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For me, the problem is fear. A decade or so back, I badly broke my arm in a mountain biking crash. The event itself barely hurt at all, but the muscles around t

For me, the problem is fear. A decade or so back, I badly broke my arm in a mountain biking crash. The event itself barely hurt at all, but the muscles around the broken arm all tensed up, and after several hours were extremely painful. The hospital gave me morphine. As far as I could tell, the morphine did nothing. I remained in significant pain for a few hours while I awaited treatment. It's impossible for me to say why. Is morphine just ineffective for that sort of pain? Or was I underdosed to prevent negative interactions with the drugs they gave me later? Or was I underdosed as a precautionary measure for opiates due to addiction? All I know is that I'm afraid of ending up in pain in the future and being denied effective treatment out of misguided concern that I will become an addict. I do not fear addiction. I fear pain.

DanBC 10y ago
Parent poster is talking about the problems of opioids for long term pain. A broken arm is not long term pain. Most doctors are not worried about opioid use for short term pain.
stinos 10y ago
The hospital gave me morphine. This seems to illustrate the US mentality towards opioids: I had a similar accident and the fracture itself didn't really hurt but the muscle tension was indeed very painful and all I got in a Belgian hospital was some Brufen (Advil in the US if I'm not mistaken) - and that did work. In Belgium opioids are generally looked at 'only if it's really necessary'. Belgium does have a severe problem with prescription antibiotics though.
mtreis86 10y ago
The old standard for morphine is give however much stops the pain. They should have pushed up to the max they're allowed, if you were still in pain. I was in an accident, and the docs gave me as much morphine and dulaudid as it took and explained that opiod reception varies greatly when in pain. The amount of dilaudid that would make you loopy now may do nothing while you're hurt, and the amount to make you comfortable while hurt would easily kill you now. Effectively the LD50 varies with pain levels.
mercer 10y ago
Sadly, in my experience addiction is often fed, if not caused, by pain avoidance. This in no way is meant to reflect on your particular situation, but I just want to point it out for the benefit of those who struggle with addiction and opt for it over alternatives. My personal struggles in this area, in hindsight, were not primarily fed by a desire to satiate a craving or desire or need, but rather much more by a fear of future pain. Ideally, this comment shouldn't lessen the struggle of those who have to deal with pain, but it should increase our empathy with those who struggle with addiction, because I'm willing to bet that in many if not most cases, there's a crippling, intense fear of pain underlying it. How rational that fear is doesn't really matter. I've seen people with a legitimate need to alleviate pain succumb to addiction. I've also seen people who 'should' be fine succumb to addiction because of less-visible, mental anguish. It seems to me both cases, and the usual murky area in between, deserve study, empathy, and solutions.

DanBC 10y ago

Parent poster is talking about the problems of opioids for long term pain. A broken arm is not long term pain. Most doctors are not worried about opioid use for short term pain.

stinos 10y ago

The hospital gave me morphine. This seems to illustrate the US mentality towards opioids: I had a similar accident and the fracture itself didn't really hurt but the muscle tension was indeed very painful and all I got in a Belgian hospital was some Brufen (Advil in the US if I'm not mistaken) - and that did work. In Belgium opioids are generally looked at 'only if it's really necessary'. Belgium does have a severe problem with prescription antibiotics though.

mtreis86 10y ago

The old standard for morphine is give however much stops the pain. They should have pushed up to the max they're allowed, if you were still in pain. I was in an accident, and the docs gave me as much morphine and dulaudid as it took and explained that opiod reception varies greatly when in pain. The amount of dilaudid that would make you loopy now may do nothing while you're hurt, and the amount to make you comfortable while hurt would easily kill you now. Effectively the LD50 varies with pain levels.

mercer 10y ago

Sadly, in my experience addiction is often fed, if not caused, by pain avoidance. This in no way is meant to reflect on your particular situation, but I just want to point it out for the benefit of those who struggle with addiction and opt for it over alternatives. My personal struggles in this area, in hindsight, were not primarily fed by a desire to satiate a craving or desire or need, but rather much more by a fear of future pain. Ideally, this comment shouldn't lessen the struggle of those who have to deal with pain, but it should increase our empathy with those who struggle with addiction, because I'm willing to bet that in many if not most cases, there's a crippling, intense fear of pain underlying it. How rational that fear is doesn't really matter. I've seen people with a legitimate need to alleviate pain succumb to addiction. I've also seen people who 'should' be fine succumb to addiction because of less-visible, mental anguish. It seems to me both cases, and the usual murky area in between, deserve study, empathy, and solutions.