Game is designed to help doctors spot drug abuse

[slimvictor]

What about if someone is truly in pain AND is addicted to opiates?
What is someone quickly breaks eye contact because they are shy, or a poor communicator, or nervous around doctors (who I find to often be egotistical, judgmental, elitist bastards)?

This game, and the FBI, have an answer: fuck them.

 

[xkassandrax]

well maybe this game can get leaked so drug users can learn how to better manipulate doctors. I guess i'll maintain eye contact and not fidget the next time i'm trying to get something. In the end it definitely just makes things more difficult for legitimate users while drug seekers will learn and adapt.

Yes. I agree.

 

[Cane2theLeft]

are pain patients generally receiving adequate analgesia, or are they systematically under-dosed? I don't hang out at pain clinics so I have no idea.

It really varies widely... largely by region but also from doctor to doctor and clinic to clinic. Compared to a lot of places in the world, opioids are a lot easier to get prescribed and we have more access to a lot of treatments that aren't as widely available elsewhere such as nerve blocks, epidural steroid injections, implanted patient-controlled analgesia pumps, bio/neurofeedback and so on.

There are certainly a lot of pain patients who are not getting adequate treatment but I think this is exaggerated on BL because you have a lot of young people who use/abuse drugs either lying to their doctors or themselves that they require 160mg oxy/day to be able to function when in reality, this is exceptionally rare and they should be pursuing more sustainable ways to manage their pain.

On the other end of the spectrum, when older people have serious/chronic conditions (especially if they are terminal), the US is probably the easiest place to get prescribed narcotic analgesics. There are always exceptions and individual doctors who are unwilling to prescribe adequate medications, but all-in-all doctors here prescribe opioids more freely than just about anywhere in the world.

I have nerve damage in my leg that causes chronic pain and since I was always open and honest with my physicians, always deferred to them, did not insist on opioids but tried absolutely anything to find relief, my doctors trusted me and allowed me to use opioids as one tool in my pain management regimen that included a lot of non-narcotic analgesics, physical therapy, steroid injections, counseling and more. I made the decision after about 4 years of treatment that I wanted to find ways to manage the pain without having to take 15-20 total prescription pills per day and worked with my physicians to find ways that I could manage my pain without them.

A substantial portion of young chronic pain patients have a history of drug use and I've observed both through pain management and years of training to be a drug counselor that as part of the addictive process, many young addicts convince themselves they need pain medication when in reality their pain isn't that severe or really there at all. You see loads of people with diagnoses like migraines, fibromyalgia and others that don't easily show up on diagnostic tests who insist that NSAIDs hurt their stomach, PT doesn't do anything and the only thing that works for them is IR dilaudid that they say they need to snort or shoot because orally it's too weak) so when patients like this make up such a high percentage of the young people physicians see for chronic pain, they are more weary and less likely to treat the legitimate patients adequately.

I've known a lot of doctors who truly care about their patients and want to help but they are so worried about feeding addictions or creating them that it puts them in impossible positions. It's not a good idea to get really young people (typically 18-25) hooked on a large doses of opioids for their entire lives but a lot of young 'pain patients' will come on BL and rail against any physician who doesn't give them high doses of opioids no questions asked.

 

[MemphisX3]

Good, how about you?

When you make your first million from doctor shopping, will you kick a little this way?

Shiiiiiiiet by the time I make my first mil you would have an email asking you to join my entourage.

 

[qwe]

hopefully some of those patients will seem anxious or demand that their pain be treated as well, and it should be helping them tell the difference between the two.

i don't think this is possible at all. in any way, whatsoever.

 

[Tryptamine*Dreamer]

This seems like it could be discriminatory against patients with psychiatric problems. People with bipolar disorder often can't stay still during manic, hypomanic, or mixed episodes. I was constantly moving my hands and feet during my hypomanic and mixed episodes. People with ADHD could have similar problems. PTSD patients who very often have been severely injured in the event that triggered PTSD would probably appear anxious. Many mental illnesses are seriously under-diagnosed or misdiagnosed. If the patient's psychiatric history is considered when deciding whether or not apparent anxiety is due to seeking drugs for non-medical use, it would lessen discrimination against the mentally ill who have been diagnosed but those with undiagnosed mental illness (many who don't realize something is wrong) would still be discriminated against.

The mentally ill are already viewed as much more likely to abuse drugs, so it is probably harder for them to get pain killers without this game. Since many mental illnesses cause anxiety or psychomotor agitation, teaching doctors that people with such symptoms are just looking to get high is discriminatory. If this resulted in psych patients being prescribed fewer pain killers than the general population it would clearly be illegal. The mentally ill feel at least as much physical pain as anyone else, possibly more since some conditions like depression can cause aches and pains.

I have never gone to the ER or any doctor to ask for pain pills, but several weeks ago I had a bad flare up of temporomandibular joint syndrome. They asked for a rating of the pain and I said 6 or 7. Thee headache had lasted a week at that point, though usually not as bad as at the ER. I thought there might be an aneurysm or something because the pain would briefly get bad enough in an instant, no warning, and I'd be down in the floor holding my head and yelling and screaming from the pain.

The pain was not at an intolerable level at the ER, but they gave me a shot of pethidine(Demerol). I have severe anxiety and panic attacks and if this game teaches doctors to suspect anxious individuals of seeking drugs to get high then I probably would not be able to get pain medication at the ER when I am in serious pain as I surely will be at some point in the future.

Pain itself makes me fidgety if it is very bad.



I don't think it is right for drug seekers to go to the ER to score because that wastes the time of doctors and nurses who could be seeing a patient who really is sick.

There should be no reason for anyone to try to get drugs that way. They should all be legal.

I do get a lot of hydrocodone from people who have prescriptions but don't use as much as they get or don't use it at all. My doctor put me on hydrocodone for severe headaches but I never asked for it because I was already getting more than enough. I did not turn down the prescription though, but that is not like actively seeking out pain meds from doctors when you have no pain.

 

[23536]

There are certainly a lot of pain patients who are not getting adequate treatment but I think this is exaggerated on BL because you have a lot of young people who use/abuse drugs either lying to their doctors or themselves that they require 160mg oxy/day to be able to function when in reality, this is exceptionally rare and they should be pursuing more sustainable ways to manage their pain.

Thanks.

I've also seen a growing amount of complaints on BL that sound legit and are unfortunate. Like this one:

At the start of December my rheumatologist office said all patients prescribed narcotics would need to come in by the end of the month. I went in on the 30th to find out that now she is legally only aloud the prescribe narcotics to people with rheumatoid arthritis and since I have ankylosing spondylitis I will now have to get my pain meds from a pain specialist. Mine along with several other conditions are in a grey area right now and a decision won't be made until April. What is really absurd is my condition is also a type of arthritis and just as bad if not worse along with other conditions not on the list.

My doctor 100% agrees with me how insane this new law is and that the fact it is in the hands of politicians makes it so much worse. As a patient with severe chronic pain living in Florida is infuriates me.

OK after rereading that one I wonder how it went for him at the pain doc.

There was an article here a while back about an entire state being gradually cut off from chronic opioids. Minnesota I think. I'll try to find it.

I wonder how the phrase "don't throw out the baby with the bathwater" originated. Were there ever any actual defenestrated babies?

 

[severely etarded]

next time you go to the doctor take a benzo...

observe nonverbal signs of nervousness, like breaking eye contact, fidgeting and finger-tapping.

 

[helium-4]

My neurologist does random drug testing when they feel like it when you come into pick up CII scripts or at doctor appointments. Honestly it is a decent way to prevent some abuse, obviously it can easily be fooled, but it puts up the risk of loosing your medications if you get caught taking other medications that aren't scripted.

 

[Cane2theLeft]

23, that person should have been receiving treatment for chronic pain from a pain management doctor already. It's not the patients fault the doctor wasn't following protocol by prescribing narcotics to patients beyond his specialty but as long as he is properly referred, that shouldn't be a problem at all.

At one point my neurologist was handling my medications but that should only be done temporarily and I was eventually referred to a pain specialist who should be the one managing the pain medication long term.

 

[23536]

but why should a rheumatologist be prevented by law from treating a condition that falls under her specialty?

Oh, it was Washington that was reported to be cutting off pain patients:

http://www.bluelight.ru/vb/threads/591364-New-pain-management-rules-leave-patients-hurting

 

[ferinox]

23, that person should have been receiving treatment for chronic pain from a pain management doctor already. It's not the patients fault the doctor wasn't following protocol by prescribing narcotics to patients beyond his specialty but as long as he is properly referred, that shouldn't be a problem at all.

At one point my neurologist was handling my medications but that should only be done temporarily and I was eventually referred to a pain specialist who should be the one managing the pain medication long term.

Its nice that you can explore all pain treatment options to infinity but what about all the people that have a pain condition and don't have health insurance. I find it really hard to build a substantial medical history Every time I go to my PCP, the first thing they want is payment. If I could actually afford health care, I would have a pretty robust history.

 

[phenethylo J]

23, that person should have been receiving treatment for chronic pain from a pain management doctor already. It's not the patients fault the doctor wasn't following protocol by prescribing narcotics to patients beyond his specialty but as long as he is properly referred, that shouldn't be a problem at all.

At one point my neurologist was handling my medications but that should only be done temporarily and I was eventually referred to a pain specialist who should be the one managing the pain medication long term.

My rheumatologist did specialize in my specific type of arthritis so it is understanable why she would want to be the one giving them to me my pain meds. Thankfully I ended up finding a good pain clinic that is giving me the right meds at a proper dose and not greatly under prescribing me to the point were I was ready to kill my self like with my rheumatologist.

My neurologist does random drug testing when they feel like it when you come into pick up CII scripts or at doctor appointments. Honestly it is a decent way to prevent some abuse, obviously it can easily be fooled, but it puts up the risk of loosing your medications if you get caught taking other medications that aren't scripted.

I am tested and they do more harm than good. They are saposed to prevent you from taking dangerous combinations and abusing your meds but all they do in cause me to go up on my opiates when I can't smoke weed do to the fact weed helps allot with my pain. I also have severe insomnia and weed is a mirricle worker for that yet I can't smoke all the time due to the tests and then i will be up so long that my med wear off and I have to take more not to mention the sleep deprivation making my pain worse.

I remember when I failed for weed at my rheumatologist that bitch called me 9am to tell me I failed and bitch at me when she knew I had insomnia and my extreamly serious inflamatory eye condition that can cause me to go blind was acting up. Luckly I was able to get her to give me my scripts back and not put the failed test in my record by getting a pain managment evaluation from a psychologist. I ended up being put on benzos for sleep after I had to temporaly stop weed. lol

It is a shame drug tests only single out weed users since a vast majority of other drugs don't stay in your system long and are easy to flush out.

 

[psood0nym]

People really in pain are willing to try a diversity of treatments and are willing to have diagnostic tests done to find out what is really wrong. They emphasized the patients they are screening in the test were adamant that NOTHING except narcotics work for them. This is more than just anxiety. As you know, I have chronic pain and because I was honest with my doctors, tried every test to determine what was wrong and tried every treatment (narcotic or not, pill or not), my doctors knew they could trust me and did so I was able to play a larger role in determining the appropriate drug regimen to find relief.

I think it's great that they are finding better ways to weed out drug abusers. It's true that SOME pain patients may be inaccurately labelled drug seekers but that is already happening anyway and a lot of doctors are under-prescribing for most or all of their patients out of fear of feeding addictions. If doctors were more confident about their own abilities to spot drug-seekers, they are going to be more willing to work with legitimate patients seeking relief.

Drug seekers make it difficult for a lot of patients to find relief and I'm sick of seeing people around here blaming the doctors for hesitancy to prescribe serious medications. If people would stop trying to use doctors as dealers, people who are actually in pain wouldn't have such a hard time getting necessary treatment.

While I don't disagree with you in spirit, this post reminded me of an interesting article I read recently. It was about lower back pain, and how now doctors are discouraged from using fMRI to diagnose it. The etiology of lower back pain is so complex that fMRI diagnosis actually more often results in misdiagnosis than proper assessment of the problems. Doctors are now encouraged to go back the old ways and say, "Your back hurts? Bed rest for 3 days then." The phenomena is such that more information simply confuses doctors rather than informs them. For example, a person's CT or fMRI scan can indicate that they have degenerating spinal discs, it may look like they have pinched nerves, yet they may not even complain of back pain at all. Alternatively, a person who does complain of pain may have a scan that indicates a pinched nerve, but when surgery is used to seemingly rectify the issue they still complain of pain. Just having people not put any stress on their lower back for a few days, on average, results in far better outcomes than the over-treatment that results from using fMRI to conclude that other treatment options like surgery are necessary to alleviate the problems.

What I'm getting at is that there is not necessarily any test that can independently verify that a person is in pain. In some cases there's just what a person reports, and there's no way to know for sure if a patient is a case of this or not. If I was a doctor I'd try to phone interview the people around the patient and ask them questions about the patient's overt symptoms (do they walk with a limp, for example). I agree that as soon as this program hits the file sharing sites doctor shoppers will use it to know how not to ask for pain medication.

 

[eldub v7.0]

Since many mental illnesses cause anxiety or psychomotor agitation, teaching doctors that people with such symptoms are just looking to get high is discriminatory

as part of this "game" (i'm an unpaid, independent actor on social security under home arrest), a patient with psychiatric and pain issues who has a long history of abuse and doctor shopping, it's working extremely well in regards to interactive, community/familiy based intervention and harm minimsation techniques - it's really quite amusing on occasion when in an "episode" for someone like myself whose treatment is still monitored and adjusting. to some extent, and to my amazement, i still have some say in my treatment. i'm playing the game right now; it goes far beyond doctors surgeries.

like mario bros, trying to win is futile.

fMRI to diagnose

while causing multiple psychotic episodes, which went through a spectrum of violent, aggressive and destructive behaviours, this technique has helped identify, what i now believe to be, a case of Peduncular Halloucinosis cause by a lesion that rests on my ocular nerve. the worst of it is over, just need to have my team back me up and confirm with a biopsy, i suppose.

*queues post traumatic slideshow*