Spokane7
27°
January 22, 2012 in City
Prescription drug abuse, deaths target of new Washington law
Joshua Dameron, seen standing on a downtown Spokane street last week, is still in rehab for a painkiller addiction that lasted several years after a work accident damaged his back. He’s clean now and says, “It feels great.”
(Full-size photo)(All photos)
Dameron got hooked on prescription pain medication after suffering a herniated disk while working in a dynamite factory. He’s one of thousands of Washington citizens who have gotten addicted to narcotic pain medications over the last decade. One doctor called the pain meds, which go by names such as Vicodin, Percoset and OxyContin, just a “fancy form of heroin.”
“I was addicted to pills, like, bad,” said Dameron. When he exhausted his supply, he would hit the ERs, telling doctors his back hurt. Eventually he was downing 20 Percosets a day. Once, he says, he got so desperate he broke his own little finger to get more drugs.
Dameron eventually wound up in drug court for forging prescriptions. He’s been living in a halfway house and hopes he’s kicked the pills for good.
Spokane County has one of the highest rates of deaths from prescription drug overdoses in the state, at 12.8 per 100,000 people. Statewide, the death rate is 7.1 deaths per 100,000 people, and in King County it’s 6 per 100,000.
Prescription drug abuse is at epidemic levels throughout the state and elsewhere in the country, despite lawmakers’ attempts to get a grip on it. Deaths from prescription drug overdoses in Washington have skyrocketed nearly twentyfold since the mid-1990s and now outstrip those from traffic accidents.
Washington has been one of the hardest-hit states, in part because of aggressive prescribing practices coupled with lack of oversight by the Department of Health.
An InvestigateWest analysis of U.S. Drug Enforcement Administration data shows Washington ranked fourth-highest nationally in per-capita prescribing of methadone in 2006 (the most recent year for which reliable data is available) and 11th for oxycodone – the two biggest killers.
“The higher deaths, and probably abuse, too, I believe has to do with higher supply or availability,” said Jennifer Sabel, an epidemiologist with the state Department of Health.
Even more disturbing, more than half of all prescription-drug-related deaths occur in the state’s poorest and most vulnerable population – people on Medicaid. A 2009 federal study showed the age-adjusted risk of death from prescription opiates in Washington was nearly six times higher for Medicaid enrollees than for those not on the program.
“Medicaid has about a death a day from prescription narcotics, and in the last two years it’s continued to escalate,” said Dr. Jeff Thompson, medical director for Washington’s Medicaid program.
New law outlines dosing limits
The cause of the epidemic has many roots, including a major shift over the last decade in how the medical community treats chronic pain. In addition, aggressive marketing of opiates by drug companies, the inability to track overprescribers, patient demand for quick fixes, the lack of insurance coverage for alternative treatments, and cost-saving moves by the state all have helped fuel the rise in death rates.
With a law that took effect this month, Washington state is making a bold attempt to reduce overdose deaths, by launching the first dosing limits for doctors and others who prescribe these medicines. The law has been heralded as one of the toughest in the nation, but loopholes and pitfalls in the system remain.
One of the biggest is a gaping hole in the state’s information-tracking system.
Most emergency rooms are not equipped to assess whether someone has already been seen across town in another ER, said Dr. Darin Neven, medical director for the Consistent Care Program at Providence Sacred Heart Medical Center in Spokane. Like Dameron, many addicted patients feed their habits by going to ERs or “doctor-shopping.” They fake or exaggerate injuries and illnesses to get doctors to prescribe pain meds.
The trend is so bad that some ERs, including those throughout the Swedish Medical Center system in Seattle, no longer hand out prescriptions for oxycodone, one of the most commonly abused pain pills.
It has also prompted the emergency rooms in Spokane to band together and mount a pilot program that uses a shared database to track people who obtain pain meds in the ER.
“We’re walking a fine line here,” said Neven. “We don’t want to become policemen, and yet these are deadly drugs.”
The Spokane ER data-sharing network started in 2006 and has now spread to four emergency rooms in Spokane and 19 others across the state. Neven, along with Lee Taylor of the Spokane County Medical Society, has applied for a grant to expand the program to all the ERs in the state.
To date, the program has flagged 633 “frequent users” of the ERs and helped enroll them in programs to better manage their pain and addictions.
The data-sharing network in Spokane is being watched as a model by other urban hospital centers.
Limitations of the law
Still, other challenges remain for reducing prescription drug abuse.
Under the new law, doctors and other prescribers with patients who need more than 120 milligrams a day must seek a second opinion from a pain specialist. But there are few of those.
Medicaid is already struggling to comply. Despite having thousands of patients currently over the threshold limit, the agency can only get one or two evaluated by a pain specialist each month, said Thompson.
“Access is an issue,” acknowledged Dr. Gary Franklin, medical director for the state’s Department of Labor and Industries, adding that telemedicine consultation programs and other efforts to increase capacity are helping but still don’t fill the need.
The new law makes Dr. Merle Janes, of Valley Rehab & Emergency in Spokane, angry. He said legitimate pain patients and doctors who prescribe for them are paying the price for the policy changes designed to nab addicts. People in real pain can’t get adequate relief, he says.
“It’s been a disaster for all these people,” Janes said.
Janes was part of a group that attempted to sue the state, saying the new rules were unfairly harming legitimate pain patients. The suit, which was dismissed, challenged the guidelines for being “arbitrary, vague and overbroad” and charged that recent investigations by the Medical Quality Assurance Commission – the state’s disciplinary agency – were motivated by “opiophobia.”
Dr. David Tauben, a clinical associate professor and director of medical education in pain management at the University of Washington, agreed that not enough doctors are treating pain well.
“But this problem was happening well before the new law,” Tauben said. He’s optimistic that the new law will actually encourage more doctors to treat pain patients because they will have guidelines to follow.
Lax oversight
Another obstacle to the success of the state’s new pain policy is the continuing lax oversight of prescribing habits.
While the law gives state regulators a reason to discipline doctors, the statute does not require the state to check whether doctors or other medical professionals are breaking it.
Unlike the federal Drug Enforcement Administration, which does monitor whether medical professionals with narcotic permits are following its rules, or the state’s Medicaid program, which tracks how much narcotic medication its doctors prescribe, state licensing agencies don’t check on practitioner compliance with laws and regulations. The system relies on complaints from patients or other professionals to trigger investigations.
As a result, the Medical Quality Assurance Commission can’t say how much of a problem excessive prescribing is for Washington doctors, dentists, advanced nurse practitioners, physician assistants and other providers licensed to prescribe these powerful medications.
An InvestigateWest review of recent cases against medical professionals found only a handful over a three-month period. The majority of those disciplinary actions involve medical workers who are themselves addicted. A few, however, had been disciplined for excessive prescribing.
Prescription-monitoring programs
One reason there has been little oversight of prescribing habits in Washington is that until this year there hasn’t been a systematic way to track the information.
Washington has been slow to adopt a statewide monitoring program that would enter all patient prescriptions in one shared database. The Legislature created such a program in 2007 but pulled its funding the next year, and it never got up and running.
Currently, 35 other states have such programs in place, and the information has led to a reduction in prescription fraud and provided a way to identify doctors who have excessive prescribing habits.
The lack of such a program here frustrated Chris Johnson, policy director for the Washington attorney general’s office. “We know from the war on meth that tracking sale of precursor drugs had helped curb the problem,” he said. “We figured the same approach could help stem the wave of prescription drug abuse.”
Johnson was part of a group that has now helped secure temporary funding to mount a prescription-monitoring program in Washington. But the funds will be exhausted by June, he said.
And even this program has limitations. Prescribers are not required to consult the new database before writing a prescription. Participation is voluntary.
In Kentucky, where it is also voluntary, only about 20 percent of doctors used it, Franklin said.
It’s also unclear how Washington will use the information it collects.
The administrators of the program will be reviewing the data to identify potential inappropriate prescribing patterns, said Chris Baumgartner, the program’s director. The system has the capability to pinpoint doctors and others who prescribe large amounts of opiates, but it hasn’t been decided yet whether the program will automatically produce and distribute reports on those individuals to various licensing agencies for investigation.
Other states have found that such proactive reporting results in reducing prescription drug abuse.
The Medical Quality Assurance Commission has the authority to survey the database for prescription abuse but said it does not plan to do so.
Too many drugs, too little treatment
Even as the system for collecting data improves, two other significant obstacles to reducing prescription drug addiction remain.
The first is the sheer volume of pills in people’s medicine cabinets, which have become the nation’s de-facto illicit painkiller dispensary.
Teenagers and even younger children pilfer their parents’ medicine cabinets for drugs, which get passed around or sold on school campuses and the street, said Mark Thomas, acting special agent in charge of the DEA’s Northwest division. According to the latest national survey, more than 70 percent of people who abuse prescription drugs get the pills from friends or family, not a doctor or other prescriber.
Stepping back further, the underlying problem is that there are not enough treatment options for drug addiction.
“We know about 10 percent of people, including kids, who need treatment get it,” said Gina Grappone, director of Science and Management of Addictions, a Seattle-based nonprofit that provides resources for families and treatment for young people.
Methadone maintenance programs, which use one of the oldest and most effective ways of treating addiction to narcotics, have long waiting lists and are simply unavailable in many parts of the state, said Ron Jackson, executive director of Evergreen Treatment Services. The stigma of being dependent on methadone, in some cases for the rest of your life, also serves as a major deterrent to treatment, as does the logistical nightmare of having to travel to a methadone clinic on a daily basis.
A growing number of doctors are licensed to prescribe Suboxone – another opioid medication used for addiction that’s provided through a doctor’s office. But it’s expensive and its long-term efficacy has yet to be proved.
Meanwhile, the number of new addicts continues to grow as people get hooked younger and younger.
“The largest group of people entering treatment for prescription abuse right now is made up of young people between the ages of 18 and 24,” said Caleb Banta-Green, a research scientist at the University of Washington’s Alcohol and Drug Abuse Institute.
Addiction experts predict that the number of deaths from prescription drugs, which fell slightly in the past year, will see a surge in the years to come as this large group of younger addicts ages and becomes debilitated by the drugs.
Deaths from opiates tend to pick up in the mid-40s because the long-term abuse of these drugs is hard on the body, said Banta-Green. “People are dying 30 years earlier than they should.”
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greenlibertarian on January 22 at 3:00 a.m.
Deaths from prescription drug overdoses in Washington have skyrocketed nearly twentyfold since the mid-1990s and now outstrip those from traffic accidents.
Pills kill. Alcohol too.
How many dead from marijuana vaporization ingestion or just smoking?
Double ought. Zero. None. Nunca. Nyet. Nada. Not Applicable
Law Enforcement Against Prohibition:
http://www.leap.cc/
It’s the rational choice, to help others.
larryak68 on January 22 at 4:08 a.m.
Yeah it is a problem. I suffer from Kidney Stones and without adequate insurance, all I can do is wait for it to pass. I try not to go to the ER just so i don’t look like an addict.
lewis8457 on January 22 at 4:11 a.m.
the main problem is the damn pills have more tylenol or ibeprophen then actual drug so a person has to take many to get them to work. what kills is the tylenol or ibeprophen. i know not spelled right it is 4am and i am waiting for one to take effect before going back to bed.
i know been out of surgery for 1 week now and the oxy they gave me doesnt even touch the pain.
i am on the verge of blowing out my liver or kidney an i am still in pain. i would rather be stoned any day
D Statler on January 22 at 7:47 a.m.
I believe that the drug manufacturers could make an effective pain killer that was less addictive. They make their money selling addictive dope legally. Our government chooses to go after doctors instead of the real guilty parties. The big Pharmeseutical Companies should be held responsible like big Tobacco Companies in the past. Both knew the product they manufactured and sold are highly addictive. Both just as guilty of covering up and encouraging over usage. A large portion of the profits from the sales of this legal synthetic herion should go directly to treatment centers. I am surprised this legislation was allowed forward by the lobbyists from big drug manufacturers. This might get into their profits and slow down campaign contributions to our elected officials. :^( Go after the little guy without addressing the big problems again. More of the same poor leadership we have come to expect.
Orphan on January 22 at 7:47 a.m.
Another law that punishes the legit people like Lewis. I have a bad back that I have avoided surgery for about 20 years but need to use pain meds a couple of times per year. All this law is going to do is make it a lot more difficult for those of us that have a legit need.
How many laws do the legislators think it will take to stop addicts? I want to know because this law will not work and evedently the older laws are not working either.
empyrius on January 22 at 7:57 a.m.
A lot of people dying from, addicted to, and even willing to stick a gun in your face for these opiate based drugs . . .
Yep, this has to be the fault of marijuana somehow . . .
Ummmmm, yea all of these opium addicts must have smoked marijuana, you know that good old “gateway” deal-e-o, when they were teenagers: yep, all of these pill-popping junkies got addicted to oxycontin b/c they smoked some weed years ago!
And in fact when any of these opoid addicts visit an emergency room, if they mention they may have consumed some marijuana in the past year, then even though they are in the hospital for an opium overdose marijuana will get a black mark for being “honorably” mentioned!
And of course your precious DEA uses those statistics to “prove” how dangerous marijuana is!!!!!!
Har har har har
Bruce (aka thatoneguy) on January 22 at 8:33 a.m.
I can totally see why people get addicted to painkillers — they alleviate not only the pain but the fear that comes with the pain. When I had surgery some years back, the hospital sent me home with some Vicodin. Man, that was great stuff. Even better than the pain going away was that my worries about whether my career was over and if I would regain full use of my hand went away too. When the thing you do for a living is the thing you always wanted to do ever since you were a kid, the prospect of losing it is pretty terrifying.
Fortunately for me, my mom was a retired doctor, and as soon as I got out of the hospital she told me “You need to get off that sh*t ASAP. As soon as you can stand the pain, throw that sh*t away and get some extra-strength Tylenol instead.” (Yes, she really talks like that.) So I did, and I’m glad I did, but I still look back with a sort of fondness at my week as a Vicodin user.
Orphan on January 22 at 9:01 a.m.
Bruce Good on your mom. I have taken pain meds on and off for 20 plus years. Every time I have to take them I cant wait to stop, I dont like the way they make me feel, I guess everyone is different.
Shelala on January 22 at 9:10 a.m.
What a misguided law! No one wants to feed addicts or condones prescription drug abuse, but little is said about a OTC that kills many each year accidentally- Tylenol.and acetaminophen. Tylenol has the ability to do permanent damage to the liver even at recommended doses over a short period of time. My concern is that the same people who are addicted to prescription pain killers as a a result of injuries or accidents or who are seeking pain relief will turn to these OTC killers. Big Pharm has deliberately failed to inform the public that even regular doses on the non prescription drugs can and has caused the deaths of many. I urge anyone seeking relief from pain of any kind, to at least do a little reading about the use of acetaminophen and Tylenol and maybe save your own life or the life of a loved one.
http://www.google.com/url?sa=t&rct=j&q=acetaminophen+dangers&source=web&cd=5&ved=0CE0QFjAE&url=http%3A%2F%2Fabcnews.go.com%2FHealth%2FPainNews%2Fstory%3Fid%3D7699582%26page%3D1&ei=Mz0cT5L_C6eOiAKvo_i4CA&usg=AFQjCNHSjJUAWSaMbFXNIb9MBXIJW9SnbA
stitch on January 22 at 9:30 a.m.
Lewis, am more concerned about narcotic analgesics that have acetaminophen(tylenol) that those few with ibuprofen…The 3 doses that hydrocodone comes in all contain 325mg of tylenol..The rec. MAX daily dose of tylenol is 3-4000mg depending on physical factors..Anything over 7000mg puts 1 at high risk for toxicity..Potentially fatal damage to you liver can result if you maintain this level for any period of time…If you are taking 20—5/325 hydro’s daily(not unheard of by any stretch) you are ingesting 6500mg of tylenol daily.. In the course of a month,That would be 75,000mg more than the rec monthly high end dose..One does wonder just how many of these OD deaths are the result of Tylenol toxicity..Lewis, judging from your entry, it would appear you are well under the influence..Your pain will eventually subside, your Quest for the Elusive Butterfly of High may not..BE CAREFULL..
Shelala on January 22 at 9:59 a.m.
I recently lost a close loved one as a result of liver damage because of the innocent regular use of acetaminophen (Tylenol) that did not exceed recommended doses. There was no way to filter out of the acetaminophen from the liver. Had anyone in the family known that Tylenol could kill in even so-called “safe” dosages, we could have saved a life. I was informed that emergency doctors see these cases more often than the public is aware of .Many prescription pain killers have acetaminophen in them and many more OTC pain relievers too. I don’t condone any abuse of any drug, but OTC drugs can be just as deadly and maybe even more so because people mistakenly believe they are safe and easily purchased. The following is a link that lists drugs (OTC and otherwise that contain acetaminophen: http://www.google.com/url?sa=t&rct=j&q=drugs%20containing%20acetaminophen&source=web&cd=3&ved=0CEwQFjAC&url=http%3A%2F%2Fwww.tylenolliverdamages.com%2Fcommon-drugs-that-contain-acetaminophen.php&ei=skkcT4m_EMrYiALp3YHRCA&usg=AFQjCNG44a2rNsnGeTd8TtO4cytzQlCkVw&cad=rja
alltheplants on January 22 at 10:00 a.m.
Cannabis extract ends pharmaceutical addiction. I’ve seen it work 4 out of 4 times for multi-year addictions with very limited withdrawal symptoms. I haven’t seen any relapses either. Its also easy to find out for yourself that it cures cancer. I’ve seen it work twice. Youtube David Triplett cured too and Rick Simpson run from the cure. Cannabis cooperatives save lives!
nslopeofw on January 22 at 10:17 a.m.
Lewis-
If you can, get the actual oxycintin by perdue, not the generic. The one made by perdue is tamper proof, and has no acetaminophen or ibuprofen. It comes in sizes as small as 5mg, and is time released. Depending on your tolerance, this might be a good fix for you. Biggest problem with OC is that you can only get one month at a time, but i see this as a good thing.
I find it ridiculous that the government made perdue come up with a fix for OC, but continues to allow the generics to be non tamper proof. WTF?
If all pain meds were tamper proof, we would not have this problem.
Scoutster on January 22 at 10:43 a.m.
Let’s see a show of hands for folks who think putting Oxy users behind bars is a cost-effective solution leading to of a reduction in use?
A classic case of govt responding to popular hysteria and putting in place policies actually working against the desired outcome.
Only law enforcement and sound-bite politicians still sell interdiction and punishment as the weapons in this stupid “war on drugs”.
But the fear works for them so they keep the carnival going at tax payer expense.
SMARTGUY on January 22 at 10:52 a.m.
These drugs are to addictive to be safe to use by anyone who is not on their death bed. I don’t care how much pain I am in I will not risk ruining my life to feed the drug company profits.
kkrimmer on January 22 at 11:11 a.m.
Each year, a staggering 440,000 people die in the US from tobacco use.
www.cancer.org
Smoking is the most preventable cause of death in our society. Thirty percent of all cancer deaths, including 87% of lung cancer deaths, can be attributed to tobacco.
• Each year, about 3,000 nonsmoking adults die of lung cancer as a result of breathing secondhand smoke.
• Smoking-related medical costs totaled $75.5 billion in 1998.
YET WE DON’T OUTLAW TOBACCO … we even subsidize tobacco farmers with our tax dollars! The US Govt is complicit in the deaths of hundreds of thousands… millions over decades… yet tobacco companies enjoy record profits and government protection for tobacco which is more harmful and harder to quit using than heroin.
lewis8457 on January 22 at 11:16 a.m.
nslopeofw i will ask my doc for some i need to call her anyway, thank you
orphan i have had back pain all my life went in for a MRI for SSI and they found a tumor growing from the damaged nerves in my spinal sac, you might want to get a MRI if you have insurance. they still do not know what the tumor is they sent it to john hopkins in boston.
smartguy i know of what you speak, i have lived with pain my whole life never let it stop me, but after surgery to replace a section of my spinal sac a tumor was growing in and the loss of 3 vertebra the pain is unbelievable.
stitch on January 22 at 12:10 p.m.
Lewis: And now we know the rest of the story(Paul Harvey) Oxycodone packs abit more of a punch than Hydrocodone, which is apparently what your taking..Your concern about Tylenol levels lead me to believe your taking well more than you should..Nslopeofw’s suggestion is a good one, but if you are taking large doses, and they aren’t “Even touching the pain”, then while talking to the Doctor ask about the Fentanyl Patch..If I take your story at face value, you may be a candidate..
Dazzeetrader11 on January 22 at 1:05 p.m.
Making new laws won’t do much. What’s hard to believe is that the ER’s at one hospital coesn’t know what the cross town ER has just done . When the scripts are filled, the pharmacy can know immediately with the rise of computers and networks.
Washington and Oregon led the charge on this. Sounds like some agency has dreamed up a new batch of bills for the taxpayer….and more control for the Government. The pharmacies know where every gram of legal narcotics is. Somebody is writing scripts. Docs get called in if the computers attached to the pharmacies, hospitals and the insurance companies red flag…which they do. It’s worse in California.
A friend of my Dad’s was hired by Doris Duke. She was his only patient for a while. Well, her butler and her had this poor guy prescribing day and night….til he said no more after a call from the State and the Pharmacy. SO he stopped and they sued him for “bad care” and abandonment. The State took his license for a full year for both overprescribing and then underprescibing ( the abandonment charge). Get the government out of medicine. These programs do nothing but generate more government jobs….and they don’t get the job done.
No doubt, addiction is a problem…as is the violence, etc that comes with addiction. MJ won’t help it…it’ll just get more people loaded. We don’t need more dope. We need more spirituality. Anyone can go to an ER and cannot be turned away. They must treat…unless it’s just a fraud.
Orphan on January 22 at 2:19 p.m.
Lewis Thanks for the tip, I had an MRI not too long ago and the protrusions & buldges have gotten larger than they were the last time.
Smartguy when you are blacking out form the pain & tossing your lunch you may change your mind. Drugs are just like anything else they are a good tool if used correctly, use them incorrectly and bad things can & do happen. Knives, guns, cars, hammers, pencils, screwdrivers, drugs all can be great things and all can be very bad.
Just because a small percentage of folks choose to misuse drugs does not warrent making everyone else suffer.
Cheek50 on January 22 at 4:27 p.m.
The problem with attempting to control addiction through controlling prescriptions is that the pill is not the cause. The disease model of addiction, used by the legal profession to attack doctors, has been in effect for 40 years. Even though prescriptions have been controlled to the point that legitimate pain patients cannot find treatment, addiction has tripled in the 40 years. Addiction is inside, based on toxicity, anxiety and living conditions. When we focus on improving lifestyle and give people hope for a better life, we will see less addiction. All Washington state has set up is attacking good caring physicians like they are doing in other states. Linda Cheek, MD
Shelala on January 22 at 5:29 p.m.
Amen, Doc! I wish our lawmakers would allow doctors to be doctors and treat their patients with the appropriate treatments to heal or relieve pain and suffering, especially with the arsenal of medicine and treatments now available.This law is a huge step backward. Addiction has been around for a lot longer then the drugs we seem to be so worried about abusing. Blaming the drugs for addiction makes about as much sense as blaming the car for the accident. Treat the addiction.
IBChuck on January 22 at 5:40 p.m.
The real problem with the reasoning behind this law is that the state uses all sorts of statistics on abuse but none on the non-abusive success of these pain meds. All they are going to do is force doctors to limit the writing of legitimate prescriptions when these prescriptions are not the true problem. “more than 70 percent of people who abuse prescription drugs get the pills from friends or family, not a doctor or other prescriber.”
Sounds like a solution looking for a problem.
From my own situation and that of others I know that use these meds for true pain relief, we would rather not be taking the pills. Conversely, those that enjoy taking the pills are those that are abusing them. Anybody that hasn’t experience constant intense pain doesn’t know what they are talking about when it comes to pain treatment. Their arguments are born in ignorance.
stitch on January 22 at 6:06 p.m.
Linda Cheek MD/Shelala.. Couldn’t agree more..Dr. Cheek, what would be your recommendation for Lewis8457?
Dazzeetrader11 on January 22 at 7:21 p.m.
Never a good idea todiagnos or give medical advice on the net. If you look at the huge majority of addicts most have a common pathway that leads them to their particular brand of shelter: FEAR. Medicating fear is what’s done. The only way out from addicition is believing that “God” and your fellow man are more important that you are. When it comes to men, you must do service work. WHen it comes to God, spirituality is key. Without those two, relapse will occur.
Oh and you must do that work to recover. Laws don’t help.
stitch on January 22 at 8:08 p.m.
“The only way out of addiction is believing that “God and your fellow man are more important that you”..Dazz, low self esteem is one of the leading causes of substance abuse..I agree with you that one must do work to recover, but to put all others on a pedestal over ones self is a relapse waiting to happen..If one cannot give their advice on this site, then they should not identify themselves as a Professional in any given area..Agreed??
greenlibertarian on January 22 at 10:28 p.m.
Please do not feed the troll.
greenlibertarian on January 22 at 11:00 p.m.
Am aware of the nightmare of addiction, but not any long term chronic high pain, not sure I can even imagine. Only had hydro or oxy (forget which one) once in my life, after throat surgery. Every swallow was a gigantic horrible thing which I’d better be sitting down because I would double over from the pain. I lost 25 lbs in three weeks, couldn’t much eat.
The narcotic did it’s job so I wouldn’t starve myself it hurt so much to swallow.
Went off them after two weeks, and it was hard, but the pain was abating.
Consider myself lucky, very lucky, in not having to deal with much physical pain. My heart goes out to ya’ll that are.
The majority of those disciplinary actions involve medical workers who are themselves addicted.
Some levity is in order:
Drugs are Us
http://www.youtube.com/watch?v=0ghh5yXlEaw
Dazzeetrader11 on January 22 at 11:22 p.m.
Greenie…you used as therapy for a disease. Addiction is completely different. And if you were on a disciplinary board, you’d soon know self mediation is a big deal. Most of the MD’s nurses and PAs are in that loop.
Many of the disciplinary actions are generated by those who inappropriately prescribe though.
Brain chemistry is the common pathway. Once it’s altered, the brain is hijacked for some. For others…not so much.
Laws won’t fix much.
katyclo on January 22 at 11:52 p.m.
As a former WA resident with chronic pain, I have to say that I am thrilled that I am no longer a resident of that state.This is a horrible law that is going to bring a great deal of suffering to legitimate pain patients and will do nothing-absolutely nothing- to stem the tide of prescription drug abuse. Drug abuse is a social problem and the psychological and societal factors that cause it, such as poverty, unemployment and despair have not changed since 1990…or 1900 for that matter, (except, perhaps, that they have gotten worse) The major difference in addict behavior today is that they have changed their drugs of choice from illegal opiates like heroin to legal ones, like methadone and Oxycontin. They were dying from one before and they are dying from the other now. It’s a matter of access, not behavior.
This does not mean that there are not problems with prescription pain medication. There is no denying the fact that some people have died because they took legally prescribed narcotics. People have also died because they took legally prescribed insulin, antibiotics, aspirin, Tylenol and a host of other “safe” medications. Adverse drug reactions (NOT drug overdoses) has been a leading cause of death in this country for years and that has nothing to do with narcotics!
The fact is that most legally prescribed narcotic related deaths were and are caused by the prescribing practices of poorly educated physicians, non-existent patient education and poor compliance with prescribing instructions(as in “do not drink when taking these drugs”) on the part of patients. Setting arbitrary dosage limits will solve none of these problems. Sending patients who need them to pain clinics would mitigate them, but with wait times for a referral as long as several months, this is simply NOT a reasonable solution.
I have lived with chronic pain for 15 years and take an opiate medication. I have no idea what drug this article refers to when it mentions the “120mg rule,” but setting an arbitrary dose limit on any medication is foolhardy and ill-advised. People who take opiates for legitimate pain develop tolerance to their medicine and must often take a higher dose of a drug in order to get the same pain relieving effect. This is related to the pharmacokinetics of narcotics and not an indication that a patient is becoming addicted. The problem can be mediated by adding new drugs such as NSAIDS to the patients existing drug regimen, prescribing short acting “break-though pain” medication like fentanyl or dilaudid, or switching to another type of long acting narcotic. However, the simple fact remains that people with intractable pain need LARGE doses of drugs in order to function. Now that some lawmakers took it upon themselves to start practicing medicine these people will be needlessly suffering.
Any time lawyers (as all politicians are) get mixed up in medicine the outcome is never good. Hopefully in this case some good lawyers will file suit in the state Supreme Court to get this ill-advised law repealed before people in pain start jumping off bridges and throwing themselves in front of trains in search of relief.
katyclo on January 23 at 12:12 a.m.
Just one more comment-
The overwhelming nature of the comments here indicate that people in WA are against this law and the mind-set that created it. So, why is it on the books?
This is just one more case of legislators over-stepping the boundaries granted by their position. In both state and federal government politicians are consistently passing laws that no one supports. This is one of the main reasons why Congress’ approval rating is barely 15%.
This is an entirely different issue, I know, but the people of this country need to start speaking up and using the Internet the way people used it just this week to stop SOPA and PIPA in their tracks. Two awful laws that were nearly a done deal are now tabled-for all intents and purposes permanently- because of the concentrated and concerted efforts of millions of Internet users. If we accomplished that we can stop these lawmakers from creating laws like this one in Washington, too.
We just need to care enough to make the effort.
Roberoo on January 23 at 7:47 a.m.
I want to thank the Spokesman Review for publishing this article as the subject matter needs to be on the table and people need to know about the difficulty in accessing pain management in Spokane. Today unless you have blue line insurance you will not find an Md in Spokane willing to take on a chronic intractable pain patient (CIPP) and even then, you will find it extremely difficult to find long-term treatment There is one clinic in Spokane which will accept a person in chronic pain, and they have a waiting list and require blue line insurance. For it’s size Spokane may be the most difficult city in the US to find treatment for chronic intractable pain, and if you are on Medicaid, Medicare, programs for the impoverished you are not going to find treatment.
While there are Md’s who are too free with their prescribing, there was no mention of web pharmacies, off shore pharmacies, pills pilfered from the manufacturer, storage, transit, pharmacy theft, and drugs outsourced by gangs and cartels. The lanes of illegal distribution have been in place for 45 years.
About 1999 Wa State went on a crusade to push methadone to those on programs funded with state money. It was cheap, available, and it worked for most patients. In 2003 a committee ( P and T Committee) was formed to study and create a list of “preferred drugs” for Wa., and they put two opioids on the preferred drug list; methadone and morphine sulphate.
Those two drugs are still the only opioids on this State’s “preferred drug list.” Methadone is there to save money as it can’t be for safety when over 2100 people have died of unintentional overdose since 2003. Methadone is involved in 64% of all drug deaths but accounts for less than 10 percent of the opioids prescribed. Most of these deaths are people on Medicaid, Labor & Industries, and programs for the impoverished. It wasn’t until Dec. 27 2011 that a “Health Advisory” by name: “Unintentional Overdose Deaths Associated with Methadone and Other Opioids” was issued by the P and T committee even though health professionals from Wa and Or presented hard data showing the death rate for people in state programs escalating every year. Perhaps if various opioids for various needs were added to the “preferred drug list” lives would be saved. Washington has lost Md’s who practiced in clinics accepting state funds, by the droves. Dr. Tauben said he’s optimistic doctors would treat more pain patients because they will have guidelines to follow. ESHB 2876 is the product of guidelines introduced in 2007, and has caused most doctors to stop prescribing opioids. Because the regulatory agencies have been vague, Md’s fearing the loss of their license have stopped prescribing, walked out of state funded clinics and programs, and left the state. In a poll taken in Sept 2011, 85% of all clinics reported they were not taking persons in chronic pain and since Sept another 10% have closed their doors to chronic pain patients. ESHB 2876 as ‘Guidelines’ caused a massive failure in Wa’s system for the treatment of pain patients. Saving dollars at the cost of lives is not what medicine is about, and restricting our good Md’s to the point that they stop treating very needy patients, even walking away from their practice, is not what laws are for. Wa. has 13 pain specialists certified to offer a second opinion for 1.5 million pain patients. If this system were a building, it would be in a heap on the ground. It’s time our legislators and the P & T committee shelve their ego’s and admit that they have created a Rosemary’s Baby, if their motives are really based in what is best for those in chronic pain it’s time they act the part.
It’s broken, fix it.
Dscarz01 on January 23 at 9:27 a.m.
WOW people - Ages 18-24 people.
Pot, Cannibus, killer bud; Our chilled out kidults ages 18-24 are too relaxed with their choices of who they hang out with, what they do to get high, and don’t realize the impact these choices will have on their lives. Irregardless of social status or how they were raised.
The region of brain that inhibits risky behavior does not fully form until age 25. This is the final stage of brain development.
Accessibility to oxys starts out being easy; bought off someone who got it from a medicine cabinet, stolen or prescribed. Next thing you know these kids are selling to use, getting jumped by someone for their pills and/or cash, and have knives & guns in their face.
Hello! It’s not about your Canibus rights or your right to pain medication - it’s about control over a VERY addictive drug which dose has to be increased as it’s use continues because the human brain builds up a tolerance, making the pharmacutical companies rich and patient/user a miserable addict who looses everything in order to continue using. Not the end result anyone wants.
Our society’s children are dying, long term chronic pain patients are still miserable.
You all know something has to be done and the foundation is a logical place to start. How about supporting something besides your own cause, how about some teamwork here folks!
nslopeofw on January 23 at 2:38 p.m.
My personal experience here in Spokane is that most if not all of the “pain management” clinics are about giving shots. If shots or surgery dont work for you, good luck. I suggest you go to Idaho or Oregon, as WA is on the top 5 list for bad states to have chronic pain in. I am lucky because of the extensive treatment i’ve had over the last 3+ years. It shows the pattern of trying to fix the problem rather than just medicate it. I continue to hope for breakthru’s in the future. Until then, I’ll do what i can to lead a quasi-normal life.
lewis8457 on January 23 at 8:25 p.m.
stitch i dont care what you think of me, i take 3- 5-500 hydros a day doc recommended. and yes i did take more of the oxy then prescribed i was in pain not that it matters. i hated them i cant see how anyone can get addicted to them. my doc put me on a steroid today to see if the inflammation will go down. i do not take pain killers to get high they are too damn hard to get. i use them for pain only, if i want to get high i smoke weed, when i can get it.
after taking oxy for 2 weeks i took zero today and only 1 and a half hydros.
give some weed anytime.
lewis8457 on January 23 at 8:28 p.m.
sorry stitch but you is wrong my hydro has 500 tylenol
Roberoo on January 23 at 11:01 p.m.
NSLOPEOFW wrote : “Until then, I’ll do what i can to lead a quasi-normal life.”
I think that is the desired aspiration of all chronic pain patients. I have worked in the field for 12 years and have never met a CIPP who wanted to take pain pills, they only do so to find some degree of pain abatement.
There is a distinct difference between an addict and a dependant. The addict’s life is controlled by the drug, they are taking an illegal drug to get high and their preoccupation and unrestrained use of the drug ruins their life. The dependant takes opioids under the supervision of an MD, the medication is taken as it is prescribed, and their lives are enhanced by the drugs ability to lessen their pain allowing them a “quasi-normal life.”
I have been a chronic intractable pain patient for 25 years and have taken the same amount of opioid for the last 12 years.
The medication allowed me to work until the degenerative condition progressed to a point I was forced to retire. When people in chronic pain have progressive degenerative diseases, as time goes on, so does their disease and their pain increases necessitating an increase of medication. For the vast majority of pain patients the meds don’t kill all the pain, they reduce it, but we function better with less pain. Opioids have been used by humans for 3000 years and possibly as much as 6000 years.For the vast majority of people in pain, opioids have been a God-send, if you think not, just ask a Vet who was wounded in a war. Until we invent an agent which doesn’t cause a dependence, and works as well or better than opioids, we will use them to help abate our pain. To deny those in pain the means to reduce it, is cruel and inhumane.
A recent study showed that those in chronic pain average life span is 10 years shorter than those not experiencing chronic pain. Pain puts stress on every system in our body, our blood pressure, our sleep,the libido, the CNS,our immunity systems ect. To rule out the means of controlling pain is to subject the person in pain to an increased potential for an early death, and a constant condition of a less than normal life. It always amazes me when those who are not in chronic intractable pain speak in mandates condemning the use of opioids for pain. They are never further than a slip-fall from begging their Md for the medication to help relieve their pain, or a blood test uncovering rheumatoid arthritis or God forbid cancer. You can’t really understand another person’s experience until you’ve walked a mile in their shoes.Too often those never having experienced chronic pain find it all too easy to moralize, condemn, and prohibit the medication.
lewis8457 on January 24 at 6:55 a.m.
i have met many in my life that thought i was faking it, in fact my last boss was a mean bastard that liked making me do duties i told him i could not do. finally i gave him a letter from my doctor explaining my conditions and limitations.
his reaction was to lay me off. i would not wish pain on anyone but bone heads like him need a good baseball bat across their back to wake up.
if we are all faking then why even make pain pills in the first place? duh?
anybody that thinks i would rather live in poverty then work a good 40 hour a week job like i did for 35 years is an idiot.
Pepper on January 24 at 2:32 p.m.
I have been on pain medication for approximately 12 years. Without it I probably would have taken my life. It allows me to actually get out of bed in the morning. My ex divorced me, however, due to multiple chronic diseases. (Shades of Newt)
Am I physicially dependent on it? Yes. Am I addicted? No. Have I ever sold or given my medication to others? Absolutely Not!
There is actually research that shows that a brain in pain processes opiods differently than a brain that is using drugs to get “high.” I wish I could give a link to these, but since they were done in the ‘80s and 90’s, I can’t remember who or where they’re located! Perhaps, some were published in the Journal of Pain, and/or The American Pain Foundation.
My point being, is that before the government makes arburitary laws which impact what physcians can or cannot prescribe, these lawmakers should immerce themselves in factual studies from around the world before they create draconian rules.
Also, one of the reasons that Oregon has more humane laws then Washington, is due to O.H.S.U.’s strong arthiritis/pain departments. The U.W.’s is crap. All they care about is what excerises might do!
greenlibertarian on January 27 at 2:57 a.m.
Again, my heart goes out to those suffering from chronic pain.