So it appears that we have an opioid abuse epidemic in our country. In 2014 28,000 people died of opioid overdoses. We read in the news about the rampant heroin overdoses and deaths that perhaps started when a person was overprescribed opioids. Recently a coworker had some rigorous dental surgery and remarked that he was prescribed 30 oxycontin tablets – such an excess.
I definitely agree that we need to relearn how to treat acute and chronic pain. We need to allow medication to be part of other therapies – physical therapy, massage therapy, weight loss, acupuncture, and over the counter medications. We need to be made to understand that pain meds aren’t intended to eradicate pain. They are meant to alleviate pain. Ultimately the pain should subside and 30 oxycontin tablets for gum surgery is definitely overkill.
So this week the CDC released guidelines for prescribing opioids for chronic pain. Chronic pain is deemed to last more than 3 months. They’re trying to do the noble thing by “recommending some extra measures for people who have been prescribed opioids. These include, taking them as directed by your physician, regular monitoring including more frequent visits to the doctors, a pain treatment plan, being aware of the side-effects, and urine testing. The guidelines exclude patients being treated for cancer-related pain, palliative care, or end of life care.” Rheumatoidarthritis.net
So the RA community took one huge collective deep breath this week. Because most of us have chronic pain. I’ve had it for 20 years. I take opioids. Not too often, but when I take them I can’t imagine not being able to take them. So is RA care Palliative care? Wren addresses that here in a great article on rhematoidarthritis.net RA patients have already had to change how they are prescribed these meds. We can get 30 days supply only with a written prescription that must be picked up at the doctor’s office.
I took 4 vicodins this week, in 5 doses. I experienced a higher pain level this week due to the barometer fluctuations and still not at my full level of RA meds due to being sick most of the winter. Each time I reach in to the pill bottle for a vicodin I have to weigh whether I really want to deplete my supply of drugs if it’s going to be more difficult to be prescribed these meds in the future. I’m active, I exercise and stay busy but I still have pain. I take Celebrex every day which negates my ability to take another NSAID such as ibuprofen. Tylenol doesn’t touch RA pain for me. I’ve tried it and it doesn’t give me the relief that a half or whole vicodin does.
I need to be able to get up and work most days. I’m a commissioned sales person with not much of an emergency fund. I have to move and function and there are days that my chronic pain needs an opioid. My fear is that we have gone too far the other way in correcting how we prescribe pain meds for acute pain and I’m going to suffer as a result. I can promise you that my friends in the RA community are like me – we take them when we need them. Taking them for pain doesn’t make you high. It makes you tolerate the pain better. I know that I will need an occassional opioid for the rest of my life – I am not ever going to abuse them.