[Pmb (OP)]

I need to rant a bit so please have patience with me. 

It seems like this country has over reacted to people abusing opiod (narcotic) pain killers. These are truly wonderful drugs when used correctly and for the right purpose. But when people abuse these meds they end up hurting everyone else who really needs them.

Doctors are now over reacting to this problem. They simply want to let people with chronic pain suffer needlessly because some will abuse them. There is a reasonable solution too. A lot of health insurances will pay for visiting nurses. They will keep the meds in a safe and give them out on a day-by-day basis. This will curb the abuse. I'd rather have the lesser of the two evils. I’ll take an addiction over severe chronic pain any day of the week.

What I really hate is these doctors thinking I don't understand narcotics or that I'm not adult enough to take them appropriately knowing full well the potential dangers and consequences. I can tell you from personal experience that anything is better than chronic pain. I can be in severe to extreme pain for days sometime. It has destroyed my life. Going on opiods can return me to a normal life. Who knows? Maybe I'll go back to graduate school and get my PhD! But living with it is horrible. It increases my blood pressure and increases my risk of heart attack or a stroke. It ruins my concentration and I'm disabled because of it. It has sapped all the joy out of my life for 8 years now.

Time to stop being stupid. That's soooo last millennium. 

[CliffordK]

There was a recent discussion about chronic pain here.

One of the things that Cheryl J suggested was that the opiates could cause a hypersensitivity to pain.  So, not only does one build up a tolerance for the pain, but one also becomes more sensitive to the pain because of the medications.

Nonetheless, over time to maintain the effectiveness of the meds, one would have to steadily increase the dose.

There are far too many stories of people who get in over their heads, so to speak, with the narcotics.  The effects of narcotics on certain individuals can be quite traumatic.  I had a younger cousin that got into a car accident, then got into narcotics, and within a couple of years, died due to a drug overdose.  Sometimes I wish I had known about it before it happened, but I doubt he would have listened to "reasoning" from me.

Now, one might argue that better access and monitoring of the narcotics is safer than forcing individuals to "self-medicate".  But, what about chronically increasing the doses?  What if the meds leave the individual in a stupor, or incapable of safely driving a car?

You might look up methadone, and methadone clinics, as one option that has been tried similar to what you are proposing of verified dosing in clinics.  Some individuals are put on long-term methadone maintenance, generally for withdrawals from other narcotics, although it is in fact an analgesic. 

[Pmb (OP)]

There was a recent discussion about chronic pain here.

One of the things that Cheryl J suggested was that the opiates could cause a hypersensitivity to pain.  So, not only does one build up a tolerance for the pain, but one also becomes more sensitive to the pain because of the medications.

In my experience what happens is that you become tolerant to the med so you have to increase the dosage and then you once again have the pain under control. There's no upper bound to speak of like other meds. I was on 40mg  twice a day. Some people take 180 mg twice a day. My pain specialist at Mass General suggests either suboxone or methadone. I tried the former and it didn't help so I want to try the later. Meanwhile I'm going to try lyrica. Some people think valium can help. Perhaps the benzo chills you out so you don't perceive so much pain.

It's quite possible that you hear so many horror stories about narcotics and think that it's terrible because you don't hear about them when they're doing well. Nobody screams HORROR when its doing its job so it never makes the papers. The news sensationalizes the bad and ignores the good in nearly all cases.

I know there are many sad stories about narcotics. But there are more sad stories about booze and you don't see anybody saying "Let's outlaw booze again!" for obvious reasons. Again, we're responsible for our actions. That's what being an adult means. If something goes wrong we have to man up about it and ask the doctor for directions. Constipation can be a problem so one has to take other meds to counter act that. I get itchy on opiniods so I have to take an antihystimine for that. You also have to make sure that you don't try to reduce the pain to zero since that leads to over medicating. Double the med is not double the results!

Now let's consider what can happen by letting people suffer. The suicide rate is greater. We don't want people killing themselves right? I was in so much pain this past wed that I nearly jumped off a tall building. Luckily I knew enough to ask for help. Then there's the high blood pressure, the reduction in quality of life, the disability, the sapping of joy etc. I'll never be able to describe the horrors I've had to suffer through. There has been so much excruciating pain that you can't fathom it unless you've lived it. That's a fact.

Thanks for the links!! As you might have noticed I was the one who started that thread on chronic pain. I have some texts on physiology and anatomy but they don't have much about pain or how pain meds work.