Amen to that! Anyone who feels worthy to judge others for use of prescribed pain medications -(and Vicodin, btw is the second lowest form of narcotic pain medication frequently prescribed in the US) -for any amount of time obviously has either no knowledge about pain management, disease processes, the true definition of addiction versus tolerance. Many uninformed people only contribute to the stigma that chronic pain patients have thrown upon them. I have been an RN for almost 20 years. I think I know a thing or two between the difference of a "drug seeker" and a person with true medical issues requiring a controlled and reasonable dosage of, for example, Vicodin or Codeine, etc. In real life, these chronic pain patients are TIGHTLY monitored, do not have any increases in dosage (unless there is absolute short term need such as postoperative pain), and most certainly do not take these for a "high". You simply don't experience a high or euphoria after using this long term at fixed dosages. If people worry about acetaminophen related toxicity, there is always the choice of Vicoprophen, which adds ibuprophen to the hydrocodone rather than acetaminophen for increased anti -inflammatory action. Chronic pain patients don't need to burn a hole through their GI tracts with pure ibuprofen at the high dosages they would require for pain management! Nor do they need huge quantities of acetaminophen. In reality, If a patient takes two to three Vicodin per day they might actually DECREASE their chances of renal & liver toxicity because they are less prone to throwing tons of OTC meds -unregulated- at their their painful conditions. In my experience as a nurse, I have seen MANY more patients that have issues with renal/liver toxicity and of course, the risk of GI bleeding because of the belief that OTC meds are a "harmless" alternative to a low, maintained and monitored dose of a mild narcotic agent. People need to stop watching House and Nurse Jackie to form their opinions about legally prescribed opiate pain meds! Do more research before you sit in judgement. There are MANY causes of chronic pain, not just low back pain. I care about my patient's pain. I know the difference between someone who wants to get high and a person having tried everything available to them under a pain management physician's monitoring of liver function tests, vital signs, and periodic urine tests to make sure the patient is actually taking the prescribed dose and that they fall into the range. But usually, at least in the region I live in, before they are even GIVEN the option of long term opioid pain relief, they are started on Physical Therapy, (a wonderful option that has helped a lot of people), encouraged in weight loss/nutritional modifications, started on antidepressants that have been found to diminish pain perception in some patients with certain conditions, (certainly not all), they attempt steroid injections if appropriate, even try prolotherapy (a controversial treatment done by some in desperation). Sometimes, what is found is that they function best on a controlled dose of drugs such as Vicodin, etc in direct relation to their medical needs. Obviously a person with any type of cancer will be prescribed more than someone with fibromyalgia or some other musculoskeletal conditions. It is up to the expertise of the physician who views the results of their x-ray, MRI, or other imaging studies, labs such as autoimmune panels, ESR rates, vital signs, complete history and physical assessments, etc. In this litigigious society, most docs I know are very (maybe TOO) conservative with prescribing.
There is no sane reason besides a true issue of addiction and loss of control over the use of their medication (not tolerance-tolerance is a natural physiological occurence that occurs with many drugs, narcotic and non narcotic!) that people should have to work hard and live constantly being reminded of their pain.
Please understand that there are many people with not only chronic, but progressive autoimmune, carcinogenic, musculoskeletal injuries that have not responded to known alternatives. Most people I know are not shooting up morphine, stealing their friends' pain meds, itching to take more than prescribed (besides post-op periods, and that's not always even the case!) In fact from what I have seen and read, most people are conservative enough in their use because they know what addiction has done to people around them. I'll be bold enough to say that in MOST cases, in AND out of hospitals, nursing homes, subacute rehabs (I have worked in all three and more areas of Nursing) people are UNDER medicated due to the ongoing stigma and fear associated with these drugs. In no way would I condone overmedication, pain meds used in a recreational or purely mood altering manner, or perpetuating a true, destructive addiction. Yes, there are people that ruin their lives, families, careers with uncontrolled drug use. Guess what? I believe there are more out there destroying their livers with alcohol because it's so much more acceptable in our culture. I drink a glass of red wine with dinner and am not against alcohol use in moderation unless you have no control over it. So why is it any different with Vicodin? Some people are drinking more and more to dull their physical pain when they could be doing so much less damage to their lives, bodies, and families.
Thanks for listening , from your compassionate RN.
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Amen to that! Anyone who feels worthy to judge others for use of prescribed pain medications -(and Vicodin, btw is the second lowest form of narcotic pain medication frequently prescribed in the US) -for any amount of time obviously has either no knowledge about pain management, disease processes, the true definition of addiction versus tolerance. Many uninformed people only contribute to the stigma that chronic pain patients have thrown upon them. I have been an RN for almost 20 years. I think I know a thing or two between the difference of a "drug seeker" and a person with true medical issues requiring a controlled and reasonable dosage of, for example, Vicodin or Codeine, etc. In real life, these chronic pain patients are TIGHTLY monitored, do not have any increases in dosage (unless there is absolute short term need such as postoperative pain), and most certainly do not take these for a "high". You simply don't experience a high or euphoria after using this long term at fixed dosages. If people worry about acetaminophen related toxicity, there is always the choice of Vicoprophen, which adds ibuprophen to the hydrocodone rather than acetaminophen for increased anti -inflammatory action. Chronic pain patients don't need to burn a hole through their GI tracts with pure ibuprofen at the high dosages they would require for pain management! Nor do they need huge quantities of acetaminophen. In reality, If a patient takes two to three Vicodin per day they might actually DECREASE their chances of renal & liver toxicity because they are less prone to throwing tons of OTC meds -unregulated- at their their painful conditions. In my experience as a nurse, I have seen MANY more patients that have issues with renal/liver toxicity and of course, the risk of GI bleeding because of the belief that OTC meds are a "harmless" alternative to a low, maintained and monitored dose of a mild narcotic agent. People need to stop watching House and Nurse Jackie to form their opinions about legally prescribed opiate pain meds! Do more research before you sit in judgement. There are MANY causes of chronic pain, not just low back pain. I care about my patient's pain. I know the difference between someone who wants to get high and a person having tried everything available to them under a pain management physician's monitoring of liver function tests, vital signs, and periodic urine tests to make sure the patient is actually taking the prescribed dose and that they fall into the range. But usually, at least in the region I live in, before they are even GIVEN the option of long term opioid pain relief, they are started on Physical Therapy, (a wonderful option that has helped a lot of people), encouraged in weight loss/nutritional modifications, started on antidepressants that have been found to diminish pain perception in some patients with certain conditions, (certainly not all), they attempt steroid injections if appropriate, even try prolotherapy (a controversial treatment done by some in desperation). Sometimes, what is found is that they function best on a controlled dose of drugs such as Vicodin, etc in direct relation to their medical needs. Obviously a person with any type of cancer will be prescribed more than someone with fibromyalgia or some other musculoskeletal conditions. It is up to the expertise of the physician who views the results of their x-ray, MRI, or other imaging studies, labs such as autoimmune panels, ESR rates, vital signs, complete history and physical assessments, etc. In this litigigious society, most docs I know are very (maybe TOO) conservative with prescribing.
There is no sane reason besides a true issue of addiction and loss of control over the use of their medication (not tolerance-tolerance is a natural physiological occurence that occurs with many drugs, narcotic and non narcotic!) that people should have to work hard and live constantly being reminded of their pain.
Please understand that there are many people with not only chronic, but progressive autoimmune, carcinogenic, musculoskeletal injuries that have not responded to known alternatives. Most people I know are not shooting up morphine, stealing their friends' pain meds, itching to take more than prescribed (besides post-op periods, and that's not always even the case!) In fact from what I have seen and read, most people are conservative enough in their use because they know what addiction has done to people around them. I'll be bold enough to say that in MOST cases, in AND out of hospitals, nursing homes, subacute rehabs (I have worked in all three and more areas of Nursing) people are UNDER medicated due to the ongoing stigma and fear associated with these drugs. In no way would I condone overmedication, pain meds used in a recreational or purely mood altering manner, or perpetuating a true, destructive addiction. Yes, there are people that ruin their lives, families, careers with uncontrolled drug use. Guess what? I believe there are more out there destroying their livers with alcohol because it's so much more acceptable in our culture. I drink a glass of red wine with dinner and am not against alcohol use in moderation unless you have no control over it. So why is it any different with Vicodin? Some people are drinking more and more to dull their physical pain when they could be doing so much less damage to their lives, bodies, and families.
Thanks for listening , from your compassionate RN.
March 2, 2012 - 6:59pmThis Comment
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