Posted in aches, Arthritis, Chronic lower back pain, chronic pain, Coping with Chronic Pain, Fatigue, Fibromyalgia, Health Care, Knee pain, Muscle and joint stiffness, Rheumatoid Arthritis, Surgeries, U.S. Pain Foundation

DEA’s Latest Attempt to Punish Chronic Pain Patients

Now the DEA’s newest proposal targets drug manufacturers by giving them quotas as to the number of controlled substances they will be allowed to produce. Here we go again … another attempt to bully and force decreases in the manufacturing of pain medications – which hurt millions of Americans suffering with some form of chronic pain. But there is little empathy toward chronic pain patients suffering from back issues, hidden illnesses, and even surgeries.

And the number of patients who have been refused pain prescriptions for diagnoses they’ve lived with for decades continues to increase as will the suicides by these patients who can find no other form of relief. Following this is the comment I submitted to the DEA and I urge you to send your story to them ASAP. In the article, “DEA Wants to Target Drug Manufacturers in Opioid Supply, by Ed Coghlan and found in the National Pain Report dated April 21, 2018, click on the article title which will take you to the proposal docket  with instructions on submitting your comments. This is opened to the public until May 4th so please send your comments in today.  Thank you.

To Whom It May Concern:

I am pleading with you to cease, overthrow, and forget about the proposal to decrease the manufacturing of controlled substances, namely, opioids.

Scoliosis, Spinal Stenosis, herniated discs, and six fusion surgeries on my back due to Scoliosis have left my spine with 2 inches of bone-free fusions. It was decided not to fuse that area because of assumed increased complications. My back pain increased resulting in quitting my job and stop instructing, choreographing, and dancing line dances, restricted my love of gardening, house cleaning, and shopping due to the impact of pressure forced on those 2 inches of my spine.

Since July 2012 I have been on disability, spent the year of 2013 contemplating suicide and wallowing in a sea of depression as new health issues arose. Less than six months ago I was diagnosed with Restrictive Lung Disease and am now on oxygen 24/7 along with the myriad of medications to address my severe chronic back pain, restless leg syndrome, fibromyalgia, depression, and lack of sleep.

Taking Percocet at the dosage of 7.5/325 mg four times a day allows me to walk on the treadmill at 2.0 mph for 30 minutes (3-4 times weekly), dress myself, make the bed, and wash dishes. I go shopping with my husband at least once a week to get out of the house and unfortunately, we come right home after the first stop because the back pain will not allow me to spend an afternoon of shopping. I walk with a cane and sometimes ride in a wheelchair. And I’ve tried to dance a little bit for exercise but the oxygen tubing gets in my way.

If I didn’t take the Percocet four times a day my day would look like this: Wake up, go to the bathroom, sit back on the recliner with heating pad and moan in pain – and this is where I would spend my day. Activity increases my pain, therefore, physical activity is gone. Going out to shop is out of the question. Household chores including picking up items around the house, making the bed, or washing dishes is out of the question because the back pain travels down both legs and stirs up the RLS … forcing me to get back on the recliner. I’d get fat. I’d be depressed. And I’d be thinking of other options that would take away the misery of my painful life.

It was revealed that the CDC inflated the numbers of opioid suicides in its report per this article: (https://www.painnewsnetwork.org/stories/2018/3/21/cdc-admits-rx-opioid-deaths-significantly-inflated) And there have already been a few suicides by pain patients who were refused pain medication, leaving the patients with suicide as their only option to relieve their pain.

Controlling substance quotas isn’t going to remove suicides amount the citizens of this country – it is going to escalate suicides. For some reason people who do not live with chronic pain, believe it can be remedied with physical therapy, acupuncture, massage therapy – all great options, but they do not last. And they are expensive.

I cannot live a semi-normal life without Percocet. I’ve tried cutting down and find myself eventually taking the required number because the pain escalates quickly. How am I suppose to live? How am I suppose to enjoy visiting my son and his family including two grandchildren? How do I face a day without pain relief?

PLEASE, I BEG you to remove this proposed rule and reconsider your actions. This rule will escalate suicides, remove quality of life, and force pain patients to spend their days and nights in bed. Is this the society you are striving for?

Respectfully,

Carolyn Robinson

Posted in aches, Arthritis, Chronic lower back pain, chronic pain, Coping with Chronic Pain, Inflammation, Knee pain, Rheumatoid Arthritis, Surgeries

Relief Options for Chronic Pain

PART 3  –  OPIOIDS

Except for Marijuana, controversy surrounds Opioids more than any of the previous medications discussed in Parts 1 and 2. Suicides, accidental overdoses, and misuse of Opioids by prominent celebrities fill the headlines and invoke a strong media reaction. This escalated attention cautions healthcare physicians to seek other options for their patients.

The American Academy of Pain Medicine, National Institutes and Health, American Chiropractic Association, and American Society of Addiction Medicine provide chronic pain and prescription opioids statistics. These statistics cover the United States only:

Chronic pain statistics indicate more people suffer from pain than the combination of diabetes, heart disease, and cancer. Excluding acute pain conditions and children suffering from pain, 50 million to 100 million adults suffer from chronic pain. Of those adults, 27% seek treatment for lower back pain, 15% for severe headaches to migraine pain, and another 15% for neck pain. Alarmingly, these numbers continue to grow daily.

Research of the prescription pain pill epidemic for 2015 shows 20,404 people died from Opioids overdoses. Prescription opioids account for substance abuse disorders by two million people. Increased national crime, pharmacy burglaries, and overdose deaths were tied to Opioids abuse.

Since the rise of prescription drug overdoses, especially prescription Opioids, views have changed among healthcare providers for prescribing Opioids for the treatment of chronic pain. However, Opioids are prescribed in cases of short-term to help patients recover from fractures or post surgery.

Your primary care physician will no longer prescribe Opioids for moderate to severe chronic pain. Instead, you’ll be referred to a Pain Management Facility where specialists evaluate and monitor prescriptions of Opioids.

Many chronic pain patients find themselves suffering more and receiving little or no assistance of treatment for their pain due to the abuse and misuse epidemic. As the fear of overdosing heightens many physicians, including specialists, seek other options to treat chronic pain. Physical therapy, minimally invasive procedures, and lifestyle changes are the preferred options. However, these options, exhausted by most chronically ill patients, bring little to no relief.

So, how do chronic pain patients find relief? If Opioids are the only option available for severe chronic pain then understanding the risks involved with these drugs is mandatory. The specialists associated with Paindoctor.com (and most pain management specialists) treat chronically ill patients using a 12-step Opioid Checklist to ensure patient safety. (You can find the risks of Opioids listed after the checklist.)

Taking Opioids is a risk. But most chronic pain sufferers take that risk to acquire a fraction of the quality of life they enjoyed prior to the onset of chronic pain.

What are Opioid medications?

As the oldest known class of drugs in the world, Opioids refer to either morphine or other opium poppy-based medications – narcotics. Opioids suppress the pain perception by reducing pain signals as they are transmitted through the nervous system.

Below are some types of Opioids (and their generics) used for chronic pain treatment. ALL of these medications require a prescription.

Hydrocodone (Hysingla ER, Zohydro ER)

-*Hydrocodone/acetaminophen (Lorcet, Lortab, Norco, Vicodin)

Hydromorphone (Dilaudid, Exalgo)

Oxycodone (Oxycontin, Oxecta, Roxicodone)

-*Oxycodone and Acetaminophen (Percocdet, Endocet, Roxicet)

Oxycodone and Naloxone (Targiniq ER)

Morphine (Astramorph, Avinza, Kadian, MS Contin, Ora-Morph SR)

Meperidine (Demerol)

Methadone (Dolophine, Methadose)

Fentanyl (Actiq, Duragesic, Fentora)

Codeine (only available in generic form)

(*Includes Acetaminophen in the compound. Avoid other products containing acetaminophen (ex: Tylenol) due to increased risk of liver problems.)

For pain relief all day and through the night your doctor may prescribe specific doses of your pain medication. However, there is a chance you may experience “breakthrough” pain. Breakthrough pain is a flare of pain experienced even though you receive round-the-clock pain medication.1 In this case, you may be given a prescription with “as needed” instructions.

Regular visits to the pain specialist are a requirement of care if you are prescribed Opioids. These visits include questions asked by your specialist:

          1. Are you responding to the Opioid?
          2. Are you experiencing any side effects?
          3. Have you developed a medical condition or potential interaction that may increase the risk of side effects?
          4. Are you taking the medication as directed?2

NOTE:  Never change the dosing of any Opioid medication without first checking with your physician. If your pain isn’t managed by the medication prescribed, your physician may change the dose or try another Opioid drug.

Opioids can be dangerous if taken with 1) antidepressants, 2)antihistamines, and/or 3)sleeping pills. Be sure your doctor knows all medicines you are taking. Other prescription drugs, over-the-counter drugs, and herbal supplements may cause additional problems when taken with Opioids.

When you’re ready to quit the Opioids, your pain specialist will advise a slow weaning off from the Opioids to help your body adjust to the removal of the pain medications. Withdrawal symptoms occur if you stop the Opioids abruptly.

As reviewed in Parts 1 & 2 of this series, most medications have side effects and Opioids are no different. Common side effects include:

*Constipation                       *Sedation

*Fatigue                                 *Nausea

*Vomiting                              *Confusion

*Dry Mouth                           *Constricted pupils (miosis)

*Itching (pruritis)

However, there are more serious side effects including:

**Urinary retention              **Hearing loss

**Respiratory depression    **Hallucination

**Hypothermia                       **Delirium

**Hyperalgesia (increased sensitivity to pain)

**Abnormal heartbeats (arrhythmias)

LARGE doses can induce:

***Serious respiratory problems              ***Depression

***Oxygen deprivation                                ***Unconsciousness

***Overdose                                                   ***Death

Taking Opioids for the long-term may cause tolerance, dependency, and/or addiction.

Tolerance occurs when the need for Opioids causes increasing the dosages.

Dependence is a physical or psychological effect. A physical dependency occurs when you (abruptly) stop taking your Opioid medications resulting in a withdrawal syndrome. Psychological dependency occurs as an emotional need for the drug when there is no physical need.

A small percentage of patients who use Opioids long-term may suffer from addiction.3 The characterization of addiction is a constant pattern of inappropriate Opioid use and may include the following serious problems:

    • Loss of control of using Opioids
    • A preoccupation of acquiring more Opioids even though pain relief is achieved
    • Although adverse physical, psychological, or social consequences may occur, the patient continues using Opioids
    • Overdose and death increases as an adverse effect

Should you take Opioids? If you suffer from moderate to severe pain, Opioid drugs can make a significant difference in your pain levels. However, you must take them safely and follow your doctor’s instructions carefully to avoid the negative effects of Opioids.

Next week, we’ll explore Marijuana and its treatment of chronic pain. Have a great week!

1Opioid (Narcotic) Pain Medications article, WebMD, LLC, 2017

2Opioid (Narcotic) Pain Medications article, WebMD Medical Reference, Minesh Khari,MD, April 30, 2017

3What are Opioid Medications? Article, paindoctor.com

 

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Posted in aches, Arthritis, chiropractor, chronic pain, Fatigue, Fibromyalgia, Knee pain, Muscle and joint stiffness, Rheumatoid Arthritis, Surgeries, U.S. Pain Foundation, Uncategorized

Chronic Pain is a Pain in the ***

Good morning!

So far nobody has found my blog post and I really haven’t shared it with anyone yet, but hoping the keywords will bring visitors sooner than later.

Chronic Pain is a Pain in the (fill in the blank on the title) or fill in YOUR Chronic Pain area! It’s in your lower back, upper back, travels down your legs, is in your legs, your feet, your hands, shoulders, neck, head…you name it and most people will share the same pain you do.

So, what do you do about your Chronic Pain? We mentioned chiropractors, pain medicines, and therapy. But I have another option for you. There is a pain organization that helps almost every type of pain a person may have. It’s the U.S. Pain Foundation. If you go to the site (http://www.IntheFaceofPain.com) you will find a ton of information, resources, and help with your pain.

Write your story for them and they will send you information to help you in the form of resources, options for pain relief, and many more interesting and informative pamphlets for you, the pain sufferer. You’ll also receive a “Pain Warrior” bracelet to wear and let people know you are a Chronic Pain sufferer. Who knows, it may catch the attention of a fellow pain sufferer and you can share this information with them.

And if for some reason, you are not able to get on the computer to check out the website, but have a question, comment to me (below this post) and I will look up the answer for you. I joined the Advocacy Group for US Pain to help others with Chronic Pain find ways to deal with their pain every day. It would be my pleasure to help you or guide you to the right person for help.

It isn’t necessary to live with Chronic Pain all by yourself. You have people, support groups, and me, who will help you find a doctor for coping with pain. Plus I’ve thought of starting a Chronic Pain group to meet once a week or once a month so we can get to know each other and share our stories about pain and how we cope with it. You never know what other pain sufferers share that you will benefit from!

Those meetings will begin when it stays lighter in the evenings. I’m not crazy about driving in the dark and some of you may feel the same way. But keep a look out on my blog page for the date of the first meeting, place, and time. We may have several meetings in different locations so you wont’ have to drive so far.

I didn’t get to write my blog yesterday, but I hope you will check it out today. We are beginning a journey with fellow pain sufferers to stamp pain out and learn to live with it.

Until tomorrow, thanks for stopping by and I hope you have a “dry” day in the flood of water pouring down out there!

Take care,

Carolyn