OT: Tough Times to be a Dr.

[FlourBluffHorn]

Yesterday my Dr kicked 23 older patients to the curb cause of the crackdown, somethings gonna happen when Cancer patients can't get pain meds, I had 8 surgiers from this guy over 6 yrs on legs and feet and he just kicks ya, he made his money offa me , so why not, Pain management is a scam, its the new word for Drug Abuse, they wanna give ya 4 diff pills when one would do the trick, I think about all them Final 4 ans Super Bowl tickets, cash, vacations ..etc them DR got from Pharma to write them scripts, makes ya wanna puke, they created this shit by their ignorance, if a Dr can't tell who needs it then he should not have beena Dr, I just went to the street and bought mine from a Guy I know who is good at his stuff, I am not gonna suffer for some shit head Dr to keep his DEA licensee, most of Dr choose the money route when they grad from med school instead of the saving life routes, some of them don't even take the Oath anymore, they are not gonna get me , I will smoke dope or whatever to cope, so this is a Big FU to all the Dr I have know before

 

[mm42]

I do blame doctors for so many people getting hooked on opioids, but continuing to do something wrong doesn't make it right.

I had two people in my life that were very good people, good employees, and good moms who have totally ruined their lives/families due to opioid abuse. Both were having issues with their backs originally.

One was a co-worker who could no longer form a complete thought or sentence. God forbid she sent a customer an email. She went from a great employee to someone who got fired because customers couldn't follow what the hell she was talking about. She is now unemployed, divorced, and moved on to heroin.

The other was my cousin who was a school teacher. She is now a divorced aid at a nursing home. And as far as I know still hooked on opioids. Her daughter just married, and she wasn't invited to the wedding. This shit is straight up poison.

If 70+ year old people or those with short life expectancy are taking opiods, and don't want to get off. I'm fine with it. But in general, doctors should stop writing scripts for opioids of more than day or 2.

I don't know FBH's situation, so I don't have an opinion on his deal, but in general stopping opioid use is a good thing imo.

 

[FlourBluffHorn]

I do blame doctors for so many people getting hooked on opioids, but continuing to do something wrong doesn't make it right.

I had two people in my life that were very good people, good employees, and good moms who have totally ruined their lives/families due to opioid abuse. Both were having issues with their backs originally.

One was a co-worker who could no longer form a complete thought or sentence. God forbid she sent a customer an email. She went from a great employee to someone who got fired because customers couldn't follow what the hell she was talking about. She is now unemployed, divorced, and moved on to heroin.

The other was my cousin who was a school teacher. She is now a divorced aid at a nursing home. And as far as I know still hooked on opioids. Her daughter just married, and she wasn't invited to the wedding. This shit is straight up poison.

If 70+ year old people or those with short life expectancy are taking opiods, and don't want to get off. I'm fine with it. But in general, doctors should stop writing scripts for opioids of more than day or 2.

I don't know FBH's situation, so I don't have an opinion on his deal, but in general stopping opioid use is a good thing imo.

You sound fair to me, I have stories about Vets and old people including myself that do need them as there is no fix for them anymore and Dr don't like to see old people anymore or chronic pain, , so its a waste of their time, like one Pain Management Dr said he makes more off the trick shots to the back...etc and the Pain implant so why would he want to mess with a 30 dollar Script,this stuff been going on for yrs and then the Pharmas get caught and the Dr and now all of a sudden its a epidemic, they better think about stopping the cartels and the fentnly and heroin and cocaine before they start something else, in reality all they are doing is making the Street Market Bigger and bigger by doing this stuff and they can't stop that or the Black web, according to DEA they can write any script they want as long as they follow the rules, some choose not to to, what good is a Dr that can't help you in all facets of medicine, Pain Management is a Dr way outa having to write the scripts, somethings gonna blow soon as people won't stand for it much longer, probably be a lotta br4oke ass Dr running around soon cause they lost patients, why would ya be scared of DEA ? Have you done something wrong or your doing something wrong all I can think of///


But, to jeopardize a human life for a Fing DEA license , that''s not being a Dr, but, it will catch up to them sooner or later,,Karma!

 

[Bwilk55]

You sound fair to me, I have stories about Vets and old people including myself that do need them as there is no fix for them anymore and Dr don't like to see old people anymore or chronic pain, , so its a waste of their time, like one Pain Management Dr said he makes more off the trick shots to the back...etc and the Pain implant so why would he want to mess with a 30 dollar Script,this stuff been going on for yrs and then the Pharmas get caught and the Dr and now all of a sudden its a epidemic, they better think about stopping the cartels and the fentnly and heroin and cocaine before they start something else, in reality all they are doing is making the Street Market Bigger and bigger by doing this stuff and they can't stop that or the Black web, according to DEA they can write any script they want as long as they follow the rules, some choose not to to, what good is a Dr that can't help you in all facets of medicine, Pain Management is a Dr way outa having to write the scripts, somethings gonna blow soon as people won't stand for it much longer, probably be a lotta br4oke ass Dr running around soon cause they lost patients, why would ya be scared of DEA ? Have you done something wrong or your doing something wrong all I can think of///


But, to jeopardize a human life for a Fing DEA license , that''s not being a Dr, but, it will catch up to them sooner or later,,Karma!

I have patients who come to me on opioids for chronic pain issues. I'll keep them going but always with a plan to wean off of them. A. They don't work B. They are dangerous. There are a whole hosts of alternative treatments that can help but unfortunately for some issues, there is no way to completely fix the problem.

What I won't do is start a new patient on opioids for chronic pain control. Maybe several days for an acute issue but not more than that.

And don't worry FBH, no one is treating doctors to sports tickets or nice trips anymore. That has been shut down pretty much - which is definitely a good thing. A lot of places won't even let drug reps bring in lunches anymore.

I'm sorry you have had such a negative experience with the healthcare industry. For a lot of patients, they got started on pain meds during the era where everyone was pressuring doctors and judging them based on treating pain. Now doctors are being pressured to avoid opiates and are being blamed for the current epidemic. Patients that got started on them back then, are now having to deal with the change in dogma.

 

[ASURAM2010]

I have patients who come to me on opioids for chronic pain issues. I'll keep them going but always with a plan to wean off of them. A. They don't work B. They are dangerous. There are a whole hosts of alternative treatments that can help but unfortunately for some issues, there is no way to completely fix the problem.

What I won't do is start a new patient on opioids for chronic pain control. Maybe several days for an acute issue but not more than that.

And don't worry FBH, no one is treating doctors to sports tickets or nice trips anymore. That has been shut down pretty much - which is definitely a good thing. A lot of places won't even let drug reps bring in lunches anymore.

I'm sorry you have had such a negative experience with the healthcare industry. For a lot of patients, they got started on pain meds during the era where everyone was pressuring doctors and judging them based on treating pain. Now doctors are being pressured to avoid opiates and are being blamed for the current epidemic. Patients that got started on them back then, are now having to deal with the change in dogma.

@Bwilk55 how are you involved in the healthcare industry? Love getting to pick the brains of people who are in the field. Currently working on my MBA with a specialization in Healthcare Administration.

 

[FlourBluffHorn]

I have patients who come to me on opioids for chronic pain issues. I'll keep them going but always with a plan to wean off of them. A. They don't work B. They are dangerous. There are a whole hosts of alternative treatments that can help but unfortunately for some issues, there is no way to completely fix the problem.

What I won't do is start a new patient on opioids for chronic pain control. Maybe several days for an acute issue but not more than that.

And don't worry FBH, no one is treating doctors to sports tickets or nice trips anymore. That has been shut down pretty much - which is definitely a good thing. A lot of places won't even let drug reps bring in lunches anymore.

I'm sorry you have had such a negative experience with the healthcare industry. For a lot of patients, they got started on pain meds during the era where everyone was pressuring doctors and judging them based on treating pain. Now doctors are being pressured to avoid opiates and are being blamed for the current epidemic. Patients that got started on them back then, are now having to deal with the change in dogma.

I appreciate what you do, there is so few of you that do try and work with a patient, but, you have to admit after 70 there is not much there, I like your idea of just trying to wean them off, however some of us older folks , it would gbe very unlikely to do so, I know my body is beat all the hell, I was a young man when it started in the A Shau and it seems like the days got longer as I got older and the body was getting old too from hard work, despite being shot in the legs, I have over come that part, but the diabetes and all that goes with it is a fight in itself, I guess the reason I use opioids cause I need to keep myself going to work on more demanding health problems at hand, I am allegic to most apain pills startin with Morphine and Oxy, I wouldn't give ya a nickel for a truckload of fentmyl or Oxy, can't take them so I am stuck at Narco or Tyn4 and thats it, Pain dr tried to give me Kinneman, can't spell too good on thaT ONE, LOTTA PEOPLE DON'T KNOW THAT PUTS YOUR ASS IN A KEYHOLE, WELL, ITS 2 DADDYS THAT MADE THAT DRUG , ONE WAS TIM LEARY THAT GAVE US LSD, THE STORY IS THAT Tim WENT On to SAN FRAN WITH HIS PART AND HIS PARTNER MADE MEDS OUTA HIS AND PATENTED IT AT . 26 CENTS A DOSE AND NOW insurance RUN IT UP TO HUNDREDS, BUT, i HAVE NO BIZZNESS RUNNING PURPLE SIDEWALKS WITH GREEN FROGS ON IT AT MY AGE..lol ...my buttons stuck sorry there...LOL Keep on doing the good work Bwilks!

 

[FlourBluffHorn]

@Bwilk55 how are you involved in the healthcare industry? Love getting to pick the brains of people who are in the field. Currently working on my MBA with a specialization in Healthcare Administration.

Oh shit Bwilks a whiz kid from the back of the room....LOL

 

[clob94]

I have patients who come to me on opioids for chronic pain issues. I'll keep them going but always with a plan to wean off of them. A. They don't work B. They are dangerous. There are a whole hosts of alternative treatments that can help but unfortunately for some issues, there is no way to completely fix the problem.

What I won't do is start a new patient on opioids for chronic pain control. Maybe several days for an acute issue but not more than that.

And don't worry FBH, no one is treating doctors to sports tickets or nice trips anymore. That has been shut down pretty much - which is definitely a good thing. A lot of places won't even let drug reps bring in lunches anymore.

I'm sorry you have had such a negative experience with the healthcare industry. For a lot of patients, they got started on pain meds during the era where everyone was pressuring doctors and judging them based on treating pain. Now doctors are being pressured to avoid opiates and are being blamed for the current epidemic. Patients that got started on them back then, are now having to deal with the change in dogma.

Bwilk let me ask you this-- as a medical professional and a former pain pill user (some would call abuser) we had access to pretty much whatever we wanted to mitigate pain in college. You could go to the team doctor, complain about your knees that he knew were ****ed up, and he'd give you vicoden. I am hesitant to talk about the "other" pain meds that were used on us but I can tell you that they were usually used while treating guys for dehydration after they ran a line on you to pump some saline into you. But make no mistake, I took pain pills all through college and even after and even to this day when I do need to use them, I don't think they have the same effect that they had on me in college. I think I developed some sort of weird immunity. Is that possible? Is it possible to have developed some sort of long term tolerance to pain meds? Even if you go year's between using them?

 

[LonghornMM]

I've seen first hand what abusing opioids can do. It played a large part in my divorce about nine years ago. My ex, who at one time was a looker, got hooked on hydrocodone. She also started taking muscle relaxers and Valium along with the hydrocodone all at the same time. It is sad what abusing drugs did to her. She's 48 years old and she looks like she's about 60. She has a very strained relationship with my son and daughter and has been arrested four times. I damn near let her ruin my life with me hanging on, thinking that I could "save her" and our relationship.

It's sad to see what used to be a great person the way that she is now. She can't/won't work. Has no money. No drive. Is lazy, unorganized, undependable, and has no accountability. At her worst, I think that she was taking about 7-10 hydrocodone pills a day, along with the muscle relaxers and Valium, which has been labeled the "trio". Many times, she was incoherent. She stole pills from friends, family and did several other things just to acquire her next fix. Best thing I ever did was finally eliminating her from my life. It wasn't easy, but it was destroying me as a person continuing to hang on to her.

 

[FlourBluffHorn]

I've seen first hand what abusing opioids can do. It played a large part in my divorce about nine years ago. My ex, who at one time was a looker, got hooked on hydrocodone. She also started taking muscle relaxers and Valium along with the hydrocodone all at the same time. It is sad what abusing drugs did to her. She's 48 years old and she looks like she's about 60. She has a very strained relationship with my son and daughter and has been arrested four times. I damn near let her ruin my life with me hanging on, thinking that I could "save her" and our relationship.

It's sad to see what used to be a great person the way that she is now. She can't/won't work. Has no money. No drive. Is lazy, unorganized, undependable, and has no accountability. At her worst, I think that she was taking about 7-10 hydrocodone pills a day, along with the muscle relaxers and Valium, which has been labeled the "trio". Many times, she was incoherent. She stole pills from friends, family and did several other things just to acquire her next fix. Best thing I ever did was finally eliminating her from my life. It wasn't easy, but if was destroying me as a person continuing to hang on to her.

TY for sharing! It does have a double edge sword when taking pills, some can't handle the sword and don't know when enough is enough, I switch off pain pills every 3 or 4 months as you build up a resistance I think, some people just pop the shit outa them and it becomes what you just got rid of, the secret is to manage it with your Dr , but, unfortunately some people don't understand that phase, I' glad you got outa of a bad situation, its heart breakin I know...but, as you know things change everyday as people too, seems like you really lost touch with her a long time ago anyway due to the drug and was hanging on, sometimes some decisions are the hardest thing you will ever do in your life, but they have to be made.

 

[Oldmanastro]

I've seen first hand what abusing opioids can do. It played a large part in my divorce about nine years ago. My ex, who at one time was a looker, got hooked on hydrocodone. She also started taking muscle relaxers and Valium along with the hydrocodone all at the same time. It is sad what abusing drugs did to her. She's 48 years old and she looks like she's about 60. She has a very strained relationship with my son and daughter and has been arrested four times. I damn near let her ruin my life with me hanging on, thinking that I could "save her" and our relationship.

It's sad to see what used to be a great person the way that she is now. She can't/won't work. Has no money. No drive. Is lazy, unorganized, undependable, and has no accountability. At her worst, I think that she was taking about 7-10 hydrocodone pills a day, along with the muscle relaxers and Valium, which has been labeled the "trio". Many times, she was incoherent. She stole pills from friends, family and did several other things just to acquire her next fix. Best thing I ever did was finally eliminating her from my life. It wasn't easy, but it was destroying me as a person continuing to hang on to her.

I “liked “ your quote only from the standpoint of you making some hard choices. Glad you did and everything, seemingly, much better now.

 

[FlourBluffHorn]

Bwilk let me ask you this-- as a medical professional and a former pain pill user (some would call abuser) we had access to pretty much whatever we wanted to mitigate pain in college. You could go to the team doctor, complain about your knees that he knew were ****ed up, and he'd give you vicoden. I am hesitant to talk about the "other" pain meds that were used on us but I can tell you that they were usually used while treating guys for dehydration after they ran a line on you to pump some saline into you. But make no mistake, I took pain pills all through college and even after and even to this day when I do need to use them, I don't think they have the same effect that they had on me in college. I think I developed some sort of weird immunity. Is that possible? Is it possible to have developed some sort of long term tolerance to pain meds? Even if you go year's between using them?

Your body changes as you get older, when I was younger I could take morphine for pain at Hospital, now that I am old I can't take it, its a body thing clob, if ya been using a drug for a while it stops working on ya, thats why you gotta change meds every so often...the human body is a mystery what my Dr tells me...lol

 

[Bwilk55]

@Bwilk55 how are you involved in the healthcare industry? Love getting to pick the brains of people who are in the field. Currently working on my MBA with a specialization in Healthcare Administration.

ASU, I'm an Internest. Recently finished my residency and certainly don't claim to be an expert but we definitely encounter certain topics frequently, including this one.

 

[Bwilk55]

Bwilk let me ask you this-- as a medical professional and a former pain pill user (some would call abuser) we had access to pretty much whatever we wanted to mitigate pain in college. You could go to the team doctor, complain about your knees that he knew were ****ed up, and he'd give you vicoden. I am hesitant to talk about the "other" pain meds that were used on us but I can tell you that they were usually used while treating guys for dehydration after they ran a line on you to pump some saline into you. But make no mistake, I took pain pills all through college and even after and even to this day when I do need to use them, I don't think they have the same effect that they had on me in college. I think I developed some sort of weird immunity. Is that possible? Is it possible to have developed some sort of long term tolerance to pain meds? Even if you go year's between using them?

Seems odd Clob. Tolerance to opioids should be transient, your bodies receptors for the drugs get down regulated so you need more and more of them for the same response. If you stop using them for a while, the receptors should increase back to normal and a future dose should have a similar effect as the first dose.

If you are quite a bit larger, the same dose may have less effect. Though, often as people age these types of meds can have a stronger effect. Not sure you are in that age range quite yet though.

 

[Bwilk55]

I appreciate what you do, there is so few of you that do try and work with a patient, but, you have to admit after 70 there is not much there, I like your idea of just trying to wean them off, however some of us older folks , it would gbe very unlikely to do so, I know my body is beat all the hell, I was a young man when it started in the A Shau and it seems like the days got longer as I got older and the body was getting old too from hard work, despite being shot in the legs, I have over come that part, but the diabetes and all that goes with it is a fight in itself, I guess the reason I use opioids cause I need to keep myself going to work on more demanding health problems at hand, I am allegic to most apain pills startin with Morphine and Oxy, I wouldn't give ya a nickel for a truckload of fentmyl or Oxy, can't take them so I am stuck at Narco or Tyn4 and thats it, Pain dr tried to give me Kinneman, can't spell too good on thaT ONE, LOTTA PEOPLE DON'T KNOW THAT PUTS YOUR ASS IN A KEYHOLE, WELL, ITS 2 DADDYS THAT MADE THAT DRUG , ONE WAS TIM LEARY THAT GAVE US LSD, THE STORY IS THAT Tim WENT On to SAN FRAN WITH HIS PART AND HIS PARTNER MADE MEDS OUTA HIS AND PATENTED IT AT . 26 CENTS A DOSE AND NOW insurance RUN IT UP TO HUNDREDS, BUT, i HAVE NO BIZZNESS RUNNING PURPLE SIDEWALKS WITH GREEN FROGS ON IT AT MY AGE..lol ...my buttons stuck sorry there...LOL Keep on doing the good work Bwilks!

FBH, if I had someone like you roll into my clinic, I'm thinking my instinct would be to keep you on what you have been using so far. See what other things we could try to maybe get you off the pain meds, and if you try them and nothing else seems to work, well, we probably just let you continue on with a limited volume of limited potency meds.

 

[Bwilk55]

I've seen first hand what abusing opioids can do. It played a large part in my divorce about nine years ago. My ex, who at one time was a looker, got hooked on hydrocodone. She also started taking muscle relaxers and Valium along with the hydrocodone all at the same time. It is sad what abusing drugs did to her. She's 48 years old and she looks like she's about 60. She has a very strained relationship with my son and daughter and has been arrested four times. I damn near let her ruin my life with me hanging on, thinking that I could "save her" and our relationship.

It's sad to see what used to be a great person the way that she is now. She can't/won't work. Has no money. No drive. Is lazy, unorganized, undependable, and has no accountability. At her worst, I think that she was taking about 7-10 hydrocodone pills a day, along with the muscle relaxers and Valium, which has been labeled the "trio". Many times, she was incoherent. She stole pills from friends, family and did several other things just to acquire her next fix. Best thing I ever did was finally eliminating her from my life. It wasn't easy, but it was destroying me as a person continuing to hang on to her.

MM, thanks for sharing.

I'm pretty certain my stepdad got addicted to opioids and thats what led him and my mom to split up. Unfortunately the man was a Vietnam Vet (Marines), purple heart recipient, who continued to serve after the war, was the lone survivor of a helicopter crash, and went on to lead a life that was pretty stressful on his body. He had all kinds of reason for all kinds of pain.

He had major back issues, had surgery, and was on a pretty steady dose of pain killers. At a certain point I'm pretty sure he would get them from where ever he could. Can't prove it but I think he even stole my fiancees wedding ring out of my dresser.

He was often out of it at home and just weird. It really changed him. We were pretty close but all this happened when I was in college and coming back I just didn't even feel comfortable around him. It was hard but the right choice for my mom to split up, he was destroying her as well.

 

[clob94]

Seems odd Clob. Tolerance to opioids should be transient, your bodies receptors for the drugs get down regulated so you need more and more of them for the same response. If you stop using them for a while, the receptors should increase back to normal and a future dose should have a similar effect as the first dose.

If you are quite a bit larger, the same dose may have less effect. Though, often as people age these types of meds can have a stronger effect. Not sure you are in that age range quite yet though.

No man. I weigh thirty pounds less than I did back then. What I can tell you is every time I took vicoden in the past, the first sign I could see that it was working was my tongue started to feel like it was made of velvet. I would catch myself in class linking my lips over and over again I guess because it felt good to my subconscious. I'm not a lip licker otherwise. Then I would feel a little jelly necked. Then I knew the juice had kicked in and I could zone out on my pain and focus on class. Let me ask you this-- first time I had surgery in college, when the anesthesiologist showed up to KO me, they gave me the dose and told me to count to 10. I did so and he was like "ooooooooo k". So they gave me more (I suppose). There was an awkward silence and shuffling of charts and back in went the needle. Eventually I woke up and I asked the attending physician who had ****ed up the blood work or the anesthesia. The doctor told me that I had an unusually high blood volume. He used the word "juicy" with a chuckle. Is it possible that if what he said was true and I do have a little more blood in my body than normal (we all know cyclist will infuse themselves with blood before races to have a higher oxygen intake) would that have an effect on how my body processes pain killers? Like "I need more because I've got more blood?"

 

[clob94]

@Bwilk55 how are you involved in the healthcare industry? Love getting to pick the brains of people who are in the field. Currently working on my MBA with a specialization in Healthcare Administration.

I can hook you up with a UVA undergrad, a SLU MBA and law student simultaneously who focused on heath care law then got her PhD in health care systems at UT. She's in Cali now running a system. She's hot as balls but if you lay a hand on her I'd be forced to geld you like a horse.

 

[TX1972]

I have patients who come to me on opioids for chronic pain issues. I'll keep them going but always with a plan to wean off of them. A. They don't work B. They are dangerous. There are a whole hosts of alternative treatments that can help but unfortunately for some issues, there is no way to completely fix the problem.

What I won't do is start a new patient on opioids for chronic pain control. Maybe several days for an acute issue but not more than that.

And don't worry FBH, no one is treating doctors to sports tickets or nice trips anymore. That has been shut down pretty much - which is definitely a good thing. A lot of places won't even let drug reps bring in lunches anymore.

I'm sorry you have had such a negative experience with the healthcare industry. For a lot of patients, they got started on pain meds during the era where everyone was pressuring doctors and judging them based on treating pain. Now doctors are being pressured to avoid opiates and are being blamed for the current epidemic. Patients that got started on them back then, are now having to deal with the change in dogma.

What really annoys me is that the role of government and the JCAH gets so little mention. The university pain management departments convinced themselves and the JCAH that they had the ability to largely rid ourselves of pain, through nerve blocks and opioids. Turns out that they were wrong. Private parties did enter the field, but it was academic physicians and the government that started it all.

 

[Bwilk55]

No man. I weigh thirty pounds less than I did back then. What I can tell you is every time I took vicoden in the past, the first sign I could see that it was working was my tongue started to feel like it was made of velvet. I would catch myself in class linking my lips over and over again I guess because it felt good to my subconscious. I'm not a lip licker otherwise. Then I would feel a little jelly necked. Then I knew the juice had kicked in and I could zone out on my pain and focus on class. Let me ask you this-- first time I had surgery in college, when the anesthesiologist showed up to KO me, they gave me the dose and told me to count to 10. I did so and he was like "ooooooooo k". So they gave me more (I suppose). There was an awkward silence and shuffling of charts and back in went the needle. Eventually I woke up and I asked the attending physician who had ****ed up the blood work or the anesthesia. The doctor told me that I had an unusually high blood volume. He used the word "juicy" with a chuckle. Is it possible that if what he said was true and I do have a little more blood in my body than normal (we all know cyclist will infuse themselves with blood before races to have a higher oxygen intake) would that have an effect on how my body processes pain killers? Like "I need more because I've got more blood?"

This isn't something I have really thought about before, but I would assume that a larger blood volume would mean the drugs are diluted more as they distribute amongst your blood volume. Similar concept to a 200 pound man needing a higher dose compared to a 100 pound woman - there is more volume of distribution in the man.

Honestly, can't explain why vicodin would have less effect now. As FBH pointed out, the body is a mysterious thing, and it does change over time.

 

[Bwilk55]

What really annoys me is that the role of government and the JCAH gets so little mention. The university pain management departments convinced themselves and the JCAH that they had the ability to largely rid ourselves of pain, through nerve blocks and opioids. Turns out that they were wrong. Private parties did enter the field, but it was academic physicians and the government that started it all.

The big push, I think in the 80s, to treat pain was so misguided. That is when pain became the 4th vital sign. To this day, our charge nurses have to go around each hour and ask patients what their pain level is.

Again, I have no problem treating pain, and many patients in the hospital have reasons for acute pain. But we also have plenty of patients who don't and this practice just puts pressure on nursing and physicians to up the ante with our pain management when it may be unnecessary.

 

[ASURAM2010]

I can hook you up with a UVA undergrad, a SLU MBA and law student simultaneously who focused on heath care law then got her PhD in health care systems at UT. She's in Cali now running a system. She's hot as balls but if you lay a hand on her I'd be forced to geld you like a horse.

Sweet, would love to chat. No need for the last part, happily married to what I consider a smokeshow. Just delivered baby #2 6 weeks ago.

 

[TX1972]

This isn't something I have really thought about before, but I would assume that a larger blood volume would mean the drugs are diluted more as they distribute amongst your blood volume. Similar concept to a 200 pound man needing a higher dose compared to a 100 pound woman - there is more volume of distribution in the man.

Honestly, can't explain why vicodin would have less effect now. As FBH pointed out, the body is a mysterious thing, and it does change over time.

Narcotics work on the brain, not the blood. Perhaps the brain does rewire itself to reduce sensitivity after constant stimulation. So much that isn't known. The Joint Commission promulgated "pain as a vital sign" in 2001. It would be interesting to study the relationship between "pain management" specialists and opioid deaths. My guess is that would be a relationship, with a years long lag period.

 

[FlourBluffHorn]

Sad news down here..a vet that had his leg amputated at the knee, came home outa the hospital after 2 weeks with 12 pain pills and after taking them correctly he ran out and tired to get a 12 refill and the Dr would not call him back, he kept complaining about the pain and he went to ER and they gave him 6 pills and about 4 days later it got worst, friends went to chk on him and found him in backyard, he shot himself in the head, he asked for help and they low balled him on the pain meds,sad.sad.sad!

 

[clob94]

Sad news down here..a vet that had his leg amputated at the knee, came home outa the hospital after 2 weeks with 12 pain pills and after taking them correctly he ran out and tired to get a 12 refill and the Dr would not call him back, he kept complaining about the pain and he went to ER and they gave him 6 pills and about 4 days later it got worst, friends went to chk on him and found him in backyard, he shot himself in the head, he asked for help and they low balled him on the pain meds,sad.sad.sad!

That sucks and we should learn from that--- so let's talk about it.

The man was obviously in pain and distraught as well as probably clinically depressed and suffering from PTSD.

Option A is to keep giving the man he drugs he wants for as long as he wants and it's likely the man OD's at some point.

Option B is to give the man enough pain pills to help him but not too much to cause the Dr to be held liable IF the man does happen to OD.

Option 3 is to give the man the pills with the caveat that he enter into a VA program for pill addictions so that he can be around other men that are battling the problem as well as men who have beaten it.

Option A means he will likely end up dead.

Option B he obviously does.

Can we try option C from now on?

 

[FlourBluffHorn]

That sucks and we should learn from that--- so let's talk about it.

The man was obviously in pain and distraught as well as probably clinically depressed and suffering from PTSD.

Option A is to keep giving the man he drugs he wants for as long as he wants and it's likely the man OD's at some point.

Option B is to give the man enough pain pills to help him but not too much to cause the Dr to be held liable IF the man does happen to OD.

Option 3 is to give the man the pills with the caveat that he enter into a VA program for pill addictions so that he can be around other men that are battling the problem as well as men who have beaten it.

Option A means he will likely end up dead.

Option B he obviously does.

Can we try option C from now on?

I don't think he has to worry about Option C anymore clob! I think trying to save the mans life would be enough on the options, its a shame to see that 13 pills can decide your fate to live or die or hurt or not, I woulda gave him 13 pills just for fighting for his country! Oh well clob , just another Vet the country doesn't have to Fu*k with , right?


There are stories like this and like MM's story happening everyday, families torn apart and suicides, some body needs to answer this situation...

 

[TX1972]

That sucks and we should learn from that--- so let's talk about it.

The man was obviously in pain and distraught as well as probably clinically depressed and suffering from PTSD.

Option A is to keep giving the man he drugs he wants for as long as he wants and it's likely the man OD's at some point.

Option B is to give the man enough pain pills to help him but not too much to cause the Dr to be held liable IF the man does happen to OD.

Option 3 is to give the man the pills with the caveat that he enter into a VA program for pill addictions so that he can be around other men that are battling the problem as well as men who have beaten it.

Option A means he will likely end up dead.

Option B he obviously does.

Can we try option C from now on?

You must believe that drug rehab works. My experience (observing friends and family) is that it doesn't. My experience is that most addicts do quit, but on their own time. That is why the JCAH was so wrong. They claimed 2000 years of medical tradition should be abandoned.