In the mid 00's I had a back issue. I tried PT, NSAIDS etc and after nothing worked I was given low dose opioids and muscle relaxers without any hassling of my Dr at all, in fact, I didn't even ask for them he just prescribed them matter-of-factly as the next course of action to my problem. After a year or so I stopped the meds after exercises helped the problem to the point of not needing meds anymore.
Fast forward to 2011 and I incurred a bad shoulder injury but this time Dr.'s were extremely reluctant to prescribe narcotics while I suffered for months.
It wasn't until I was in the ER for the 4th time that I finally got an adequate dosage with more than a few day supply(still a low dosage but I don't need much) . Still, over the course of care, for my condition and others, I was told by about 60% of Dr.'s (out of a large sample size I might add - I have multiple health problems) about how I should get off the pain meds because they weren't helping me, even though they were... Recently I just went to a pain clinic at a world renowned hospital and even there I was told I should get off pain meds because they were bad for me and don't work well when previously I read so much about how the clinic pride themselves on exploring every option available. Also, I've yet to be prescribed a controlled muscle relaxer when muscle spasms has constantly been my biggest pain issue. I have finally been diagnosed with a nerve condition that has been causing muscle wasting/atrophy/contracture/spasms and more in my shoulder for the past 4 years, yet Dr.'s avoided prescribing these meds for me even when I was in a completely disabled/bedridden state for months. This type of behavior denies important medicine to the chronic pain patient and facilitates an air of distrust between both the Dr and the patient - the Dr. not trusting the patient to use meds responsibly and the patient not trusting the Dr. to adequately treat their medical condition. Not only this but the avoidance of narcotic med prescribing has turned from 'I don't want to prescribe this b/c abuse potential' to 'I don't want to prescribe this b/c I believe it doesn't even work for chronic pain' maybe I'm missing something but where is the research that says it doesn't work for a significant portion of CP population?
The anti-narcotic agenda has no doubt come in response of painkillers widespread abuse and the public/gov't backlash to the epidemic. However, just because people abuse these drugs doesn't mean they don't work for Chronic Pain patients, one doesn't negate the other. It seems that we are going from a Dr. culture where these meds were once over-prescribed and now, with people overcompensating/over-reacting, we are in the early stages of a culture where they are being under-prescribed for chronic pain.
Instead of vehemently denying access to these meds, why can't we find the happy medium?
What are your thoughts on this? And proposed solutions to the problem? Have you found it harder to get a prescription for these type of meds now compared to some years ago?
Personally, I think, pain contracts work well, so why not implement something like a government standard pain contract across the country(USA)? So every Dr. that prescribes these meds to CP patients has a protocol to follow and gov't/people can feel better about controlling the issue. This way, Dr.'s that don't use contracts would be forced to use a system to weed out the abusers, Dr.'s that don't prescribe these meds at all can have a system where they can feel comfortable doing so, the government/people pressuring gov't feel satisfied they are curbing the issue and the responsible chronic pain patient can have access to vital meds. We should regulate the meds use not deny it altogether. It's a win-win-win-win.
Unfortunately, with the way things are going it seems that we will probably go further down the fearmongering path before things balance out, which is extremely unfortunate. Thankfully, I'm only on a couple Norco a day now and not completely dependent on pain meds anymore so I don't worry about this as much anymore but I still feel the need to stand up for those in chronic pain dealing with this issue.