Walking a Fine Line - How Doctors Can Prescribe Narcotics without Feeding Addiction
We pain patients and our doctors face some real problems when it comes to narcotics, such as Vicodin and Oxycontin. As patients, we don't want to be treated like criminals for simply managing our pain, yet we understand that there are some criminals out there trying to scam doctors out of those meds. Doctors, meanwhile, want to help legitimate patients feel better, but they don't want to give drugs to addicts.
So how do we show that we aren't addicts, and how can doctors be sure they're giving drugs to the right people?
A new study from the University of Michigan and Ohio State University offers a solution. And implementing it takes work from both doctors and patients.
The study consisted of putting measures in place in one busy, multi-doctor clinic. First, it created an opioid registry of all patients who got opioids from the clinic. Second, it required doctors and patients to sign agreements detailing conditions for receiving narcotics. One condition was random urine tests for illegal drugs. Another was allowing the clinic to check state prescription records to see if patients were getting drugs from more than one doctor at a time.
The study showed that 35% of the 167 patients on the opioid registry violated the policy in some way. Those taking a medication containing oxycodone were twice as likely to be violators.
While 35% seems pretty high, the researchers expected the rate to be higher than it would in private practice, because this was a clinic where patients were likely to see a different doctor each visit, which makes it easier for addicts to slip through the cracks.
Are you willing to periodically take a urine test and have the doctor check your prescription records in order to consistently get your refills? Do you think a system like this should be in place everywhere? Post your comments here or in About.com's Fibromyalgia & Chronic Fatigue Syndrome forum.
Suggested Reading
- Read more about the study, and see if you'd like to recommend it to your doctor.
- Learn more about your prescription drugs, interactions & side effects with About.com's Drugs A-Z.
- Get info on multiple treatment options for fibromyalgia & chronic fatigue syndrome.
It may be a necessity for the medical system. I would be willing to do this if the testing could be done in a way that would not cause me to inconvenience my employer. I would want my doctor to be sensitive in explaining WHY I would have to submit to periodic tests. Perhaps a doctor could give a very simple pamphlet and say a few words in explanation that it’s a program-mandated requirement and in no way implies that the doctor does not have trust in me.
Patients should be made aware of things that could cause them to have false-positives (poppy seeds!)
Ultimately, it’s unfortunate that things are the way they are in the medical system. Can we honestly say that doctors CAUSE people to become drug-addicts? So, why are doctors held responsible for the personal choices that people make? Sure, if a doctor thinks someone is a drug addict, they can refuse to treat someone. Doctors shouldn’t have to be so fearful!
Would I submit to urine testing? Yes…if it would mean I could get the meds. necessary to control my pain. However, I shouldn’t have to do this. If I was getting illegal drugs…do you think i’d need to see a doctor for more? It’s costly and an infringement on others rights. Maybe the next thing would be to enter our homes and see if we have been on the internet searching on how to make our own drugs. I do totally approve of checking state records for the amount and type of prescriptions that have been filled for the individual. I have nothing to hide, so it’s not a problem. But to have to submit to a urine test just to get what I need…I would do it…I just feel it’s unnecessary and gives others more power/control than i’d like to see.
I have a unique perspective on this prescription drug problem. I take pain medication and hate the way I am treated like a drug addict when I have never abused my medication but I also know the games and tricks that drug addicts play to get what they want. My ex-husband is an addict. I saw how easy it was for him to get what ever he wanted even when the doctor knew he was an addict and even when the doctor was told he was abusing. I believe that extreme regulations on pain medication will only prevent or hinder people in pain from getting relief and having a better quality of life. The drug addicts will ALWAYS get what they want no matter what anyone does to stop them.
This subject really hits a nerve for me. I know for a fact that narcotics do work for FM pain. But of course the word “narcotic” is a dirty word. I have talked to hundreds of people with FM who say that narcotics DO work and I know they are the only thing that touch my FM pain. They are trying to minimize this illness and say that narcs don’t work because if they admit it, then they have to admit how horrible this pain really can be. And addiction? Come on. Pain pills were MADE for pain. And that is what they should be used for. If I have a choice of “addiction” than I would take that over having this horrible pain that is likely very similar to cancer pain. Traditionally narcs were preserved for short term pain or those with cancer that are dying. Ok, we might not be dying but it sure feels that way to alot of us. And where is this research that says narcs don’t work for fibro? Who did they study? I do know it was not the hundreds of people I have talked to in the last 5 years with FM. I am fed up with the false information going to doctors about this disease. Every patient should be given the option with the risks vs. benefits. We should be allowed to relieve this horrible pain in some way. I am lucky, I have a doctor with some sense. And I am not a druggie. I never asked for or needed a narcotic until my 40’s when FM hit me so bad.
Debra R.N.
I’m a native american living on a reservation I’m suffing from head injury do to an assult. I was hit with tire iron across the face and kicked about the head. I have no say in my treatment. I take pain meds. get treated very poorly by health care dr.s I have no say. It suck being native american. THRID WORLD TREATMEAT. Looking for outside help.
Welcome to the new police state of medicine. Because of the rogue agency known as the dea thousands suffer unnecessarily. Put bluntly the dea is practicing medicine without a license and dea agents have no medical training or medical degrees. What transpires between a doctor and patient is not the business of the government of anyone else for that matter. Keep these right wing sociopaths out of my doctor’s office!!
My pain management doctor is currently under state investigation and the DEA has asked all surrounding pharmacies to stop filling his prescriptions. I have a T7 compression which causes terribly debilitating effects and have been on Norco 10/325 for about a year. Since all the pharmacies stopped filling his prescriptions, I decided to try to stop taking the medication. When I did so, I had terrible withdrawl effects for about 4 days. Then I spent nearly 6 months out of work because my back pain was so intense I couldn’t do anything but lay around all day. In these six months, I went to several doctors who have all said the same things: physical therapy, TENS, massages, Celebrex, Voltaren, etc. I have tried them all – including spending over $500 per week at regular physical therapy – 4 days a week in traction. Two hours after therapy, I hurt again. Now my doc is prescribing Tramadol. Kind of takes the edge off but I still have problems getting up during the day because of the pain. At first, when I got off the Norco, I was really proud of myself, but the longer I have gone without it, the more and more hopeless I get over the pain. I am in my late 20’s and can’t imagine a life with this much pain.
All that being said, I can’t find a doc that will prescribe me the meds I know work (Norcos). I actually saw one doc that said “I don’t have anything against prescribing narcotics, but I don’t want the police busting down my door, so I don’t prescribe anymore.” Is this a joke? Tramadol side effects are worse than Norco and they are similar in their pain relief method (Opiod-like) but since Tramadol is not a narcotic, any doc will prescribe it. Problem is, no one will prescribe what works best for me with minimal adverse affects.
I’d love to know how many DEA agents are in chronic pain. I’d love to know how many of them are board certified physicians. The fact is, the war on drugs has been lost on all levels. Those who can’t get opiods will turn to opium or heroin. There’s always a fix for the drug addicts. Let’s stop making our drug problem a legal issue and start making it an educational issue. Teach abusers the dangers and consequences. But ultimately, STOP TORTURING PAIN PATIENTS by throwing our doctors in jail or scaring them out of prescribing narcotics. It’s not your place to tell my doctor what they can and can’t give me to give me some semblance of a normal life.
My 83 year old Grandmother is a cancer patient whose doctor wont prescribe narcotics. Isn’t it enough already.