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Physicians React: Are They Taking Right Path Now With Pain Management and Opioids?
- Thread starter Gry
- Start date
"continue reading with a MedScape account" no. it looked interesting too...
GenghisKush
Well-known member
Full text: https://archive.ph/feDXf
how can a doctor evaluate another persons pain level ? i've been refused pain meds simply because of my hair length over the last 50+ years. i cut my thumb damn near off with an ax splitting kindling (in my 40s) before i discovered that pain meds (demerol) existed beyond aspirin... they are NOT going to take the patients word for what they need. if you complain, they'll assume you just want more dope, and give you less for punishment. "fuck your pain level..."
Ca++
Well-known member
Not in the UK. They take your word for it. Private medical care in the states, surely follows similar procedure. It's a case of, are they paying, and will they leave. Then give them what they want. Always thinking about big pharma's offerings. Such as free pens at the trade shows.
They are trying to say stop that. While also saying, there is more to pain relief than opioids. Have two aspirin for that deeper cut, then trying scoring at a different type of dispensary.
They are trying to say stop that. While also saying, there is more to pain relief than opioids. Have two aspirin for that deeper cut, then trying scoring at a different type of dispensary.
Gry
Well-known member
Physicians React: Are They Taking Right Path Now With Pain Management and Opioids?
Jon McKennaDecember 30, 2022
A Medscape report that explores how physicians prioritize substance abuse among leading American social issues also reveals their divergent views about a proper role in pain management through opioids.
The Centers for Disease Control and Prevention last month updated its guidelines for prescribing opioids to adults with acute and chronic pain. In part, the new guidelines 1) urge clinicians to maximize use of nonopioid therapies, 2) support lowest effective dosages and immediate-release drugs when physicians do turn to opioids, and 3) ask doctors to prescribe no greater quantity of opioids than needed for the expected duration of the patient's pain.
Some survey respondents in the "Substance and Opioid Abuse Report 2022: Drugs and Alcohol Are Challenging Problems for Physicians and Their Patients" believe doctors still overfocus on pain management and 0-to-10 pain scales, even during the nation's opioid crisis.
"It's easy to become addicted to opioids when [physicians are] using a pain scale in the hospital and stating that post-op patients should be encouraged to use meds when they are at a 3," an ob/gyn said. "If patients were told to expect significant post-op pain going into surgery, then they would have appropriate expectations post-op."
"Our MIPS forms tell us that we need to present a plan if a patient complains of pain greater than zero," a rheumatologist respondent added. "Primary care people feel compelled to treat pain. This has resulted in a far more cavalier use of opiates, because other medications have failed."
And a toxicologist felt continuing "pressure on doctors for their overprescribing during the opioid crisis" would be a positive for society.
Beware Unintended Consequences
But some physicians in the Medscape survey felt the pendulum needs to swing back to more aggressive pain management, including prescribing opioids when appropriate. "Chronic pain and cancer pain patients are often undertreated by MDs, pharmacists, nurses, and support staff," one internist argued. "These caregivers are not educated properly on pain control, and that is so unfortunate."A number of other doctors pointed to unintended consequences for which they said champions of stricter oversight of opioid prescribing cannot avoid responsibility.
"I think the government's crackdown on physicians…has actually worsened" the opioid crisis, a gastroenterologist said. "Now, people are more often going to the streets and are getting fentanyl-laced drugs, resulting in accidental deaths. It's a big problem."
That viewpoint was backed by an orthopedic surgeon.
"Discouraging legal prescriptions doesn't cure opioid use disorder," he argued. "Other doctors and I are afraid to prescribe opioids, which is a boon to the illegal drug trade. Opioid prescriptions have been nearly cut in half in 10 years due to the new guidelines and rules, but overdoses and illegal opioids have nearly doubled."
For more news, follow Medscape on Facebook, Twitter, Instagram, YouTube, and LinkedIn
Credits:
Images: Dreamstime
Medscape Medical News © 2022 WebMD, LLC
Send news tips to news@medscape.net.
Cite this: Physicians React: Are They Taking Right Path Now With Pain Management and Opioids? - Medscape - Dec 30, 2022.
chilliwilli
Waterboy
Where i live opioids are not easy prescribed because of the very high addiction risk that comes with them.
I saw a grand aunt in her 80s crying because she craved that stuff after her multible disc rupture but she was more pesperated because she had that cravings. She had to take it because of her strong pain and only for a short term but still got addicted.
And the for some easy prescribed opioides are not for the good of the patient they are for the big turnover for the pharmaceutical companys.
No one needs opioides for a sprain they are for the really hurting stuff.
Imo you dodged a bullet with your haircut.
GenghisKush
Well-known member
The first time I saw any version of this figure, circa 2012, I was blown away.
It shows (for example) from clinical data that the probability of long-term opioid use (ie at least 3 years after the initial prescription) for a patient who takes a 5-week course of an opioid drug is 20%. One in five.
It shows (for example) from clinical data that the probability of long-term opioid use (ie at least 3 years after the initial prescription) for a patient who takes a 5-week course of an opioid drug is 20%. One in five.
the FDA will cheerfully take a physicians ability to prescribe controlled substances away to force compliance. but i'm not naive, quite a few folks "fall" or cut themselves trying to get a scrip. it is a "damned if you do, damned if you don't" situation. should they take the patients at their word & possibly further enable an addict, or lower a truly injured persons quality of life with pain not properly addressed ?
cutting it by a math percentage is not a caring nor moral solution in my eyes...
you might be right. never been a fan of opioids whether needed or recreationally myself, although the ten demerol got me through the ax/thumb fiasco pretty well. used to have vicious migraines, but they don't respond to pain meds, different pain altogether.
chilliwilli
Waterboy
I got it sometimes when the weather changes or foehn wind is blowing. Pepermind oil on the temple helps me but it only makes it lighter
mine were apparently triggered by surges in blood pressure. around my 50th birthday, my doctors caught it elevated and gave me medicine for it. 15 years now without one & i don't miss them at all!
Three Berries
Active member
I've put the medical industry right up there with lawyers.
Gry
Well-known member
Those who paint with a broad brush have little interest in accuracy.
have several friends on low-level pain medication (Lortab) for years old back injuries that won't/didn't respond well to surgery. a couple have been drug-tested recently, and their doctors tell them "if you are using cannabis, you will forfeit your prescription medications". another one apparently has a very high metabolism, and they were going to pull his script because urine screen did not show his medications! he took that days dose while they watched and went back the next day to be tested again, nothing. they apologized for doubting him, and he has not been tested since.
I occasionally notice that with my resident kidney stones as well. I assume it is something to do with atmospheric pressure changes. I suffered for 20 years with the stones, so I have tried everything. The only meds that ever really worked was a Demerol IV that I lived on for 5 days in the hospital one time. I got a new bag every 3 1/2 hours but by 3 hours I was writhing in the bed. The hospital was gradually closing and they put me in the last room in a darkened hallway. Now that was a strange experience. I swore the black night nurse was an evil voodoo queen . . .
Gry
Well-known member
This past Sunday when the storm hit here, I let two homeless people stay in my laundry room to get them
out of the weather. In the middle of the night I heard screaming .
One of them had done a puff of fentanyl, and fell out on the floor floor.
No pulse, eyes rolled back in their sockets, skin was cool and clammy.
I keep a supply of Narcan in my fridge.
It took repeated packs of Narcan to revive him. He is alive and OK now.
The fentanyl is everywhere, and we are only going to see more of the stuff.
Heard this morning of a ten year old who died as a result of taking a single puff
of a cannabis joint, they suspect that he may not have even known that it had been
laced with the stuff.
I would urge everyone to procure the reversal drug Narcan, you can get it at just about
any drug store. The stuff is easy as can be to use, open the package, shove it in their nose
and push the red button to squirt the stuff in.
Bear in mind it was created to be used on traditional opiates, the fentanyl is much stronger,
so that it may take repeated doses to bring someone back.
out of the weather. In the middle of the night I heard screaming .
One of them had done a puff of fentanyl, and fell out on the floor floor.
No pulse, eyes rolled back in their sockets, skin was cool and clammy.
I keep a supply of Narcan in my fridge.
It took repeated packs of Narcan to revive him. He is alive and OK now.
The fentanyl is everywhere, and we are only going to see more of the stuff.
Heard this morning of a ten year old who died as a result of taking a single puff
of a cannabis joint, they suspect that he may not have even known that it had been
laced with the stuff.
I would urge everyone to procure the reversal drug Narcan, you can get it at just about
any drug store. The stuff is easy as can be to use, open the package, shove it in their nose
and push the red button to squirt the stuff in.
Bear in mind it was created to be used on traditional opiates, the fentanyl is much stronger,
so that it may take repeated doses to bring someone back.
Gry
Well-known member
This past Sunday when the storm hit here, I let two homeless people stay in my laundry room to get them
out of the weather. In the middle of the night I heard screaming .
One of them had done a puff of fentanyl, and fell out on the floor floor.
No pulse, eyes rolled back in their sockets, skin was cool and clammy.
I keep a supply of Narcan in my fridge.
It took repeated packs of Narcan to revive him. He is alive and OK now.
The fentanyl is everywhere, and we are only going to see more of the stuff.
Heard this morning of a ten year old who died as a result of taking a single puff
of a cannabis joint, they suspect that he may not have even known that it had been
laced with the stuff.
I would urge everyone to procure the reversal drug Narcan, you can get it at just about
any drug store. The stuff is easy as can be to use, open the package, shove it in their nose
and push the red button to squirt the stuff in.
Bear in mind it was created to be used on traditional opiates, the fentanyl is much stronger,
so that it may take repeated doses to bring someone back.
out of the weather. In the middle of the night I heard screaming .
One of them had done a puff of fentanyl, and fell out on the floor floor.
No pulse, eyes rolled back in their sockets, skin was cool and clammy.
I keep a supply of Narcan in my fridge.
It took repeated packs of Narcan to revive him. He is alive and OK now.
The fentanyl is everywhere, and we are only going to see more of the stuff.
Heard this morning of a ten year old who died as a result of taking a single puff
of a cannabis joint, they suspect that he may not have even known that it had been
laced with the stuff.
I would urge everyone to procure the reversal drug Narcan, you can get it at just about
any drug store. The stuff is easy as can be to use, open the package, shove it in their nose
and push the red button to squirt the stuff in.
Bear in mind it was created to be used on traditional opiates, the fentanyl is much stronger,
so that it may take repeated doses to bring someone back.
