Eliminating Pain Management Doctors

country, try world!! i am in australia, to see pm at the hospital a psych evail is part of the process!!! ect is not for pain. and i am saddned that this life saving treatment is being used in this way. and yes, have had ect as well. a course of treatment, which is six. ooops and aussie on the forum!!!!!! lol.

all the best with it. you seem a likely candidate. continue your research, as knowledge is power.

T, I am so sorry to read what has happened with you. However, nothing surprises me any longer about treating chronic pain. I had a very bad gut feeling many years ago that people needing medications for chronic pain were going to be out in the cold more or less. I think we will see more of this as time goes on. More & more states will be eliminating narcotics for treatment. One of our mods moved to a state a couple years ago & found out quickly he would not be prescribed any meds. He ended up going to another state & was a candidate for a pump & drives to that state for refills of his pump.

Its not going to get any better. People do not believe you when you tell them if you are on a high dose you better figure out how to lower it because you may be out in the cold. Its a reality not a tidbit of information.

Thanks, Susie. I knew we were headed for trouble back in March when the CDC put out its recommendation that no narcotics should be prescribed to non-cancer or non-acute pain patients for any reason in order to "solve" the addiction crisis in our country. Can't help but wonder when these twits will realize that withholding medically necessary care from ALL patients does not cure addiction. We need funding for research & treatment of addiction disorders, not to add a second group (pain patients) to the list of those who can't access proper treatment. What do they expect us to do without PM? Lay around in a nursing home for decades until we finally die?

We had solved this problem. It's soooo frustrating that we're now returning to the witch doctoring nonsense from decades ago. Yes, some people overdo it with the pain meds, but millions more of us use them responsibly in order to care for our most basic needs & maybe even work a little.

But that argument falls on deaf ears with the government. We just elected a new senator, but I know I used to get almost weekly updates from Sen Kirk about how hard he was working in the Senate to pass a bill outlawing all opioids (because apparently that's how you "prevent & cure" addiction-- obviously I disagree). I wrote to him over & over again to no avail. I don't know whether his elected replacement will be any better, but you can bet there is a growing fervor in this country (including the incoming President) to get rid of all opioids for the foreseeable future.

I hate to say it, but I think you're right that rather than counting their lucky stars they still have access to pain meds, anyone who's still on them should be preparing for the inevitable reality that they'll be taken away.

T, now this is just my thoughts as to why things has changed & are continuing to change. It was probably 7 years or so ago, I was reading lots news stories about how the rise of narcotic use had skyrocketed in the prior 10 years. These reports had all of their graphs showing the increase in use over several years, however, it was based on the age bracket of 40 & below!! They went in to detail of people that were able to continue to work & then the ones that were disabled.

The point of these stories was the effect this had on the country's economy at present & in the future. Naturally they painted a very grim future. No where in these reports ever, was the term pill mills or drs that over prescribed or addiction issues ever mentioned. It was all about numbers & the economy.

Call me crazy or whatever, but my gut feeling was as I continued to read these news stories over time that pain mgt was going to take a huge hit. It has & it did. Now the government is involved & calling the shots. Look at the senator that ignored your letters.

Over the years I have seen countless people come through here that suddenly had no access to pain meds or a drastic reduction & they ask how can I get a dr to give me my pain meds. It still shocks me the amount of people that have been on pain meds for years that have no clue of all the changes that has been made. Suddenly they show up at their dr appt & the good dr says well we are going to reduce your medication or we are weaning you off.

Just my 2 cents worth.

T, none of the numbers they report are accurate, never have been & never will be. Like you at a young age I began having terrible pain that turned into chronic pain after many years. I was fortunate enough to have drs that were able to help me remain working for many years. It was not chronic pain that disabled me, it was crohns disease that finally took me out. Once it reared its ugly head it was like a domino effect that hit me. Pain mgt was pretty much non-existent in those days.

As I said earlier, after reading those news stories for 2 years my gut feeling told me that the changes that would take place were not going to be good for patients & I was right. It was all the behind the scenes plays & moves that has us where we are today. They all worked together to bring us where we are today.

I just don't know what people will be able to do.

Karen, first of all, please accept my sympathies on the loss of your friend. The world is better for him having been here & it is a great loss that he is now gone.

I get that kind of hopeless, dark thinking. I battle it myself more than ever now that I have lost access to any kind of pain management... but the fighter left in me knows that if I don't keep living & fighting for CP rights, those without disabilities will take over everything and the world decidedly will be worse off for it. Tammy Duckworth, who lost both her legs & use of one arm in Iraq is who our new IL senator is. If there is any way possible, I hope she would let me or another CP patient testify before Congress about the real & crippling effects of these types of laws. They let parents of addicts testify, but never hear the other side. They make serious decisions with only half the information. I have to have hope that if not for our generation, than for the next one things can improve for pain patients. Otherwise, all the ADA laws in the world will quickly become useless. CP'ers will end up ostracized like the AIDS patients of the early 1980's.

Please do hang in there, ok? We would miss you terribly if you weren't here.

Tirzah,
Unfortunately that's the way much of the US is going. I moved from CO to NY left year because I was unable to live alone (or work, so I'm broke) any more due to my disability. I literally called every place within 100 miles of my new home but couldn't find a single doctor that prescribed opioids. I went to one place where they put me through an awful experience that put my mom in the hospital overnight due to the stress they caused and her ending up having to be taken in an ambulance to the hospital after my appointment. I had two appointments before that, the first one with a PA who told me I had to wait a month and then come back to meet with the doctor. Well, I waited that month and then in my next appointment they told me I had to meet with their psychologist first. At that point I had run out of meds weeks before and was in agony so severe I hadn't slept in weeks and was hallucinating and ready to find a high bridge. When they took my mom to the hospital, I ended up in the ER too because of my pain, which at that point had me out of my mind after almost a month with no meds and maybe 20 hours of sleep in that month. I told them the situation in the ER, and they called the place I'd just been where they talked to the doctor I'd never even seen who proceeded to tell them I had an addiction problem and I needed to stop taking pain medication. Keep in mind I've been taking pain meds for a dozen years every day for extremely well documented problems I'd had two major surgeries for!

After the law changes last year in NY, 98%of opioid prescribers got out of the business. I'll be the first person to say many doctors had been prescribing opioids with little to no restraint, and a large number of the people taking them could and should be taken off them, and a large number of people who actually needed them could and should have been on lower dosages. However, there's no way 98% of the people in NY taking opioids fell into the first category of not needing them at all, especially when you consider everyone seeing a specific doctor who stopped prescribing them definitely didn't call into this category, but hot cut off from their supply regardless unless they could find a new doctor to take them on. The only way I personally silver my problem was because a friend of the family wrote me a prescription that got me through a couple of weeks of my first month and a half in NY, and then called in a personal favor from a doctor she used to work for that did PM and got him to take me on despite the fact he wasn't taking new patients at that time. I was at the end of my rope at that point after a month without any meds and was probably days away at most from not being here any more. I'm surprised my heart didn't give out during that time. I have a blood pressure cuff home and my pulse was regularly at 170+ beats per minute while lying in bed, and my blood pressure was a consistent 180/120. Not good...

Several big fall outs of this cutting off of many people who actually needed meds that I don't see or hear mentioned, but I try and raise awareness of are:
1. How many of those people ended their own lives due to being in horrible, constant pain they couldn't treat?
2. How many new illegal purchasers of prescription meds did they create?
3. How many new heroin users did they create, most importantly again Fri those people who desperately needed pain meds and had no other outlet?
4. Less importantly, yet important none the less, how many new heroin users did they create out of people who were addicted to opioids yet didn't need them, and who then turned to heroin?

There already is massive, unmeasured and unknown fallout of this policy change. Beyond the consequences of my points above, there are things such as the strengthening of the Mexican drug cartels as they shifted from marijuana growing to heroin and Fentanyl production and sales. The large-scale legalization and decriminalization of marijuana of course helped drive this, but it was this policy change to make opioids the devil that really did it. But now I'm getting too long on my post and getting political to boot so I'll stop there!

Now here's one really important thing I'd like to correct you on however:
With respect to the CDC publication/recommendation you mentioned from March 2016, you provided the wrong information in that it is NOT about chronic pain patients or prescribing to people who are actually in pain. I took the time to read and reread it and it clearly says it is recommendations for addiction treatment, and people treating chronic or end-of-life pain should continue to use their own best judgement. I can't count how many news agencies, whether they be TV, magazines or newspapers who got it wrong and said what you did, that it was a new recommendation for treatment of all people taking opioids. It specifically was NOT that!

Tirzah said...
Actually, there have been studies of its use for chronic pain:
/www.ncbi.nlm.nih.gov/m/pubmed/11749873/
/www.google.com/amp/www.practicalpainmanagement.com/amp/361?client=safari
/www.researchgate.net/publication/6916972_Electroconvulsive_therapy_for_neuropathic_pain_A_case_report_and_literature_review

I'm praying it works for me. My psychiatrist is one of them on that "chronic pain team" and she convinced my PM to pull me off everything (and I do mean everything-- even Lyrica & Imitrex) and to refuse to even give me meds for the withdrawals. So I'm out of my mind in pain, and barely able to keep even 4-5 crackers down on a given day. I've lost 10 lbs in the past 6 days & no one seems to give a care. My PCP thinks this is a completely terrible plan, and that I should be allowed to resume the PM regiment that I was on for the past 10 years, but she doesn't prescribe C-II's so I'm out of luck in that front.

I was given a choice of ECT or reimplanting the SCS that gave me infections for 8 straight years before it was finally explanted after nearly taking my life. Much as I hate to say it... frying my brain sounds better than another deadly infection.

Look into Kratom, no one should have to be forced into withdrawal or pain for that matter. I got reasonable priced from EZ Kratom and service is great. Happy Hippo is another good one but a little more costly. Green Maeng Da in 7-8g doses as needed (4-6 hours) got me off of Oxycontin with little side effect and I can take as needed for pain. Just don't drink more than a mug of coffee with Kratom as the plant is in the coffee family and may cause tremors with too much coffee.

Another big plus is you will think more clearly and have a bit more energy than with opiods. I am thrilled that I learned of this.

Post Edited (ChickenArise) : 12/4/2016 7:52:15 AM (GMT-7)

I believe the DEA is back-tracking on its plans to ban Kratom. This re-thinking of policy is due to an outpouring of feedback provided by chronic pain patients who have benefited from Kratom.

Kratom is gaining legitimacy and backing. Do not count it out as a possible option.
- karen -