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Insight or opinions welcome

I am currently awaiting several surgeries and have been going to doctors to work out a way to manage the pain until things are all set to move forward. I am strongly against myself taking an opioid pain medication at this time and am trying to deal with it in a less risky manner. I would like to note that I am not against them overall but due to my family history of addiction I would like to avoid them as long as possible. I do understand that it is likely that I will need them during recovery, I just want to wait as long as I am able.my question is, why is it that other people I know as well as things I read suggest that doctors act like you are a drug addict if you ask for an opioid pain medication for what seem like both short term and valid reasons but when I ask to avoid them, that is all they seem to want to offer? Is this a situation unique to me or have any of you had this or a similar situation occur with your pain management? I do not understand what is so strange about not wanting to go quite so hardcore yet.

By Byrd7
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12 comments

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1

At 69 years, and a somewhat sordid background, I've had my share of bumps and dings. My old flight surgeon, and, my current primary physician, off the record, have always given me two choices.
Choice #1 = class three pharmaceuticals.
Choice #2 = whiskey.
Now, both are addictive as hell if you're susceptible to such things. But from personal experience, Wild Turkey works pretty well, less expensive, no prescription required.... Demerol, Percocet, Codine.... all have, for me, more negative side effects than whiskey. But then, I've never had any really serious pain... as in not manageable.
Note: Never mix whiskey & pills. NEVER.

But your kidneys and liver? Alcohol as pain killer almost always leads to addiction issues.

I'm more aware than most, as a lot of women with Endo wind up alcoholics. I had a horror of that due to a family history so it never became my go to.

The Uncle with the alcohol problem died in his 50s. Others lived longer but the emotional toll was lousy.

And yes not everyone who uses it becomes addicted.

@RavenCT
@RavenCT
Something's going to kill us.
I'd say that my 'addiction' to carbohydrates stands a much better chance of killing me than whiskey or drugs. Or maybe, my addiction to fast cars, skydiving, and guns might play into this algorithm.
But your point is well taken. I'm an 'alcoholic by the state of Ohio's clinical psychological definition.
But I still function in 'the world'... Drugs, Sex, & Rock & Roll..... to hell with society!!! smile009.gif

1

I work in behavioral health. I'm sure there are people who use the pain killers without issue. I don't see those people.I see the ones who use them and then get addicted and then want more and then go for heroin because it is cheaper. My advice is avoid them if you can.

3

I had a very painful and serious bone tumor surgery, and took Vicodin during my recovery for about a year. And I needed it, too. I found that when you're taking something for pain, and not for kicks, at least for me, I didn't "up the dose" or get addicted. When it was time to stop, I just stopped. You say your family has a history of addiction, but if you have a stable life with social supports and healthy relationships, I'm sure you wouldn't automatically become addicted for just taking medically necessary pain pills. I'd stay away from the stronger ones, though.

Orbit Level 7 Jan 12, 2019
3

You take what you need to keep pain Maneagable, as lots of pain retards healing. Period.

Wise words.

2

I would agree a TENS machine may help and to be honest simple paracetamol is adequate for all but the most serious pain. IV paracetamol particularly. (Hmmmm thats tylenol). I wouldn't be prescribing opiods post surgery for many reasons, not least of all sedation as you will need to be moving around as soon as possible. However I would not worry to greatly as regards addiction if your px is time limited. Maybe for one week. Work with your prescriber to find the best for you.

Amisja Level 8 Jan 12, 2019
2

This is an extremely tricky one. Apart from anything else, different people have different responses to pain medications, and different people have different tendencies towards addiction part of which appears to be genetic. From personal experience, I seem resistant to opioid addiction, and one of the other painkillers (tapentadol) is totally ineffective for me.

Given the current backlash against opioids in the USA (which backlash is an over-reaction to my mind), and your own apparent genetic risk, it might be to your advantage to have an in-depth discussion with your medical team, and to inform yourself of the various analgesics, their modes of action and their risk factors before you have that discussion. At the very least you will be much more involved in the decision-making process and you may be able to convince them that you know what you are talking about. Again from personal experience in Australia, which also has its own opioid backlash, this worked for me.

irascible Level 8 Jan 12, 2019
3

Just listened to a TED talk where opioid usage in usa hospitals is way oversubscribed, with very little planning in place in weening the patients carefully off of them.

hippydog Level 7 Jan 12, 2019

I see planning as crucial. I was heavily involved in my own pain management plans for two recent big operations.

2

Pain management is really wacky in the country right now.

If you have a valid chronic pain condition getting medicated appropriately is a tightrope walk.

I imagine you are seeing an Opposite effect. They don't want to treat you as a pain patient so they want to do "quick and easy" regardless of whether it's good for you or not.

A pain/nerve block might be very effective. It depends on where you have the pain. They are not a ton of fun however. Long needle - into the spine or locating the appropriate nerve cluster? Nope no fun.
Or nerve burning. That can work for up to three months. Also not fun. (But all non opioid). And very effective for some folks.

Possibly a TENS Unit might help you manage pain? Again depending on where it is.
Lidocaine patches or Muscle relaxants perhaps?

There are a ton of possibilities but location of the pain has to do with treatment.
Also we have a Pain group if you want to ask there. I'll get the link: "Pain Management and Chronic Pain"

Folks there might have knowledge of more recent treatments.

RavenCT Level 9 Jan 12, 2019
1

Not sure if you would qualify, but I would look into medicinal pot.
[doh.wa.gov]

kiramea Level 7 Jan 12, 2019
3

Nothing is wrong in your thinking. Because of the opiod scare, doctors are highly nervous when patients request opiods, even if they justified. Doctots sre under their own microscope these days.

However, doctors are a conservative lot in general. It is hard for them to change or adapt. Because opiods worked so well for pain management for their patients, its a paradigm they are stick on. The overarching paradigm in modern medicine is one ot trearing symptoms. Medicate the symptom and hide it, but forbid that you seek out the real cause of the disease and address that. In this way they are assured a constant clientele flow, as the same disease reappears in a different manifestation elsewhere in the body.

They are very poor at considering or prescribing alternative pain control practices. So they are caught on this roller coaster of their own making.

t1nick Level 8 Jan 12, 2019
2

I have heard of similar apparent contradictions, but no personal experience with it. I would think it's unethical for them to not offer a non-opioid when you've asked for such. I mean, to the point that they should be reported.

bingst Level 8 Jan 12, 2019

I apologize for not being more clear. I had one doctor who strongly pushed harder drugs and several others who keep bringing it up. I had to change doctors due to mine retiring. In the search for a new one this was an issue. The doctor I have now was willing to give me ibuprofen 800s but now my insurance will not cover any more refills. Also this new doctor is great but almost always unavailable. Again, I apologize for the confusion. I sometimes forget that doctors and insurance companies are separate entities.

3

If they cannot offer an effective alternative, you will have to suffer with pain. Have you considered cannabis?

I use it daily ? it has made things easier by far. My issue is that in the past I broke several bones throughout my body and never had them examined. (I didn't realize anything was broken) my wrists and elbow are manageable. There are days I have to avoid using them but as long as I give them a break they usually are reasonably functional again in a day or two. My neck however does some odd things. The bones that broke healed all wonky and are pinching one of the main nerves going to my right side. It also shows signs of damage to the spinal cord but I try to avoid anything to strenuous so it doesn't seem to be getting much worse. At least not super fast. With the neck though, I never know what will set it off. I reached for a seasoning above the stove once and had it pinch up for almost 3 months. I was a severe addict 17 years ago and even though I have no urge to go back i fear putting my foot in that door again. I cannot go forward with the spine surgery until I find stable housing (at least 6 months in one place) due to the recovery requirements. So for now I try to be gentle.

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