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Challenges of Treating Chronic Pain in People with Opioid Dependence


As headlines about opioids focus on misuse of the drugs, physicians who treat patients with chronic pain are grappling with how to deal with opioid dependence. At the recent American Psychiatric Association meeting, pain specialists said that treating patients in pain who are dependent on opioids involves a delicate balance between managing pain relief and risk of drug abuse.

“One of the challenges is that we don’t have good estimates of how common it is for chronic pain patients to develop problematic opioid use” says Jennifer Potter, PhD, MPH, in the Department of Psychiatry at the University of Texas Health Science Center in San Antonio. “The vast majority of people with chronic pain do not go on to develop an opioid addiction, so it’s important for patients to understand that if this medication benefits you, it’s not necessarily a concern. We can’t let our response to the rise in prescription drug abuse to be denying access to all people in pain who can benefit from opioids. We need to build our understanding so we can manage our risk of drug abuse effectively.”

Rates for co-existing chronic pain and opioid addiction vary depending on where you look, Dr. Potter says. “For patients in a pain clinic, addiction rates are relatively low, but in a methadone or buprenorphine population, between 34 to 40 percent will have a chronic pain complaint,” she says.

A doctor treating a person for pain needs to look for potential risk factors for substance abuse, such as a personal or family history of other types of substance abuse or psychiatric disorders, Dr. Potter says. “If a person has one of these risk factors, they shouldn’t automatically be denied opioids, but they should be informed of the risk of dependence and be monitored for potential abuse.”

For some people with chronic pain, medication isn’t always the answer, says Dr. Potter, who is studying the treatment of opioid dependence and chronic pain through a grant from the National Institute on Drug Abuse. “There’s a false assumption that giving medicine makes pain go away, but in chronic situations that doesn’t always work,” she says. “Many people only get some reduction in pain.”

Non-Opioid Pain Treatments

Patients with substance abuse issues can be treated for pain in a variety of ways that don’t involve opioids, says Sean Mackey, MD, PhD, Chief of the Pain Management Division at Stanford University and Associate Professor of Anesthesia and Pain Management. “A multidisciplinary approach is needed to treat patients in pain who have substance abuse issues,” he says.

There are non-opioid drugs such as anti-epileptic drugs, antidepressants and anti-arrthythmic drugs, which can be effective in treating pain, Dr. Mackey says.

Patients can also be treated with psychological therapies, as well as physical and occupational therapy, he says. Many patients, however, do not receive a multidisciplinary approach to treating chronic pain because it generally requires the resources of an academic medical center. “Doctors who are treating patients without these resources need to collaborate with others who have the knowledge they don’t, either in addiction medicine or pain medicine,” Dr. Mackey advises.

If a doctor weighs all the options and determines that opioid treatment will work best for an opioid-dependent patient in pain, buprenorphine or methadone may be good options, he says. “Buprenorphine and methadone have strong analgesic benefits, and we commonly use them in this situation,” he says.

For a patient using methadone, one approach is to use a “blinded pain cocktail” in which methadone is ground up and mixed in with baclofen as a binding agent, with cherry syrup as a base. “We tell the patient what’s in it, but not how much,” Dr. Mackey says. “We closely track their quality of life measurements, and we can go up or down on the methadone accordingly. If we have a patient with clear control issues we only give out small doses at a time, or we hand it over to a trusted family member.” Mackey does acknowledge that the use of this tool is time and staff intensive and may be more than a small community practice can handle.

When treating patients with both chronic pain and a substance abuse disorder, Dr. Mackey advises making sure that they are receiving psychological counseling, either in a group or individually. “Many treatments we use in substance abuse overlap with chronic pain treatment—the psychological and behavioral skills are the same,” he says.

He also suggests an opioid contract for some patients, which establishes an understanding between patient and doctor that the patient will only receive opioids from that doctor, and from only one pharmacy. The patient may be asked to submit to urine drug screening, and is told that if their medication is lost it will not be replaced, and stolen medication will only be replaced if the person brings a police report.

“While even the most careful clinical pain management cannot eliminate risk of opioid misuse in patients with a history of addiction, good communication, knowledge of non-opioid treatment alternatives and appropriate monitoring and care in structuring opioid management can reduce risk significantly,” Dr. Mackey says.

102 Responses to this article

  1. linnietea / September 12, 2014 at 3:31 am

    I’m a chronic pain patient having established diagnosis with treatment.Dr+orthopedic PA did everything before realizing I couldn’t take certain medicine.They treated me for neuropathy(military issues from job) knee injury( surgery cancelled due to Nurse Practitioner anger at being transferred to inpt,dx bronchitis instead of CHF) 3 years ago hip fx,fell 3x acquired sciatic pain.MRI suggestive of herniated disk,extra lumbar disc,meniangioma,YET my doctor who is at the veterans hospital,decided before he met me,he was prejudiced against me because years ago I’d been treated in psychiatry.As of 3 years ago,it was found I had ben delayed/misdiagnosed as a psych patient when I had Graves disease(an overactive thyroid mimicking psychiatrist behavior) I had been beaten down for 38+ years /however,my NOW PC feels in order for him to feel comfortable,he insists I must have an active mental illness with full participation in the MHC because this will justify his ability to discredit me.
    I was exonerated by both psychiatry and the psychological services,both saying I didn’t meet any criteria for mental illness.
    Still,the doctor has terminated med that one doctor for 14 years then 5 doctors (1per year) yet none considered me a threat nor insisted psychiatry hold me doctor was prejudiced prior to meeting me,which is typical of physicians who demand blind trust from uninformed patient.
    Is this appropriate,the veterans hospital is abusing patients everyday.
    I can’t take their drugs,adverse reactions(it’s on my record) yet what has worked 19+ y they have terminated just because.I was put on these medications but as a last body has issues with drugs.psychotropic drugs,I begged not to be given,ended up with me having a drug induced stroke so doctors civilian wise get kick back from pharmaceutical companies,VA doctor one payer system,but directors get the bonuses.
    If the issue was drugs,I’ve returned the wrong morphine to pharmacy,I’ve had people offer to sell me’s not about that,my quality of life has been taken away.I feel as though I’ve been raped of my dignity.

    • Gary Bradshaw DAV / September 15, 2014 at 2:38 pm

      Linneta I to am a Disabled Veteran & in the VA Healthcare system ,I have spinal cord injuries ,I have had 1 surgery thus far Anterior Cervical Dysectomy W/ fusion 5-6-7 ,which I wished I had done more research before I went through with it ,if you look up AARP 4 worst surgeries Fusion is #2 on there list ,I am in need of 2 more surgeries there is a better Procedure Laser Spine surgery But the VA will not Pay for this type surgery I have been through absolutely everything for Pain management from 30 epidurals Tens unit to the newest Accupunture & this Accupunture is a joke ,I think someone @ the VA has been watching to many TV commercials you know the one Pax Prentice Drug Addiction clinic for the super rich in Calf ,I have had 6 Drs in 3 yrs ,I was on very high doses of pain Meds my quality of life seemed to be Better ,But now there new policy is to take all Veterans off pain Meds I never lost meds never called in early & signed Pain contract ,I guess my point to this is that you do everything they tell you to the letter & they the VA treats you as if your some low life drug addict for wanting relief from Pain ,I have recently found out that if you are a service connected Vetetan you can go to a Methodone Clinic & the VA will pick up the tab ,But I will not ,because to do this you are labeled Drug addict .i have asked tobe seen by a Dr @ the VA that I have been with many years they refuse so I have to move to another VA Farther away. This is not right the way they are treating us

  2. darren kent yonker / August 28, 2014 at 9:32 pm

    Its funny how some of the people say how some people messed it up for everybody do you not realize some people aren’t fortunate enuff to be blessed with a good life and shit happens but most of you who say your not addicted is bull. if you take a high enuff dose of opiates you will become addicted over time but the way the system works is people who really are not in that bad of shape get everything and the people who truly live a life in constant chronic pain are lucky to get much of anything that is how it is for most people and that is how it will always be

  3. Wickedlin / August 25, 2014 at 2:55 pm

    My bro was in a horrific industrial accident 9 yes ago his skull was compressed 3.5 inches it broke prefectly along the lines where it joined he lost his left eye , every bone in his head and face was broke .Now he has plates and screws holding his head and face together. He has brain damage no impulse or anger controll .We thought he would die. However he didnt but he is in constant terriable pain., and needs pain meds.he has a tolerance that would kill a horse, we know its killing his liver and his brain..the other day they took away 80 of his pills so he has been begging xanex he’s eating so many to equal what they took away he’s been doing weird things he almost set the house on fire.he fell asleep with butcher knives laying on him from what he was eating..we are poor no insurance.his family is scared to put him in detox or rehab cause they can’t lose his disability. But we cant go on like this he going to kill one of us or himself by accident.what can we do? I don’t want my brother to die.

  4. Abe / August 20, 2014 at 6:12 am

    I sympathize with all of you as if your were my twins. My wife has Fibro and horrible rheumatism of the spine she only discovered during one of many spinal operations. I have spinal stenosis and have undergone several operations. We both have had fusions and titanium rods implanted. We use opana, valium,dilaudid and tyzazine as needed. They work just enough to allow us to drive and move about a little.

    A couple of months ago we made an appointment with our P.A. of over 5 years for our usual appointment. Seems the Senior and only doctor up to that point had taken on a new doctor with specialties in the area of pain management. Well our appointment kept getting changed and we started getting suspicious. We were out of our meds and were guaranteed on the phone that until we could see our P.A. we would have the standard prescriptions ready for us and all we had to do was walk in and pick them up.

    My wife bet each other what would be the end result of our visit. The bet being that we were being played and there would be no prescriptions available, and sure enough we came in and were told we couldn’t see our PA. That we had to see this new doctor who denied that were told that we would get any prescriptions and had the nerve to suggest to my wife that she see a psychologist as she was delusional. Well, I was listening in on the phone call were she was told that we would have the RXs ready for us. So apparently 2 people suffered the same hallucination as too what was said.

    Our PA had also been trying to find alternative pain blocking methods the last one he was working on was a new electronic device that fit in the ear, something to that effect. I guess we will never know

    Well we were told we will no way be allowed to see the PA who was of the old school of kindly practitioners with umpteen compassion for his patients.

    We said we would not see this Doctor, we never agreed in coming in for our RX to see this Doctor but did so just to find out whats going on. We found this doctor to be odious and lacking in simple bedside manner. So since they changed the rules of the game, we demanded as determined by the AMA, a letter saying they would no longer treat us, which the new guy implied and were obligated to provided 3 references to get same medical type care via other physicians. To date almost 2 months later no letter. Fortunately when I was working I had a wonderful Employment Law colleague who said they would do their best to put the screws on.

    Whats even worse is that we took Urine tests and mind showed signs of opiates and my wife didn’t, conclusion. My wife was a nefarious drug dealer who used the prescriptions to buy and sell painkillers rather then use them herself. That one deserved and got a string of obscenities I was so incensed and my ADHD made my mood even fouler.

    I live in the Los Angeles area and if anybody has found a Chronic Pain Mgmt doctor with license to prescribe because my wife is a functional 10 on the pain meter and is a courageous woman. And she has a lot of allergies, You name it, even down to the tape they use in the hospitals to hold tubes in place, they break out.

    Oh and like Ray, the new guy also use the “I will loose my license” fable as an excuse.

    So please, on my knees, more for my wifes sake then anything else if anybody has found a decent compassionate pain doctor who prescribes prescriptions without looking at you as a criminal, can someone please help and post a referral here.

    Good Luck to all of you and dam the violators of the Hippocratic oath

  5. Lori / August 11, 2014 at 1:31 pm

    It is how crazy desperate we get when our pain isn’t being treated. I’ve had the same thoughts as Becca about just going out and trying heroine. I couldn’t believe someone like me was having those thought. Thankfully I was finally accepted into a pain clinic and I get more than an adequate amount of pain meds.
    Now I have another dilemma. After losing my gp (london ontario region is horrible for this problem right now), I can’t get my imovane! So my pain is being managed but I can’t get any sleep! Anyone who’s been there knows how your quality of life is crap when you’re not sleeping.
    So I go from thinking about doing something crazy like heroine, to thinking about finding someone to trade sleeping pills for pain pills. And why don’t I feel like this is wrong?? I simply see it as two people getting screwed over by the health care system and doing the only thing they can with the crap they’ve been dealt.
    That option isn’t easy though either. Where do you start when you’re a law abiding citizen. You can’t exactly just start walking up to people..,”hey do you have imovane? Can you get some? Want to trade for dilaudid?”
    I’m so frustrated. It shouldn’t be difficult. I get they have to watch for addiction..,but shouldn’t the choice really be ours??? If we have verified pain:sleep problems, shouldn’t we be given all the options, risks, rewards and be allowed to make informed decisions???
    Sigh! Rant rant! I could go on for hours!

    • Matthew / August 13, 2014 at 2:34 pm

      Yes I agree with you. It seems to me that all the drug junkies on the streets influence on how people with pain get treated. I wonder how many suicides can be linked to honest people who cannot get the care they need. Because living with constant pain sucks. Two things all Doctors should go thru and that is severe pain for a week without opioids and two weeks of severe withdraws. Look if you are in moderate pain constantly it is enough to drive you insane. Luckily most Doctors do care and can tell the difference between an addict and a individual who is drug intolerant. And needs their pain medicine increased after several years of taking it.
      And they kill me when I hear a Doctor say anyone who takes pain medicine right. Usually does not become an addict. For starters they have no idea how many people take more of the pain medicine sometimes and run out before their refills. Because one they could be getting extra somewhere else. Two they may just be dealing with withdraws and waiting on the next visit. Their is no way to monitor that. Once a person gets to the point of being on the same medicine for 15 years. And their Doctor states this is all we can do. Well do you really believe that person is always just going to suffer and not at least take some extra occasionally? We are only human. And pain sucks.
      I know that a lot of Doctors really do care. And there are a lot of high paying jobs they could of taken. Yet they chose to help people. But for the ones who became Doctors for the prestige or money. Are real easy to identify. And more than likely not going to have a lot of patients because half the people IN THE WORLD go to the Doctor because of pain. Or with a pain associate. A lot of people in the medical field I believe are scared of the DEA and or feeding addicts. I cannot blame them. But if someone is in constant pain just get over it and give them what they need. Quit being so judgmental and just plain sorry. If someone hurting wants to relieve their pain let them. Because living in pain is hell and misery.
      That’s why someone dying of cancer gets what they want. Why make them suffer. Oh yeah so its okay to let another sort of pain suffer because your worried about some damn addiction. How pathetic…

    • Vinny / September 18, 2014 at 1:12 am

      I was just placed in a similar situation, only in addition to pain meds, I’ve been on Klonopin for seizures ans anxiety disorders. Long horrible story short, pharmacy gave me wrong drugs, after getting replacements (on bench in full view of 10-15 “patients.’ Stopped at store for “wasting Syndrome” supplements, and car broken into.

      The “replaced “wrong” med was supposed to be 30mg oxycontin, but when I took my meds right in front of him, it was almost 3 times stronger! Eighty milligrams…didn’t matter, ARNP had me cut of both meds, and pain management rules “force” a 30-day taper from the klonopin, when even otherwise healthy people go through 2-7 YEARS of withdrawal, many commit suicide and develop permanent psychoses and/or brain damage.

      In my case, it will be a death sentence…the only possible “out” I have found is under certain medical situations,is to “opt out” of Obamacare (there are even hardship exemptions from the fines,” until (unless) the immediate problem can’t be resolved in two years.

      All I can say is how sad I am at how our veteran’s are being treated, and regardless of my “murder by medicine,” as long as I can function, I will NOT just lie down and die

  6. Shelly / August 2, 2014 at 11:44 pm

    I have severe and major medical issues and I am grateful that I don’t have chronic pain because I see how difficult it is to live a normal life when needing the assistance of opiates. I had the unfortunate experience of a minor pelvic procedure (after 10 of 20 years being cancer free!) that caused pain so bad that it would make me nauseated and light headed. I had to take Oxycontin before while hospitalized and I hated taking it. Four days of vomiting, feeling a headache so bad like an ax being swung into my skull before I could tolerate it. Then came the hysterical mood swings. OMG, never in my life had I felt so up and down! It is obvious my last line of choice in pain management. While my dr and I tried to determine the source and duration of pain that I was being caused for this new procedure, she and my GP were helpful to dispense Percoset 5/325. It worked great and I used 20 pills over the course of 60 days. I had been prescribed 15 more for a month and another 15 more for two more months. Now my dr has decided that I am just pill seeking and says she refuses to dispense me any more opiates for pain management and I will just have to deal with it. Sadly, there is also an alternative surgery that she refuses to do that may alleviate the long term pain I am feeling. I’m afraid to see another doctor because I’m worried it will look like im shopping for drugs! I know it is wrong for me to feel that way because of an insensitive and alarmist doctor. I have many non-medicinal alternatives I use for pain management and it is absolutely insulting to me that when any patient is in legitimate need we are treated like criminals.

    • Erics mom / August 17, 2014 at 10:31 am

      I could not agree more. I’ve dealt with chronic pain for 14 years now.
      The first several years were hell – then I found a PM clinic that had chiropractic care, PT, laser treatments, massage and a pain doctor who wasn’t afraid to give you medications. For the next several years I did well – sometimes my pain level was around a 2 and then I’d have some bad times at an 8 – but at least I could enjoy my life and family. The clinic closed more than a year ago and the dr. who was with them for 3 to 4 years before closing is taking care of the patients. Now I have been on 75 mc fentanyl for seven straight years – in the past 3 to 4 years I DECREASED my Vicodin from 4 to 6 tablets a day down to TWO … I’ve not had my patch increased in seven years. Last pain started to go up and up. I have not been at a 2 in this past year and I spend more time at a 9 than anything else. I’ve had 3 different injections & procedures (epidural, some kind of nerve block and something else) I’ve tried Nucentya and Norco. I had breathing problems when I took the Nucentya. The dr will not increase my patch. I understand the next step would be 100mc. But I have been on so many different medications that made me throw up, constantly nauseas, headaches, blurred visions, oh and how many times have I had calls from the dr’s office that says “oh hi, please dont’ take your ____ anymore – it looks like it is causing ___ problems”
      When I was placed on the patch I was told that it was a miracle drug for chronic pain patients. I was scared to death to use it but for the first time I woke up and was able to get out of bed and have a life – I didn’t have to roll out of the bed and pray that the pills would kick in soon.

      “I” thought the patches were supposed to be so great because the abuse level is so low?
      I’ve heard that pain drs want to place their patients on long term acting meds because it lowers the abuse rate but helps with pain…so what is it? and why wouldn’t my dr increase the patch? I don’t want to try something new on the market – I’ve been there and done that.

      These drs don’t realize when we try something new, we have to wait a week, 2 weeks, a month to get back in to change the non working med. That’s not a lot of time IF you are not laying on the couch in severe pain … watching everyone else live life.

      I absolutely love life … I love my family – I love those days when I actually can cook and clean and go shop for fun. But I tell you, its run thru my mind a million times that I don’t think I can live another 10 years like this … I have to – all my son has is me. I don’t like to be “high”. I don’t even drink alcohol because I don’t like the feeling of not being in control. I don’t want hangovers, I am fine with life straight … I just want to be able to do laundry without running back to sit down and rest for 2 hours after 1 load.

      When is someone going to help us?
      I agree where someone said these drs should live 1 week with the pain.
      The secret is, they can’t know that the pain is for only 1 week – they have to wander
      if they will ever feel better again. That’s the kicker.

      I guess I just had to vent.
      Maybe someone who can make a difference for those of us with chronic pain will read this and help us. I don’t like to ask for help. I don’t like to call attention to myself. But at the place I am – I want to be able to live my life again – with lower pain scale. God bless.

      • Jen / September 18, 2014 at 10:40 pm

        Oh my goodness, it’s like you’re reading my life right out of a book. :’-(

    • Linnette / August 29, 2014 at 11:57 pm

      Shelly. I would love to talk to you! After 12 years w/chronic pain, and doctor (same one) prescribing me multiple opiates, starting with 5mg Hydrocodone, then higher & higher. Even though I hated the side effects and could basically not function like a normal person, I would take it only when absolutely necessary on a work day and at night. Then on the weekend, I would take all 8 Hydrocodone 10/325. Then like you I was scared of OxyContin because of the Intervention TV show. So, after many “no’s to Oxycontin, Roxicintin) she out me in Petaca-something for a month to build my tolerance so she could prescribe me with Derigesuc/Febtynal. I went from 25ncg to 50mcg to 75ncg, then 100 mcg, and u called that day and let her know I wanted to back down to 75 mcg. It still want helping. Along with many other NON abuse known medications like antI-inflammatories, sleeping pills (Ambien), Cymbalta (got very sick), Anti-anxieties,Mirilax, and after accumounture, chiropractors, over 50 visits with physical therapist with exersize at home. Walking was also highly encouraged by her abc I did walk all I could. I’d always “pay for any physical actions with being up all night, missing work, couldn’t even bend over. She also had me on Fentynal 50 mcg and Hydrocdone 10/325 for a LONG time…I Hated the patch!! It was a ball in chain and she took no time explaining the great changes that were debilitating, humiliating, the labeling by other doctors even, my faniky freaked about constantly and told do many people in our small city of Des Moines. So, 2/2013 I ended up with a lapse in health insurance and he patches were $400- $500. I begged her and my family doctor telling them it was restricting and my family was considering me addicted because I was “physically dependent”. They just didn’t get it. And I had no light at the end of the tunnel. This was my opportunity to say take me off. I can’t afford it. So she told me I needed to taper, offered Oxycintin, etc. I said I could do it with Hydrocodone. 6 days into withdrawal I was so bad that someone calked my mom in the night and she rushed me to the ER. I was admitted for 3 days and given TONS if benzodiapines and fluids. Then on the third day, my family physician ordered Fentynal! So the slapped a 25mcg Fentynal on me and I bawled my head off. After all that????

      So, I ended up staying on the hatch and the Hydrocdone until recently when I went to the psychtrist (believe me. I’ve seen my share over this course if time & been on a roller coaster if meds. All didn’t work IR the side affects outweighed the benifits. So he gave me samples of Brintellix. I called my pain doctor to let her know. She said it was “good”. Then I woke up the 2nd morning after taking a dose, with tremors, my heart racing, sweating. Pal stations…just like a panic attack, only I waft worried and hadn’t had time to stress. I’d just opened my eyes. It dawned on me. Brintellux was new. I calked the pharmacy. He didn’t 30 minutes in the phone explaining I was in a state of Serotonin Syndrome. That they would have caught it at the pharmacy and the doctor should have known that gave me Fentynal. Basically, he babysat me by phone that Saturday and if the effects didn’t stop within a few hours he was having me call for an ambulance. It Serbs I was about to go into A. A Coma or B. Death!!!!
      So, then they prescribed Lexapro. Basically the same., my pain doctor admitted that this is the first time she find out the Fentynal releases Serotonin rapidly!

      So, I got my way, the only thing that didn’t do this was Moriphine, a step down. Morophine IR 15mg. To see how I did, because the IV one made all my senses Dulles and felt drugged after my surgeries.
      But all she cares about was the anti depressant. I love my therapist, my new psychiatrist needs to cross reference his drugs though.
      Next thing after two weeks, we move down to Extended Release Moriphibe 3 times a day. And bam!!! A truck not me. And I was out of this works. I knew I couldn’t drive, friends, family. Church took turns coming in to check on me.

      Here comes the kicker. When I went off the Hydrocodone and began the combo if Ir Morophine/Fentynal 25 Mcgs I says is take he Hydrocone (which was almost full) to the pharmacy return program that stared recently. She said “no, just hold on to them just in case you need them down then road. You have a safe place for them right?” I replied “Is that ok with the DEA, yes in my medicine safe.”

      Ok. So I’m told to call this past Wednesday with a full update after giving it time. I called the nurse and left two lengthy messages..that I was on Lexapro, that I was druggy feeling, that I could recall my last dose and was depending on others for that and everything else. I told her everyone in my family was worried and scared II would overdose accidentally or take the wrong thing. told her I wanted to see if we could drop to a lower class of opiates and make just a maybe have what I’ve heard referred to as a “breakthrough” med if it wast enough and my pain was style there. That I was groggy, yada yada. Sonsgr calls me back and I picked up and she says, Dr B wants you to take one Mirophine 15 mg per day and up to 6 of the Hydrocodone you have. My reply, I wanted to go lower than Mirphine and my family and friend flushed anything that wasn’t in my list of prescribed meds to help me. She calked me back, said. Don’t take ANY Morophine, come in at 12:15 tomorrow, this is bad need for you and just get a ride and we will regroup. I go in, she does my Vitaks, I told her about the high blood pressure the day before at the primary doctor. (I always have low I’d pressure) it was again high.

      Dr B, my pain doctor of 12 years whom I’ve never asked for anything other than to go off Fevntynal , even when my meds were stolen says. I will help you ween with theoretic yiur Moriphine, I will handle yiur care, but I will never prescribe an ipuate for you again.” And was BRUTAL! All I could think ideas withdrawal and pain, and that this person had no trust in me after I proven trustworthy for 12 years. The conversation went terrible. So, I would give you my number or email somehow if we could talk. What about our rights? What about the fact she had me on too heavy if drugs that my supping system made a call to the pharmacy and disposed if any potential problems. Thru just didn’t realize she had fm keep the Febtynal too abc it was in a cubby by my bed.

      She cut me off just like that. I’m hurt. Angry, Confused, and scared to death of the pain an suffering to come,

      She said I was irresponsible with my drugs because I “let them do that abc find her I had a locked safe place.” Yes!! Where the Morophine was kept as well and I let her in there or (him) depending on who was there.

      That I was do out if it, having then dose me was safe. She said no one called the office. It was Satursay and hey did!!! They just didn’t want to do the on calm. Doctor when the pharm it’s said to dispose of it!

      Sorry got typos..stressed as all get out in Des Moines!

  7. Avatar of Osito
    Osito / July 31, 2014 at 8:08 pm

    Wow! I knew there were people who didn’t get addicted to narcotics, but I never knew such a website existed. I’ve felt all alone (except for my brother who has been great to me) for so long. I developed chronic migraines on December 28, 1984. The first couple years were rough, as I was self-administering morphine or Demeral (IM) almost daily. I never once felt drowsy or euphoric. Eventually, I got to the point where I could control the nausea that accompanies severe pain, and I began taking oral opiates in the oxycodone and hydrocodone families. It was bad back then. I was in serious danger of liver damage. Over the years, I was able to keep cutting the dosage little by little. A couple times, I would stop daily dosing and try just gutting it out with much less effective painkillers. Once I went about 20 months with the only narcotics being administered in the ER for once or twice-monthly events where I lost control of an attack. When I turned 50, the headaches seemed to change a bit. They became more “stubborn”. I was diagnosed with CDH (common daily headaches), a form of migraine akin to cluster headaches. My doctor suggested that I see a pain specialist. I signed the contract, and began a course of therapeutic methadone. I didn’t last a month; I just couldn’t stand how the methadone made me feel, especially when I was not having severe pain at the time. My doctor wanted me to try again. I again signed the contract and was put on a therapeutic regimen of Oxycontin. Again, I didn’t last a month. Shortly after stopping the Oxy, I suffered a “dissociative episode”. They called a “nervous breakdown” when was young. It is my belief that the therapeutic regimen of opiates was so hard on me, that my brain chemistry was scrambled. I worked successfully for 18 years with the migraines, but am now disabled with PTSD – that was the diagnosis of the Social Security Disability Board psychiatrist.

    I used to tell people that the migraines weren’t that bad; nobody ever died of a headache. I now know that hundreds of Americans, if not thousands die every year from migraines…many, if not most, from traumatic shock. I’ll bet most of them had trouble finding a doctor that would treat their pain adequately. I’ve had my share of trouble with getting the narcotics I hate, but need, but all-in-all I think I’ve been fortunate…but the future doesn’t look very bright. My state doesn’t have medical marijuana, so I’ve never tried it. So, I’m forced into this cycle of narcotics for pain and anti-anxiety meds for the narcotic side effects.

    I’m getting old and I am beginning to get some pretty painful ailments. I won’t take narcotics for those, but the other pain meds, like NSAIDs, are literally deadly. I have completely changed my diet – nearly “paleo” – to cut down on inflammation, and I am experimenting with various herbal teas. I tried poppy tea, but it causes excessive anxiety, so I only use non-narcotic ingredients. I am currently trying a blend featuring corydalis root. I hope it works.

    Reading this thread made me cry. It’s a shame…it’s a REAL SHAME…the way most of you have been treated. I pray that SOMEBODY figures out that for some people narcotics are a necessity and not an addictive agent.

  8. SuicidalPain / July 31, 2014 at 1:51 am

    I was diagnosed with SLE, Fibromyalgia, Chronic Fatigue, among a plethora of other chronic ailments. I have been on Oxycontin for the last 10 years – 20 mg twice a day. I have always taken it exactly as prescribed, NEVER gone up in my dosage, NEVER asked for more and NEVER abused, NEVER *lost* or ran out of my medication. My doctor retired and this new doc refuses to continue treatment and treats me like a common street addict!
    This is the kind of crap that will make legit pain patients turn to the streets to self medicate.
    In no way is this going to deter illegal drug use. It’s just going to create more. Who the hell are they kidding??

    • Matthew / August 13, 2014 at 2:43 pm

      Exactly and well worded. I am sorry you are dealing with that bs.

    • Astal / August 22, 2014 at 4:56 am

      How does it feel when you get treated like a criminal huh? Not fun, ive been dealing with it for years and my fiance just started dealing with it recently because her doctors are assholes, she has documented disc protrusions ect… but they wont give her pain meds because shes 24, so shes supposed to just deal with it is what her doctors said. So we both get meds of the street.

      The whole system is bs and yes all PM doctors need to have either broken legs, or injured spines/discs and see how it feels without pain meds and then they need to have severe withdrawls with no option for relief. Bastards need to burn in hell.

  9. Fred / July 21, 2014 at 7:32 pm

    It’s a shame when people can’t get there meds for pain..but I have a son who started shooting the pain meds that get into my I have a double issue I don’t know how to help

    • medano / August 17, 2014 at 8:14 pm

      Be responsible and lock the stuff up. If anyone can get ahold of my pain medication besides me, that’s my fault.

  10. Becca / July 11, 2014 at 9:10 pm

    I find it slightly amusing that here we are all looking to get some relief for our pain, on website. I too have chronic pain issues and my Doctor up and retired on me with no warning after being on this medicine legitimately for 12 years. I am also disabled as I have both a muscle disease and degenerative disc disease and a spinal fusion L4-5. So now I am stuck trying to find a Doctor while being in constant pain (3 Doc’s refused before I even got 2 words out.) and I am sick of it. How is it that I personally know people who get it and then turn around and sell it to supplement their income but the ones that really need it can’t get it. This country is a joke, I say that after reading the senate committee’s latest about the war on drugs. It’s quite comical as at one point they said they were looking to replace Marijuana with a safe substitute! You spray it on your tongue. Now I ask you, what is the point? They would rather have you get high on spray??? If I can’t get help I’m thinking about turning to heroin because I can’t even function in this much pain, I’m just plain tired. Good luck to all…..

    • Robert / July 14, 2014 at 8:28 pm

      I also find it misleading, that they only focus on addiction. What about the other side of the Opiate use, for medicinal chronic pain, that goes by untold and ignored? A person can die just as easily from being in pain, as they can from overdose! But you will not find the anyone giving you any information or statistics on that topic! I’ve personally been hospitalised 10X(not including surgeries), due to chronic pain! After having my kain meds cut in half. Then waking up in ICU, with Dr.’s looking over me asking, “What happened?”. Well let’s see, my Dr. cut my pain meds back, “again”, then you put me on a pump, because I’m in chronic pain! So basically, I have to be hospitalised, forced to take large doses of Opiates to get a hold of my pain. Then sent back home with what I was on before it was cut back, when I could function!

      • Brian / July 16, 2014 at 2:23 pm

        I too am disabled. Have been on pain meds 10 years, so yes, of course I am physically dependent. 3 or more pills per day for 10 years and they want you to lie about it.

        I am home bound so going to doctor is big deal, but manageable. I don’t even mind the drug testing, as I have such severe stenosis I get empathy at doctor.. And prescriptions as long as I lie about being physically dependent.

        Now my nightmare is at pharmacy. My meds have gone from $20 to $200 per month for same meds. Some pharmacies don’t fill control substance prescriptions on my Medicare insurance. Fewer are willing to order if it is not in stock, meaning I some times drive to 5 or more pharmacies for schedule 2 meds. I know it is string stuff few need, but you would think a legal script for major meds would get you empathy at drug store. Some locally owned pharmacy’s politely refuse my business, saying they don’t sell those drugs. Chain pharmacies all differ..but even the pharmacisist on duty differs…which makes it impossible to predict each experience.

    • Lori / August 11, 2014 at 1:26 pm

      It is how crazy desperate we get when our pain isn’t being treated. I’ve had the same thoughts as Becca about just going out and trying heroine. I couldn’t believe someone like me was having those thought. Thankfully I was finally accepted into a pain clinic and I get more than an adequate amount of pain meds.
      Now I have another dilemma. After losing my gp (london ontario region is horrible for this problem right now), I can’t get my imovane! So my pain is being managed but I can’t get any sleep! Anyone who’s been there knows how your quality of life is crap when you’re not sleeping.
      So I go from thinking about doing something crazy like heroine, to thinking about finding someone to trade sleeping pills for pain pills. And why don’t I feel like this is wrong?? I simply see it as two people getting screwed over by the health care system and doing the only thing they can with the crap they’ve been dealt.
      That option isn’t easy though either. Where do you start when you’re a law abiding citizen. You can’t exactly just start walking up to people..,”hey do you have imovane? Can you get some? Want to trade for dilaudid?”
      I’m so frustrated. It shouldn’t be difficult. I get they have to watch for addiction..,but shouldn’t the choice really be ours??? If we have verified pain:sleep problems, shouldn’t we be given all the options, risks, rewards and be allowed to make informed decisions???
      Sigh! Rant rant! I could go on for hours!

  11. EthericBliss / June 20, 2014 at 7:18 pm

    It’s called a death panels. Look ‘em up!!

    - EB

  12. Concerned family / June 4, 2014 at 5:56 am

    I have a family member who had major back surgery and was prescribed OxyContin by a pain clinic. It started out fine until the signs started to appear. Needing more, constantly complaining of pain. Until we found the person laying slumped over with a cigarette nearly ready to burn the house down hanging loosely from their finger tips. People on these drugs need to be closely monitored while using. Addiction happens so fast and without warning. I know there is legitimate need for some people to use these meds. But it is very scary to watch someone almost die from a pill.

    • EthericBliss / June 20, 2014 at 7:41 pm

      I would consider this a RARE occurrence and fear-mongering at LEAST. NOTHING “happened” so WHY even make a note of it? Other than my first sentence/ -EB

    • max / July 24, 2014 at 10:33 am

      Please be careful what you say that is a very rare accurance opioids are actually a quiet safe drug I am 23 years old and have severe pain due to a couple car accidents even tho I have a severe legitimate injury you can probably guess how hard it is for me 2 fined a doctor the doctor I had has died passed away and the clinic took me from 60mg of morphine every 3 hrs and 15 of oxicodone very 4-6 hours and cut my maintenance dose from 60 to 30 mg then to 15 then to 0 then my oxicodone 15s to 5 then 2 0 took me completely off the withdrawal s wernt to bad luckily they were nice en of to ween me off rather than cold turkey but still I’m in severe pain and cant find another doctor that Le prescribe me opioid pain meds I also am taking classes to be a pharmacist but I have recently went on an leave of absence because of the severity of my pain iv been on leave of absence for a year now and I am considering not going back when I had my meds I managed to get tru the day but know I find myself in bed sometimes 18 hours a day not only because of the pain but the depression it brings iv actually resorted to growing the papaver somniferum the opium poppy so I can cure my pain with some poppy pod tea they really easy to grow and as long as u don’t got producing heroin from them or cutting the pods you can just claim thare for oriental purposes and they do grow in gardens around America but anyway I really hate when people post stuff like that and I hate when all these bastards are abusing these medications it happens all tru out history jackasses ruining thing for other people pain is ruining my life I’m on the edge and cannot take much more opioid pain killers are the only thing that works for my pain physical therapy made it worse muscle relaxers don’t do anything and no the only thing that works I can’t get because people like you and your friend that almost overdosed and burnt the house down or whatever what has this country become makes me want a puke

    • max / July 24, 2014 at 10:35 am

      60mg every 8 hrs I ment

  13. Avatar of Sara
    Sara / May 1, 2014 at 10:05 pm

    What’s that saying “Never judge a man until you have walked a mile in his shoes”? I figure I have two choices. I can take pain medications for my condition and actually enjoy parts of my life, keep my job, continue to be a contributing member of society and deal with being labeled, scowled out, treated like a drug seeker, and talked about behind my back…OR I cannot not take the meds, lose my job and be debilitated, …be denied disability because they will they’ll say I can work at least a little bit.
    Yeah, that shower you get up and take in the morning so easily….or writing with a pen, trying to open a bottle cap…enjoy it, because you never know when it might go away.

    • Jen / June 5, 2014 at 10:49 pm

      I feel this way constantly, I am so sick of living like this. I get a very small supply of meds each month but my tolerance level has increased so much over the years, it doesn’t even work as prescribed. I’ve tried talking with the dr. He refuses to go over and refers me to pain clinics that think I’m an addict even though I have proof that there are lots of things wrong. So I just shut my mouth and get what I get and then save them for the days that I know I have to do something, like shopping, or walking a lot. Etc. I do not even like being high I hate the feeling I’m strictly needing pain relief and don’t know where to get it fully. I have only one dr that gives them but as I said he’s not comfortable with my tolerance level. I just don’t know what to do but I can’t do this anymore. I know what you mean about the showering and writing. I’m glad you can still be a member of society, I live off disability because of shitty doctors and shitty parents as a child. This all probably could have been prevented with the proper care in the first place but they screwed me all of them, what do I get? A subpeona every month for dr bills and a horribly disfunctional back.

      • Michael Disabled Veteran / June 20, 2014 at 2:53 pm

        Your plight is well taken. I developed a tolerance to all oxycodones and referred by the VA Hospital for methadone. I refused to be treated with so much misunderstanding and signed up with a professional pain management center. Yes, it is possible to develop a tolerance and that should be understood by medical pros who play Russian Roulette with our lives.

    • Vicky / July 2, 2014 at 5:44 pm

      You could not have said it any better. Sara thank you you saved me repeating what I’ve been streaming for years now.

  14. Mike / April 25, 2014 at 10:53 am

    Physicians have resources at their disposal to verify if someone is a legitimate pain patient. Is their evidence of a traumatic event? If so they can check the patient history for MRI’s, disc dessication, prescription monitoring programs, and the patients criminal history (if drug offenses are indicated) etc. Corrupt doctors have a clear disincentive to check these things because it cuts into their bottom line. They want you back so they can profit from referrals and revolving visits. Just sit outside of the Florida clinics and you’ll see thousands of twenty year old patients “suffering” from intractable pain. Keep drinking the Kool-Aid people.

  15. Avatar of Stephanie
    Stephanie / March 22, 2014 at 11:38 am

    How does the pain clinic know if you’re getting opiates from another doc?

  16. Avatar of Debra Welch
    Debra Welch / March 12, 2014 at 10:13 pm

    Ok, so what do I do about the pain if my doctor takes me off opiods? Surgery, that I may or may not need? Whatever they put me on, can not interact with the meds for my ADHD and Bi-Polar depressive disorder. Am I supposed to live with my leg feeling like it is on fire, and swollen from the knee down to my ankle? Is that normal? What about sitting on my hip and butt on my couch, in a chair, in my car and feeling my leg go numb. I could go on and on, like all the rest of you. The DEA, media and people without chronic pain keep talking about getting rid of these drugs. What do you plan on replacing them with, that doesn’t interact with my medication so that I don’t commit suicide?

  17. Avatar of Amy Maretsky
    Amy Maretsky / March 8, 2014 at 12:36 pm

    On methadone and still can feel chronic pain / fibermialga. Looking for pain management clinic the dose Dual actually I can’t remember diagnosis -mental, ex-drug abuse 6yrs clean, chronic pain, fibermialga, thyroid disease, oxygen, wheelchair, & starting a pain management clinic. HELP!! I’m sick of being tethered to 7 days a week 5AM EVERYDAY FOR 7yrs. For six years I’ve had clean urines. I’ve bent over backwards to comply they know I won’t leave because recently had pneumonia & the docs @ the hospital dropped my dose to 40mg after being on 115mg for 7 yrs! When got out of the clinic they are making me run around in circles to get put back up not to 115mg but so I’m not in severe pain CONSTANTLY!!!!

  18. Avatar of terripin99
    terripin99 / February 18, 2014 at 11:41 am

    Was prescribed fentanyl patches- for severe back pain which has destroyed my quality of life for the past 2 yrs. Finally Ive decided to have surgery(this Thursday is the date.).- The doctors in thier infinite wisdom,discontinued the patches after prescribing them for 3 months. They were the only drug that worked.,and I was prescribed them all..along with every kind of silly therapy known.
    Now ,as wrong and as illegal as it may be..I found a source for the same patches that I was being prescribed. Its a damn shame that I was pushed to such a thing,,but when you cant even get out of bed,,or walk the dog without pain that is so disabling you feel like jumping off the roof–this is what I resorted too.Doctors tell me that they were afraid of getting me addicted..I think they are much more afraid for themselves if they keep prescribing this drug. I dont care about the addicting part- Hell, Im 58 yrs old…so if I need to live with a patch ..who cares?
    Now the question is ,after this spinal fusion surgery , am I going to have a hard time with post operative pain meds?- I think so..God..I hope Im wrong… Ideally the surgery is unbelievably successful and I walk out a new man. More likely I am going to need pain medication. Now because I had to illegally find patches (because they didnt want to prescribe then more then 2 months),,how much will they hold that against me?- Will I be looked at as a common addict with drug seeking behavior?
    I have to tell them that Ive been using then after they stopped prescribing them and just hope someone has a little compassion. I can not live in this much pain day after day ,day after day ,day after day

    • Cathy D / June 27, 2014 at 8:22 pm

      I have been on the fentanyl patch for 6 years for chronic pain due to nerve damage and fibromyalgia. I was on 75 mcgs for most of those years. Recently my doctor decided to take me off. I know the reason is because the government is getting in behind doctors for prescribing pain meds. This is all thanks to those that have abused them and those that do whatever they have to to get them to sell. Those of us that need them are now paying for it. He changed mine to 50 mcg for 1 month and 9 days at 25 and i was supposed to be off. When i dropped to 25 i was miserable!! Not only was the pain bad but the withdrawals were a nightmare! I could not sleep, i was awake for 48 hours and had taken ambien and something for nausea!! I could not sit still i walked the floors and cried!! I finally made the decision to put my 50 mcg. back on. Since being on the 50 i have felt great other than still have some pain at times and have to take a lortab. I have also been on Lortab for many years. I am not addicted, i dont have to have it, i have never abused either of them. I go days without taking them with no problem. I don’t get high from either of them. I do think maybe the 75 was too strong for my system because i don’t feel bad on the 50 mcg. Ok, my point is i don’t care either if i live on it the rest of my life because without them my quality of life would not be good at all. I couldn’t handle the pain. I am 53 years old and with age i have developed arthritis and i have a few herniated disc in my lower back. Just be careful with the patch. If you have a fever take it off, even hot water in the shower can cause it to release too much medication. Don’t use a heat pad on it! i have done lots of research on them. I know it’s been several months now but i hope your surgery was a success and you don’t need the patch at all!! Good luck!

    • Brian / July 18, 2014 at 6:33 pm

      I don’t see you jumping off of a roof if you are truly confined to a bed as you said in your statement.

  19. Avatar of BRIAN
    BRIAN / February 8, 2014 at 1:49 am

    the thing is if you have to put your hand on a bible in court with three professional doctors on brachial plexus and three lawers and all deem you as having a non-repairable injury and cronic pain and say you will have this for life and for a person addicited check there eyes for being dielated?????????????

  20. Avatar of Jennifer Russell
    Jennifer Russell / February 7, 2014 at 2:53 pm

    Stopping opiods for pain due to “fear of addiction” WILL NOT make the pain one takes them for magically disappear. I hear this common idea all over. If your spine is badly degenerated, for example & take opiate pain killers for it, stopping them WILL NOT stop that condition or pain from existing. Where some are getting these ideas is beyond me. All that’s really going on is people suffering needlessly, while those just wanting to get high find their fix easily! Something very screwed up here!

  21. Avatar of Amy
    Amy / February 4, 2014 at 4:32 pm

    Yes, buprenorphine will help tremendously with getting off the narcotics! Just remember, 8 mg per day is all that is needed! Some people take 16-24, but any dose over 24 is wasted sue to the ceiling effect of the drug. My problem is that I saw a buprenorphine doc on my own decision 3yrs ago. Began tapering down and 2 wks ago find out that I have necrosis of the femur. My primary doc is aware of all my meds and now that I am in extreme pain, he is very reluctant to prescribe ANYTHING. feel like I shouldn’t have been so truthful. Now I am screwed. Need hip replacement and a doc who understands my situation!

  22. Avatar of Becky
    Becky / September 17, 2013 at 9:06 pm

    I have read most comments but my question is, I have been on vicodin for 15yrs, in the last 2 years I have been abusing it. I need to take it because of my pain but not abuse it. If I take Suboxone will this help?

    • Bonnie Kopicki / June 8, 2014 at 9:39 pm

      You saud the last two years you have been ABUSING the Vicodin and then turn around and say your not abusing it !That’s very condescending ans confusing!!Which is it?

    • Michael Disabled Veteran / June 20, 2014 at 3:05 pm

      If your truly in pain your not abusing vicodin. Vicodin is a short-term drug for toothaches and sprains. You may need a timed release drug like 12hr morphine sulphate. Its effective and seems to work for long time periods (Ive been on it for 2 years and it still works). Hydrocodone or Vicodin are the same. Generic vs trade name.

  23. Avatar of conspiracy
    conspiracy / September 17, 2013 at 1:03 pm

    I know that a lot of the opioid pain med issue is a result of our government’s domestic war on civilians labeled “War on Drugs” The U.S Government has no business meddling in the patient doctor relationship. All doctors take an oath “to do no harm” how can they honor this oath if the DEA is scaring the doctors. The DEA has no concern for the patient their concern is the pharmaceutical companies are selling opioid’s they are manufacturing therefore keeping the government’s profits out of the picture. America’s G.O.D is Guns, Oil, Drugs. Why did we fight a war in Korea and Vietnam? Could it be to control the opium trade in the far east? Which is why win or lose the “War” the U.S. still wins in regards to the opium trade and arms sales. Why did we fight a war in Iraq? Could it be for Oil? Why are we still in Afghanistan? Could it be to control the opium trade in the middle east. Afghanistan is in a very strategic location between Europe Asia and the middle east which is why the USSR tried to control this country. The US gets to control the opium trade and sell missile defense to allied countries and install the defense system in one of the most strategic locations on the planet. The last war we fought for the good of man kind was WWII, but yet we still fight wars and sell arms to allied countries. Our Government knows that there is far more money keeping “drugs” illegal. In the big picture our Government controls the drug trade on the seas they allow the drugs they control to pass while ceasing the drugs they don’t control, and they get to sell arms to the foreign Governments trying to stop the non approved drug organizations. The U.S. wins both ways and looks like hero’s in the process.

  24. Avatar of Dave
    Dave / August 23, 2013 at 9:48 am

    I do not agree that people who have chronic pain will not become addicted to opiate painkillers!!! I have seen cancer patients who are in severe pain become addicted!!! Many of these drugs are close cousins to heroin!! This ‘excuse’ that only people who are not in a lot of pain would likely become addicted against someone who was in a great deal of pain, is nothing more than pure spin from drug companies and even some doctors!! Anyone prescribed opiates will run the risk of their body (and mind) becoming addicted!!!

    • max / July 24, 2014 at 11:30 am

      Why do you put !!! Marks after heroin heroin is just diamorphine thare sounds a lot better when you say diamorphine doesn’t it and actually thare are countries that perscribe diamorphine for pain there’s such a big stigma on heroin the only reason it’s chosen to be the most abused opioid is because you only need the simplest chemicals to make it wich means anyone and thare grandma can make it with a little research but really diamorphine is one of the weaker opiates compared to fyntynle wich is 100x stronger than morphine or 50x diamorphine or lofentanyl wich is 100x stronger than fyntynle or etorphine back in the 70s they cut white heroin or diamorphine with 3methlefyntynle fyntynle and dozens of other fyntynles cousing tons of overdoses just to give u an idea 10 mcg of low fyntynle not 10 mg 10 mcg .1000mg in a gram 1000 mcg in 1 mg. 10 mcg of lofentanyl is equall to 100mg of morphine with to diamorphine is 2x potency of morphine also some of the fyntynle,s can have a half life or can last 18 hrs plus even 36 hours in some cases no now you see that heroin is just another opiate in the broad spectrum of opiates witch can all be used for thare medically us full applications for example fyntynle is used in conjunction with other meds to provide anesthesia and is preferred because it has a short half life or duration around 1 to 2 hours witch means they can get the surgery done and get you recovered and out as fast as possible ware morphine, s half like is 4 to 6 or even longer wich means the patient has to stay in the hospital longer thare are opioids that even have a shorter half life Like su fyntynle . A fyntynle . Remefyntinyl wich can have a half life of 30 min

      • max / July 24, 2014 at 11:37 am

        And you are also confusing the words addiction and tolerance or physically dependant being addicted to and opiate and being physically dependant are to totally different things just because you are physically dependent do sent mean your addicted if you addicted to an opiate that means your abusing it or giving high off of it if you are physically dependent or have tolerance that means your taking it for medical reasons for pain but you body is dependent on it and if you were to stop you would go into withdrawal but just because your dependent on it doesn’t mean your an addict

    • max / July 24, 2014 at 11:50 am

      And yes most people that take opioid pain meds over long periods of time will become Dependent and develop a tolerance to those opioids. But when you have severe pain dependence and tolerance are a very vary small price to pay and I’m not talking about a tooth ach im talking about 24 7 pain that eats at your soul that you goto live with your whole life and thats what paeple dont understand they dont know what pain is thars lots of different types of pain but anyway what people are saying is most people will not become addicts that are in pain management programs most will become Dependent but not become addicts please get your shit straight before you go around calling cancer patients addicts not a very nice thing to say and is part of the problem ignorance I mean

    • Jennifer Russell / July 29, 2014 at 5:16 pm

      I believe the “addict” hysteria isbeing quite succesfully created by the “Rehab” business. Get everyone to think they’re addicted= $business$ Yes, my friends father, hours away from death by cancer, no chance, this is it, was denied pain relief in his final hrs due to hospital fear he may get addicted! My God, a dead addict! Do you all hear how hysterical you’ve let yourself become? Those “addicts” who don’t stop is because they don’t want to! They like that high, take more to get higher. Ban everything, ppl will still find something to get “high” from! And your mom or dad or kid will scream in pain I or you cant imagine till dead. Will you be happy then? No, you’ll scream “why didn’t someone do something! ” Uh, you all were too worried about “addicts.” Good Lord.

  25. carl / July 16, 2013 at 10:07 am

    The runaround that some of these Drs. put us through is outrageous. First, let me say that my Dr. put me on the Fentanyl patches last year for my arthritis in my knee, hip shoulder, and both hands. I’m also a diabetic and suffer from severe neuropathy. After about 3 months I took myself off of the patches because I was somewhat controlling the pain with anti inflammatory meds. I went back to taking my Subutex as well. Now a year later the pain has worsened to the point of now needing the stronger meds. And now the dance begins. They know my pain is real, they know that I’m not drug seeking (or at least they should) yet they still play this game of giving me meds that do nothing for the pain, and still cost me a fortune. I should have just shut my mouth a year ago and kept getting the Fentanyl. But I thought that if I was being deceitful, then it could hurt me down the road. So I decided to be honest and for my honesty I can’t even get out of bed in the morning. I’m so tired of this constant bickering with Drs. to prescribe the proper pain relieving meds so that I may to at least get some measure of relief. I’m only 54 and I walk like I’m 80 years old. There are some days that I wish that God would just take me so I don’t have to deal with this constant agony. It’s a terrible way to live.

  26. Avatar of carl
    carl / July 16, 2013 at 9:48 am

    It’s a shame when we try to be honest with the doctors and yet we are still stigmatized because of our disease. Then they wonder why patients lie to them. As far as I’m concerned letting people with addiction suffer with constant pain is sub standard care, period.

  27. Avatar of dave
    dave / May 1, 2013 at 11:17 pm

    i have lived with cronice pain for 4years i had a 14 hour back surgery with rods and pins i will be in so much pain i will be in tears at night when i wake up it takes me 2 hours to move i live with my pain at all time 5 and night 8 9 my doc stoped my pain meds i can hardley get out of bed all you people who are out there never living with pain i mean every day and night i have6 grand children i can only may be hold for a few min go to park with them i sit on bench with my pain meds i can atleast walk with them a little bit my wife is disabled i can not get dis becouse she will loose here ssi here med is over 2000 a month so i get 0 but over qualfy for it so not only do they take my pain med away but screw me i worked all my life im 48 years old but you doc had to live with this for 1 hour you would do the same i hat the pain med but takes my pain down so i still can have some life but would rather make me feal like a druggie when im in tears asking for reliefe i think a lot of it is wor on drugs i hope thoes people go thrue the hell there putting me thru or want you to go see a shrink just becouse they can not fix you or they are the one who messed you up in the first place

  28. Avatar of Midknight
    Midknight / April 30, 2013 at 12:58 pm

    Something I have always found very strange is all the people I have witnessed firsthand who are absolutely against the use of opiates in pain management except in extreme cases e.g. at deaths door from cancer etc. UNTIL they are for whatever reason dealing with severe pain, THEN it’s ugh ah cough,scratch head……well THIS is different I HAVE TO HAVE THEM. LMAO Ohhhh aint that sweet? THEY are “special”.

  29. Avatar of Mike
    Mike / April 21, 2013 at 4:18 pm

    I suffer from chronic pain, I have most of my life. In the last half dozen years it’s become so bad that I have had to take daily pain medication.

    I’ve had surgeries, steel in my back, spinal fusion etc. …twisted spine, deterioration etc..
    In addition I’m fortunate enough to have decent insurance that would cover a spinal cord stimulator implant. I can’t imagine the amount of pain medication I would need without it. Even with it my pain level is substantial.
    I also do other things DAILY. Heating pad and/or ice pack every morning when I take my medication and use heat/cold in afternoon or evenings as well. I have an inversion table to help decompress my spine. NOBODY can say I am not trying multiple things to help relieve my pain. I only have a few vertebrae left that aren’t fused at the bottom of my back and I really don’t want to lose that tiny bit of mobility that I have left until/unless it’s unavoidable. …not that a single doctor I’ve seen can guarantee that fusing (fill in procedure here) will remove the pain and not lock it in or make it worse.

    Now the *Pain Management Center* I go to, a large one, is basically telling me that the state of Texas is craping on them and saying that the patients have to be stepped down / off pain meds if it isn’t *fixable* and only treated as chronic. Insanity. I’m at a total loss as to what I’m going to do or where I should look next.

    For 1 to 2 years I’ve had my pain managed and been able to function and at least do part time jobs. Now after only one month of this ‘stepping down’ of Morphine and other medications I’m using a cane quite frequently just to get around. Even laying in bed and trying to sleep more than a few hours without waking up in pain is out of reach.
    This foolish ‘war on drugs’ and ATTACK ON THE DOCTORS has to stop. It’s killing the actual patients that NEED help. It’s causing people to suffer NEEDLESSLY because doctors are afraid that their license will be pulled or they will be hauled off in cuffs because SOMEONE ELSE is abusing the system.
    Doctors shouldn’t be punished for doing their job or having compassion. The state/gov should concentrate on real drug problems and let the medical field do it’s job.
    Attacking the medical industry will only cause more suffering of patients, INCREASE illegal drug traffic and cause MORE people to be UNABLE to work and pay TAXES because they can’t manage their pain.
    I’ve worked mostly 12 hour shifts all my life and now I can barely get out of bed in the morning and make it to my heating pad in the living room because MY DOCTORS are paying the price for a BROKEN system that can’t do it’s job.

    • Erics mom / August 19, 2014 at 6:15 pm

      I totally agree with you.
      These men & women who are doctors go to school for years to learn what to do.
      These “agencies” read over a few papers, documents, and decide that we need a
      “war on drugs”.

      14 years ago – I was sent to a “pain management center” – back then the PM centers were new. So new that I told my general practitioner “I don’t WANT to manage my pain…I want it to GO AWAY!” she laughed and told me more about the center. BACK THEN the government said “it was inhumane for people to live with chronic pain” (remember this?) so all the PM clinics started to pop up – they put us on patches, oxy meds, etc etc….and they monitored us carefully. The first time I had to take a pee test, I was mortified! I thought my dr didn’t trust me. I told him this and he explained they had to do the UI’s for everyone.

      So now – 14 to 16 years later – the SAME GOVERNMENT who said “people shouldn’t have to live in pain” are shutting these clinics down. I love being American and I wouldn’t want to live anywhere else – but the heck is going on?

      I personally have not had my meds increased in seven years! I know this is really good for tolerance … I have never “lost” my meds – I don’t mis-use them. I dont’ want to die – I don’t want to overdose … I don’t want to leave behind a son and grandson who had me die from an overdose or suicide. Believe me, I am so frustrated and in so much daily pain – I only hold on to life for them. But I also want to be able to occasionally go to the park with them to see my grandson play and run … I want to stand at my oven for 12 hours during Christmas and bake … I want them to visit an impeccably clean house … I want to work so I can buy THEM things … I’ve even had to go to this place to think if I had to make the choice of giving up the last 5 years of my life to have a decent life now .. (decent meaning I am not laying on the couch cringing from pain …literally unable to talk because I can’t even think)
      I’d do it. I don’t want to give up 1 second of my life – but also…I don’t want to say no, I can’t … I don’t feel well … one more time.

      I actually think, I’ve developed some kind of anxiety disorder this past year because of the pain. My blood pressure which was measuring low 1 1/2 to 2 years ago (when my pain was under control) is now high … I get so aggravaited being in pain – I’m having chest pains.
      I know
      it sounds dramatic … believe me, I can’t stand dramatic and I probably would never tell anyone else this – but that’s how I’ve become.
      I’ve let doctors poke me in the spine and hip, 11 times …
      from myleograms to epidurals …
      in hopes one of the injections would help.
      I’ve had several tests where you have to lie so still on a hard table for 40 plus minutes …
      I wish the drs could just feel how bad I hurt after those …
      I used to say “I wouldn’t wish this pain on my worst enemy” ..
      now, I wish I could just hold someones hand and they would feel exactly
      how I feel at that moment. Wonder what they would do?

      Today my legs into my butt cheeks hurt so bad it feels like someone has taken them and just rung them out like a wet washrag. Last night I couldn’t lay on my right side because it was burning so bad I would have thrown up. Oh well – may as well learn to live with it because I don’t see any help for us in sight … I’m afraid. I just don’t understand what happened with this “Patients right to pain relief” thing ?

  30. Avatar of Kari
    Kari / March 17, 2013 at 6:26 pm

    If someone has sever chronic pain and has been an opiate addict and now refuses opioids is there an alternative? I have read through everything but monitoring an opiate is not even an option for me. I am poverty stricken and do not have the resources to pay for extensive studies and pain clinics. Please help

    • Gail / August 13, 2014 at 2:30 pm

      Hi Kari… I was reading through some of these replies and came upon yours. I actually put in my search engine to find out what pain clinics do different because my internist can no longer prescribe my pain medications due to one of his patients either committed suicide or accidentally took to many so he opted to just give up on prescribing period because the DEA is becoming so ridiculous he doesn’t want to do it anymore. I am writing because I have been where you are at. I was homeless and no money. One thing that you can do because you are poverty level is to find out from your pharmacist who makes the drugs that you need. Then say its Glaxo-Kline. go on a computer at Library or friend and print out the form and fill out and get RX from Doctor and send it in or have Doctor’s office fax it for you. Most of the time you can get it free. They would send to Doctor and then Doctor would let you know and you pick up from him because it’s controlled substance. I have a lot to say but I don’t want to take up so much space. I have had a lot of pain for years, a lot of aliments. Just to name a few, Diabetic, Chronic Fatigue Syndrome, Fibromyalgia, had to have Thyroid taken out in 93 because tumor inside it, benign, gallbladder out, ovarian cysts, obesity, degenerate arthritis throughout body, neuropathy. I don’t know if you have ever heard of the down winders. Well, when my mother was pregnant with me there was radiation that was accidentally released from Hanford Nuclear plant by Tri-Cities in Washington state so Doctors have concluded that it has a lot to do with all my issues. 3 1/2 years ago after being on pain medications for 25 years. I decided to go off of them to see if I was having rebounding issues from being on them for so long I couldn’t remember a time I didn’t have them in me. Long Story shortened I was seeing a mental health provider because I had severe depression most of my adult life so I thought it was time to figure out all these addictive issues I have and see if using the opiates for pain played a role in a lot of the addictive personality that I had struggled for years. If I quit one I would usually go to another. Example: I have always had a weight problem and this one has been the hardest to overcome. While in treatment one of the Counselors put it in perspective like I had ever heard it before. When someone becomes dependent on anything that makes us feel good. I took my pain meds because I needed them but I can’t sit here and tell you that on occasion I took an extra one for that little bit of high so I could veg out and not have to think about stress or wanting to escape for 10 minutes. My best friend for years use to tell me that until I dealt with the underlying mental or emotional pain I would always choose to do something to not feel the pain. She said that for years I had tried to run around the pain, go over it, under it and until I walked through this pain I would always struggle with addiction. The counselor put it this way. Somewhere in my timeline of my life and it is usually it is in our childhood, I was going along just fine and then somethings happened which I understand now because of the addictions and going off the pain meds. I was able as an adult able to think itelligently and put it together and walk through that pain so I could once and for all stop the destructive behavior. Eating, gambling, sex, spending lots of money just to get at my husband, and then the opiate use helped my pain yes but it also helped me to push the pain away and not put it all together. Well on that time line he drew a line on the chalkboard then he used the analogy of cucumbers and pickles. So I drew my line when I was about 10 so from birth to 10 I was a cucumber. A nice cucumber, big, crisp, nice color just a good looking cucumber. Then something happened and I became a pickle. I had to stop right there because once you become a pickle you can never be a cucumber again. You will always be that pickle. I loved this analogy that he used. It worked for me. I was always fighting to try and go back to the cucumber stage and fighting to get there through all the addictions I had developed. I guess that what helped me was it wasn’t the fact that I had become dependent on my pain pills, gambling, all of it I could never reverse and change it. I was using all my energy trying to go back instead of going forward and working on being a dill pickle. This might sound stupid but I needed to share that today. I haven’t slept since yesterday morning because of being stressed about going to a pain clinic. I worked so hard in rehab to not gamble, worked on addiction to food to make me feel better, and the pain meds for 14 months I lived in rehab and I made a lot of progress with me and my addictions and being a pickle. I was getting close to leaving rehab and graduating so I was starting to prepare to go back over to the Seattle area and look for work and to live life without the crutches. Will I always struggle you bet. Oops no betting! This is the ironic part. I am writing and telling you about going to pain clinic. The last couple of months at rehab I started feeling really bad. Pain in and around abdomen area, was sleeping with heating pad at night etc. Then one morning I got up and I was all wet like I peed the bed but it didn’t smell like urine but my bed and pj’s were wet. So I thought well I better go to walk in clinic and see if maybe I have bladder or kidney infection. I had never peed the bed. So it was startling. No blood or anything. So the doctor did urine and blood test and I didn’t have any infection. So this Doctor told me I should see an OB and make sure all is ok. So I made appointment and he ordered an outside ultrasound and an inside one too. So he had me come back in and he told me it was a cyst that had ruptured and I had another one also that was beginning to burst. So he diagnosed cystic ovarian something. Found out later that all my sisters had this and I didn’t know it was hereditary. Then he said that the ultrasound also showed a growth on my kidney. He told me that nl. ot to worry about it, most of the time these growths are benign and I could wait for couple more months and see my Doctor in Seattle and have CT scan there since I had no money etc. I asked are you sure and he said yes. God works in mysterious ways. When I got to Seattle my Doctor told me we would get the CT scan and not to worry about paying for it at the time. So I scheduled for next day. So I drank contrast and they shot me up with dye as well. He told me not to take the diabetic medicine until the dye out of system so go get blood test in 3 days and then I can start taking meds again. So three days passed and I went in and was waiting for the Doctor and I asked the nurse if my results were in and she said sure and would you like to see the report so I said sure. Well, she had not read the report before she gave to me which was a big mistake. I was reading away by myself in the room and received some very painful results. You see if I hadn’t gone to rehab and stayed off my pain meds for 14 months the pain medication would of masked my symptoms and at that moment I was thankful I was a pickle. I went out of room and my nurse looked at me and she said Gail sit down I was crying and apparently white as a ghost. My tests showed that I had stage 4 renal carcinoma in left kidney and it had metastasized to lymph nodes, left kidney that growth had over doubled in size and it was in left hip bone. If I hadn’t gone thru rehab and went off pain meds I would probably be gone. The radiologist called hospital over on Oregon coast where I saw other Doctor and had them send it over. The radiologist in Seattle said when he looked at the one from Oregon Coast He could tell then it was cancerous. But waiting sent it into Stage 4. My Doctor is so great. He canceled rest of his appts. and we meant with oncologist right away. They call me there poster adult. Most people with stage 4 don’t have long but I have been on chemo for 3 1/2 years, They thought that when the tumor stopped decreasing in size from x-large grapefruit to baseball size it had died. When they went to take out it wasn’t dead, it was still 30% viable. So after 14 months of no pain pills guess what, I have been on them again. Got pretty painful for a time before surgery. I was in intensive care for three days .They were having hard time with heart beat staying between 30 and 40. but finally went to my room. Then I moved back to Coast and lived with parents for 3 years. Just moved out and friend living with me and being caregiver. So that’s my dill pickle story. I have to be on chemo for rest of life. I was able to go off before but with having cancer and now have spot in lung, liver and lymph nodes that I go to Seattle every other month for tests and see internist and oncologist. my pain is constant and some days I wonder if I should go off but I don’t have time to feel sorry for myself. I wish everyone on here the best. I give God the glory and am thankful I was off The pain meds because I wouldn’t have known much was wrong. Smile today!

  31. Avatar of Dr Bill Belfar, MD
    Dr Bill Belfar, MD / March 17, 2013 at 10:39 am

    Nobody was born with chronic pain or drug addiction. They learned it. Opiate dependence is based on tolerance and withdrawal. If you have these, you are dependent or addicted. The best way to treat pain is with carefully monitored pain medication, being opiate or non-opiate and good education for substance abuse. If you are abusing any drugs or medication, there is a reason you are doing so. Substituting marijuana for opiates is substituting one addiction for another. It is not any better. Don’t kid yourselves.

    • j henderson / May 22, 2014 at 3:01 am

      I have not had chronic pain all of my life but I have it now. I have severe chronic pancreatitis with calcification and atrophy. My life before I was prescribed pain meds (opiods) was laying on the couch in a fetal position. Looking for the best way out of this life.
      My pain doctor saved me but not until I had tried every med, pharmaceutical and herbs, yoga, tai chi, acupuncture, and psychiatric therapy.
      I was getting along. I mean just getting along, able to work part time, go to the gym, and walk my dog. Now the powers that be want me off of all of my meds. There is nothing they can do for me, I’m been told this by surgeons and GI docs. I am unable to take the new SSRI meds but take an old antidepressant that just makes me a zombie. I have no quality of life.
      You all need to take a good look at the legitimate patient. Why are we being punished for what some movie stars and bratty kids did? If you want to look at poisons out there? Look at sugar, red meat, save more lives? take away the assault weapons which no one needs other than to kill or maim another person
      I have cut down on my dose dramatically and cry myself to sleep every night. I can’t eat for fear of the pain. Look at both sides before you start judging others and suggesting like sheep what you here from the drug companies. Our system is in a mess and government has no business in it. I’m an old lady, I hope the people who said Obamacare was going to kill off grandma is right. I’ll be first in line.

      • Brian / July 16, 2014 at 2:47 pm

        Please don’t give up!

        You are not alone. I need 90 oxycodone pills per month and every month I sweat what pharmacy will assist me. Fewer are willing to order when not in stock, and they all roll their eyes every month.

        Medicare D plans won’t cover my meds, not without a mail order and required doctor paperwork that he won’t provide.

        So I know your frustration. Having to choose between food and meds is big problem for sick people in this country. But if we all stick together, our voices will be louder

  32. Avatar of ER45flatback
    ER45flatback / January 7, 2013 at 5:11 am

    I have a damaged steell rod on my entire spine. Back,arm and legpain. I went from codiene to oxy to fentanyl to booze.
    I no longer drink at all but the back pain coupled with severe withdrawals leaves me with nowhere to go cgo but in a coffin.

  33. Avatar of Matt Paperplanes
    Matt Paperplanes / September 28, 2012 at 1:46 pm

    20 years daily opiod prescribed. last 10 sick on buprenorphine. Recently diagnosis ankylosing spondylitis and in now it’s “sorry we thought you were faking your poison and pill seeking, but you’ll have to live with it.” I should not suffer, I am an honest single parent. I just want to go on duragesic but no one will help I am easy to die

  34. Avatar of Jolene
    Jolene / August 11, 2012 at 6:07 am

    What about puffer fish, bee, spider, and cobra venom based “drugs ” to name a few?
    I read several articles of cobra venom in patches so it’s all day relief. ..which if you have chronic pain the biggest problem is the up and down of pain…. and abuse starts with relating livable pain with meds and bad pain as NEEDING meds… I also read these venom based meds are widely used with great success in Asia,Europe and Canada. they are cheap.

    I think we need to investigate these drugs… its natural and non addictive.

  35. Doug / August 16, 2011 at 5:51 pm

    What are you all smoking? Doctors and Big Pharma can’t get rich off a plant! Have some pity for their suffering, would you? I know not all doctors are motivated by profit, but it is disappointing how many “need” to be subsidized by drug companies because their 6-figure income just won’t cut it without a little “boost”.

  36. Steve Westen / June 27, 2011 at 8:22 am

    How about instead of over-relying on opioids, how about using, non-physically addicting, fewer side-effects, no death, safer alternantive cannabis. Proven to assist with pain related illness. We over prescribe and over-rely on opioid medications and though the tide could change from over use of opioids for pain to overuse of cannabis for pain, at the least, cannabis won’t kill you or cause over-whelming withdrawls and phsyical dependence. Whether you personally think cannabis should be legal or not, for whatever level of freedom, the bottom line is that it is a safer alternative to opioid pain management.

  37. Brinna Nanda / June 24, 2011 at 9:37 pm

    Funny, I looked through the whole article and I do not see any mention of the alternative analgesic that has the least side-effects, the safest profile, and the greatest potential for reducing the need for opiates. Yes, cannabis. The fact that it was not even mentioned in this discussion shows how completely distorted our public discourse is on this subject.

  38. Brinna Nanda / June 24, 2011 at 9:13 pm

    Hate to bring up the obvious, but in the US Pharmacopeia prior to 1942, cannabis was used as a very effective method to reduce opiate addiction. So, we already have a tool in our arsenal that has been shown to potentiate opiates so that smaller amounts can be used for the same analgesic effect, but because of our hair brained approach to public health, we don’t use it. Sad, really.

  39. Ben House / June 24, 2011 at 7:48 pm

    Recent publication of data showing the close proximity of emotional and physical pain receptor systems in the brain offer valuable insights. These are hinted at in this article, but not well addressed. Clearly assessing the role of the emotional pain and especially the incidence of fear seem a reasonable standard that might offer insights in treatment planning.

  40. Bill Lapadat / June 24, 2011 at 6:28 pm

    Tolerance and addiction are not the same thing. I appreciate the comments by John Bancroft.

  41. Stewart B. Leavitt, MA, PhD / June 24, 2011 at 4:50 pm

    I wonder if opinions and attitudes toward opioid analgesics would be different if healthcare providers as a part of their training, as well as government officials or other policymakers, had to endure several months of chronic pain. At that, it would be an unfair exercise because, unlike actual patients, the others would know there is an end in sight to their pain and suffering. Patients do not have that luxury and often worse than the pain itself is the lost hope of relief or lasting recovery from their daily agony.

    While all of the concerns about opioid analgesic safety and the impact on public health are valid — to some extent — have the fears been elevated out of proportion with reality; considering there are more than 76 million chronic pain sufferers and an extremely small percentage of the population is misusing and abusing the medications.

  42. Avatar of Rocky
    Rocky / June 24, 2011 at 4:46 pm


  43. Avatar of John Bancroft
    John Bancroft / June 24, 2011 at 2:20 pm

    There has to be a recognition not just lips service to the fact the opioid based pain meds result in tolerance.
    The pain and treatment communities need to recognize that part of the treatment can and should include a process of reducing tolerance so that meds can be kept at a steady state and therefor the risk of addiction managed as well.

    • Brian / July 16, 2014 at 2:51 pm

      You make too much sense John. They will never be logical on this topic!

  44. Avatar of Valli Genevieve
    Valli Genevieve / June 24, 2011 at 2:07 pm

    I am curious about Dr. Potter’s statement on Opiate addiction. She says: “One of the challenges is that we don’t have good estimates of how common it is for chronic pain patients to develop problematic opioid use” but then she goes on to say the “vast majority of people with chronic pain do not go on to develop an opioid addiction.” How do you know? People seeking treatment for opiate addiction has exploded over the last decade, in Maine, going from 28 people per 100,000 to 338 people per 100,000. Most physicians use the 2009 AAPM/APS guidelines for prescribing but a close reading of those guidelines reveals that 16 out of the 21 experts are on the payroll one or more pharmacy company and their own guidelines, they rate as having very low evidence. So we are blithely prescribing highly addictive substances that can destroy whole communities based on little evidence and put forth by experts whose recommendations are tainted.

    There is no evidence that people with non-cancer chronic pain can be safely and effectively treated with opiates over the long run. We have medically induced epidemic on our hands – we need to rethink our approach.

  45. Avatar of jerome ennis
    jerome ennis / June 24, 2011 at 2:53 pm

    Great and accurate comments Valli Genevieve. All too many decisions to prescribe drugs is dependent on whether or not the prescribing individual has a vested interest as in, Stocks In Said Pharmaceutical Company. Ritalin is one of the most highly prescribed drugs on the market and is also a drug that is prescribed, in about 90 percent of the cases, where there is no evidence that it should be prescribed, and this is especially true in the incidence of this deadly drug being prescribed to children. The prescription rates on all pharmaceutical drugs are way up and I hate to be the one to say it, but I honestly do believe that doctors over-medicate and over-prescribe drugs, especially addictive drugs. Thanks, M. Jerome Ennis, MA/Addiction Therapist

  46. Avatar of Bill Lapadat
    Bill Lapadat / June 24, 2011 at 6:26 pm

    @ Valli Genevieve…
    Have you ever lived with chronic pain? I’m not talking about a creaky, arthritic knee. I’m talking about “can’t walk without the Fentanyl patch.” Or, had your second-grade daughter say to you, “Daddy, don’t use the cane today” as you walk them into school after their dental check-up?

  47. Avatar of Diana
    Diana / March 25, 2013 at 7:46 pm

    There is as much, if not more, evidence that patients with chronic non-malignant pain can be treated long term with opiates without risk of becoming addicted. This is a great review of the literature from a very well respected pain researcher and clinician, Howard Fields…

  48. Avatar of Connie
    Connie / October 26, 2013 at 10:48 am

    I sm one of those “addicted” persons dependent on opiates for pain relief and from my perspective, I am grateful for the trade. I LIKE being able to walk and bend without screaming out in pain. It makes all the difference. The steroid cortisone shots have a lot more side effects. I don’t abuse my pills. but I do depend on them. Now, how to stop the PROBLEM users?

  49. Avatar of Mike
    Mike / April 25, 2014 at 10:32 am

    Big Pharma pays the reps, the reps pay the doctors and the doctors get paid bonus money from the big healthcare networks every time you grace their doors. It’s ALL about profit at the expense of the patient. Once they have you hooked on opiates and benzo’s they have you for life.

    There are doctors taking in patients who violate pain contracts, who evidence dirty urine and who have been arrested for diversion. They simply don’t care. As for the patients, they adore their “dealer/doctor” because he’s giving them EXACTLY what they want.

  50. Avatar of Keith Brooks
    Keith Brooks / April 26, 2014 at 4:35 pm

    All of the holier than thou comments on here from people that have never been in agonizing long term pain, personally I don’t care who does what it’s none of my business as long as they’re not hurting anyone else, and save the “but they are” comments because having access to pain medication helps more people than it hurts by a far cry. I’ve seen it, I’ve experienced it. You better just hope that you are never the one that’s in pain so intense that dying sounds like a good idea because you can’t get relief.

  51. Avatar of jmurcko
    jmurcko / January 25, 2013 at 9:32 pm

    your message made my day!! Someone actually gets me and what i’m going through..god bless

  52. Avatar of Karen Ernst
    Karen Ernst / April 23, 2014 at 6:52 pm

    A big shout out to to the person who described chronic,debilitating pain. Pain that affects every area of your life. It is exhausting,& causes one to lose purpose and zest for life. Resulting in a vicious cycle of stress,depression & increased pain.
    Nothing will take chronic pain completely, It make it bearable.
    If medication increases the quality of someones life … Who has the right to say it is wrong, addiction or not.
    Dont judge unless you have walked a mile in my shoes.

  53. Mike / April 21, 2013 at 4:23 pm

    Small edit for above message: “only treated as chronic” should have been “only treated as Acute”, or ‘occasionally’ treated, like it was a flare up of some kind.

  54. Midknight / April 30, 2013 at 1:15 pm

    AMEN ! Now that should be made into law.

  55. Keith Brooks / April 26, 2014 at 4:39 pm

    Methadone is the same way and yet it’s vilified, so your wrong, the DEA will always want to destroy lives.

  56. Avatar of Sashi
    Sashi / June 25, 2013 at 5:52 pm

    I truly understand what you are going through. I’m only 39 years old and already had three major back surgeries. I have a 7 year old daughter who doesn’t understand why mommy can’t bike ride, run, walk fast if at all sometimes. I try my hardest not to complain and keep my tears for when I’m alone. My knees are now going and I have arthritis in my hips and knees and might need double knee surgery. My husband just recently got laid off so I once agin have no health insurance. Thank god workers comp is paying for my meds for my back. Trying to get them to understand that my knees gave out because of my back. This has been going on for three years now and the pain is at its worse. My pain dr basically told me if I don’t get my knees fixed that I will need a knee replacement. I can’t imagine going through another surgery. But back to the point. No one will ever understand the pain we people are in, nor do they care. God forbid I tell anyone in my family that I’m on pain meds because they would think I’m an addict. People really don’t get it. I don’t abuse my medicine. I go to the same doctor and pharmacist every month. Never failed a urine test. I would be a cripple if it wasn’t for the pain medicine. Part of me wishes that the people who judge us could walk in our shoes for just one month and see how they would feel then. Now without no health insurance I have no chance to save my knees. The sad thing is I’ve been working on the books since I was 15. Been paying taxes since then and I can’t even get insurance from the government. People who are really in pain rely on these medicines just to get though the day. Like you I have tried everything before I went to narcotics. There are days when I feel like its just not worth it anymore. If it wasn’t for my child and husband I don’t think I would be here anymore. This is the first time I have ever wrote anything on these sites but sometimes you need to vent and lord knows no one else want to hear me complain, because they just don’t understand. I wish you well, I wish all of us who are in chronic pain to get through each day. I would do anything to get my life back but this is what it is. I guess that’s all I have to say. Wish everyone well and good luck with this horrible government crap.

  57. Avatar of Sharon
    Sharon / July 2, 2013 at 4:24 pm

    Hi Diana,
    Until I was 31 years old, I would have agreed with you about people taking med’s correctly do not all become addicts until it happened to me!! I’ve never had anything control my life, until I Vicodin starting taking over. I am so frustrated at how Doctors can feed you all the narc’s they want to prescribe, but when it comes to me taking suboxone (opiate blocker) and then because of freaking POLITICS, my Dr. can only have 100 people under her taking the medicine that we need to come off and be clean. I have never been broken down, weak type of person, but when it comes to withdraws I only want the pain to stop. I want my life back, and I took my med’s right so I hate to tell you that NO ONE can help but become an addict because it is your body that starts having to have the medications. I did NOT chose to want this to happen, and by all means when it comes to it being a choice for anyone….DRUGS ARE NOT PREJUDICE. I wish they were then my life would not be in the shape it is in now. I was you at one time because I thought my friends could just “STOP”. I told them it was only up to them not realizing what they were going through. Unfortunately it is too late by the time you understand what they have been telling you because you are now in the same shoes you told them they were weak for being in and I would say it is all a choice. Little to late by the time I fully understood they were right along. It is soooo hard to admit this too because I have never been weak until it came to becoming an addict. I just want to feel normal, no pain, and be happy just because my brain is producing my natural ability to be happy without having to take a chemical to just feel OK. To be an addict feels like being in a jail cell, you and only you can get yourself out of this place, even having the key to unlock that cell doesn’t help because the withdraws are so bad you will be calling that cell home again real soon. I am sorry for sounding angry, but I was you saying the same thing until I had to be on pain killers and I just wish I could have seen a slight picture or feel a tiny withdrawl before listening & trusting my Dr. because I would have cancelled that appointment never looking back that is a promise. I just pray one day after coming down few milligrams at a time I can be free even though the odds are against me I’ve never wanted anything more, yet can’t wait to take the medication just to feel OK, not high as a kite on it just function-able in society like I was once upon a time… I’m sorry for my frustration, but I have been where you are and I was wrong. The only way to stop it is NEVER start or take a drug that has a high potential rate for addiction. You can take a couple of scripts and be OK, but long term pain management will never work!!!

  58. Avatar of L-1 ~ Sacrum
    L-1 ~ Sacrum / August 20, 2013 at 1:58 pm

    I am so sorry for your anger, BUT you can be admitted to a hospital & taken off of drugs. Many of my friends had to do this in the 60s & 70s. I believe highly in opiate pain control. What difference does it make if you are dependent on opiates or anti depressants? You cannot just STOP anti depressants either. I have 7…SEVEN…Ruptured discs in my spine, Scoliosis that is degenerative. There is NO CUSHIONING left in between the Vertebra from L 1 to the Sacrum….That is 5 Ruptured discs Impinging on Nerves. There is also 1 in my neck, and 1 in the thoracic region of my mid back. I am not a candidate for surgery as the neurosurgeon said I would lose too much flexibility. I am in Constant, Intense Pain 24 hrs of the day, because when there is no cushioning between vertebra what do you have? Nerve Impingement. LOTS of Pinched Nerves. I have been at the point of going to one of the states that allows Dr. assisted suicide, you do not know the pain I feel, I am an invalid in my own home. I am only 60 yrs old, and cannot stand, sit, or walk for longer than 5 minutes. My Dr. is very stingy with the pain meds & I don’t like them either. BUT, I would like to be able to walk around again, and if it takes being dependent on opiates to attain mobility, then so be it. My GREATEST fear is losing the Dr. that I am about to put my faith in. I am seeing a new one that is an anesthesiologist & board certified in pain medicine. The Dr. I have been seeing is nothing more than an MD with a certification in physical therapy. He has had me on a rollercoaster with the pain meds. On one, then he changes it, on another & then he does it again. I have been seeing him for 10 yrs, when the pain started I was not educated in WHAT type of Dr to see…But now I see I have not been in good care. GOD made the Poppy, he put pain relief in the world, but these Drs are so afraid of addiction, they hesitate to use it, yet they freely prescribe anti depressants that they mostly “don’t know exactly how it works” (from the PDR) and you have to be weaned off of them, so they are ADDICTING…your body is dependent on them. MY FEAR is the Dr. Dies, or Moves out of state, and once again you find yourself in intense Constant Pain. I do NOT like taking pills, But if it comes down to being bedridden (as I am now, from bed to chair, then because of sciatic pain in my butt I have to move to the bed, different position) I am eating ALL frozen dinners, cannot stand long enough to prepare a meal. And YOU say you wish you never saw the Dr. that relieved your pain? Well..I guess you don’t really know what REAL PAIN IS…..should people just STAY in pain, or go out of state to die…What is your answer? NO ONE TALKS ABOUT THE DEPENDENCE ON ANTI DEPRESSENTS yet you cannot stop taking them either. A Diabetic is dependent on Insulin, would you deny them that? Then Why Deny Someone in CHRONIC Pain, pain medication? This really kills me about what people think, what Drs. think….All the While, There are the PILES of MRI’S & CATSCANS showing you are suffering to the maximum. What do you suggest we do?

  59. Avatar of Trainy
    Trainy / September 9, 2013 at 1:25 am

    I share your pain and understand your frustration! BUT you are not alone. I’ve been struggling with addiction since my first back surgery at 15yrs old. Now 4 surgeries and 1 C- section later Im 33 and still can’t figure out a way to manage my pain for long periods with out meds. I was also on suboxone but my dr. kept me on way to long and now Im 4 days in with out it, after a long taper, the withdrawals are not that bad. Of course im tired and in some pain but as you know the poison has to leave the body. Did it help me get off Norco, YES ABSOLUTELY! But I feel that people think this a miracle drug and that it will solve all their pain and addiction problems. Thats not really the case. The pain is still there its just you brain is covering it up. For me it was just an easy way out, because physical therapy and working out and going to 12 step meetings, is a lot of work!! Im really on your side though Im just sharing my experience and trying to give you another look at things. I may have to return medication at some point but I hope thats not the case. Trying other things and relying on a power greater than yourself may be the answer. I know it was for me in the past. I was sober going to meetings, working out, and was out of all pain. I know that was not me, there was a higher power working in my life, i just turned my back on it.
    I never abused my suboxone but while i was on it i was just maintaing. For me Ive been on both side of recovery with chronic pain and life without drugs if POSSIBLE for me is really living, not just maintaing. i never read all the stuff that suboxone can do to you if you are on it for a long period, so if you do not have a good dr he is not going to guild you through each phase as he is suppose to. Mine didn’t and 2 years later i was just dependent on suboxone. well best of luck to you. just do your research before you succumb to another drug. Ive been in that jail you speak of and its no fun! but there are ways out and you dont have to do it alone. this is just my experience.

  60. Avatar of Tammy
    Tammy / January 31, 2014 at 10:10 pm

    It is so very frustrating to me when I hear people call themselves an addict when, they were very likely only dependent on opiates. Withdraw sucks whether you are an addict or not. Dependency happens to almost anyone who spends a length of time on narcotics. If you are not weaned off the opiates slowly enough or if you are still suffering from the painful condition that you were originally rx’ed opiates for- then there’s a good chance you are only dependent. Even if you had some symptoms of addiction. Then you could be going through pseudo- addiction. I truly believe the spread of misinformation just like in your post is a big part of why the general public just doesn’t get it. There are so many people out there still suffering from untreated chronic pain because someone convinced them that they became addicted when it was only a dependency on the narcotic. Suffering withdraw isn’t a pleasant experience for anyone!! Whether you are an addict or dependent on narcotics. Please get some further evaluation before giving in to someone giving you the tag of an addict.

  61. robinladda / September 5, 2013 at 3:44 pm

    For all you out there, wanting it used for chronic pain, I’ll have you know as a child of the HIP generation, 60s/70s I smoked a lot of marijuana, partially because it Hightened all of my senses. I tried it for my Ruptured vertebrae (7) and guess what? It hightens the pain also. So WHY would I want to take something that makes the Pain Worse? It also gives me and not only me, Panic attacks. It is very mild when used for pain, alcohol deadens the nerves way better than pot, it’s what they used in the early times, thru the cival war when there was no morphine to be had. Marijuana also has long term side effects. My brother is a walking example of them all. He smoked pot on a daily basis, thru out the day, every day since 1964…he got busted, he went from a mild marijuana to the hydrophonic stuff, and now because of the law, he cannot smoke or carry any, and guess what? He has constant panic attacks, Major Depression, Shakes constantly…and 5 anti depressants took it’s place. Now he can’t get off of those. He made it last almost a lifetime, and he is a MESS. A lot of people have heightened sensation when smoking it, as I do, panic attacks while smoking (as I do)…and it is a weak opiod for chronic pain. So just because it’s good for you, doesn’t mean it’s good for everyone. Man…I’d hate to have a tooth pulled with just marijuana for the pain. THINK before you post. You’re not in much pain if you could have a tooth pulled with just marijuana, and I mean a tooth that has a toothache, you couldn’t kill the toothache pain, much less the pulling of the tooth with only POT.

  62. Avatar of Lynda
    Lynda / November 9, 2013 at 4:21 pm

    We must be identical twins. Exact same problems and no pain relief in over 3 yrs now. I pray to die each and every day. Are there any states where dr assisted death is approved? This is NO WAY TO LIVE. It is pure torture and suffering. I feel you my sister… God help us please.

  63. Avatar of Gata
    Gata / December 4, 2013 at 7:23 pm

    Well i hate when ppl tell me what i can and can’t take. It’s not the drugs that are the problem its obtaining the dam drugs that cause ppl to lie cheat and do whatever to talk to a doc for 5 min and hope he believes u enough to give u expensive dam meds. Ppl can function perfectly fine on opiates, no violent behavior or slurred talking even work on ladders and rooftops all day. Ppl need opiates wether for pain or just because they are addicted and for the latter category its like taking meds from a bipolar patient same dam thing. The drugs should be legal in the first place. But we have to tale matters in our own hands as a supposedly free ppl. I will never rely on doctors to tell me im in pain and hope to god that some judgemental doc who i see for ahalf hour will write me a script or worry that big brother is checking up on me. Remember heroin tho stigmatised and highly taboo doesnt need to be injected and it is exactly the same as opiate pain killers and cheaper to buy on the street. Also u can grow opium yourself its laughably easy to grow in almost any climate as well as indoors. Now while you all cringe and say im crazy uderstand this whats crazy is that a lot of ppl even have to resort to a street drug because our gov says we cant have it and docs like gods wield the power to choose wether we deserve relief. I say screw them all take care of yourself either live in excrutiating pain hoping a dr will give enough of a dam to help u or do something taboo and be pain free. Unforunately for some this is how things have to be until drug proabition ends and we are free to choose to put whatever we want into our bodys for better or worse.

  64. Avatar of D.J. Amick
    D.J. Amick / January 4, 2014 at 3:41 pm

    Kudos to John Bancroft for understanding the basics of pharcokinetics in long term pain med use. Tolerance is inevitable but manageable if the practitioner cares. Switching meds on a quarterly basis along with adjunct therapy to potentiate meds such as Ketamine, and others under investigation

  65. Tammy / January 31, 2014 at 10:25 pm

    I realize that this post was made in 2013 so, maybe my words are too late to help the OP. I still wanted to try in case someone else comes along and feels similar. Why in the world would anyone suffer withdraw needlessly? There ARE methadone clinics out there that would at least help with w/d’s. Then talking about checking out? Of course your life is rough. I too live with-untreated chronic pain. I would not and could not ever give up. I have two kids (one teen and one now “grown”) who would spend the rest of their lives wondering why they were not good enough to make me want to stay. I would leave behind too many people (and even if it’s ONE that IS one too many) wondering Why? Yes, I suffer daily now and I know what that is like. Why in the world would I choose to check out early and leave my loved ones in daily pain because of it? Please!! As horrid as the pain and possibly withdraws might be- THINK about the sentence you would be giving your loved ones who you leave behind. You sentence them to the lifelong question of Why. They will forever wonder if they could have done something to stop it. How can anyone think that is fair? Keep trying to change things. Have faith in God (or whatever higher power you hopefully believe in). Hug your family and keep em close. This life is a heck of a lot shorter than you realize.

  66. Keith Brooks / April 26, 2014 at 4:54 pm

    The DEA and their propaganda machine are doing this to us, call you government reps and ask what they are going to do for us, ask what their position is and vote accordingly. Write them and keep writing them, ALL of them! There are millions of us that live in pain because of the overzealous DEA, LET’S STOP THEM!

  67. Keith Brooks / April 26, 2014 at 5:00 pm

    Who wants to fight for a county or let their children fight and possibly die for a county that doesn’t allow a doctor to relieve a patients pain? Let the DEA send their kids to fight!

  68. Avatar of Ray
    Ray / May 3, 2014 at 3:08 am

    Thank you for that Tammy! That happened to me ….
    Everyone convinced me I was an addict, until I finally went to see an addiction psychologist and check myself into the mental ward. There they said you’re not an addict and your just dependent. They said to get over it and keep taking your pills.

    I kept taking them for the last two years never increasing the dose, never losing my prescriptiion, and now my doctor just told me that even though I’ve been compliant on my pain contract, he can no longer prescribe me opiates because his boss said so and he’s afraid to lose his license.

  69. Brian / July 16, 2014 at 2:38 pm

    My problem is pharmacies won’t order anymore, so I have to some times go to 5 or more pharmacies or find monthly meds

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