... impossible to find a MD to prescribe an adequate dose to control my pain so my quality of life is very poor. How can I find a MD who will treat me effectively? I have multiple lumbar disc ruptures, stenosis and severe diabetic foot neuropathies extremely painful unresponsive to Lyrica or Neurontin.
It is not just CT, it is all over the US but some states are worse than others. We have our wonderful government to thank for that and I suspect it will only get worse. The DEA is under pressure and in turn pressuring doctors to get away from prescribing opioid pain meds to patients with non cancer chronic pain. Some of the newer studies have come to the conclusions that long term opioid therapy doesnt improve function and therefore should be used. In my opinion, increased function is nice but quality of life should be contemplated too! It is also well known that "facts" in these studies can be skewed to go whichever way the prevailing "wind" blows. There is a group of physicians and politicians who are leading this crusade. One in particular PROP (Physicians for Responsible Opioid Prescribing), is appealing to the FDA to have the word moderate (as in "for moderate to severe pain") to be stricken from indications on most of the stronger opioids like Oxycontin, morphine and Opana so that they are indicated for severe pain only PLUS they want to restrict opioid therapy for chronic non cancer pain to no more than 100mg of morphine (or its equivalent in other drugs) per day and restrict treatment to no more than 90 days. The number of 100mg of morphine is an arbitrary number they have pulled out of their collective rear ends. There is no studies that say 100mg of morphine or less is safe and/or effective for every person. And to limit treatment to 90 days is ridiculous, like chronic pain goes away after 90 days!! It is called chronic for a reason! PROP is backed by a lot of folks who have lost loved ones to opioid abuse. It is easier to blame a drug company, drug or a persons Dr than it is to come to grips with the fact your loved ones were abusing their medications. Many of the deaths referred to by these groups involved opioids mixed with bezodiazepeines and alcohol but they are targeting the opioids as the cause. There are groups of Drs who oppose these people but these voices against opioids are very loud to the "Powers That Be" in Congress and to the President. So the government is coming down hard on the DEA and the FDA to make changes to prevent this so called "prescription drug abuse epidemic" and since the DEA has been unsuccessful with fighting the illegal drug trade, they have turned to easier targets-physicians. If a physician gets sited as over prescribing, the DEA can come in and take all of his assets and essentially ruin them and their future. They are dragged through the media circus and even if it is proven that they are not guilty, the media leaves that part out. Which brings us to another source of "voice", the media has jumped on this like a dog on a bone and if you listen to mainstream media, they would have you believe that anyone on opioid medications, and Oxycontin in particular, are all slavering drug addicts! They are scaring the public into believing that taking medications for pain is deadly and anyone taking medications for pain will automatically become an addict. Opioids can be dangerous if abused. One must be careful when taking them. If you stick to your Drs recommendations and dont mix them other sedating drugs or alcohol, you can be relatively safe. Opioids are not a total answer for everyone. For some, they should not be used and in some people, they can make pain worse but if a Dr screens their patients well, opioids can be a very useful tool in pain management. I'm not sure what the answer is for you but try a pain management specialist. They are more likely to prescribe opioids than primary care doctors will. PCP's are especially scrutinized and many of them dont have adequate training in treating chronic pain. When you see a pain management specialist, bring a list of everything you have tried and how it worked, or didnt work, for you. Once you do find a Dr who will prescribe pain meds, be sure to follow your opioid contract to a "T". Most PM docs will have you sign a pain contract and this usually states to the effect that you will stick to your prescribed dose, wont get pain medications from other sources, you will use one pharmacy to get your pain medications filled and some ask for random urine screens and some ask for pill counts.
Another thing I encourage ALL chronic non cancer pain aptients to do is to write or email your Representatives and Congressmen (and even the President himself) and tell them how much you have been affected by this "war on opioids". Tell them how difficult it is to get treatment and how much this affects your quality of life. Perhaps if we, as chronic pain patients, raise our voices loud enough we will be listend to and be able to get proper treatment from our doctors. Most of us dont WANT to be on these drugs. If there was a non opioid option out there that did relieve pain as well as opioids but didnt cause euphoric feelings, we would be able to sort the recreational users from the true pain patients right away but until that day comes, we need to fight for our rights to be treated with any option out there without being made to feel like a criminal for asking for relief. No other chronic disease is treated the way that chronic pain is. No one would dream of telling a diabetic they could have so much insulin and to just quit eating!
I truly hope that you can find someone to treat you. If you try some of the web sites for chronic pain like the American Pain Society, Chronic Pain Foundation etc. some of them have doc finder tools where you can enter in your area and it will bring up pain docs in your area. It has been a long time since I have visited those sites so I dont remember, for sure, which ones have doc finders. Enter "chronic pain" into your favorite search engine and it should bring up the associations and societies web pages. You can find a lot of useful info on those sites too. Good Luck!
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