Please Stop the War on Chronic Pain Sufferers

vicodin

Every day, there is a breaking news report warning readers about the opiate epidemic. These reports detail the alarming uptick in deaths related to opiate use. These deaths are ALWAYS caused by drug abuse, a fact that is often lost in the sensationalized details of death by opiates. The FDA and  federal and state governments have called for and enacted new laws and regulations meant to curb opiate use and abuse. One former FDA chief even went so far as to say that doctors were wrong to think that alleviating pain was an essential part of patient care. Some regulatory agencies suggest that doctors should encourage chronic sufferers to use over-the-counter medications or alternative treatments such as massage therapy or acupuncture. And for those sufferers who have tried everything and are still in pain? Suck it up. We have a drug epidemic on our hands and we don’t have the time to care about your pain and suffering.

As long-time readers know, I live with unrelenting, chronic pain. Fibromyalgia, osteoarthritis, narrowing lower back disc spacing, and non-specific neurological problems have landed me in a wheelchair and robbed me of any meaningful opportunities for working outside of my home. (Here’s hoping my upcoming book will be a New York Times bestseller.) There is no such thing as a good day for me. Days are rated on a scale of tolerable pain on one end to screaming pain that makes me want to end my life on the other. Each and every day I take four 12.5/325 mg. Vicodin and four 50 mg. Tramadol. When needed, I also use hot compresses and a TENS unit. One thing is for certain…when I go to bed tonight one thing that will await me when I awake in morning is pain.

I have been seeing the same primary care doctor for 19 years. I first saw him when I began to feel tired all the time. From that came a diagnosis of Fibromyalgia. My doctor has had to helplessly watch as my body has turned on itself and rendered me an invalid. While he can treat my diabetes and high blood pressure, and send me to specialists to address other problems such as cancer that threaten my existence, there is little he can do for my pain except commiserate with me and then prescribe narcotic pain medications. He knows — because I remind him of it from time to time — that  I do not expect him to fix what can’t be fixed. I am a realist. I accept my life as it is. What I do expect from him is help with my chronic pain. He has always put my needs first, but thanks to increased government scrutiny, my doctor is increasingly finding it hard to properly help with my pain.

My doctor is now required to closely monitor the total narcotic load of his patients. My load stands at 60 percent, well below the 80 percent threshold where my doctor is required to justify his treatment of my pain. He is no longer permitted to write narcotic prescriptions with refills. I must see him every two months, at which time he writes me two prescriptions for my pain medications. My doctor believes the government is now standing between doctors and their ability to provide competent care to their patients. It now costs me $181 every time I see my doctor. This means that it costs me over $1,000 a year just to get my narcotic prescriptions. Drug companies, always looking to increase the bottom line, have increased the cost of my Vicodin prescription by 300 percent since 2013. All told, it costs over $1,500 a year just to treat my pain. Since I am on a consumer-driven, high deductible ($3,000, to reach 80/20 and $6,700 maximum out-of-pocket) insurance plan with no drug benefit, most of my pain relief costs come right out of my wallet.

And even worse, I am treated as if I were a criminal. I recently had to sign a drug contract that permits my doctor to randomly test my urine — at my expense —  to make sure I am actually using the prescribed pain medications. I have NEVER abused my pain medications, but because federal and state governments can’t or won’t regulate pill mills and illicit narcotic use, I am punished for the criminal behavior of others. As is often the case, people who play by the rules are punished because of the bad behavior of others.

If regulatory agencies don’t come to their senses, doctors will be forced to break the Hippocratic oath. No longer able to find affordable pain relief, patients will turn to street drugs or alcohol. Some patients will likely choose suicide over a life of unrelenting pain. Is this really the goal of another phase of the failed war on drugs? What about marijuana? you ask. When legalization comes to Ohio, chronic pain suffers such as myself will be likely be forced to see pain doctors who use draconian methods to manage their patients’ needs. Office calls will be more expensive and random drug testing will become mandatory every visit. As is always the case, this economic burden only adds to the sufferer’s pain, a reminder yet again that patient needs do not come first.

Do you suffer with chronic pain? How has your treatment changed in recent years? Please share your thoughts in the comment section.

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18 Comments

  1. Karen the rock whisperer

    This is infuriating. I am a chronic pain sufferer as well, though at a much lower level. But acetaminophen-codeine keeps me at least somewhat functional, without stomach ulcers. I fear the day when that pain relief goes away because of government overreach.

    This is the War On Drugs all over again. I’m not sure that accomplished much except to militarize law enforcement and to enrich it at the expense of innocent people. Astounding collateral damage. But nobody cares about collateral damage, like people with real pain getting shafted.

    Reply
  2. RJW

    I’ve been using Kratom to supplement my pain meds. It’s legal FOR NOW. I don’t take it every day, more like once a week. However, a pain sufferer that is close to me needs it far more. Last time at Pain Clinic, he was told he couldn’t have ANY MORE FUCKING MEDS, due to taking Wellbutrin. Yes, I’m angry. I do realize her hands were tied. When we see her again, I have another suggestion that she may be able to put into place. But I am far more angry for my “friend” than I am for myself.

    Now, neither I nor my “friend” have used marijuana YET. We haven’t really broken the law in regards to the Kratom either. Although at this point, my conscience would be clear, I simply don’t want to have legal hassles. And my friend’s counselor stated he had patients who were taken off their necessary pain meds, and they were forced to buy heroin.

    Yes, I am majorly pissed.

    Reply
  3. Don Boyd

    My wife was injured in a car wreck six months ago and, although she has come a long way toward recovery, still has chronic pain. Her pain was controlled on medication while she was in hospitals and inpatient rehabilitation but now that she’s at home the medications prescribed for her do not control her pain. Our primary care doctor for the last 30 years has said she can’t do pain management referred us to a specialist. We have the impression that the pain management specialist is afraid to prescribe the kind or amount of medication it would take to achieve control. And of course the pain clinic folks, though polite, convey the impression that they suspect malingering or worse–requiring urine checks, etc.
    Your situation is far worse than ours–we were state government employees, and being part of a very large employee group has afforded us excellent medical insurance that wraps around our Medicare (although Medicare rules for coverage do apply). And as her pain is related to a traumatic injury, there is some reason to hope that in time healing will give some relief. A question (since you’ve been in this situation for a while): Has it always been this hard to get adequate pain management, or has it become harder lately?

    Reply
    1. Bruce Gerencser (Post author)

      Much harder, today. I actually saw the local pain management doctor several years ago. He showed zero interest in hearing what I had to say. He didn’t even bother to ask me about my illness and pain history. He did a physical exam, determined I needed numerous tests and in-hospital procedures. My insurance company said no and I agree with them. I was so angry over this. All I wanted was help in managing my pain…you know, an evaluation of my medications and suggestions as to what might work better.

      The total costs of the tests and procedures? Over $10,000.

      Reply
    2. Dane Fletcher

      Hey Bruce… thanks for the post.

      After a serious accident and several surgeries, I’ve been in pain management since 2004(ish). Over the years I have taken every conceivable combination of narcotics, steroids and procedures. Currently, I take (6) 30ml morphine ER tabs per day and (5) 10/325 oxy IR for breakthrough pain. Additionally, I take 300ml Wellbutrin ER/day and 40ml Adderall/day.

      I mention the last two in a chronic pain thread because the Adderall does wonders for me in that regard. (I’ll leave it at that unless someone wants to know more.) I am able to contribute in an office environment (very light duty) for 40+ hours a week. Without my medication I’d be house bound… maybe worse. BTW… the meds are $250ish/mo and office appts are 50/mo–all out of pocket.

      The changes I’ve seen in the last 12 years are substantial… some needed… some, way over the top. I guess I’ve come to accept feeling like a criminal. I’ve gotten used to it… and that sucks. My Dr. and I were just discussing how her first consideration in treating a patient is often FDA regs rather than patient needs. And when that’s the case the govt often has more to say about treatment options than Dr.s do.

      Reply
  4. J

    During the last three months, I found myself in excruciating pain twice and both my doctor and my dentist bailed on me. Last year, my husband had stomach surgery and was given the equivalent of a dozen Tic Tacs. Whatever that safer alternative to hydrocodiene was didn’t cut it, and my pleas for RX help from the surgeon went unheard. So I watched as he sobbed for two weeks and called everyone I could think if begging for weed or anything that could take the edge off. That could have ruined me professionally and us financially if anything would have happened. It’s INFURIATING and demeaning.

    Reply
  5. KatieS

    So what do you suggest to curb abuse? I really do understand you need the narcotics for real pain management but my ex got addicted to vicodin after back surgery and turned into a person whose whole life was consumed by looking for drugs. He has a network of people that get narcotics as a prescription and would sell them. So he spent all day on the phone looking for a few pills. He would take anything, tramadol, oxycontin, vicodin, percoset and ended up smoking heroin. He nearly destroyed me and our kids. I lost almost everything, including my own health.
    He may indeed need some kind of pain relief for his back but it’s hard to tell at this point.
    I just wonder how to balance the needs of people like you against addicts that destroy everyone around them.

    Reply
    1. Bruce Gerencser (Post author)

      Addiction to anything is a possible outcome as long as humans are involved. The state of Ohio now has a statewide narcotics database. Doctors and pharmacists now have access to data in every patient who has been prescribed narcotics. This puts an end to people being able to get scripts from multiple doctors.

      The FDA and state law enforcement need to go after pill mills. Close them down and revoke the medical licenses of the doctors running the clinics. It’s a joke right now….very little actual enforcement. The government has all the data it needs to go after Dr. Drug dealers.

      As far as illegal narcotics on the street? Perhaps it is time to figure out where these drugs are coming from. I suspect they are being manufactured outside the US and Canada. These supply lines need to be shut down. Of course,shutting off the supply lines will likely drive addicts to use other drugs such as heroin.

      Reply
  6. Melissa Montana

    I have fibro too, and I agree with you one hundred percent. The lack of concern among doctors never ceases to amaze me. It isn’t just the war on drugs, it’s the attitude in this country that if you dare to complain and ask for help for your pain, you are a crybaby who needs to “suck it up and deal with it.” Politicians who see the disabled as lazy and weak also promote the idea that chronic pain patients are whiners who need to toughen up. I am sick of hearing from people with more ordinary problems (as they roll their eyes) “Gee, my back aches, and I still go to work.” Chronic pain is a serious problem, but unfortunately, until America becomes better educated and more companionate, people will suffer.

    Reply
  7. Robert

    Sing the song of our people! I’ve been on pain management for 15+ years for back issues – of course they’d “prefer” me to have the risky surgery … but now I have no health insurance thanks to the Criminal Rick Scott rejecting the medicaid expansion (that wouldn’t have cost Florida hardly anything). Like you, Bruce, I was required to sign a narcotics “contract” with my Doctor about 3 years ago … never mind that I have rigidly followed the rules and laws. Thanks to the DEA and FDA they moved Hydrocodone up to Schedule two and reduced the prescribing “guidelines” (read: Forced demand) which forced me to accept a 25% reduction in allowable pain medication – again, nevermind that from day one I have strictly adhered to all legal requirements, I’ve only gone to one doctor and one specialist and all prescriptions are given through my Primary Doctor and I’ve stuck to the same pharmacy and have gone DAYS without medication waiting for them to get delivery so as not to appear to “drug seek” by going to other pharmacies that probably have it in stock (and likely right across the street!)

    There will come a day when they will try to end opiods as a medication … when they do, I’ll be a dead man walking – I suffer enough WITH the medication – I won’t live without it.

    Reply
  8. Marja

    I shredded a disc in my lumbar in a yoga class last year and was out of work on medical leave for 8 months. I learned really fast that pain is a game changer. I had no idea. People who have not experienced significant, continuing pain on a daily basis just don’t get it. Failing to relieve that kind of pain when treatment is available is akin to torture.

    Reply
  9. Stephanie

    I was wondering if anyone has tried Magnesium for pain? I just heard of the help it can give since most people are very low on the mineral and prescription meds takes it to deficient levels. Read the “Magnesium Miracle.” I had a back fracture and was looking for natural alternatives to pain meds and to help with my Osteoporosis. I shall be trying it very soon now as it seems to be a great help with many pain and sleep issues. I agree with all that is said here.

    Reply
  10. S

    Interesting article along the same lines – how panic is causing overregulation of all OTC meds: http://reason.com/blog/2016/05/11/where-will-opioid-panic-lead-how-about-r

    Reply
  11. M

    I suffer from something Called P.K.D. there is no cure for it. Transplant at best… a match is very slim. in pain all the time, can’t take any med’s apart from Tylenol, as it could even worse the function of kidneys.
    this sux… Gov needs to wake up… and pull its finger out of there butt and do something, as many are suffering and go unheard cry’s; Pain Also comes in different levels and forms and sometimes, pain is not always Physical!!! its intrunal and can also have different side effects/out come and veries from persone to person its not One Size Fit’s All.

    Reply
  12. Troy

    I don’t know if you caught the CBS news (or 60 minutes) interview with Dr. David Kessler (former FDA head), but he said something I found utterly bizarre:, “There was a notion that pain was the fifth vital sign, you wanted to relieve pain, that that was essential. You dosed until the pain was alleviated.” I’m like WHAT? there’s something wrong with prescribing drugs enough to eliminate someone’s pain?
    This is obviously a tragic case of barking up the wrong tree.
    The people in power need to appoint an FDA head who has chronic pain, it should be a job requirement.

    Reply
    1. Bruce Gerencser (Post author)

      Yes, he’s the dumbass I referenced in my post. I couldn’t believe what he said.

      Reply
      1. Troy

        I didn’t realize you had links to CBS in there. I saw the rebroadcast of the 60 minutes segment on the evening news and thought, that reminds me of that post on Bruce’s blog.

        Reply
        1. Bruce Gerencser (Post author)

          I didn’t see the show. I read his comment in a news article. I couldn’t believe that someone with any understanding of pain and medicine would make such a statement.

          Reply

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