Doctors and poor pain management

[Tortoise]

My friend recently had his appendix removed and it was done the old fashioned way, ie one big cut as opposed to keyhole surgery. You know what the doctors prescribed for him? Fucking panadeine forte! That's right, a dude has some pretty serious surgery and all he gets are tablets with 500mg paracetamol and 30mg of codeine. WTF!? Is this normal?

Swim had surgery for appendicitis when he was in America and at least he got Vicodin, which seem much stronger than panadeine forte.

Honestly, what is wrong with doctors who underprescribe pain meds? If you ask me they should have at least prescribed endone (paracetamol + oxycodone 5mg) considering we don't have hydro in Australia. It just seems that they're scared to prescribe anything stronger than absolutely necessary, even if it means less effective pain relief for the patient. Sad.

Reputation Comments on this post:

	good thread
	His posts are overall informative

[Mint boi]

Some doctors are ridiculous. A friend of mine had an accident in spain last summer, slipped on a pool edge, broke his nose, split open his lip and forehead, needed 6 stitches, guess what he was prescribed for pain? 400mg ibuprofen pills, Helped with swelling i guess, but crap for pain management.

[stoneinfocus]

Around here it´s just 2 -x days of piritramid (Dipidolor tm) it works, but they´re afraid to prescribe/give it to their patients for more than 2 days.

This is ridiculous, as you need a year to develop a serious opiat dependence, not to mention that pain seems to be an antagonist to any form of opiate dependency and they´re afraid of dependency even when giving a few days opiates.

-"One shot and you´re on!" *lol* Sad but true, how this prejudice made it to academics, who should know better.

[Jatelka]

"You need a year to develop serous opiate dependence"?

Source? Science behind your statement?

Opiate tolerance develops much quicker than that

Reputation Comments on this post:

I agree w you jat.

[stoneinfocus]

Originally Posted by Jatelka

"You need a year to develop serous opiate dependence"?

Source? Science behind your statement?

Opiate tolerance develops much quicker than that

W.S.Borroughs "Junkie" .. when he speaks of a full blown -so to say- addiction, with tolerance sky-rocketing after abstinence afer one year, which is what he´s talking/writing about, I trust him, although there might be huge interpersonal differences.

I read in an enceklopedia that it would take at least 1 months, with multiple morphine injections a day to develop an addiction, with withdrawl and all the fun-stuff.

[samuraigecko]

Originally Posted by stoneinfocus

W.S.Borroughs "Junkie" .. when he speaks of a full blown -so to say- addiction, with tolerance sky-rocketing after abstinence afer one year, which is what he´s talking/writing about, I trust him, although there might be huge interpersonal differences.

I read in an enceklopedia that it would take at least 1 months, with multiple morphine injections a day to develop an addiction, with withdrawl and all the fun-stuff.

Throw some Hammer or Morphine (or any other opiate for that matter) up SWIY's arm for 2 weeks strait and then tell us that it would take at least a month. LOL. That is just totally ridiculous information and dangerous to post as such in a forum such as this which can influence other people.

Opiate dependence and tolerance begins very quickly. After the 10 to 14 day mark ones own body will discontinue the production of endomorphins (a type of endorphin which is most similar to Morphine) and the brain will become Dependant on the introduced opiate because the brain is no longer producing its own endorphin which the opiate mimics. As use continues the endorphin pumps will no longer even work until full withdrawal and reconditioning of the brain has occurred. In some instances people have permanently damaged these endorphin pump systems which has resulted in a full blown depression which cannot be recovered from. For more information and links to help provide the proof for this one may look at "what makes an opiate" thread or other threads one has posted in to substantiate these facts.

Hope this has been of help or insight.

[ironmics]

Originally Posted by Jatelka

"You need a year to develop serous opiate dependence"?

Source? Science behind your statement?

Opiate tolerance develops much quicker than that

Yep, definitely took less than 60 5/500 Vicodin for swim to get dependent, not "serious" I suppose, but he's glad that he never went back to get more. This was over a months time also, so he was only take 10mg of Hydrocodone a day.

[Psych0naut]

Never in my life did I get opioids for serious pain, not even after surgery for post-operative pain, nor when I had an inguinal hernia which was the most painfull experience in my life(in most cases it doesn't hurt much, in mine it did!)
The only country where opioids are prescribed in abundance seems to be the US, but in Europe prescriptions for opioids are rare, unless you're dying. Ofcourse there is the odd exception, but this is certainly a general rule, a lot of people who need opioids don't get them, because doctors are afraid to prescribed them.

Reputation Comments on this post:

it would seem in the Neth. rx should be ez to aquire. guess not

[yaba]

Originally Posted by Psych0naut

Never in my life did I get opioids for serious pain, not even after surgery for post-operative pain, nor when I had an inguinal hernia which was the most painfull experience in my life(in most cases it doesn't hurt much, in mine it did!)
The only country where opioids are prescribed in abundance seems to be the US, but in Europe prescriptions for opioids are rare, unless you're dying. Ofcourse there is the odd exception, but this is certainly a general rule, a lot of people who need opioids don't get them, because doctors are afraid to prescribed them.

Swim is Dutch and his old family doctor was old school! When swim was 14 he went true a hard time and his doctor give him 3x 10mg diazepam daily and thermazepam at night. Also when swim had tooth pain he went to a emergancy dentist in Amsterdam. The dentist asked receept swim told him no thanks, he said ok I do it a bit cheeper. When swim asked him for pain killers he wrote down paracetamol+codeine swim told him they aren't working. He asked swim what do you have in mined ? Swim sad morphine and he replyed I can do that for you. Not sure what it was bit it knocked swim out!

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good post

[Psych0naut]

Originally Posted by yaba

Swim is Dutch and his old family doctor was old school! When swim was 14 he went true a hard time and his doctor give him 3x 10mg diazepam daily and thermazepam at night. Also when swim had tooth pain he went to a emergancy dentist in Amsterdam. The dentist asked receept swim told him no thanks, he said ok I do it a bit cheeper. When swim asked him for pain killers he wrote down paracetamol+codeine swim told him they aren't working. He asked swim what do you have in mined ? Swim sad morphine and he replyed I can do that for you. Not sure what it was bit it knocked swim out!

How long ago was it that SWIY got the prescriptions for diazepam and temazepam? Untill recently benzodiazepines were widely prescribed in the Netherlands(the sole exception of abuseable pharmaceuticals which aren't to hard to get a prescription for), though it has changed in the last few years due to goverment pressure. Though SWIY was very lucky getting a prescription for a strong opioid at the dentist, when my 4 molars got extracted I didn't get any painkillers, just a few lidocaine shots in my gums before the procedure. Apparently in the US, it's pretty common to give people IV benzo's and often even IV opioids on top of that, even at the dentist for things like getting your molars extracted, it's insane ..

[beentheredonethatagain]

Originally Posted by Psych0naut

Apparently in the US, it's pretty common to give people IV benzo's and often even IV opioids on top of that, even at the dentist for things like getting your molars extracted, it's insane ..

I have had a lot of dealings with doctors , pain managment, and some dentists, never and never have even heard of a dentist administering opiods IV, never.

In fact only in either an abulance or in a hospital has opiods been given to beenthere.

IV benzos given in hospital or a clinic prior to a stressful type operation.

[bloodred1889]

as swim said in a previous reply, we need to stand against doctors in the uk and europe and make them see that not all ppl are drug seekers and not all back pain can be cured with anti imflamatories, paracetamol and exurcise.

swim has had chronic back pain for 7 years now, and the pain is getting worse, its in swims legs, arms, lower and upper back and in most cases it states that if the pain in your back moves to your legs then somthing more serious then back pain is there, but still swim is refused pain relief, becuase... its too addictive.
all swim is given time after time is, a refural to a rumatologist, paracetamol and an anti imflamatory.

WTF.

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how's things doing now.

[yaba]

Originally Posted by bloodred1889

as swim said in a previous reply, we need to stand against doctors in the uk and europe and make them see that not all ppl are drug seekers and not all back pain can be cured with anti imflamatories, paracetamol and exurcise.

swim has had chronic back pain for 7 years now, and the pain is getting worse, its in swims legs, arms, lower and upper back and in most cases it states that if the pain in your back moves to your legs then somthing more serious then back pain is there, but still swim is refused pain relief, becuase... its too addictive.
all swim is given time after time is, a refural to a rumatologist, paracetamol and an anti imflamatory.

WTF.

Swim has a similar problem he has genuine lower back pain and recently he has a problem with his neck and shoulder. He works in health care his doctor is the best one he probbally can get in his region.

He first got: Diclofenac sodium 25/50 mg dual release he didn,t like them and got Co codamol 30/500 mg and they wern't strong enough now he is on Tramadol. Can he push for something better ? And what will be the best thing to say ? He doesn't want to piss them of either.

It appears to swim that the bigger pain someone is the more he will be helped.

[beentheredonethatagain]

oxycodone is only prescribe for chronic pain, not accute.

[bloodred1889]

Originally Posted by beentheredonethatagain

oxycodone is only prescribe for chronic pain, not accute.

yeah swim has chronic pain but swim doubts she will EVER get oxycodone, as that is for cancer patiants, at least around here.

[Laudaphun]

Originally Posted by beentheredonethatagain

oxycodone is only prescribe for chronic pain, not accute.

Not sure what California's regulations and such are but oxycodone is commonly given to high school kids who get their wisdom teeth out. SWIM's first ever prescription for narcotics was in the emergency room for oxycodone/acetominophen 10/650. This was only a prescription for a few days to alleviate the soreness of the next few days due to an automobile accident.

Oxycodone in it's time-release form should and is typically used in chronic pain rather than accute, but the oxycodone/acetominophen(paracetamol) preparations most certainly are used for accute pain and not just for chronic pain... at least in my state. On the other hand, who knows what regional differences there are as the U.S. is a fairly large country.

Reputation Comments on this post:

somewhat agree, except oxy for teeth?

[myfavoriteaccident88]

swim has never ever received oxycodone or oxycontin (time release oxycodone) from a doctor.

Thank god for swim he has other ways of getting the pills, they are amazing.

and 10-20mg is nothing.. for swiim it takes at least 60-90mg per shot to give a nice rush and a good nod.

[OhCasey]

Originally Posted by beentheredonethatagain

oxycodone is only prescribe for chronic pain, not accute.

Thats not true Swims orthopedic Surgeon prescribed him Oxycodone 10/325 for his after surgery pain but just one refill.

[Laudaphun]

Originally Posted by OhCasey

Thats not true Swims orthopedic Surgeon prescribed him Oxycodone 10/325 for his after surgery pain but just one refill.

Of course oxycodone is used for plenty of other things other than chronic pain. I think people are begining to get the brand names and active component mixxed up. Oxycontin is a time-release formulation of oxycodone that is used for chronic pain for the most part. But your regular 5mg or 10mg oxy/APAP formulations are used all the time for pretty much anything and everything... just depends on the dr. and the person. SWIM never saw his grandfather get anything prescribed other than oxycodone 5mg/325mgAPAP ande he never had any chronic pain.

BTW, in the US. Oxycodone is a schedule 2 constrolled substance, therefore your dr. cannot write you a prescription for any oxycodone containing preparation with refills. You sure you aren't thinking about hydrocodone 10mg/325APAP cause that can have up to 5 refills.

[stoneinfocus]

Originally Posted by bloodred1889

as swim said in a previous reply, we need to stand against doctors in the uk and europe and make them see that not all ppl are drug seekers and not all back pain can be cured with anti imflamatories, paracetamol and exurcise.

swim has had chronic back pain for 7 years now, and the pain is getting worse, its in swims legs, arms, lower and upper back and in most cases it states that if the pain in your back moves to your legs then somthing more serious then back pain is there, but still swim is refused pain relief, becuase... its too addictive.
all swim is given time after time is, a refural to a rumatologist, paracetamol and an anti imflamatory.

WTF.

Sure, it´s a joke, they get things teached all ´wrong, like corticosteroids are demanded by the patients in ever increasing doses, to get high, which is not true: corticosteroids do make you high, but only for a week, then it´s just an awful receptor and HPTA-downregulation and it´s needed in high doses to do what it should do, and doesn´t make you high anymore.

For back-pain e.g. dexamethasone is prescribed, I liked testosterone and dianabol along with some diclofenac or, which worked along with the anabolics without any dose increase, 0.5mg dexamethasone every other day.

Withaout anabolics (AAS) I had to take 8mg dexamethasone/day and it didn´t do much, except for sides. With AAS, no sides, no pain, no dose-increase, as estrogen is needed for the upregulation of the glucocorticosteroid-receptor anmd AAS for the estrogen and to even out the HPTA negative feedback.

[Olivier]

When SWIM was about 14, he had appendacitis and had to have surgury. He was in the local ER for a few hours, didn't give him any meds til his parents were telling them he needed them, finally got some morphine. Then he was transported to another hospital with an adolescant surgeon and had surgury that day. He got morphine in the hospital, got out the next day and then didn't get ANYTHING. He was crying all day because it hurt so bad, he got tylenol from his mom, who was a former nurse. She should have fucking known better, because she's also been in the same situation.

That's fucked up. Even though age was only part of it, he didn't even get some ibuprofen, maybe his parents never picked up the meds for a reason, but still. It was the most fucked up thing he's ever been through.

[stoneinfocus]

Swim was hammered 10-20mg´s of morphine equivalent into his arm at a hospital for 8 days and there was nothing... absolutely nothing even hinting to any kind of addiction, pain-increase after discontinuation or depression whatsoever.

[samuraigecko]

Originally Posted by stoneinfocus

Swim was hammered 10-20mg´s of morphine equivalent into his arm at a hospital for 8 days and there was nothing... absolutely nothing even hinting to any kind of addiction, pain-increase after discontinuation or depression whatsoever.

10 to 20mg Morphine a day for 8 days is hardly a recreational dosage or comparable to an opiate users normal dosages. It takes a fair bit more than that to produce the result one was actually talking about. In this range one will not experience almost any of the effects one mentioned, depression etc. Most Heroin users can put a 30mg MScontin up their arm and not even feel the effects. Much higher dosages are needed for the brain to stop producing endomorphin.

Hope this has been of insight

[Tortoise]

Apparently opiates used therapeutically (ie, to relieve physical pain) do not cause nearly the same dependance as the same dosages used purely recreationally. Plus, we're all different; some people just react differently to different drugs.

[JJx23]

I have a serious wrist injury and am prescribed Percocet. It is chronic pain, but Percocet is a strong drug. I have had Vicodin and it touched it lightly, the Perks work wonders though. I am shocked at how other countries handle patient's pain, that's ridiculous.