem at all, because lets face it, when you first start out you are not thinking "can't wait to get hooked" but "I can do it, I'm not like that guy" I DON't care who you are, that is what you BELEIVE until its you, and with dope and other opiates being so prevelealnt now I just see more street addicts... I'm starting to stray away from the point and ramble...my main point is this isnt going to help anything, they are delusional if they believe it is, it's mainly just going to hurt people who are in pain, because if you truly are an addict 120 15's or 30's is only gonna last ya a week or so BEFORE your on the street looking again anyway...now if you aren't an addict you'll be set for the month but I'm straying

Edit: Oh, the person I am talking about had 4 back surgerieres in life and was in a car wreck which left them with metal rods goin all through there legs after having there legs pretty much crushed and having to get pulled out by jaws of life in the wreck to even get them loose...was prescribe 90(some months 120) 30's but the doctor retired, every new doctor laughed at the roxi sciprt and this persons pain, and they were given 120 percocet...the are 60 years old, this is my aunt, not a dealer, or fellow drug useer...fucked up right? She hobbles around all day, and if it rains you do not want to be around... it's sad that this is going to be the people(or is the people) that this is going to affect...if your an addict YOU WiLL find a doctor or get it on the street, none of this shit matters....
 
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MyDoorsAreOpen said:
This may be true, but in my experience gabapentin and TCAs are definitely in the same league when it comes to treating neuropathic pain. The thing is, these drugs don't act directly on the pain as much as they promote the body's pathways for nerve repair, which indirectly, long term, reduces neuropathic pain. Which brings me to my next point: the best treatment for neuropathic pain is to remove the insult to the affected nerve, whatever it is. No treatment for neuropathy is effective long term without this piece in place.
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I have fibromyalgia. There is no actual damage - my nerves are sending the wrong signal to my brain.

Do opioids have a role in the treatment of neuropathic pain? Yes, but typically short term. Damaged nerves, after all, can take weeks to months to heal, even after the source of damage is completely removed and the body optimized for maximum nerve repair. While drugs like gabapentin or amitriptyline do their thing at getting this healing process underway, I find it appropriate to mask the residual pain with opioids as needed. But unless there is no end in sight to the nerve damage the person is likely to suffer, I don't see a role for daily opioids for years and years in most patients.
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I don't really have an opinion on the best way to manage anyone else's chronic pain, but I personally have no interest in taking daily opioids for years and years. If you look back through the thread, I've been discussing occasional use during episodic flares of chronic pain conditions. But that's not permitted, because "ooga booga addiction".
 
Opiates are the only releif I get. Injuries from work and now ms. My doc has tried to up my opiates. From oxy to hydro morph but I won't because the pain will get worst and I don't want my tolerance to get bigger. I'm in Canada and my doctor knows I'm addicted but she also knows the pain I live with. The cdc should stfu and let people with chronic pain take what's needed to help. My life is cut short already It's cruel to let a person spend their last days in agony. Absolutely disgusting actually
 
I am with burnt offerings on this, however, I do believe opioids should just be a tool, but there needs to be more research done on ways to treat pain long term.
 
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