Opioids Oxycodone patient forced into cold turkey

[negrogesic]

Well if it’s legit pain he may need to go the pod rout as bupe can help there, but it’s not a full ago

Well fibromyalgia more resembles neuropathic pain (with neuropsychiatric components), so its very different from the type of acute pain that opioids are generally prescribed for. Few physicians will prescribe opioids for fibromyalgia, and when they do it is generally something like tramadol. Additionally opioids don't treat neuropathic particularly well, especially in the long run.

But regardless, even if the physician disagreed with the treatment, it takes a pretty cold hearted b*tch to not taper off someone who has been on opioids for an extended period of time. Not that they are any worse in general as practitioners, but I find that when it comes to a shitty male physician versus a shitty female physician, the shitty female physician is capable of more coldness and lack of empathy.

Part of this comes from the simple human behavioral phenomenon of women being significantly more risk averse then men, which makes them far tighter on the prescription pad since their sense of self-preservation and fear of losing their license for overprescribing narcotics is stronger than their male counterparts. Thus, this doctor was unwilling to write even a small amount of oxycodone to taper said person off.

 

[MsDiz]

But regardless, even if the physician disagreed with the treatment, it takes a pretty cold hearted b*tch to not taper off someone who has been on opioids for an extended period of time. Not that they are any worse in general as practitioners, but I find that when it comes to a shitty male physician versus a shitty female physician, the shitty female physician is capable of more coldness and lack of empathy.

Part of this comes from the simple human behavioral phenomenon of women being significantly more risk averse then men, which makes them far tighter on the prescription pad since their sense of self-preservation and fear of losing their license for overprescribing narcotics is stronger than their male counterparts. Thus, this doctor was unwilling to write even a small amount of oxycodone to taper said person off.

Wow, this is a stretch.

 

[ownstrength]

Well fibromyalgia more resembles neuropathic pain (with neuropsychiatric components), so its very different from the type of acute pain that opioids are generally prescribed for. Few physicians will prescribe opioids for fibromyalgia, and when they do it is generally something like tramadol. Additionally opioids don't treat neuropathic particularly well, especially in the long run.

But regardless, even if the physician disagreed with the treatment, it takes a pretty cold hearted b*tch to not taper off someone who has been on opioids for an extended period of time. Not that they are any worse in general as practitioners, but I find that when it comes to a shitty male physician versus a shitty female physician, the shitty female physician is capable of more coldness and lack of empathy.

Part of this comes from the simple human behavioral phenomenon of women being significantly more risk averse then men, which makes them far tighter on the prescription pad since their sense of self-preservation and fear of losing their license for overprescribing narcotics is stronger than their male counterparts. Thus, this doctor was unwilling to write even a small amount of oxycodone to taper said person off.

I think it's fairly demonstrable that women are more risk averse than men, because men are more likely to get themselves hurt/killed taking risks.

But isn't it also the case that women are more compassionate and would have more consideration for the suffering of a patient?

Also their risk-averseness could apply to the patient experiencing unnecessary withdrawal.

I appreciate your concern for the OP's well-being, I'm just wondering if there is any data out there that female doctors are less likely to prescribe opiates than male.

 

[negrogesic]

I think it's fairly demonstrable that women are more risk averse than men, because men are more likely to get themselves hurt/killed taking risks.

But isn't it also the case that women are more compassionate and would have more consideration for the suffering of a patient?

Also their risk-averseness could apply to the patient experiencing unnecessary withdrawal.

I appreciate your concern for the OP's well-being, I'm just wondering if there is any data out there that female doctors are less likely to prescribe opiates than male.

Yeah, there is data on this. And I have a sense risk aversion supercedes compassion in most cases, and compassion likely declines over time as physicians become desensitized over time (and after dealing with the bullshit that patients give them). You also have to imagine the personality types of women who become physicians, more logic driven than feeling driven, like INTJ type personalities, etc.

The data:

"[W]e performed a descriptive, retrospective study of 1.13 million medical providers who made drug claims to Medicare Part D in 2016, analyzing gender, specialty, and drug category. We found that male providers across diverse specialties prescribe significantly more medications, including opioids, benzodiazepines, and antibiotics than female providers by volume, cost, and per patient. These observed gender differences in prescribing, while agnostic to the quality of care provided, nonetheless inform the design of prevention strategies that seek to reduce iatrogenic harms related to prescribing."

Hamamsy, Tymor & Tamang, Suzanne & Lembke, Anna. (2019). Examining Gender Differences in Opioid, Benzodiazepine, and Antibiotic Prescribing. 10.1101/19003533

1.13M practitioners is a hell of a sample size, and the difference wasn't minor.

This is not to say they are any worse as practitioners -- overprescription of narcotics and antibiotics is bad practice. But they are certainly less likely to prescribe narcotics. Inevitably a determinant in this is risk aversion.

But on a side note if i were in her shoes I think I'd agree with this doctor that oxycodone might not be the best treatment course. But cutting off a long-term pain patient cold turkey is bad practice.

I guess the bigger question was the usefulness of me even noting the phenomenon, but i guess i just have a bit of a tendency to pontificate

 

[Pickledlemons]

Get on kratom in the immediate term.. you can buy it online for really cheap and its legal so yeah, go order some right now. Once you're on kratom and relatively stable I would suggest trying to find a different doctor for getting on bupe long term. You could stay on Kratom but the duration is really short so it gets frustrating fast. There's got to be a more understanding dr in your area, 10 years definitely needs treatment imo. Another option is to just go on the dark web and buy more oxy there... but its ridiculously expensive and can be risky so not recommended.

 

[Pickledlemons]

"[W]e performed a descriptive, retrospective study of 1.13 million medical providers who made drug claims to Medicare Part D in 2016, analyzing gender, specialty, and drug category. We found that male providers across diverse specialties prescribe significantly more medications, including opioids, benzodiazepines, and antibiotics than female providers by volume, cost, and per patient. These observed gender differences in prescribing, while agnostic to the quality of care provided, nonetheless inform the design of prevention strategies that seek to reduce iatrogenic harms related to prescribing."

Yeah thats my experience too. The last time I had a female doctor she prescribed me seroquel but I was supposed to go into the pharmacy every other day to pick it up... only two at a time, FOR SEROQUEL! Yeah I threw that rx out.

 

[Pickledlemons]

Wow, this is a stretch.

It is? How so?

 

[negrogesic]

Yeah thats my experience too. The last time I had a female doctor she prescribed me seroquel but I was supposed to go into the pharmacy every other day to pick it up... only two at a time, FOR SEROQUEL! Yeah I threw that rx out.

Damn now that's some seriously over the top hypervigilance

 

[ownstrength]

Yeah, there is data on this. And I have a sense risk aversion supercedes compassion in most cases, and compassion likely declines over time as physicians become desensitized over time (and after dealing with the bullshit that patients give them). You also have to imagine the personality types of women who become physicians, more logic driven than feeling driven, like INTJ type personalities, etc.

The data:

"[W]e performed a descriptive, retrospective study of 1.13 million medical providers who made drug claims to Medicare Part D in 2016, analyzing gender, specialty, and drug category. We found that male providers across diverse specialties prescribe significantly more medications, including opioids, benzodiazepines, and antibiotics than female providers by volume, cost, and per patient. These observed gender differences in prescribing, while agnostic to the quality of care provided, nonetheless inform the design of prevention strategies that seek to reduce iatrogenic harms related to prescribing."

Hamamsy, Tymor & Tamang, Suzanne & Lembke, Anna. (2019). Examining Gender Differences in Opioid, Benzodiazepine, and Antibiotic Prescribing. 10.1101/19003533

1.13M practitioners is a hell of a sample size, and the difference wasn't minor.

This is not to say they are any worse as practitioners -- overprescription of narcotics and antibiotics is bad practice. But they are certainly less likely to prescribe narcotics. Inevitably a determinant in this is risk aversion.

But on a side note if i were in her shoes I think I'd agree with this doctor that oxycodone might not be the best treatment course. But cutting off a long-term pain patient cold turkey is bad practice.

I guess the bigger question was the usefulness of me even noting the phenomenon, but i guess i just have a bit of a tendency to pontificate

Huh! Well the research checks out! Thanks for sharing that's an interesting data point to consider.

 

[Fire&Water]

I laughed
I cried
I shit my pants

 

[negrogesic]

Ok ok, it's 100% my fault, did not mean to derail this thread, but lets keep this about the original subject. Was just making an unrelated observation, obviously I have a chip on my shoulder here too based on some bad personal experiences.

 

[Fire&Water]

But
you are 100% correct
based on personal experience

 

[MsDiz]

Ok ok, it's 100% my fault, did not mean to derail this thread, but lets keep this about the original subject. Was just making an unrelated observation, obviously I have a chip on my shoulder here too based on some bad personal experiences.

I’m not going to derail it any further but to keep it on the topic a bit, female patients are less likely to get opioids or indeed any pain relief medications than males, from any gender of prescriber.

OP, you didn’t respond to my question but if you indeed have EDS, having your file notes from your previous Drs should help if they do in fact show issues you’re having like dislocations etc. if you have no proof of that then you’re not going to be taken seriously.

Opioid prescriptions are down and for good reason, they don’t help and you develop tolerance, studies show being on them long term can actually make your pain worse, to put it simply.

Surely pain clinics in America are supposed to offer alternatives? I’d be asking what those are and ensuring you have a plan to deal with your issues. Getting physical therapy will help, there are steroid injections you can get which will help too, even Botox in some cases.

 

[negrogesic]

I’m not going to derail it any further but to keep it on the topic a bit, female patients are less likely to get opioids or indeed any pain relief medications than males, from any gender of prescriber.

Females and also minorities -- as well whites of low socioeconomic status -- are less likely to get narcotic scripts.

 

[Señor Moreno]

Plumbus said it. The dirty bitch is fucking torturing you. Being afraid/ hesitant of giving a person a first script for opiates is one thing, forcing a 10 years pain patient to cold turkey without a taper because she sees "no reason to keep taking it" is on another level of brutallity.
10 years round the clock on oxycodone IS a reason to prescribe it. She fucking knows it. If she thinks it is not helping, then that whore has to taper you off. If you have to do it on your own, people have told you: kratom, lope, clonidine...
I wish you the best, I really do.
If I were to be a medical authorithy, many bastards like her would be losing their licence for torturing people, no for prescribing rational amounts of pain meds. They had made a promise to help people, but all they care is about money.
That said, nerve related pain will only find relief on opiates to a degree.
Lyrica helps nerve pain, but there is not free lunch with them either. I also have nerve pain and also am prescribed it and never will use it around the clock again. It is the most tolerance inducing drug I have seen in my life. And pregabalin wds are not fun.
It is the ugly truth we have to endure, mate.

And about males/ females docs, my experience is mixed, but the pattern I reckon is: the more reputated in the medical system or the closer they are to retirement they are, the more prone to prescribe.

 

[WellTramer]

For example Slovak republic banned the kratom but it is still available under the forms of Javanica and Hyrsuta and its litteraly the kratom being sold under the different names.

 

[Keif' Richards]

Hi everyone!

I’m not even sure if this is the right place for this or if this is something I know how to explain succinctly but here goes nothing.

I’ve been a chronic illness patient for almost ten years. I have several diagnoses, almost all pain disorders. I’ve been on opiates for all ten years. But never could get my doctor to go past 10mg 4x/day. Would sometimes take an extra here and there when things got bad. So I recently started at a pain clinic and thought it was my saving grace. Finally an impending quality of life!

The woman I saw at my eval was so kind and compassionate and understanding and saw where I was coming from. She wanted to switch me to buprenorphine and go from there. I was open to trying it. Did my urine test and booked my next appt three weeks out.

That appt was today. Where I got one of the cruelest doctors I’ve ever seen. She explained there’s “no reason” why I should need pain control and she wants an MRI of my spine (Had three. All fine) to prove that I’m fine. And I’m out of my oxycodone. She gave zero fucks about me going cold turkey after 10 years of round the clock meds.

I know this is nothing compared to the dosages I see on here. But I’m in utter agony because *shocker* I’M A CHRONIC PAIN PATIENT WHO NEEDS MEDS.

How can I help myself with this cold turkey drop? I’ll worry about what the next forty years of degenerative pain looks like after.

As a side note: I did have Valium but that’s been taken as well. The only med I currently have that I’ve seen talked about is Lyrica (pregabalin)

Things are crazy right now in the United States. It's not a very sympathetic system. A lot of ex-pain clinic folks have been moved to Methadone clinics. You see a lot more people at the clinic with this "WTF where am I?" look on their face, some look like they're in there 60's. Meanwhile, powerful Opioids are more available on the street than they ever have been, but I firmly believe there is no good way to go about medicating yourself with street Opioids. I truly think the Methadone option might be your best bet.

 

[MsDiz]

Things are crazy right now in the United States. It's not a very sympathetic system. A lot of ex-pain clinic folks have been moved to Methadone clinics. You see a lot more people at the clinic with this "WTF where am I?" look on their face, some look like they're in there 60's. Meanwhile, powerful Opioids are more available on the street than they ever have been, but I firmly believe there is no good way to go about medicating yourself with street Opioids. I truly think the Methadone option might be your best bet.

Honestly? Methadone for a patient who’s been on a pretty low dose of oxy for being on it 10 years? Someone who has a connective tissue disorder? Thats poor advice and maybe it’s because you don’t understand connective tissue disorders. They are degenerative and OP will most definitely need strong pain medication when they get older/if they have an emergent issue like a hip dislocation, for example. Going on methadone, whilst it would ease withdrawals, is madness. Connective tissue disorders are best treated with physical therapy, weight training, using braces/other aids, cold therapy/heat therapy, the list goes on.

Absolutely do not agree with the Dr just discontinuing your prescription but she might have done you a favour. Take a month or two and assess your current pain issues. Patients here regularly take tolerance breaks, to see where they are with pain and if any new issues have arose during the time between breaks that they might not fully have realised and obviously to reduce tolerance. Work with the pain clinic as they should be giving you a treatment plan for therapy etc. (I am not really sure of the US pain clinics but over in uk/Ireland this is the point of them.)

Living in pain absolutely sucks, it’s constantly there, even with pain killers, it’s constantly gnawing at you. I would honestly also advise going to therapy, doing CBT or DBT and finding a way to accept it and learning ways to get out of your head a bit.

My own personal experience - I have a connective tissue disorder (and lots of comorbidities) I have recently stopped a long term prescription of strong opioids which I was on for probably more than 10 years. My pain has actually reduced and I suffer from dislocations every day. I am happier and I am definitely more clear headed. Bumping up my PT and utilising heat/cold does work pretty well and whilst I know connective tissue disorders differ for everyone, I’m 38, I danced and did gymnastics when I was younger so I’ve so much damage and I manage it pretty well now. I do have PRN opioids for extreme pain and I use them very sparingly. This is to show you that all is not lost just because you no longer have an opioid prescription. I don’t think there’s any reason you couldn’t also have PRN meds but they will need to see you willing to try other options.

This is just an attachment to show the other issues with long term opioid treatment. It has references for studies used, for those interested in reading further.

Long term harms of opioids

Opioids Aware: Side effects and harms to consider with long-term opioid use

fpm.ac.uk

 

[Señor Moreno]

Agree.
I have a condition where pain nerve is involved.
I am also on methadone, have been forever.
First thing is the nature of the pain, opiates are not the best for that. Better than nothing? Sure.
Second, the way they dose in a clinic, once a day, is not the way to use methadone for pain.
Op will not get the relief she/ he needs, will ask for a increase, and they will be more than happy to do so and hand- cuffing the Op even further and in less than a year he/she will be on a 3 digits methadone daily dosage, because you know, they absolutely CAN'T give a person a 20 mgs increase of a morphine or oxy script, but somehow they CAN put and keep a person on 150 or 200 mgs of methadone day. ..

Have been there, for ages, only leading to massive constipation and crazy tolerance, a level of tolerance that will jeopardize Op's chances of benefit from a opiate if she/ he developes a new condition in the future. Also will make things hard if Op has to undego surgery and post operation pain.
I have been on 150mgs a day, but now, after experimenting all that shit, I cut it down and have been last years on 30-40.
I grew to understand that the shit was doing nothing for nerve pain, even more, it was worsening it by inducing hyperalgia ( sp?)
You can bet 30 mgs don't hold you as well as 150 mgs, but, at the end of the day, I have improved.
I manage the nerve pain part of my condition with Lyrica and physio, and when I suffer other kind of pain I can use opiates again.
Fisured a bone a year ago and I found total relief from it on less than 90 mgs morphine sulphate where 300 mgs of it didn't do shit for me years ago pain wise, and even won't hold me well 24 hours...
A pain patient can also have an addictive disorder, but those are two different conditions that need two different treatments

 

[Keif' Richards]

Honestly? Methadone for a patient who’s been on a pretty low dose of oxy for being on it 10 years? Someone who has a connective tissue disorder? Thats poor advice and maybe it’s because you don’t understand connective tissue disorders. They are degenerative and OP will most definitely need strong pain medication when they get older/if they have an emergent issue like a hip dislocation, for example. Going on methadone, whilst it would ease withdrawals, is madness. Connective tissue disorders are best treated with physical therapy, weight training, using braces/other aids, cold therapy/heat therapy, the list goes on.

Absolutely do not agree with the Dr just discontinuing your prescription but she might have done you a favour. Take a month or two and assess your current pain issues. Patients here regularly take tolerance breaks, to see where they are with pain and if any new issues have arose during the time between breaks that they might not fully have realised and obviously to reduce tolerance. Work with the pain clinic as they should be giving you a treatment plan for therapy etc. (I am not really sure of the US pain clinics but over in uk/Ireland this is the point of them.)

Living in pain absolutely sucks, it’s constantly there, even with pain killers, it’s constantly gnawing at you. I would honestly also advise going to therapy, doing CBT or DBT and finding a way to accept it and learning ways to get out of your head a bit.

My own personal experience - I have a connective tissue disorder (and lots of comorbidities) I have recently stopped a long term prescription of strong opioids which I was on for probably more than 10 years. My pain has actually reduced and I suffer from dislocations every day. I am happier and I am definitely more clear headed. Bumping up my PT and utilising heat/cold does work pretty well and whilst I know connective tissue disorders differ for everyone, I’m 38, I danced and did gymnastics when I was younger so I’ve so much damage and I manage it pretty well now. I do have PRN opioids for extreme pain and I use them very sparingly. This is to show you that all is not lost just because you no longer have an opioid prescription. I don’t think there’s any reason you couldn’t also have PRN meds but they will need to see you willing to try other options.

This is just an attachment to show the other issues with long term opioid treatment. It has references for studies used, for those interested in reading further.

Long term harms of opioids

Opioids Aware: Side effects and harms to consider with long-term opioid use

fpm.ac.uk

I'm really sorry for how this sounded. I don't want to act like I'm diagnosing or recommending a specific medication for a specific medical condition. I'm speaking completely as a layperson with an admittedly small understanding of literally all of the conditions which you have just described @MsDiz and that our original poster has experienced.

Think of me speaking purely as someone commenting on the political/legal/practical side of things. For many, many people out there in the United States (I can really only speak for my country), Opioids are not prescribed in significant quantities. If I hear someone saying "Hey, I really need to be on Opioids, but nobody is prescribing them and I'm running out of options", I sadly have to say that the Methadone clinic is the only actual option for a lot of folks.

...and it's a shitty option at that. I've known people who have moved from pain management to the Methadone clinic who now are in severe pain and dependent on Methadone. So, please try to understand I feel like my hands are tied in that all of the options I can give from where I stand are not actual solutions to the problem.

If someone says they want to be on Opioids, there's the clinic. That doesn't mean it's an actual solution to their problem, it just means it's a place that will give them Opioids and again, I apologize if that was misguided or insensitive. It's not a fair system out there right now.