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I¹ve never pushed the issue with pain control. I let my new doctor know

that ultram wasn¹t doing anything for me and that vicodan worked much

better. Right away he started talking addiction, so I knew I had a

narcophobic doctor. I told him that I read numerous studies that say

narcotics taken for pain rarely cause addiction, but may cause dependence.

His answer was darvocet. Darvocet is about as useless as ultram. It is

very depressing. Not knowing doctors in this new town, I don¹t want to be

labeled as a narcotic seeker. I wonder if they ever took statistics of

people that bought them illegally. My mailbox is full of offers to buy

painkillers on the internet, but my doctors won¹t give them to me.

I am so happy for you and others that have compassionate doctors that treat

pain. I would also take the least amount that I could. I too believe that

the majority of doctors believe in their oath. I¹m sure they feel they are

doing the right thing by keeping me off of narcotics, however I truly

believe that my muscle pain and fibromyalgia are a result of untreated pain.

Over the years I¹ve found that I am more and more sensitive to touch. The

pain I had used to be confined to the standard FM pressure points, but now

it is all over. Pain causes me to tense my muscles. He did prescribe

flexeril, but that is to sleep. He thinks if I get a better night¹s sleep I

will have less pain. I sleep much better than I used to, although not as

good as I¹d like, but I see no improvement in muscle pain.

We will see things change in the future. I know much work is being done in

pain research.

I hope is taking a much needed break. She surely deserves it. But

knowing , she is off reading something for us LOL!

a

> a: Thank you for your words. I also wish there was something to

> control your pain, and I know you have researched and tried many

> natural remedies. It makes me so unhappy that so many people suffer

> because a few addictive personalities ruined pain control for people

> that truly have a need. I am very lucky to have the docs I do, in my

> case 3 of them got together and decided I would get oxy with percocet

> for break thru pain. Many times they have tried to convince me to up

> the dose, but I have declined, in the back of my mind I keep thinking

> it will be there for the day I REALLY need it. I don't believe docs

> prescibe these drugs to shut the patients up, and still believe that

> the docs oath of " Do no harm " in most cases holds true, although I am

> not so naive to think they are all Gods. Once again I truly

> appreciate your input, and I guess we will have to keep on praying

> that someday it will change. Kathi in OK.....PS Is taking a much

> deserved break?

>

>

>

>

>

>

>

> -- In , a <paula54@t...> wrote:

>> > Kathi,

>> > We can¹t give up hope that one day this issue will be resolved.

> Hopefully

>> > they will find a way to block the euphoria that drug users get when

> they

>> > circumvent the time release action. So many people have had

> wonderful pain

>> > relief and if my doctor would let me try it, I¹d do it in a

> heartbeat. I

>> > miss so much life because of pain and can¹t stop wondering what my

> life

>> > would be like if I found something to help.

>> > The stigma of being an abuser isn¹t fair. I¹m so happy that you

> and others

>> > have been helped so much. I know the decision wasn¹t made

> lightly. I know

>> > you researched well before taking it and realize that the benefits

> far

>> > outweigh the risks. I too have a fear of the steroids and feel

> they are

>> > much more dangerous that pain meds. I have a fear of ALL drugs,

> but what

>> > choice do I have. As those that know me know, I¹ve tried

> alternatives for

>> > many years, and suffered a lot of joint damage during those years.

>> > You have nothing to apologize for. This group is here to discuss

> what works

>> > for us and that is all that you were doing.

>> > You have to stay as pain free as you can so that you can prepare

> for the

>> > happiest event, your first grandchild.

>> > It is such a blessing to know that you will be able to enjoy this

> child so

>> > much more since your life has been improved with pain meds.

>> > a

>> >

>> >

>>> > > : First may I say thank you for your posts on narcotics, I

> only

>>> > > wish the stigma and misunderstanding would some how self resolve.

>>> > > Then I would like to say I am sorry, I was'nt trying to imply

> anyone

>>> > > should take anything only citing experience. I don't take any med

>>> > > before I have researched it throughly. Having scleroderma they are

>>> > > always trying to give me something, I think they feel they must DO

>>> > > something, and as there are no proven therapies they feel

> helpless.

>>> > > Judi is in the same kinda of situation, I believe. But, if

> something

>>> > > works, and for me oxy does, I have a half a life back, I will

>>> > > continue to take it. It took alot of convincing for me to try it,

> and

>>> > > then I was so embarrassed because I could have felt so much

> better if

>>> > > I had tried it to start off with. In IMHO there are alot more

> scary

>>> > > drugs, and steroids would be my NO.1 choice to NOT take, along

> with

>>> > > several others. I have gone off and on my oxy without any

> withdrawal

>>> > > problems, and I have been to a few pain clinics, their drug of

>>> > > choice was methadone, which ....I....could'nt tolerate. We each

> react

>>> > > to drugs differently, so I would never knock anything that works

> for

>>> > > some one else. It seems the stigma will never go away, and the

>>> > > narcotics will always have a bad rap, it is to bad these articles

>>> > > don't compare them with other choices. And of course the bottom

>>> > > line ...all drugs are bad for you, you are putting a chemical in

> your

>>> > > body that was never suppose to be there, of course the wonderful

>>> > > diseases were'nt suppose to either.....thank you for trying to

> keep

>>> > > us all educated......hugs Kathi in OK

>>> > >

>>> > >

>>> > >

>>> > >

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Say, a and Kathi, I last posted at 8:02 AM - you guys are slave

drivers, LOL!

On a more serious note, a, that is VERY disappointing news about

your rheumatologist. Is there a good pain management clinic nearby?

Seems as though many physicians have their ideas and policies about

opioids, but most of them don't focus on or serve the needs of the

patient.

A couple of months ago, I saw a new endodontist during another tooth

emergency. After money and insurance discussions, he and his staff were

careful to point out that ibuprofen is a wonderful analgesic and that

they rarely prescribe anything else. I told them it was OK because my

dentist would give me narcotics if I needed them (which is true), LOL!

Caught them off guard. They didn't expect me to say that. Why dance

around it, though? Just tell me straight out: " We don't prescribe

opioids. "

You know, ibuprofen is a very good drug, and I use it frequently for

various things, but there are times that it is not the drug of choice.

I really would like to know what your physician envisioned, a - that

you would be breaking into the nearest Walgreen's very soon after

getting your Vicodin back? Does he have an inkling of how you suffer? Or

does he try not to think about that?

Also, with the sort of pain you have, he really should be offering you a

sustained-release formulation so that you can be comfortable all of the

time.

And, since we haven't had enough controversy around here lately, I'll

say that I believe that large numbers of physicians who treat

rheumatology patients often DO harm them by neglecting to aggressively

treat their pain. Isn't allowing a patient to suffer harmful to the

patient? Isn't withholding medication that can safely alleviate

suffering harmful?

Why do the same rheumatologists who freely, and often carelessly,

dispense prednisone, antidepressants, and benzodiazepines single out

opioids as the class of drugs that can cause " addiction " ? Why can't they

even learn the terminology? Why can't they distinguish between

recreational abuse and physical dependence? Why can't they have a heart?

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

Fwd: Re: [ ] Re: a......Thank You

I¹ve never pushed the issue with pain control. I let my new doctor

know

that ultram wasn¹t doing anything for me and that vicodan worked much

better. Right away he started talking addiction, so I knew I had a

narcophobic doctor. I told him that I read numerous studies that say

narcotics taken for pain rarely cause addiction, but may cause

dependence.

His answer was darvocet. Darvocet is about as useless as ultram. It

is

very depressing. Not knowing doctors in this new town, I don¹t want

to be

labeled as a narcotic seeker. I wonder if they ever took statistics

of

people that bought them illegally. My mailbox is full of offers to

buy

painkillers on the internet, but my doctors won¹t give them to me.

I am so happy for you and others that have compassionate doctors that

treat

pain. I would also take the least amount that I could. I too

believe that

the majority of doctors believe in their oath. I¹m sure they feel

they are

doing the right thing by keeping me off of narcotics, however I truly

believe that my muscle pain and fibromyalgia are a result of

untreated pain.

Over the years I¹ve found that I am more and more sensitive to

touch. The

pain I had used to be confined to the standard FM pressure points,

but now

it is all over. Pain causes me to tense my muscles. He did prescribe

flexeril, but that is to sleep. He thinks if I get a better night¹s

sleep I

will have less pain. I sleep much better than I used to, although

not as

good as I¹d like, but I see no improvement in muscle pain.

We will see things change in the future. I know much work is being

done in

pain research.

I hope is taking a much needed break. She surely deserves it.

But

knowing , she is off reading something for us LOL!

a

> a: Thank you for your words. I also wish there was something to

> control your pain, and I know you have researched and tried many

> natural remedies. It makes me so unhappy that so many people suffer

> because a few addictive personalities ruined pain control for

people

> that truly have a need. I am very lucky to have the docs I do, in my

> case 3 of them got together and decided I would get oxy with

percocet

> for break thru pain. Many times they have tried to convince me to up

> the dose, but I have declined, in the back of my mind I keep

thinking

> it will be there for the day I REALLY need it. I don't believe docs

> prescibe these drugs to shut the patients up, and still believe that

> the docs oath of " Do no harm " in most cases holds true, although I

am

> not so naive to think they are all Gods. Once again I truly

> appreciate your input, and I guess we will have to keep on praying

> that someday it will change. Kathi in OK.....PS Is taking a

much

> deserved break?

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Well gee wiz , you took 14 hours off! The NERVE of you LOL!

We¹re not slave drivers, you¹re just missed :)

I¹m sure there are pain clinics here but I¹m not at that point yet

because then I¹m afraid that they will think I am seeking narcotics. Being

in a new state with new doctors, it could be conceived that way. My

activities are more limited than maybe they would be if I had pain meds that

work.

I¹ve heard of many people getting pain meds from their GP when their rheumy

wouldn¹t prescribe them, so maybe that is an option. If nothing else, maybe

my GP can refer me to a pain doctor.

I often wonder what these doctors think or don¹t think. It¹s easy enough to

get my medical records and see if narcotics are being abused. As many

surgeries as I¹ve had, it should be clear that I¹m not like the people that

get addicted after being on pain meds. I don¹t like taking pain meds but I

don¹t like it when pain stops me from activities that I might be able to do

if my pain was treated. I just wish I had the nerve to go get ankle

replacements and then maybe I wouldn¹t need stronger meds.

What gets my goat the most is the fact that the pain we suffer from isn¹t

temporary pain that will go away. It is permanent. So who gives a rats ass

if I become addicted? Fix me or at least use what is available to

Alleviate the pain!!

a

> Say, a and Kathi, I last posted at 8:02 AM - you guys are slave

> drivers, LOL!

>

> On a more serious note, a, that is VERY disappointing news about

> your rheumatologist. Is there a good pain management clinic nearby?

>

> Seems as though many physicians have their ideas and policies about

> opioids, but most of them don't focus on or serve the needs of the

> patient.

>

> A couple of months ago, I saw a new endodontist during another tooth

> emergency. After money and insurance discussions, he and his staff were

> careful to point out that ibuprofen is a wonderful analgesic and that

> they rarely prescribe anything else. I told them it was OK because my

> dentist would give me narcotics if I needed them (which is true), LOL!

> Caught them off guard. They didn't expect me to say that. Why dance

> around it, though? Just tell me straight out: " We don't prescribe

> opioids. "

>

> You know, ibuprofen is a very good drug, and I use it frequently for

> various things, but there are times that it is not the drug of choice.

>

> I really would like to know what your physician envisioned, a - that

> you would be breaking into the nearest Walgreen's very soon after

> getting your Vicodin back? Does he have an inkling of how you suffer? Or

> does he try not to think about that?

>

> Also, with the sort of pain you have, he really should be offering you a

> sustained-release formulation so that you can be comfortable all of the

> time.

>

> And, since we haven't had enough controversy around here lately, I'll

> say that I believe that large numbers of physicians who treat

> rheumatology patients often DO harm them by neglecting to aggressively

> treat their pain. Isn't allowing a patient to suffer harmful to the

> patient? Isn't withholding medication that can safely alleviate

> suffering harmful?

>

> Why do the same rheumatologists who freely, and often carelessly,

> dispense prednisone, antidepressants, and benzodiazepines single out

> opioids as the class of drugs that can cause " addiction " ? Why can't they

> even learn the terminology? Why can't they distinguish between

> recreational abuse and physical dependence? Why can't they have a heart?

>

>

>

>

> I'll tell you where to go!

>

> Mayo Clinic in Rochester

> http://www.mayoclinic.org/rochester

>

> s Hopkins Medicine

> http://www.hopkinsmedicine.org

>

>

> Fwd: Re: [ ] Re: a......Thank You

>

>

>

> I¹ve never pushed the issue with pain control. I let my new doctor

> know

> that ultram wasn¹t doing anything for me and that vicodan worked much

> better. Right away he started talking addiction, so I knew I had a

> narcophobic doctor. I told him that I read numerous studies that say

> narcotics taken for pain rarely cause addiction, but may cause

> dependence.

> His answer was darvocet. Darvocet is about as useless as ultram. It

> is

> very depressing. Not knowing doctors in this new town, I don¹t want

> to be

> labeled as a narcotic seeker. I wonder if they ever took statistics

> of

> people that bought them illegally. My mailbox is full of offers to

> buy

> painkillers on the internet, but my doctors won¹t give them to me.

>

> I am so happy for you and others that have compassionate doctors that

> treat

> pain. I would also take the least amount that I could. I too

> believe that

> the majority of doctors believe in their oath. I¹m sure they feel

> they are

> doing the right thing by keeping me off of narcotics, however I truly

> believe that my muscle pain and fibromyalgia are a result of

> untreated pain.

> Over the years I¹ve found that I am more and more sensitive to

> touch. The

> pain I had used to be confined to the standard FM pressure points,

> but now

> it is all over. Pain causes me to tense my muscles. He did prescribe

> flexeril, but that is to sleep. He thinks if I get a better night¹s

> sleep I

> will have less pain. I sleep much better than I used to, although

> not as

> good as I¹d like, but I see no improvement in muscle pain.

>

> We will see things change in the future. I know much work is being

> done in

> pain research.

> I hope is taking a much needed break. She surely deserves it.

> But

> knowing , she is off reading something for us LOL!

> a

>

>

>> > a: Thank you for your words. I also wish there was something to

>> > control your pain, and I know you have researched and tried many

>> > natural remedies. It makes me so unhappy that so many people suffer

>> > because a few addictive personalities ruined pain control for

> people

>> > that truly have a need. I am very lucky to have the docs I do, in my

>> > case 3 of them got together and decided I would get oxy with

> percocet

>> > for break thru pain. Many times they have tried to convince me to up

>> > the dose, but I have declined, in the back of my mind I keep

> thinking

>> > it will be there for the day I REALLY need it. I don't believe docs

>> > prescibe these drugs to shut the patients up, and still believe that

>> > the docs oath of " Do no harm " in most cases holds true, although I

> am

>> > not so naive to think they are all Gods. Once again I truly

>> > appreciate your input, and I guess we will have to keep on praying

>> > that someday it will change. Kathi in OK.....PS Is taking a

> much

>> > deserved break?

>

>

>

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Guest guest

a, I know exactly what you're saying, but I DO give a rat's ass

whether you become addicted, LOL.

That's what mystifies me about this whole thing: If you are in pain 24/7

due to a chronic condition, why don't doctors worry about that pain that

has about a 100% probability of

being a significant problem if left untreated or undertreated? Instead,

they are very concerned about the small chance that you will become

addicted to a medication that has a very good chance of relieving your

pain and greatly improving your quality of life.

This is an excerpt from a fascinating lecture on pain management issues

for people who are true addicts:

" . . . So there is some evidence that when patients are in pain, they

seem to be somewhat protected from the addiction kind of responses that

we see occurring when opioids are given.

In other words, pain may actually protect patients from becoming

addicted to opioids. Here we have a set of 22 chronic pain patients at

a pain clinic. They have been on chronic opioid therapy for over a

year, they have had pain for over 11 years, and most of them are on a

controlled released morphine sulfate of 60 mg with large standard

deviation and they had a variety of nociceptive and neuropathic type of

chronic non-malignant pain. Fifteen of them spontaneously withdrew from

their opioids for over 24 hours for different reasons. They just

spontaneously stopped taking their opioids. Other patients only the

mildest withdrawal could be elicited in minority of patients (4) of whom

3 permanently withdrew. So these patients, who were on chronic opioids

for over a year, when they spontaneously stopped taking their pain meds,

only the mildest withdrawal could be elicited. Their pain did increase

but we didn't see a lot of withdrawal from these patients. This tells

us that maybe being in pain with opioids, that somehow you are protected

from some of the tolerance and physical dependence that occurs. There

must be something about taking opioids in the presence of pain that

protects you from some of these phenomena.

There is a part of the brain where physical dependence occurs, again,

that pathway where the rewards occurs and then the pathway that

underlies the behavioral parts of addiction.

We believe in the presence of pain, we don't see physical dependence

does not occur to the same degree; we know that reward does not occur at

the same degree; we still don't know if pain blocks out the aberrant

behavior part of the pathway but it does appear in the presence of pain,

we don't see some of the addictive phenomena occurring to the same

degree. Physical dependence doesn't occur to the same degree, the

reward doesn't occur to the same degree and it could be that the

behavioral pathway is knocked out as well. The presence of pain may

actually protect the brain from developing addictive phenomena. "

HPNA APN MONTHLY WEB-TELECONFERENCE

December 17, 2003

" PAIN MANAGEMENT AND THE ADDICTED PATIENT "

PRESENTED BY: PEGGY COMPTON, RN, PhD

http://www.hpna.org/WebConf_APN_Dec03.asp

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

Re: [ ] Re: a......Thank You

Well gee wiz , you took 14 hours off! The NERVE of you LOL!

We¹re not slave drivers, you¹re just missed :)

I¹m sure there are pain clinics here but I¹m not at that point yet

because then I¹m afraid that they will think I am seeking narcotics.

Being

in a new state with new doctors, it could be conceived that way. My

activities are more limited than maybe they would be if I had pain meds

that

work.

I¹ve heard of many people getting pain meds from their GP when their

rheumy

wouldn¹t prescribe them, so maybe that is an option. If nothing else,

maybe

my GP can refer me to a pain doctor.

I often wonder what these doctors think or don¹t think. It¹s easy

enough to

get my medical records and see if narcotics are being abused. As many

surgeries as I¹ve had, it should be clear that I¹m not like the people

that

get addicted after being on pain meds. I don¹t like taking pain meds

but I

don¹t like it when pain stops me from activities that I might be able to

do

if my pain was treated. I just wish I had the nerve to go get ankle

replacements and then maybe I wouldn¹t need stronger meds.

What gets my goat the most is the fact that the pain we suffer from

isn¹t

temporary pain that will go away. It is permanent. So who gives a rats

ass

if I become addicted? Fix me or at least use what is available to

Alleviate the pain!!

a

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