Osteoarthritis and physiotherapy

I know you didn't ask me but it is a common misconception that a person will automatically get used to the dosage their on and then have to increase. There are people that that happens too but there are also people who can stay on the same dose for a decade and not need to change the dosage. And I'm one example of that. I have been on the same dose for 10 years now. And I have talked to other people who have been on the same dose as long as I have or longer.

There is also a condition that some people have that make them resistant to all forms of opiate. There's a test to see if that person has that condition and if so then they need a considerable amount more opiate then the average person would need. I don't know if once they get on a dose if they then need to increase more frequently or at all.

It's an interesting subject, isn't it?  Recently there was a radio program here, Canada, which discussed the rather dire opioid crisis we are experiencing including a fascinating account of people who had got very quickly addicted to their particular medication, not the one mentioned by Stephen, and needed to keep increasing, but then were able, with considerable difficulty, to wean themselves off.  Now a program is being developed to help family doctors who've got their patients on these meds but now have to get them off.  As the doctors put it, they are taught lots about giving patients medication but nothing about how to take them off again. 

When I had a broken leg I was prescribed by the emergency room doctor 50 Oxycontin.  At this point they didn't even think I had a fracture, just a badly sprained knee.  I said I wouldn't have that in the house.  In the end I got 20 Tylenol-3, which lasted for a whole year, eventually being used for headache, and even my husband helped use them up!  It occurred to me that this casual over-prescribing of a far too powerful drug for what I needed (no chronic condition here) is the sort of thing which leads to addiction.  I could easily have been a patient who didn't know better.

I don't know a lot about the Canadian press so I can only speak about the US and how it relates to opiate crisis. But approximately April 2016 the Press got word that our CDC had published a guideline for prescribing opiates. It was meant to address only regular doctors not pain management doctors and it was meant as a guide not a law or rule. But the Press ran with this and has now got everyone believing that a chronic pain patient taking long-term pain meds is the problem. So all the politicians jumped on this bandwagon because it looks good to their constituents. For instance a senator in Ohio has passed a law that will not allow them to fill more than three days worth of pills. And now the DEA is making all these doctors afraid to prescribe it even though they know that chronic pain patients need it just to survive. As a chronic pain patient myself for 13 years I will tell you that even the very first pill I took did nothing to make me high it's simply relieved my pain and made me very tired. Because chronic pain patients are in so much pain that they do not get a high from the opiates they take. But a person with acute pain can get addicted to the opiates that the doctor gives them. And that often happens with another family member stealing the leftovers and taking them to get high. And I'm glad that you turn down the 50 Oxycotin for what was thought to be a sprain no less. That's a horribly irresponsible thing for him to do. But here in the US because of this opiate crisis the government is funding certain types of opiate medication to help the addicts get off of opiate and taking away the chronic pain patients necessary pain meds. I think that's a little opposite of what we should be doing. These things that these addicts are getting are Suboxone and methadone. The problem with both of those is that there's never a reason to stop them. So an addict will start the methadone or the suboxin and then stop all other opiate medication and stay on this other opiate for years and years. Never tapering down even. And I just read an article the other day that said there is a heroin clinic in Atlanta Georgia. Apparently a heroin addict can go into this clinic and be given clean heroin to inject. And I'm not talking about a clinic that just gives clean needles, this one Clinic is giving clean heroin to heroin addicts. And that article also stated that Canada was looking into this type of Clinic and waiting to see how it works. I think they need to be going after the heroin users that are on the streets. But that's hard to do and we have already been doing it without a lot of success. So they're going after the easy ones, us chronic pain patients.

I'm sorry this is such a long post but I hope you got to the bottom without too much trouble. But this is a subject I am very involved in.

Same is happening here in the UK Anhaga.  I'm intolerant of opioids and when I first had a rather nasty accident I was not happy that I couldnt take the oramorph offered - I just vomited it straight back up, same with Tramadol - nor the codeine because that just gave me instant, and violent stomach spasms.  Morphine is still the most effective pain killer and I couldnt only take lesser and not quite as effective pain meds.  In retrospect I'm very glad I cant take morphine, I seem to hear of more and more people in my social circle who get prescribed these meds and then get in to a situation of increasing dosages, and not being in a place where they can stop taking them.  I'm definitely of the opinion that these types of drugs should be last port of call when all else has failed but more and more they seem to be given out like candy - gets the patient out of the doctors office I guess - easy fix for the doctor, lifelong struggle ahead for the patient.

I do understand where you are coming from.  I don't think I've implied that people who NEED the drugs shouldn't have access to them.  But you must admit that there has been over prescribing of them to people who didn't need them - mine being one case.  There is a connection, here at any rate, between prescriptions and crime, where people, usually seniors, are robbed of their medication, or, even more concerning in a way, people get into the criminal market and actually sell their medications.  Measures put in place are intended among other things to prevent anyone from being able to fill multiple prescriptions.  A doctor was recently charged with making fraudulent prescriptions and reselling the pills.  Dealing with illegal drugs the old way, "war on drugs", obviously doesn't work.  Otherwise I have no opinion on the matter, I don't know any more than what I hear on the news.