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Thread: Article: What it's like to be a doctor treating chronic pain today

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    Default Article: What it's like to be a doctor treating chronic pain today

    https://www.seattletimes.com/seattle...patients-pain/

    The front page of today's Seattle Times has a large article describing what it's like to be a doctor treating patients with chronic pain in today's medical climate. An interesting read.

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    Hey, @dtek, thanks for this! What a well-written, balanced article this is. It definitely supports the notion that "addiction" and "dependence" to pks are very different issues, and points out that there is a strong need for prescribers to not only recognize those distinctions, but to also treat each patient in a medically-appropriate manner, depending on their condition. That's basically all chronic-pain patients have been clamoring for, since the CDC guidelines were last revised a couple of years ago. Of course, not every patient needs a lengthy course of strong opiates, but some do, and those patients should not be forced to live their lives in excruciating pain, just because of some stupid "guidelines" that are meant to be just that, a guideline based on some average (hypothetical) patient.

    Great catch!!
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    Quote Originally Posted by calgal99 View Post
    patients should not be forced to live their lives in excruciating pain, just because of some stupid "guidelines" that are meant to be just that, a guideline based on some average (hypothetical) patient.

    Great catch!!
    Thanks @calgal99.

    I'd also like to point out that physicians and other prescribers should not have to fear for their livelihoods for recognizing that some patients need treatment outside the guidelines and for appropriately treating those patients. I'm not in any way suggesting that physicians who over-prescribe should not receive guidance and, in extreme cases, censure. But when the "guidelines" become hard limits, some patients will not receive the treatment they need.
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    I laugh (or cry) when the cdc said they “never meant for doctors to forcibly taper or completely stop opiate therapy.” I know of three elderly women ALL who couldn’t even get a single pain med because of the pressure from the government. And as mentioned in the article, treating folks like criminals has led many folks to stop voluntarily.

    We haven’t stopped selling alcohol despite a whole lot of alcoholics. I just have never understood this mentality. At least the article points out that the deaths haven’t stopped despite making pain meds so much harder to obtain.

    Maddening was the “pushback” by more government officials when the cdc offered to revise the guidelines...
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    @jaders, I have to admire your reasonable words when describing the cdc and other govt. officials. It's so maddening to me to watch these powers flip flop with their guidelines and then when it comes to alcohol all the hypocrites come out. Someday maybe the most logical thing to do would be to let the patient have a voice. That's where the reasoning lies.
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    Quote Originally Posted by jakemoe View Post
    @jaders, I have to admire your reasonable words when describing the cdc and other govt. officials. It's so maddening to me to watch these powers flip flop with their guidelines and then when it comes to alcohol all the hypocrites come out. Someday maybe the most logical thing to do would be to let the patient have a voice. That's where the reasoning lies.
    Oh, you know - anyone who actually ASKS for an opiate pain med is automatically a drug-seeking addict. Actually I've read on here that asking a doctor for ANY medicine, (like you actually EDUCATED yourself) is frowned upon by doctors. It's so ridiculous. They always tell you to be honest with your doctor, but they've set it up so being honest is about the LAST thing you feel comfortable doing. I feel very lucky to have an excellent doctor, but it definitely took a few years to establish that trust. If she retires or moves, just the thought of having to try to find that again is scary.

    At least I do think the pendulum is starting to swing just a bit back. Now if we can just get the friggin' customs to go back to where they didn't care about personal med use..
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    My husband regularly prescribes opioids as a surgeon. No one restricts him or watches over him. This is really for primary care physicians. My husband finds it unethical to not prescribe narcotics after surgery. He limits the number for benefit of the patient but not for anyone overseeing him. He has found that ibuprofen and aspirin at the same time often works better after the first three days.

    Chronic pain is horrific and no one should have to live with it assuming we have treatments. Not everyone taking tramadol is going to heroin when the supply runs out. I would rather have a dependency than suicidal thoughts. Depression is the worst pain I ever experienced and not many people understand. Tram is saving my life even at 100-200mg a day.
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    Even if the CDC guidelines are updated, the states that have already implemented laws regarding dosages, face to face appointments, and urines samples are not going to do away with those laws. Some doctors might feel more comfortable if the guidelines were updated but I don’t see many doctors changing their minds about prescribing. They either already do or don’t and those that don’t have it set in their own minds that opioids are bad.
    @jaders...I’m one of those people who stopped voluntarily because I felt like I was being treated like a criminal and because your life has to revolve around specific appointments and refill times. If I wanted to go on an extended vacation. Or away for the winter to a warmer climate, how exactly could I do that? You’re not allowed early or extra refills and I don’t think my doctor could just send a new prescription electronically to another state, never mind overseas.

    For them to assume everyone gets addicted is ridiculous! When I reduced the first dosage I had some moderate side effects but each reduction resulted in no new side effects (sort of like stomach spasms) but it did result in the old pain levels.

    I’m waiting for the news reports though that proclaim the opioid epidemic is now over since I no longer take any oxy.
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    What makes matters worse is that the doctors ends up apologizing for NOT being able to give you what you need, even though they know you are in pain. I went to an orthopedist for the pain I still have in my ankle (now both feet) and he apologized that he can only give me tramadol and referred me to a pain management doctor (where I haven't made an appointment yet) and is having a tech come into their office next Tuesday for them to make a mold of my feet and fit me with braces that he said should help stabilize me with some PT.

    My primary care doctor, in January this year, prescribed me Hydrocodone, 45 tabs. When my son took it to CVS, they would only give me 21 tabs, which was for 7 days according to the "law" as well as my insurance company's policies, so I had to forfeit 24 pills. When I told her about this when I saw her in April, she said she was disgusted that she cannot give patients what they need, and gave me Tramadol to take twice a day with 3 refills (which I am surprised that CVS is refilling without calling the doctor to check on it)
    Incompetence Kills

  11. Article: What it's like to be a doctor treating chronic pain today

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