You normally hear this term when someone is talking about people who abuse some substance.. The vast majority – if not all – of people who abuse some substance has mental health issues. That is why they want to “change their feelings” .. they are dealing with monkeys on their back or demons in their head.. They refuse to seek mental health therapy, can’t afford mental health therapy or doesn’t realize that there is mental health therapy that will help them.. They are self-medicating to “escape”.. change how they feel… Or as Dr Timothy Leary, would say…. Turn On, Tune In, Drop Out ….back in the crazy hippie days in San Francisco in the late 60’s.. http://en.wikipedia.org/wiki/Turn_on,_tune_in,_drop_out
But the phrase in the title of this post would also fit to chronic pain pts receiving adequate therapy..
It makes them feel like being able get out of bed in the morning.. because they had a good night’s sleep.. not being in pain and not having to look forward to another day.. suffering in pain.
It makes them feel like they are “normal” or somewhat near normal.. what everyone else takes for granted.
It makes them feel like they can go to work and put in a full day’s work
It makes them feel like they can be a good spouse
It makes them feel like they can be a good parent..
It makes them feel like there is hope that tomorrow may be as good as this day is. Although that all may depend if a Pharmacist has decided that their C-2 Rx is not going to be accepted and filled… basing their decision on their “professional discretion” that is overly influenced by their personal biases or phobias.
Filed under: General Problems
I think, Steve, that you want to be an advocate for these people who need chronic pain meds. I have to tell you though, these patients already have advocates. Their pharmacist. Every pharmacy has pain patients and every pharmacist knows who their regular pain customers are. As a caring pharmacist I would not allow a regular pain patient to go without their legally prescribed drugs. It is as important to me as the pharmacist as it is to the patient who is in pain.
The problem is the bad docs. The problem is the jerks posing as legitimate patients. The problem is doctor shopping, ER hopping and polypharmacy. The solution is pharmacists who know their patients and are committed to taking care of them. The solution is saying NO to the bad ones. We know who you are and you’re not pulling that shit in my store. Now GET OUT before I call the cops.
You need to change your focus, Steve. It sounds more and more like you just want all scripts filled regardless of circumstances. It sounds like you are pro-diversion, pro-abuse and really don’t care about legitimate patients. Fortunately, most pharmacists aren’t like that.
William.. I am sorry that your impression is so far off the mark.. We have four states (FL, IN, OH, WA) that bureaucrats have decided to practice medicine and arbitrarily put limits on the mgs/day that a pt can get. Your comment is that we know who our patients are.. would work.. if there was never a new chronic pain pt.. first diagnosed.. you don’t know them.. so who is going to take care of them ? That sounds like when I was a teen.. I couldn’t get a job because I didn’t have any experience.. but I couldn’t get experience unless I can get a job.
. It is estimated that only 20% of the pts get adequate pain management.. and law enforcement wants drugs on the street.. they don’t get to the street.. they don’t have a job.. or they have to go after the cartels.. that carry AK-47 ,shoot back and don’t provide a good paper trail. Addiction is a disease.. but .. it is illegal to “treat” a addict. Addiction is at least partly a mental health issue.. but we put addicts in jail and make them criminals. Should we put Nicotine addicts and Alcoholic in jail ? Or is that an acceptable addiction because our bureaucracy is “addicted” to the sin tax that those two products generate ? Those RPhs that are doing their job.. taking care of legit pts.. they don’t have to fear, DEA, ADA, BOP. If all the RPH’s did their job.. I would not have to advocate for any pt. From the chronic pain pts that I exchange phone calls and emails with.. not all RPH’s are doing their job.
I never ask for early refills, I hate going to the pharmacy or having something delivered and have to wait all day for a script. I cant stand the sight of pills ,so much so I stopped all vitamins, the less pills I have to swallow the better. Depending on a darn pill to get me through the day because chronic pain has me in its grips makes me feel weak. And I’m not a weak person ,everyone is vulnerable but this question always haunts me, WHY ME. I’m a good person and never harmed anyone, never been arrested, never stole anything. I take that back I stole a pair of jeans one day when I was young , I put my jeans over the pair I stole and I still feel bad about doing that. I don’t know why I did that when my Mom taught me better. She sent me to a private Catholic school till I was in Junior in high school. Then finished high school in a public school. I hated it , I have a learning problem, dyslexia and some other thing that kept me from learning like other kids did.
I’m a good person and care about other peoples feelings. Why all the pain I ask myself. What did I do so bad to deserve this, I was taught to be happy with the things I do have and give thanks to the Lord, a lot of people have a lot less than me.
The one thing I feel bad about is I get pretty darn good relief of my chronic pain and there are a lot of people suffering that cant find help. I want these people to have what I have. Like any disease chronic pain should be looked upon and treated like any other disease.
So I end this with saying I’m able to move forward, I give thanks for what I have and believe in God. If not for him I would not be writing this today. I’m not perfect and made mistakes when I was younger. Time passes us by like a cool spring day.
The summer days are long but the years pass fast.
Mark exact same thing can be said for mental illness. My husband is bipolar. Instead of pain meds he uses several controlled items to help control his relapses and allow him to keep working. He also has sleep apnea. He takes high doses of xanax to keep his manic issues down, Lunesta to help him sleep and Adderall to help him concentrate. This is in addition to standard bipolar meds Relapses are common and I have to often in consultation with the psych doc increase and decrease doses in between fills. We get the run around alot too. I even though I stick to 2 pharmacies due to their hours AND they know im a pharmacist I’ve had issues sometimes getting his xanax filled early. So far as long as psych calls.and oks it we’ve been good.withdrawal from benzos can be dangerous as they can seizure. Just like chronic pain, mental.illness still has not been.accepted as a.’real.disease’. I pray that you will find.relief from your pain. Know there are still some of us that put outpatient needs first. Lol maybe that’s why Im having trouble.getting full.time…my age and metrics be d—ed!
Per Steve:
Chronic pain and mental health.. if not the only subjective diseases that we deal with … they are where most (subjective ) pts are encompassed in these two disease states.
I might also add they’re not getting pain meds from the dentist, surgeon or another doctor without the primary prescriber knowing about it. Red flag for me is they still take their chronic pain med yet still insist I fill the dental vicodin or post prodcedure vicoden, percocet and neither of the any of the precribers seem to know anything about the other. It’s OK to turn down the pain med Rx for a post procedure…you already are on something for pain. If that doc in consultation with the primary prescriber of the main pain meds decide to allow you to use some extra to cover the discomfort from your current situation….have them discuss before the procedure and CALL US so we can document it and then the refill comes up early we have the info so we can tell the insurance why the refill is needed early or why there is a small duplicate RX. KEEP US IN THE LOOP AND MAYBE THOSE RED FLAGS WOULDNT POP UP SO OFTEN. If we all work together, life will be easier for everyone. but documentation is important at all levels. prescribers and pharmacists.
Pharmacists don’t have a problem with people who are chronic pain sufferers AND follow all the laws and procedures regarding their narcotics. I have many of these patients. Here’s the big differences:
1. They never ask me to fill their medication early.
2. They don’t lose their mediation, claim that it was stolen, dropped down the drain, fell into their bowl of cereal, etc., EVER.
3. They see the same doctor every month, not every 21 days.
4. They’re aware of the laws and the onus of responsibility on the pharmacist.
5. They don’t pressure the pharmacist to hurry because they “need it right now.”
6. etc. etc.
In most issues with life, it is just a few apples that spoil the bunch. With narcotics, I would really venture to say that it is just the opposite. We pharmacists deal with narc addicts and losers that overwhelm us ~ we work hard to give EVERYONE the benefit of the doubt, but like I said… that’s hard to do, and a few of us are going to give you genuine pain sufferers a squinty eye on occasion. It is what it is, sorry.
I applaud Steve for his hard work keeping these post interesting and meaningful.
Back in 1994 when my chronic pain began I didn’t want to accept the fact this thing would put a halt to my life till I did something about it. I felt guilty at first to depend upon a medication to make me more normal. But in time I came to realize the pain had me in its grips and there was not much I could do and wanted to keep moving forward, I cant stand for something to hold me back from moving on. Now I look at it as just another medication in the arsenal of medications that comes from a pharmacy. I don’t much care what people think of me and the medication thing but expect to be treated with respect, the same way I would treat other people. Over the years I’ve learned a lot ,I never post while angry or annoyed and if I hit send I assume responsibility of my writing.
I just don’t understand why opioids are looked down upon , I promise you if you had never ending pain for more than a year you reach for whatever works, then move forward from there.
Each morning I wake up I give thanks for another day with a lot less chronic pain than before. Its our right to be as pain free as possible.
Thank you,
I read several pharmacists’ blogs and I have really been amazed to read stories of how awful patients are, gaming the system, dealing with Medicaid, etc. and how the business has changed. I try to treat my pharmacist with respect to the professional skills they have and their willingness to answer questions. As a chronic pain patient, I am so–I don’t even know the word for this, really–vindicated to read your posting today. Especially in the case of “invisible” diseases or disorders. To have to rely on a pill to wake up, a pill for pain, a pill to go to sleep and on and on. Well, it does make you wonder if life is the precious gift that it is. Anyhow, thank you for acknowledging that there are many people who truly rely on pharmacy products just to get through the day, and not just for fun. Great post.