Land of the hurt
One of the most frustrating problems with health care in this country is the paranoia and ignorance surrounding pain and pain treatment. There are doctors who refuse to prescribe anything for pain associated with Crohn’s disease; I know because they’ve told me so. I could crap blood 8 times a day, bent over double from cramps and pain, not able to leave the house – and still acetaminophen was my only recourse. It’s not an exagerration to say that Vicodin helped save my life – or at least kept me from killing myself.
There is no sound medical reason for a refusal to treat pain, just fear of government attention – which is understandable, because the government pays a lot of attention to doctors who prescribe pain meds. Unfortunately, this means many patients (not just those with Crohn’s) suffer because their doctors lack the testicular endowment to do right by them.
And so I’m ambivalent about this new initiative announced by the FDA:
A new control program will result in new restrictions on the prescribing, dispensing and distribution of extended-release opioids like OxyContin, fentanyl patches, methadone tablets and some morphine tablets.
If this helps ensure that patients who need these drugs – and only those patients – get them, then it’s a good thing. If like every other federal initiative on the issue, this has a chilling effect on physicians’ willingness to prescribe narcotics, then it’s a bad thing. I want it to be the former, but painful experience tells me it’s likely to be the latter.
I predict this will have no effect on the wealthy who abuse these drugs (e.g., Cindy McCain and Rush Limbaugh), but will further limit access to them for chronic pain sufferers who rely on insurance to pay for them.
Good god. I thought I was the only one. Being a pediatric CD patient was hell. My doctor now is a gem- my little bottle of Tylenol 3 goes everywhere with me. I’m terrified of when I have to move on to a new doctor. The government will do nothing but screw over people like us with this one.
It is so frustrating to me that so much of the focus on controlling narcotic abuse is aimed at prescribing physicians and pain patients. Patients who have legitimate chronic pain/chronic illnesses are not the ones abusing narcotics. So I get worried whenever I see initiatives like this, because I forsee very little effect on narcotic abuse, but increasing denial of these meds to patients who legitimately need them.
I’ve seen research showing that chronic pain patients actually have a lower rate of narcotic abuse than the general public. (This research was done years ago so it’s somewhat outdated.) That tells me that, once again, the efforts to curb narcotic abuse are being focused in the wrong place. More info here: http://www.helpmyhurt.com/2009/01/17/fear-of-addiction-to-pain-meds-misplaced/
It is already very difficult for a chronic pain patient to get these meds. I think this new initiative will only make it more difficult for those who need the meds.
Be well,
MJ
@Hydro: I wouldn’t bet against you there. I think the target is more the rural recreational user; I’m sure you’ve heard the term “Hillbilly Heroin”?
@Lisa: I think the next subhead for my title graphic will be something like “You’re never the only one”. A lot of CD patients struggle with pain, and a lot of gastros refuse to write for pain meds. We deserve to be treated better than this.
@Max: I’d be interested in seeing those studies. It’s worth mentioning that somewhere between the chronic pain patient and the broken-rib patient are a lot of chronically ill people who don’t need pain meds all the time but really do need pain meds some of the time – ie folks with acute, recurrent, but not chronic pain. They tend to get left out of discussions about pain med policy, but end up shut out by these initiatives, too.