I’ve been pretty open about the fact that I am not exactly what you would call “Stable” most of the time. I have BiPolar Disorder. I’ve been to the locked looney bin more than a few times and on top of all that I have a few chronic pain disorders that put me on medications that I can only fill once a month, I have to sign contracts to get stating that I will not go to the ER – I can only be proscribed these meds by one doctor, that this doctor can completely cut me off for any reason and they don’t even have to tell me why, that I can’t seek a second opinion and a number of other things that I’m sure some of you are familiar with.
It took me two years to get into a pain specialist, now that I am seeing one I’m learning that being a pain patient in America is very much the same in most peoples eyes as being a junkie.
I’ve been un or under insured for most of my adult life..just like almost every adult I know. The “Healthcare reform” we have been undergoing as a country and fighting about loudly has not really fixed the issue, nor is it likely to. For now though, I have medical insurance and am able to see a pain specialist and get medication that has improved my quality of life greatly.
With that though, comes a host of other problems. Pharmacists can at any point refuse to fill a prescription for any reason, and they don’t have to tell me or any other patient why. I’ve had pharmacists ask me blatantly why I am getting the kind of medication I am in front of other people (I’m not to keen on the world knowing what meds I take). I’ve had issues with communication with doctors in Emergency Rooms. I once went in with a 102 degree fever, blood in my urine, a kidney infection and was passing stones and had a doctor refuse to treat my pain there – even after I told them NOT to send me home with medication because I was on a pain contract because (This is a direct quote) “I don’t give pain meds to people on pain contracts because it’s too risky”. Because of the laws in this country and the repercussions for doctors (Some of them have been rounded up and are now serving 25-50 year prison sentences for proscribing “Too much pain medicine” – by the standards of the American DEA – most of which are not medical doctors).
So we have, in this country a situation where ley people (I.E. Lawyers with no medical degree) are deciding what is appropriate medical care and we have given them the right to do this. Doctors who are put on trial in these scenarios are prosecuted under RICO statutes. The same laws that are used on Drug Cartels. They are treated as criminals and often their patients are arrested as well and told they will go to prison as well unless they testify against their doctors.
So basically, every time you get a prescription for pain medication at a doctors office, or you are given a shot at a hospital the doctor is taking a risk. Usually it’s nominal but for pain patients like me – it is something we are all too aware of.
In America, there is currently no criteria to separate the behavior of someone who is addicted to drugs and drug seeking and someone who is in serious pain, that pain is under (or un) treated and they are just looking for some relief.
This is incredibly problematic for a number of reasons. Namely, the current laws governing pain management and the dispensation of pain relief drugs in this country have completely destroyed the doctor/patient relationship.
For example, If I go to my doctor and I tell him/her that my meds are not working and I’d like to try ________________ (Name of medication) or I’d like a higher or more frequent dose that is two of what the DEA calls “Red Flag” behaviors. I’ve asked for MORE Pain medication and I have asked for a medication by name. You only need to exhibit one red flag behavior one time to be cut off for good. Once you are labeled a drug seeker and cut off, you will likely never be able to get your pain treated again – regardless of the horrendous circumstances that put you in that doctors chair in the first place.
in 2008, the DEA was given a score of 0 out of 100 in their progress in the “War on Drugs” their response to this was to shift their focus off of street drugs and become 100% invested in “The war on prescription drugs”. With this comes the DEA keeping tabs on every script a doctor writes, every pill or patch you get…everything. There have been MULTIPLE studies that have shown that the majority of people illegally obtaining prescription drugs are NOT going to doctors and getting the script themselves, nor are they buying them from pain patients.
This brings to light another issue. With my pain contract, I have signed that I am responsible for these meds. If My purse gets stolen, and someone sells my meds and gets arrested, I can be prosecuted for distribution of narcotics. My doc will not refill that script for a month and I am put in the position of potentially going through withdrawal (Because I am physically dependent on these meds at this point). All because someone stole my purse.
So, as a pain patient I have little to no rights. I can’t seek a second opinion. I have to get permission to go to and Emergency room. At any time I can be cut off or God Forbid arrested. The Pharmacist can refuse to fill my script based on something as pitifully simple as “You don’t look sick so therefor you don’t need morphine.” My doctor can cut me loose at any time…and yet, I’m supposed to be grateful because someone is allowing me to get my meds.
My life is infinitely better with them.
Do people abuse these drugs and the system? You bet. They always have.
But how is treating everyone like a criminal going to solve anything?
How does this not drive people to street drugs which are often cheaper, and more private?
The DEA has shut down a ton of “Pill Mills” they have successfully scared every doctor in the country out of treating their patients the way that the standard of care in the medical texts says they should be treated for pain (Which is simply just “Opiate Titration to Analgesic effect” Its open ended and you stop when the pain stops). And still, there is now a near epidemic explosion of heroin all over the country again.
What is the answer? I’m not sure…but I can say that treating everyone as if they are a criminal is not the way to go. Nor is prosecuting medical doctors the same way and with the same iron fist they prosecute drug cartel leaders.
It’s a complicated issue for sure, but the way we are handling it? Isn’t helping anyone. Least of all the docs and the patients.
xo xo xo