I sit on the front lines of this battle. I am on pain management and have been for years because of Fibromyalgia. Each day I take close to 20 different pills that do things like keep the pain at bay, reduce muscle spasm, increase my ATP, and reduce neuropathic pain. To get these medications I had to sign a 10 page legal document that details the exact rules I must follow. If I break the rules, my meds will be cut off, leaving me in cold turkey withdrawal.

I have to go to the doctor monthly, submit to regular urinalysis (to make sure I am taking my meds) and have to bring all of my medication bottles with me to each visit. I also cannot have any alcohol or recreational drugs, and must notify my pain management doctor the second that I am being treated for a psychological condition. I submit to these things (and others)because without this medication, I likely would have put a bullet in my head by now. Despite this, finding a pharmacy to fill the scripts is next to impossible. In a city of about 4 million people I found exactly 1 that will dispense my pills.

I can always tell when the feds are cracking down on my doctor..that is when I have to do an urinalysis every single time I come in. It is sad that we are left to this when attempting to treat pain.

-Julie

All will be well when the government controls all healthcare decisions.

Snort.

Julie, I am sorry to hear about your situation. However, I am not surprised. We now live in a Big Brother / Nanny state.

My wife, mother, and several in-laws are or were health care professionals. According to them, the medical establishment is so freaked by the "drug war" that DYING patients are denied strong pain meds -- for fear that they might become "addicted."

There is also a lingering notion that experiencing pain is somehow noble, and avoiding pain shows a lack of "character."

Sick, indeed.

In these two cases, the two people have real and evidential need for these high levels of medication, and at least in Julie's case (and we must assume the other) have shown they are not being abused or misused.

Alas, in the majority of cases (or so I suspect), such high doses are not being done solely for the elimination of pain. (Rush, jack osborne, I could name a bunch, and I'm sure so can you) Therefore, I don't consider it entirely unreasonable to look at any such uses with extra care to ensure it's on the up-and-up.

I can understand it's a problem, and I've no desire to see such treatment go away, but considering the situation, it may be an understandable inconvenience.

We all have to show drivers licenses to buy Sudafed now, we all wait in line a little longer at the airport, and I'll bet farmers have to hand a few extra papers in when they pick up that shipment of nitrate-heavy fertilizer. It's an inconvenience for the legal user to have to be treated as a criminal, but in this case, I see it as close enough to the line that I might just agree with it.

The reaction to the advocacy group, however, no way. They are advicating for the people who really need those meds, as opposed to demanding a blanket relaxation of the laws across the board. Sometimes "pro-drug" groups will tout the medical aspects of legalization and decriminalization, when a good slice of the membership just wants to get high.

@Vinnie,

Just for clarification (I reread my post and I understand I wasn't very clear), I have no problem with complying with any reasonable, and some unreasonable requests. I am a VERY complaint patient, mostly because I understand that the doctors need me to be in order to keep their licenses.

What bothers me is the harassment of doctors and patients. I understand that doctors who prescribe pain medications should be monitored more closely, however many doctors are loosing their license and going to jail even though they are following the rules. As we get older, we are all really going to be screwed if we don't get the DEA under control.

-Julie

There are only a few things that cause me to have a visceral reaction of pure outrage, and this is one of them. What the f*** is wrong with somebody who thinks condemning sick people to unbearable pain is an acceptable tradeoff for possibly making it slightly harder for someone else to get high?

I can understand it's a problem, and I've no desire to see such treatment go away, but considering the situation, it may be an understandable inconvenience.

It's not an "inconvenience" when doctors are so scared of BS prosecutions that you can't get pain relief at all. It's torture.

Holy crap, Julie. I read the article on Forbes a little while ago (Insty has linked to it). As someone who (cautiously) supports legalization, I think this is worse than outrageous. Even if you don't support legalization, holding doctors to strict liability for how the drugs are used is a gross abuse of the legal system, and a perversion of justice all the way around. And it's absolutely pointless besides; as Brian 2 points out, it makes it about 0.0001% more difficult for junkies to get their stuff.

I wish some really well-know doctor in the sports med field, like say James Andrews or Frank Jobe, would take up this cause. The whole world of sports and sports fans would be on board.

I hope Harvey A. Silvergate has his life completely in order, because federal prosecutors are going to be perusing it with a magnifying glass if I understand the usage of "obstruction of justice".

@Julie - Wasn't trying to imply you weren't cooperating - the details you listed suggested you were. My point was that considering the potential for abuse (not to mention the possibility of growing addicted to such high doses), such strictures are not terribly outlandish. I hope you are receiving some comfort as a result, and of course wish you luck in continuing to do so.

@Brian - Again, we're talking about where the famous "line" is here. These people are caught in a situation where they are following the laws and standards, surrounded by many who are not. They are the exceptions, and as such must prove the rule, if you will. No, they should not be refused their meds, and I don't see anyone in this thread suggesting that. But if x number of people are getting superdoses of pain meds for nefarious purposes, I don't consider it unreasonable to believe that person X+1 might be as well, and require some backup.

Even if you don't support legalization, holding doctors to strict liability for how the drugs are used is a gross abuse of the legal system, and a perversion of justice all the way around.

The really nasty part of this is that doctors who previously would go into medication management (treating pain with medications in a palliative manner) are now moving to 'pain management clinics'. Their entire goal is to get you off of medication through forced exercise, physical therapy, and psychotherapy. You are set up for enough appointments with each of the specialists that it is a full time job, and at the end, if you are still in agonizing pain, they say you aren't following through at home and drop you from the practice. It makes money, that is for sure.

This type of practice probably does help people with lower back pain or a localized muscle injury, but for pain disorders, phantom pain, or cancer/post cancer pain, no dice. Doctor's don't want to risk being thrown in jail, and who can blame them?

I recently had to find another pain doctor because mine closed up shop in the city and ran for the 'burbs' (after many months of constant harassment by local police and DEA). Most weren't taking new patients, of those left, the majority wouldn't prescribe medication on the first visit. Since I am only given 30 days of medication (with no refills) I had to hunt one down that would, or suffer again at the hand of morphine withdrawal. It is still possible that I will go through all of this, go to the appointment, and the doctor will refuse to prescribe my meds. It's an awful place to be, and no one knows how insidious constant pain really is until they are in the middle of it. I wouldn't wish it on my worst enemy.

-Julie

@Vince. I understand that you believe me, and I have no problem with following the rules, but I disagree with your (possible) assertion that many pain patients are using them for nefarious purposes. I know that some people abuse the medications, however most patients are just very thankful that someone believes their pain.

This article ( http://www.medicalnewstoday.com/articles/135800.php ) details the results of a major evidence based review of opioid abuse during pain management, and among other things found this:

A systematic review, encompassing 17 studies of patients with moderate-to-severe chronic noncancer pain who were treated with opioid analgesics for at least 6 months, found opioid abuse in only 0.4% of patients. Signs of opioid addiction were evident in only 1 case out of 2042 subjects evaluated (0.05%).

In reality, the people who go to pain management are very unlikely to abuse the medication, and if they are, the abuse will be caught earlier and treatment can commence. As far as selling the medications, to make any money at it you would need to hit up multiple doctors at the same time, using multiple pharmacies (none of them in a chain that tracks your medications like Walgreen's) and pay for it all in cash (no insurance). There are much easier ways to get the meds (rob the pharmacies as an example). I agree that patients should be required to follow the rules, as this keeps abuse down. However, these doctors are being harassed without any due cause.

-Julie

But if x number of people are getting superdoses of pain meds for nefarious purposes . . .

There's no such thing as taking pain meds for nefarious ("flagrantly wicked or impious; evil; wicked; vicious; extremely wicked or villainous") purposes. Obviously it's against the law, but other than that I don't see what the big deal is. Do pain meds make white women want to have sex with black men? What makes Vicodin addiction more sinful than being overweight?

Do pain meds make white women want to have sex with black men?

ROFLOL

That is WAY too fucking funny. I let our a snort laugh in the cube farm when I read that one.

http://www.youtube.com/watch?v=QxdEV28_TgA

-Julie

It's funny and awful at the same time. It's attributed to Harry J. Anslinger.

It's funny and awful at the same time. It's attributed to Harry J. Anslinger.

Yes, it was a part of the debate on making reefer illegal if I remember correctly. Awful in its original context. Pretty funny in this one.

-Julie

I read recently that the FDA wants to outlaw vicodin and percoset and other meds containing tylenol, because some people take large amounts to get high and harm their liver by taking the huge tylenol overdose. Excuse me, but 99.99% of the country has to suffer because you don't want a few dumbfucks to pay the consequences of their actions?? WTF! Do post-surgical patients just get Advil then , or what?

I was in the Er a few weeks ago with excrutiating abdominal cramps. They gave me morphine in my IV, but would not send me home with anything, and looked at me like I was a drug-seeker when I asked. I'm sorry, but if you feel I need morphine while there, I probably need something that night at home too, no??? Pain is not heroic. There is no need to suffer pain in this day and age.

Vinnie: @Brian - Again, we're talking about where the famous "line" is here. These people are caught in a situation where they are following the laws and standards, surrounded by many who are not. They are the exceptions, and as such must prove the rule, if you will.

What? Patients and doctors using pain medications to actually control pain are the minority? Citation seriously needed.

No, they should not be refused their meds, and I don't see anyone in this thread suggesting that.

That's the inevitable result when you support the legal harassment of doctors who prescribe pain meds.

I read recently that the FDA wants to outlaw vicodin and percoset and other meds containing tylenol, because some people take large amounts to get high and harm their liver by taking the huge tylenol overdose.

Momof4, I was hoping that you'd misread, but here it is:

http://www.msnbc.msn.com/id/31664450/ns/health-more_health_news/

Man if this really goes through I am FUCKED when I run out of my overflow pain medication (Norco).

-Julie

"Man if this really goes through I am FUCKED when I run out of my overflow pain medication (Norco)."

I think Obamacare will pay for end-of-life counseling.

I really do not understand the thinking of someone who will sentence even one person to unnecessary pain in the pursuit of a paycheck. That kind of evil needs some end-of-rope counseling.

Julie, I emphasize. I suspect I too am a patient victim. I live with pain on a daily basis and have trouble getting doctors to even discuss pain management. This explains a lot.

@muggle

Despite all of the bullshit, getting on pain management is worth it. You might want to check your insurance website (if you have insurance) to see what specialists they have in pain management. If you find a good one they can make your life a hell of alot easier.

I'm sorry that you are hurting too. I don't wish chronic pain on anyone.

-Julie

A mentally sound adult should be free to do what he or she wishes with his or her body so long as they do not expect others to pay the price.

People in hospitals really do seem to look at everyone like they're a junkie. I was in the ER for a possible concussion a few weeks back, with a massive headache that was going into its 7th hour. I asked a hospital worker if there was any way I could get a Tylenol or Advil while I waited, and the guy looked at me like I'd asked him to hold my bong.

When my mother came home from the hospital for home hospice, I was given a large bottle of Percocet with instructions to give them to her every six hours. I decided pretty quickly that I was going to give them to her whenever she asked for them.

Monica, I know exactly what you're talking about. I have a close friend with chronic liver problems, and every time he has to go to the hospital, the first thing they ask is "what drugs have you been using today?"

Thanks, Julie. Doc appointment today and if it's as unsatisfying as others have been, I'll do just that. Was on hydroco which also helped with IBS-like symptoms I have but got labelled drug-seeking for asking for renewal on the script and wasn't even taking as often as prescribed. Needless to say, new doctor today. Hope we both get sorted out soon.

And, yes, it's pretty damned heartless to not care if a patient's in pain. I've been thinking docs have been pretty damned cold but, like I said, this explains a lot and will be kept in mind when approaching.

I wonder are other meds, especially those so largely advertised, like anti-depressants and sleep aids, treated the same way?

Some folks report help with EFT. See www.emofree.com.

I am not connected in any way with emofree. My son who went to med school used it on a number of people with generally good results for a variety of emotional problems, not pain.

The sad news is it doesn't work for him, and he sure needs it.

If you go to youtube.com you can see it in actual use, and with the free download of the manual, it could be free.

I've just been reading your comments. I'm also in pain management, and recently had to relocate.
I walked into the Pain Managemet clinic with 4 years of Dr's notes,treatments, and current medications I had been taking.
This Dr, said I that the dosage was to much. He cut my pain medication dosage from 30mg to 15mg, and the amount from 180 to 90 a month.
what I had been been taking didn't stop my pain, but it at least mad it bearable.
The people who are abusing the system are making it harder for the one's who really need the help.

I have heard of people who go to several Dr's and different pharmacies, and get 3 or 4 prescriptions filled each month. Is there not a system in place to catch them instead of making it harder on use.