THE DAMAGE DONE BY 60 MINUTES

I watched 60 minutes.

And my heart sank.

Pain patients don't matter.

I know those people are hurting. They lost someone they loved to addiction and the problem all started with opioids. I basically heard them tell me that I don't know what it's like to lose someone and that it could have been different if they hadn't gotten hooked on opioids.

They wrong.

I know very well what it's like and it makes me angry. 

Very angry.

I'm not angry at the system and I'm not angry at the drugs. I'm angry because the typical reaction is, when any tragedy happens, is to blame the object and outlaw it. It doesn't matter that there are many law abiding people that depend on these medications to live a functional life. The only thing that matters is that some people have died and that they are somehow not to blame; the pills are to blame.

Funny, it doesn't work that way with alcohol related deaths.

We don't blame the car.

Let's put this under a microscope and have people spend more than 30 seconds in pain management. Instead of throwing hydrocodone or oxycodone at patients who have a tooth pulled let's try using some common sense. Instead of spending less than ten minutes with a patient in pain management and leaving with narcotics wouldn't it make sense to have some counseling go along with it? Let's also do some genetic testing so we know what the dosage should be and how it will be metabolized by the individuals system. Instead of throwing prescriptions at people could they just talk to you first and find out what is going on? Would that be too difficult?

And while I'm on the subject.......

All this so-called "shaming." There's fat shaming, body shaming, skinny shaming, illness shaming and now pill shaming..... all this garbage. When is just being mean "shaming." Puts a sweet spin on someone who just wants to be cruel. Everyone has an opinion behind a keyboard. Social Media is wonderful in some respects but, I'll tell you, I'm REAL glad it wasn't around when I was in school. 

If you don't agree with someone it is now ok to be cruel.
No. It isn't.

So we are now going to pill shame. It's not like I've got a boo-boo on my finger and prescribed pain medication. Voodoo pain is the pain that I live with. I know that at any point in time someone is going to stab that little voodoo doll with a pin and I will feel a stabbing pain somewhere. If they hug and squeeze that little voodoo doll I'm going to have a dull ache all over my body. Again, this pain I've learned to handle. It's when the pain increases to whole other level; my whole body feels likes it's being compressed like a junk car that is being compressed to the size of a box of cornflakes. That voodoo doll? It's being stabbed all over....over and over again with a ferocious intensity. 

It is that pain that makes have to take pain medication to make it tolerable.

There are a lot of people like me. Maybe I don't have an addictive personality. I heard that one from my doctor. Maybe it's because I metabolize opioids slowly. I can't take very much because it stays with me. People that metabolize it quickly may have to have a different dosage or maybe that's where the trouble comes in. I don't know. I just think we have to do things differently.

The knee jerk reaction of taking it all away will not work.

It didn't work with Prohibition.

It didn't work with the war on drugs.

All it serves is to push it underground.

Which is precisely what is happening.

CHRONIC CASUALTIES

Why?

Societal pressure?

Weakness?

Sometimes we are our own worst enemy. Every day we have to fight a war. War against pain, war against fatigue, war against an invisible illness that most don't understand, war against indifferent doctors and war against pharmacies just trying to fill our prescriptions.

Why then do we turn the war on ourselves?

I've been to support meetings and read blogs and hear people talk about medication. Some even seem proud that they don't and haven't given in to prescription medication. That's good if it works for them but to make anyone else feel less than human for taking them is wrong. Using medication that you might become physically dependent upon isn't a sign of weakness. That is an unfortunate side effect of maybe feeling normal and productive. I know I am intensely aware of the fact that I am dependent upon them. 

Dependent not addicted.

We, however, err on the side of the addict.

Maybe we're trained to believe that it's greedy and selfish to want something for ourselves. All I know is every time I swallow a pill I feel weak. 

And that, my friends, is stupid.

If we are responsible and knowledgeable about the power of the pills, if we "follow the rules" then there shouldn't be any self-loathing about using narcotics or pills that help us get the restorative sleep we need or take away intense pain. When did it become the norm that suffering is noble? 

It isn't.

We can do so much more when pain isn't creating havoc in our bodies. If we can sleep then maybe, just maybe, we won't be as stiff and sore in the morning. If that happens maybe, just maybe, we can get the exercise that we need. Don't people get it? It's a vicious cycle. We need exercise but it just hurts too much to start. There are days that I'm at the gym with tears running down my face. 

I think we need to like ourselves a little bit more and not look at medication as weakness. There are a lot of therapies out there and every one of us need to tweak them for our own use.  I don't think we should feel bad if we use medication to feel better. Having said that, there is a fine line between believing the pill will keep us out of pain and knowing that it will never eradicate the pain. The difference between a tool and a crutch is huge.

We fight a war every single day.

And sometimes it feels like we should give up.

We can't.

And we shouldn't be one of the civilian casualties.

WHY SHOULD WE CARE ABOUT KRATOM?

What is it?

How is it used?

Is it safe?

I don't know.

I wrote this about Kratom a couple of years ago and it seemed that it's a good time to bring it up again.

I was reading about the latest thing to pop up about painkillers. People on forums and Facebook have been talking about it.

And they've been trying it.

Ok....first things first. What is it? Kratom is from a tree or, more specifically, the leaves from the mitragyna speciosa tree. The trees are indigenous to Southeast Asia and have been used in traditional medicine for centuries. Thailand has banned its use and there are several states where Kratom is also banned. It's been used in the management of chronic pain and it behaves like morphine. 

The DEA lists Kratom as a drug of concern.

One thing they did find was that Kratom helped the withdrawal symptoms of opioid dependence. When Kratom was quit suddenly the side effect was diarrhea and a runny nose. Considering what the withdrawal symptoms of narcotics can be I would think that Kratom would be studied. 

The other thing is that Kratom doesn't have the respiratory depression that opioid have. When you have a medication that helps pain without the risk of overdose it sounds like it should be studied. Why haven't the pharmaceutical companies looked at it?

Or have they? GlaxoSmithKline looked at it in the 60's but nothing came of it. Let's face it, something must be off either in the delivery or the drug itself. They could make a ton considering the opioid problem in this country. 

It can cause drowsiness, fatigue, nausea and stomach discomfort and constipation. It has the potential for abuse when you exceed the recommended dosage. If you decide to use this be very sure that it won't interact with medications that you are taking or have taken. Be very careful. Just make sure you research it very carefully before you make your decision. 

Is it addictive?

I don't think anyone knows.

There are animal studies that show that a tolerance can be built up over time.

And the directions state it can be habit forming.

That kind of signals addictive to me.

But what do I know?


DEA INFORMATION ON KRATOM

IS THE F.D.A ON D.R.U.G.S???

I'd say....

ARE THEY ON DRUGS?

But I never like to state the obvious.

For those of us in the chronic pain community, we know how difficult it is to receive adequate treatment. If we tell the truth about our pain, we are considered neurotic. If we underplay it, we obviously don't need medication. 

There's no easy way to play it.

On October 25, 2013 the FDA drew huge praises from the addiction community by moving hydrocodone with acetominaphen to a Schedule 2 narcotic. What this means is that instead of going back to your physician every six months for followup, you have to return in three months. In addition, the doctor cannot call in your refills. You must hand the prescription to the pharmacist personally. They have made it harder to get Lortab, Vicodin and other addictive painkillers. They are supposed to make painkillers harder to abuse. For example, they inject Oxycontin with a gel that makes it harder to crushed and snorted. This kind of abuse deterrent is supposed to be a public health priority. 

So what did they do?

They approved Zohydro. 

Zohydro is a long acting opioid. This drug is not intended for as-needed use. This is for patients who need long term, around the clock treatment. Obviously, you wouldn't get this for a tooth extraction. 

This drug is not messing around. You can't drink alcohol. Let's face it, you're not supposed to drink with any pain medication but alcohol with this medication can result in fatal hydrocodone plasma levels in the blood. You even have to be careful taking anything that contains alcohol. This can even mean cough syrup.

You are also instructed by the insert to swallow Zohydro whole otherwise it can be fatal. 

This is their strong stance against substance abuse?

So what that tells me, this drug has the ability to be crushed up and snorted. To be fair, the makers of Zohydro have contracted with a Canadian company to come up with an abuse deterrent formula but who knows how long that will take. This drug was meant for cancer patients but everyone knows it will be on the street soon enough. Pill mills will push these babies out and they can be crushed, snorted and will kill people.

I love the insert on this drug. When addressing who should be prescribed this drug they talk about the opioid "naive." WHAT?? I've never heard that phrase before and I'm not sure I like the way that sounds.

What does this mean to me? It means people will start abusing this powerful drug and many will die. The people who it is intended for will have a hard time getting it after the stats start coming in. People need to be out of pain but because of pill mills and addicts those who truly need opioid therapy will be out of luck.

I thought the difference between Schedule 3 and Schedule 2 narcotics, as far as the refill requirements, was interesting. I live in Nevada and I have to go every 30 days to the doctor for a refill. 

Go every three months?

Not even close.

And you better not take it to a new pharmacy either.

They probably won't fill it.

COLLATERAL DAMAGE

Why?

Societal pressure?

Weakness?

We are our own worst enemy. Every day we have to fight a war. War against pain, war against fatigue, war against an invisible illness that most don't understand, war against indifferent doctors and war against pharmacies just trying to fill our prescriptions.

Why then do we turn the war on ourselves?

I've been to support meetings and read blogs and hear people talk about medication. Some even seem proud that they don't and haven't given in to prescription medication. That's good if it works for them but to make anyone else feel less than human for taking them is wrong. Using medication that you might become physically dependent upon isn't a sign of weakness. That is an unfortunate side effect of maybe feeling normal and productive. 

We err on the side of the addict.

Maybe we're trained that it's greedy and selfish to want something for ourselves. All I know is every time I swallow a pill I feel weak. 

And that, my friends, is stupid.

If we are responsible and knowledgeable about the power of the pills, if we "follow the rules" then there shouldn't be any self-loathing about using narcotics or pills that help us get the restorative sleep we need. When did it become the norm that suffering is noble? 

It isn't.

We can do so much more when pain isn't creating havoc in our bodies. If we can sleep then maybe, just maybe, we won't be as stiff and sore in the morning. If that happens maybe, just maybe, we can get the exercise that we need. Don't people get it? It's a vicious cycle. We need exercise but it just hurts too much to start. 

I think we need to like ourselves a little bit more and not look at medication as weakness. There are a lot of therapies out there and every one of us need to tweak them for our own use.  I don't think we should feel bad for wanting to feel better.

We fight a war every single day.

And sometimes it feels like we should give up.

We can't.

And we shouldn't be one of the civilian casualties.

THE REVERSE WAR ON DRUGS

The war on drugs. 

It sounds good. 

Countless lives have been ruined because of them.

But, as usual, things go awry.

It's very irritating to me when I hear that in order to get a prescription at some of the chain pharmacies you have to go through some song and dance and convince the pharmacist that you actually need them. 

Oh, and I'm not talking about the patient.

I'm talking about the doctor.

It's ridiculous when the pharmacists puts your doctor through an interrogation. They want to know if they've tried every other remedy before prescribing opiates. This is absolutely unbelievable to me. When can a pharmacist override the doctor? Who went to medical school??

Well, it seems it's happening every day.

I understand that there are pill mills out there. It should be fairly easy to catch the ones who doctor shop and refill scrips from different doctors at different pharmacies. I will agree that they are abused, HOWEVER, why do we have to start living our lives from the position of the abuser? When is the pharmacy allowed to use CYA (cover your a**) as a legitimate tool for dispensing prescriptions given to you by a doctor? 

I will agree that people need to be conscientious and responsible. You don't leave them about when you have children in the home. You need to understand their power but that doesn't mean that the people who are responsible and need them to actually function on a daily basis need to be looked at as some kind of addict. 

Pain is debilitating. 

I also understand overdose but if it can be caught before it's irreversible why isn't naloxone being used more? Naloxone reverses the effects of the opioid and could save thousands of lives due to accidental overdose.  Addiction is a whole other animal and unless the root problem is dealt with all the naloxone in the world won't help. 

It just sounds like anyone who uses opiates is automatically labeled an addict.

That is SO wrong.

Where is the balance?

As usual, when it comes to legislation...

Common sense and balance are missing.