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It has become an absolute joke. I have had 6 surgeries for Crohns, a back surgery due to wear and tear from high level athletics, and am a long term sufferer of

It has become an absolute joke. I have had 6 surgeries for Crohns, a back surgery due to wear and tear from high level athletics, and am a long term sufferer of an aggressive leukaemia. Despite using opioids responsibly for over a decade, I am regarded as nothing more than a drug seeking pest the very few times I have actively sought pain relief during in-patient hospital stays. Prior to being dropped entirely from my Oxycodone IR script (30 10mg pills a month, truly not a large amount) without any warning due to my pain doctor finally simply giving up on the system, I had never asked for an increase in a dose ever - despite still having plenty of untreated pain. Legitimate chronic pain patients are being abused at this point in order to save face for the broken, rent-seeking pharmaceutical system that enabled the prescription opioid 'crisis' in the first place.

BaronVonSteuben 5y ago
Yep, absolutely. My doctor of 10+ years recently retired, leaving me in search of a new doc. I've been managing my pain for 15+ years just fine with 10mg Hydrocodone. In 15 years I only once asked to increase the dose, and it was only from two pills per day to three to help me get through the afternoon/evening better. A minuscule dose. After doing "new patient" appointments (which by the way were like $200 to $300 each) and not having a doc willing to take me on as a patient unless I dropped the opioids, and making several calls (who refused to tell me over the phone whether the doctor was even open to controlled substances without that $300 "new patient" appointment) I gave up. Since coming off the opioids my quality of life has plunged. I struggle with depression and thoughts of suicide now, especially when I'm unable to leave the house or my bed. I went from stable and productive and what doctors used to say is the model patient, to being miserable. Every doc has offered to give me additional antidepressants or crank up the doses of those, but none are willing to treat the pain that is exacerbating it. I absolutely believe that what the medical establishment is doing to people like us (withholding treatment that we know works) is cruel and borders on torture. It is the epitome of taking macro-level stats and explanations and applying them broadly on the micro-level, regardless of the harm caused. I believe Hippocrates would be rolling over in his grave to hear that these people took an oath to "do no harm." For the record. I mostly don't blame the doctors. They are protecting their medical licenses, which the DEA and FDA have proven they are willing to revoke over the slightest anomaly. When the feds started throwing pain specialists in federal prison because some tiny percent of their patients were abusers, it really drove home that individual doctors are not allowed to think anymore. You implement government policy, or you risk financial ruin and even jail time. I don't blame them for being cowards. I probably wouldn't risk imprisonment on a stranger either.
- atdrummond 5y ago
  I don't blame the doctors either. My pain doctor was a rural boy from my hometown who made good, graduated from Berkeley and finished medical school and finished desirable postdocs at Harvard. He simply straight up quit pain management as a specialty rather than be forced to provide his patients with what he considered subpar care. The loss of doctors like him hurts particularly badly, as it leaves us with pain specialists who either knowingly ignore the decades of successfully treated patients who used opioids or the remaining (and they do still exist) pill mill operations, who have simply gotten more sophisticated in their execution. Regardless of which doctor archetype chronic pain patients end up with, they're going to suffer.
- google234123 5y ago
  We also now know that those treatments kill people and users gain dependence and tolerance to opioids. It’s more than just protecting their medical license.
  - atdrummond 5y ago
    The proportion of patients who become addicted from properly prescribed opioids is extremely small. The majority of addicts created were provided with opioids that were not appropriate for their particular medical situation, in doses that were too high, and on a regimen that exceeded in length what was supported by the medical evidence. The proportion of new cancer patients who go on to receive palliative care that includes opioids who end up becoming addicted has always been, and remains, in the low single digits. For patients with a genuine need and who are properly inducted and maintained on them, opioids are a powerful and useful medical tool. Further, the bulk of use in illegal opioids stateside, such as fentanyl and its analogues, is not (at least today) driven by the conversion of the legal opioid user to an illegal drug user. Fentanyl is now commonly found in drugs that never previously would have contained an opioid, such as counterfeit benzos and MDMA. Further, the majority of fentanyl users on the street arrive at its use after consuming other illegal/street drugs. For those who started on other opioids, their first opioid will tend to be the illegally diverted pills or liquid cough treatments containing codeine/hydrocodone called "lean". Very few new users of fentanyl and fentanyl analogues come from legal opioid users, mainly because very few new users are now inducted on reckless prescriptions such as an immediate script for 180 Oxycontin and 240 benzodiazepene pills a month. Your narrative is about a decade out of date at this point. Thomas Kline is a superb resource if you want to take a deeper dive into the actual statistics and how the narrative of a crisis was used to systematically deny law abiding patients the pain treatment they should receive. https://twitter.com/thomasklinemd https://twitter.com/thomasklinemd
Gatsky 5y ago
Sorry to hear you have this problem. Chronic pain understanding and management is medieval, and seemingly getting worse rather than better over time.
- atdrummond 5y ago
  I really appreciate your kind thoughts. Thankfully Vipassana meditation has helped keep me sane in spite of the inane restrictions my doctors have been put under and also just so happens to help reduce the pain to a somewhat more manageable level. It's funny that a lot of the patients most aggressively hurt by simplistic one-size-fits-all reforms like the 90 MME cap are the patients most likely to support, and already be utilizing, integrative medicine. Such patients have been dealing with pain for years, decades often - they're not going to turn down any potential solutions that might help. All they ask is for their doctors to be given the autonomy necessary to prescribe legal, needed medications when called for.
throwaway684936 5y ago
noodlesUK 5y ago
I’m curious what the situation is outside the US. My personal experience has always been that I’ve been able to access whatever drugs I’ve needed in the UK, but I also am white and don’t look like a “Drug user™”. I’ve never heard the words opioid crisis in a European context (but have of course heard it in a US context).

BaronVonSteuben 5y ago

Yep, absolutely. My doctor of 10+ years recently retired, leaving me in search of a new doc. I've been managing my pain for 15+ years just fine with 10mg Hydrocodone. In 15 years I only once asked to increase the dose, and it was only from two pills per day to three to help me get through the afternoon/evening better. A minuscule dose. After doing "new patient" appointments (which by the way were like $200 to $300 each) and not having a doc willing to take me on as a patient unless I dropped the opioids, and making several calls (who refused to tell me over the phone whether the doctor was even open to controlled substances without that $300 "new patient" appointment) I gave up. Since coming off the opioids my quality of life has plunged. I struggle with depression and thoughts of suicide now, especially when I'm unable to leave the house or my bed. I went from stable and productive and what doctors used to say is the model patient, to being miserable. Every doc has offered to give me additional antidepressants or crank up the doses of those, but none are willing to treat the pain that is exacerbating it. I absolutely believe that what the medical establishment is doing to people like us (withholding treatment that we know works) is cruel and borders on torture. It is the epitome of taking macro-level stats and explanations and applying them broadly on the micro-level, regardless of the harm caused. I believe Hippocrates would be rolling over in his grave to hear that these people took an oath to "do no harm." For the record. I mostly don't blame the doctors. They are protecting their medical licenses, which the DEA and FDA have proven they are willing to revoke over the slightest anomaly. When the feds started throwing pain specialists in federal prison because some tiny percent of their patients were abusers, it really drove home that individual doctors are not allowed to think anymore. You implement government policy, or you risk financial ruin and even jail time. I don't blame them for being cowards. I probably wouldn't risk imprisonment on a stranger either.

atdrummond 5y ago
I don't blame the doctors either. My pain doctor was a rural boy from my hometown who made good, graduated from Berkeley and finished medical school and finished desirable postdocs at Harvard. He simply straight up quit pain management as a specialty rather than be forced to provide his patients with what he considered subpar care. The loss of doctors like him hurts particularly badly, as it leaves us with pain specialists who either knowingly ignore the decades of successfully treated patients who used opioids or the remaining (and they do still exist) pill mill operations, who have simply gotten more sophisticated in their execution. Regardless of which doctor archetype chronic pain patients end up with, they're going to suffer.
google234123 5y ago
We also now know that those treatments kill people and users gain dependence and tolerance to opioids. It’s more than just protecting their medical license.
- atdrummond 5y ago
  The proportion of patients who become addicted from properly prescribed opioids is extremely small. The majority of addicts created were provided with opioids that were not appropriate for their particular medical situation, in doses that were too high, and on a regimen that exceeded in length what was supported by the medical evidence. The proportion of new cancer patients who go on to receive palliative care that includes opioids who end up becoming addicted has always been, and remains, in the low single digits. For patients with a genuine need and who are properly inducted and maintained on them, opioids are a powerful and useful medical tool. Further, the bulk of use in illegal opioids stateside, such as fentanyl and its analogues, is not (at least today) driven by the conversion of the legal opioid user to an illegal drug user. Fentanyl is now commonly found in drugs that never previously would have contained an opioid, such as counterfeit benzos and MDMA. Further, the majority of fentanyl users on the street arrive at its use after consuming other illegal/street drugs. For those who started on other opioids, their first opioid will tend to be the illegally diverted pills or liquid cough treatments containing codeine/hydrocodone called "lean". Very few new users of fentanyl and fentanyl analogues come from legal opioid users, mainly because very few new users are now inducted on reckless prescriptions such as an immediate script for 180 Oxycontin and 240 benzodiazepene pills a month. Your narrative is about a decade out of date at this point. Thomas Kline is a superb resource if you want to take a deeper dive into the actual statistics and how the narrative of a crisis was used to systematically deny law abiding patients the pain treatment they should receive. https://twitter.com/thomasklinemd https://twitter.com/thomasklinemd

Gatsky 5y ago

Sorry to hear you have this problem. Chronic pain understanding and management is medieval, and seemingly getting worse rather than better over time.

atdrummond 5y ago
I really appreciate your kind thoughts. Thankfully Vipassana meditation has helped keep me sane in spite of the inane restrictions my doctors have been put under and also just so happens to help reduce the pain to a somewhat more manageable level. It's funny that a lot of the patients most aggressively hurt by simplistic one-size-fits-all reforms like the 90 MME cap are the patients most likely to support, and already be utilizing, integrative medicine. Such patients have been dealing with pain for years, decades often - they're not going to turn down any potential solutions that might help. All they ask is for their doctors to be given the autonomy necessary to prescribe legal, needed medications when called for.

throwaway684936 5y ago

noodlesUK 5y ago

I’m curious what the situation is outside the US. My personal experience has always been that I’ve been able to access whatever drugs I’ve needed in the UK, but I also am white and don’t look like a “Drug user™”. I’ve never heard the words opioid crisis in a European context (but have of course heard it in a US context).