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Are your Doctors over-prescribing Pain Meds?
07-04-2011, 12:01 PM, (This post was last modified: 07-04-2011, 12:20 PM by 1171.)
#1
Are your Doctors over-prescribing Pain Meds?
Are you endanger of overdosing?
Do you need Pain Management?
what are the red flags for overuse?

you can review dosage guidelines on how opiates should be prescribed as well as information on what is the best practice for pain treatment.

common opiate prescriptions:
codeine, fentanyl transdermal, hydrocodone, hydromorphone, methadone, morphine, oxycodone, oxymorphone


the state of Washington has published extensive guidelines to deal with the growing problem of opiate overuse and pain management treatment.

http://www.agencymeddirectors.wa.gov/



Data collected in Washington state show:
* During 2004–2007, 1,668 WA residents had confirmed unintentional poisoning deaths due to prescription opioid related overdoses6. Nearly half of these deaths were in the Medicaid population.
* Unintentional opioid-related overdose deaths increased 17-fold during 1995–2008.
*Hospitalizations for opioid-related overdoses increased 7-fold during 1995–2007.
*Addiction treatment admissions, where prescription opioids were the primary drug of abuse, increased from 1.1% to 7.4% between 2000 and 2009.
* Prescription opioid-related overdose deaths now exceed non-prescription opioid-related overdose deaths.
*The death rate from unintentional poisoning exceeded the death rate from motor vehicle crashes in 2006, and the gap continues to widen
Reply
07-04-2011, 02:10 PM,
#2
RE: Are your Doctors over-prescribing Pain Meds?
Gosh, 1171...I just didn't know that. I hope you get off that stuff then, because...[Image: blowing-nose.gif]I'd really, really miss you if you fell off and over into the big nowhere....
Reply
07-05-2011, 02:10 AM,
#3
RE: Are your Doctors over-prescribing Pain Meds?
http://www.urbandictionary.com/define.php?term=winky
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07-05-2011, 06:49 AM,
#4
RE: Are your Doctors over-prescribing Pain Meds?
[Image: image004rollingontheefloor-1.gif]
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07-05-2011, 08:51 AM,
#5
RE: Are your Doctors over-prescribing Pain Meds?
The answer is a BIG YES but I believe most PM Doctor's are Honest in there decisions. I think the patient is the culprit in this major issue by lying about there actual pain due to dependence on a opiate.

My desire is to take as little as possible of a Narcotic for pain. I use Nerve burning as a way to decrease pain for instance and a Ten's Unit.

I will always say DO NOT BEGIN TAKING A NARCOTIC unless every avenue has been exhausted. If you can function with your pain leave Narcotic's alone.

I am very "dependent" on my 2 Narcotic's plus Lyrica and Ambien. I hope one day to rid this mess out of my body but currently I cannot due to pain level.
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07-05-2011, 09:38 AM,
#6
RE: Are your Doctors over-prescribing Pain Meds?
A good PM doctor is worth it. For me when it put me on Dilaudid it was for 4mg. They didn't stock that so he wrote it for 2-2mg pills, they way I can take only one if I don't think I need the full 4 mg. That way I'm only taking what I might need instead of the full dose. It might cost more for more pills instead of cutting the 8mg pills in half but to me this is better for my health.
It's hard to keep the pain level low along with keeping the pill intake low so it not only hard on us it is just as tuff for the doctor to give us what we need with out going over board
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07-05-2011, 10:46 AM,
#7
RE: Are your Doctors over-prescribing Pain Meds?
My Dr fights with my IC all the time as he writes my scrips for my meds for smaller meds and I take 2 so I have control over my meds they say its cheaper to order the higer dosage pill but then I have to take it all weather I need it or not..some months are bad mosty winter months I need them all...summer months are not so bad and I can take less I have the pool to help deal with pain....
........I love cats, I just cant eat a whole one by myself......







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07-05-2011, 11:31 AM, (This post was last modified: 07-05-2011, 11:50 AM by 1171.)
#8
RE: Are your Doctors over-prescribing Pain Meds?
pain management doctors generally have much tighter control over pain med dosage then typical primary physicians and are aware of the dangers.
if you are not under pain management monitoring then the washington site has a dosage calculator to determine the danger area

it translates common opiate prescriptions into it's Morphine Equivilant with a threshold of 120 mg per day.
codine = 8 mg/day
fentanyl = .5 mc g/hr
hydrocodone = 1.2 mg/day
hydromorphone = .3 mg day
oxycodone = .8 mg/day
oxymorphone = .4 mg/day

referal to pain management is required for anything over the 120 mg/day.

the guidelines on the site can be very helpful for those who want better pain treatment




Reply
07-05-2011, 12:54 PM,
#9
RE: Are your Doctors over-prescribing Pain Meds?
Now this is a red button topic of discussion. Its no secret that each Pain Management Dr. has their own idea of appropriate opiate use. I believe the "best practice for pain treatment." is the one that is "tailored" to the sufferer's symptoms. Opioid tolerance can not be factored into a one prescribed dose fits all government website, as this is part of a medical condition, which will vary among patients. The "red flag" you seek is best described as the point of when the opiate given begins to produce non productive actions such as "Doctor shopping, calls to Dr for "lost scripts" and most importantly when the drug given begins to provide a negitive influence in the sufferer's life.

It was not long ago when the drum beat was to under treat pain leaving the sufferer to suffer needlessly because the Dr is afraid of the government. There needs to be balance. I believe that the regular prescribing of schedule 2 narcotics should rest solely on the shoulders of the pain management specialist not family practice MD's or DO's. Certainly not a one recipe fits all suggestion off a government site.

Now that the pain sufferer's advocate groups have gotten the government to allow a way for the "TRUE" pain sufferer to obtain treatment that is appropriate, in the last 10 year there have been increased amounts of pain meds prescribed thus maybe this can account for the increases in accidental over doses/poisonings??

Freebird makes an excellent point of patient accountability. Use of the WHO ladder is a must when ones pain requires medical intervention with pain meds. Insurance companies are another obstacle for the pain management Dr as the Dr should not need to fight with an insurance company to get a suffering patient the appropriate dose and brand of medication.

Today those prescribed potent narcotics (schedule 2) are ALL in a national data base, which includesthe patient's name, the active ingredient prescribed, date, Dr, and dose. Many PM Dr's require a pain contract as well. There are other safety measures, in place to prevent diversion, which I feel are needed if the Drs are going to be more comfortable in listening to a pain patients symptoms.

I wish you all a pain free day, if possible?

BUG


(07-04-2011, 12:01 PM)1171 Wrote: Are you endanger of overdosing?
Do you need Pain Management?
what are the red flags for overuse?

you can review dosage guidelines on how opiates should be prescribed as well as information on what is the best practice for pain treatment.

common opiate prescriptions:
codeine, fentanyl transdermal, hydrocodone, hydromorphone, methadone, morphine, oxycodone, oxymorphone


the state of Washington has published extensive guidelines to deal with the growing problem of opiate overuse and pain management treatment.

http://www.agencymeddirectors.wa.gov/



Data collected in Washington state show:
* During 2004–2007, 1,668 WA residents had confirmed unintentional poisoning deaths due to prescription opioid related overdoses6. Nearly half of these deaths were in the Medicaid population.
* Unintentional opioid-related overdose deaths increased 17-fold during 1995–2008.
*Hospitalizations for opioid-related overdoses increased 7-fold during 1995–2007.
*Addiction treatment admissions, where prescription opioids were the primary drug of abuse, increased from 1.1% to 7.4% between 2000 and 2009.
* Prescription opioid-related overdose deaths now exceed non-prescription opioid-related overdose deaths.
*The death rate from unintentional poisoning exceeded the death rate from motor vehicle crashes in 2006, and the gap continues to widen

Reply
07-05-2011, 01:20 PM,
#10
RE: Are your Doctors over-prescribing Pain Meds?
yes I had to sign a contract with my Dr and the drug store..I also carry a card with me stating I am a PM patient so if I have to go to a ER for anything I have to let them know up front I am a PM patient and what drugs I am on they in turn call my PM Dr to Okay anything....I use one ER for anything that goes wrong....now I dont know how this would work if I was in an accident far from home but the card is in my wallet by my ID card so its there.....I am always on the hunt for natural ways to relieve pain so I dont have to use pain meds because they mess with our minds and bodies...anyone who takes them knows that
........I love cats, I just cant eat a whole one by myself......







Reply


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