Anger directed at drug abusers

Let'sgoflying!

Let'sgoflying!

Touchdown! Greaser!
Joined
Feb 23, 2005
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west Texas
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Display name:
Dave Taylor
My wife broke her leg in three places plus shredded ankle and knee ligaments - on Sunday during a emergency call to help downed hikers. (she's a paramedic).
The ER gave her three days of pain meds, "the law only allows us to do 3 days".
You can't get an ortho appointment til the 20th (2 weeks) and they only give pain meds to post op patients anyway!
The PCP says this morning, "we can't help you". WTF?!?

So she is in pain level 5-8, is not sleeping, all because the medical system has slammed the door shut on people who have a bonafide need for pain medicine! Thanks a lot, effing drug abusers.

She is already icing, elevating, resting, CBD, lidocaine patches, acetominophen (can't take nsaids). She needs hydrocodone!
I'm going to punch the next drug abuser I see in the nose!
Why does the medical system have to way over-react in this way? There is sometimes a bonafide need for certain medications and anyone can tell from the radiographs, 'yeah, that's gotta HURT'.
 
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(sorry about the injury and pain)

Any pain management units in a local hospital? They might be able to give her alternatives to hydrocodone.
 
Can't be passive unfortunately. Don't take no for an answer. Unfortunately, that's what drug abusers do too, so it's still tough for the docs.

This is typical behavior for drug abusers and government. It's everyone else's fault that the drug abuser chooses to abuse drugs.
 
Let'sgoflying! said:
The ******** Law, as far as I’m concerned
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The really sad part of this is the criminal pill pushers will ignore the law and probably never be caught and the honest members of the medical world will follow the law then results like yours.
 
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I have a suspicion that it's not a "law" but the company that owns the ER is paranoid about a lawsuit. And the Texas legislature.

By any chance, is your PCP part of Humana or another major HMO? You need to find another physician ASAP to help, even if it's a hassle with your insurance. Do not be held hostage by the insurance company.

I had arthroscopic on my knee in June, I got a 30 day supply of oxycodone as I walked out the door (of which I've taken NONE).
 
I sympathize and I agree with you wholeheartedly. I had the same issue with an abscessed tooth that started on a Friday and got no relief other than the bottle of Jack Daniels. The local ER was of no help whatsoever. I was given the same excuse as you were given. So after the drama and everything, this is how I fixed the issue.
I went to my primary care physician, who I know fairly well. I explained the situation. He wrote me a prescription for the really good stuff. Citing on the notes “ for back trauma as needed”. When I asked why he was so accommodating as I was kind of surprised. He said “I have a registry that I can tapped into to see what prescriptions you’ve had for the last five years. I saw that you weren’t doctor shopping, so I was happy to write you the prescription.” Went to the pharmacy. Received an enormous bottle of the good stuff. it sits in my freezer until it is needed. Every couple of years I do the same thing and throw the old stuff away.
It’s kind of like a fire extinguisher. If you need it now and don’t have it, you are SOL.
 
Let'sgoflying! said:
The ******** Law, as far as I’m concerned
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I'm concerned that the providers were ********ting you, and I would have asked for the providers to cite the law.

According to this CDC article half the states have limited prescriptions for opioids to less than seven days, but I don't see where the three days comes from. I think they were copping out.

I understand the legislature wanting to get drug abuse under control, but as a physician (retired) I think state medical societies would strongly oppose legislation like that.
 
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I understand your frustration but the blame lies in many laps. Major lawsuits in the late '80s/early '90s from inadequate treatment of chronic pain led to providers making sure their patients were comfortable by encouraging use of analgesics (mostly narcotic). Enter personal injury suits initiated by addicted individuals/surviving family of a 'deceased by overdose' and by state AG's against drug manufacturers, distributors, pharmacies and providers and you have knee jerk regulations or state/corporate imposed guidelines on prescribing narcotic pain relievers. Afraid of being sued or sanctioned, the prescribing providers have to walk a tightrope. Unfortunately, some patients will suffer. I know, as a provider that prescribes analgesics postoperatively I am stuck in the middle between stupid pharmacy corporate directives and my patients.
 
dbahn said:
I'm concerned that the providers were ********ting you, and I would have asked for the providers to cite the law.

According to this CDC article half the states have limited prescriptions for opioids to less than seven days, but I don't see where the three days comes from.
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Law or no law doesn’t really matter if they are not going to write you the prescription. Unfortunately also while I’m sure that your wife does not look like a drug abuser, the fastest growing segment for drug addictions is the over 50 crowd.
 
dbahn said:
They're entitled to use their own judgment in writing prescriptions, but they're not entitled to lie about it being beyond their control. That's a cop out.
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Unfortunately, they obviously care more about any potential downside rather than a patient’s pain. Blame the lawyers too
 
Time to find a new PCP. The ER isn’t a doctors office. Their mission is to treat the emergency and get you stable enough for your primary care doctor to treat any long term effects. Your pcp should have setup an appointment to see you within a day or two of getting out of the hospital and they should be in charge of treating any pain. If your PCP won’t see you and won’t treat you then you need to find someone else as they aren’t acting as a primary care physician.
 
Morgan3820 said:
Unfortunately, they obviously care more about any potential downside rather than a patient’s pain. Blame the lawyers too
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And/or they aren’t willing against what the computer tells them they can do.

“Resistance is futile…you will be assimilated.”
 
I'm sorry that your wife is going through this.

This is the exact opposite of the situation that I had with my broken wrist in Monterey California. Had my ortho visit the day after my ER (less than 24 hours after my injury), surgery 3 days later. I would really push to get an appointment (and surgery, if required) ASAP. They'll likely want to do surgery and the more the bone has had a chance to "heal" before that the harder things are. Quick surgery and then PT once able helps lead to better outcomes.

Incidentally, a friend broke his collarbone a bit over a month after I broke my wrist (in Chicago) and was in almost the exact same spot. ER, ortho next day, surgery a couple days later, now recovering. His recovery seems to be following mine. The plate and screws work well.

I am not a doctor, just someone who had a broken wrist and has been happy with my treatment and recovery.
 
While opioids are being unprescribed, your PCP telling you 7 days is all they can prescribe just doesn’t want to do the paperwork to justify the prescription.,
 
So there I was… on my back unable TO MOVE, AT ALL, for a coupla weeks. Pain finally reached a 9, I call 911 (hospitals are telling me they can get me in, in 9 weeks or so…) one night as I’m just screaming in pain. Paramedics said they can get me to the ER, but assured me they would do nothing for the pain, as it wasn’t life threatening! WHA???

So back to screaming I go…

Long story short, got in for a micro discectomy a week later. Literally walked out of the hospital, having not been able to even put a pillow under my head for weeks. Walked right to the pharmacy, where they happily gave me pain meds, that I never needed or used… crazy.
 
It has nothing to do with drug abuse. The abusers are still getting plenty of it. It’s all about the money. With greater control they can make more money.
 
Wife had surgery. A concerning mole on her shoulder that had grown down. Took her home and went to CVS to get the pain and antibiotics filled. I was told that they needed to call the doctor and get it cleared because they thought the pain pills was too strong and insurance and the pharma wanted to double check. Said it would take a day or two to get it all cleared, but I can take the antibiotics now. I was livid. She literally had a section of her shoulder scooped out and her skin sown back together. I was lucky after sharing my "thoughts" that I asked if I could just pay for the pain pills out of pocket. She checked and said yes. It was under $10 bucks. Out in 5 minutes.
 
172andyou said:
It has to do with trying to not create more abusers.

I mean, there have literally been billion dollar settlements due to mismanagement of opioids.

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As mentioned...it is multifactorial. However, big pharma has deep pockets and no one complains when the finger of blame rests solely on them. True, they have made contributions to the problems with opiod addiction, but addiction also requires a willing participant being the end user. In the middle is the prescriber that can be at fault if they are not using their privileges properly. It is tough to be a prescriber in a society that expects to feel no pain and also expects 'a doc to write a scrip for anything that ails them' but yet want to blame you if they are an addict. The fingers point in many directions.
 
Look at the Sackler family. Their irresponsible marketing of Oxycontin created thousand of addicts, many of whom died, but they ruined the lives of countless others. They paid out a massive amount of money in a settlement and laughed all the way to their own banks.
 
Way back in 2010 I had to have a kidney stone removed by surgery. What a honeymoon for my wife who had only been in the US for a couple months.

Anyway, the Dr. gave me a prescription for 30 days worth of Oxycodone. Yes, you read it correctly, 30 days.

I returned it and asked for 10 days worth. He told me he did not want me to be in pain, but prescribed as requested.

This was in Texas, maybe doctors over prescribing could have been part of the problem.
 
Zeldman said:
Way back in 2010 I had to have a kidney stone removed by surgery. What a honeymoon for my wife who had only been in the US for a couple months.

Anyway, the Dr. gave me a prescription for 30 days worth of Oxycodone. Yes, you read it correctly, 30 days.

I returned it and asked for 10 days worth. He told me he did not want me to be in pain, but prescribed as requested.

This was in Texas, maybe doctors over prescribing could have been part of the problem.
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In 2010, when I was 19, I busted my knee up skiing and had surgery. They prescribed me 60 of oxycodone without blinking. I took maybe 3 before I didn’t need it. I was a freshman in college. Had I been of a different mindset I could’ve turned a tidy profit. Was amazing how they prescribed it like candy.

Interesting to see the difference in the hive mind here on pain meds vs anti-depressants. Another thread here people were saying you shouldn’t need anti-depressants to deal with “normal things” like family deaths. Yet here, people are outraged that someone with a broken leg didn’t get pain meds. Doesn’t seem that different to me… (for the record I think it should be a case by case basis and there are cases where medicine is warranted and cases where it isn’t. Not one size fits all).
 
Zeldman said:
I kinda thought the same thing.

(no no, of course we would not do things like that...)
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Yeah. Would’ve been trivial to do so on a college campus. Obviously I didn’t but I was really surprised how they just handed this out. The surgeon was even affiliated with the college medical system!
 
I wonder if they keep the other 4 days worth from each patient to use for themselves or sell on the street. I’m sure there is some tracking or chain of custody, but for every procedure there is a loophole that a creative user or dealer can figure out. Cat & mouse.
 
Two years ago I fell off my airplane and sustained 14 fractures of 11 ribs, a collapsed lung and 5 vertebral fractures. Without oxycodone I’d be dead now.

The current stinginess with narcotics is unconscionable.
 
Drug dealers are getting a bad rap. They'd never let your wife suffer this way. See what happens when you try to do things the legit way? Are you going to let her spend two weeks in agony, or are you going to the black market?

Maybe I should sell t-shirts:
"If you think drug dealers are so bad, try calling a physician the next time you need more than three days of pain meds."
 
Zeldman said:
I kinda thought the same thing.

(no no, of course we would not do things like that...)
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Some years ago I crashed my motorcycle and needed orthoscopic surgery on my left knee. The doc prescribed 30 days worth of oxycontin, but I only took one the first day and then ibuprofen was enough. I told my surgeon I still had most of the Rx left and he said, "Have you thought about eBay?" ;)
 
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Maybe we could all scrounge through our medicine cabinets and send our leftovers to @Let'sgoflying! .

Better yet - one of the mods could create a sticky where we could keep a running list of our unused meds as a resource for POA members who can't get what they need from their PCPs.
 
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murphey said:
...I had arthroscopic on my knee in June, I got a 30 day supply of oxycodone as I walked out the door...
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Same for my knee-replacement surgery, also in June. And I had no trouble getting a renewal for a second thirty days (most of which I ended up not needing, fortunately).
 
When I broke my back they would only give me 5 days at a time. I got enough refills but I had to show up in person to get them issued.
 
donjohnston said:
i guessing it would be a state law.
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That's a logical guess, because it's certainly not a federal law. But I don't think it's a law at all. And if I were practicing in a state that had that law I'd be ********, even though I prescribed narcotics very sparingly in my own career in orthopedic surgery. But that's not a policy that should be decided by elected laypersons, no matter what.

Doctors often overprescribe narcotics for two reasons. First, they don't want to be bothered at all hours by desperate patients dealing with pain thinking a "pain killer" will eliminate it and second, they don't want to lose patients who might consider them "uncaring" or not in touch with the patient's feelings. I also knew a few docs who just liked the power they perceived they had for having the prescribing privileges in the first place. "But doc, I'm in severe pain." "OK, I can fix that."
 
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