The opioid crisis

My mother and I both suffer from severe chronic pain. We are treated like criminals these days with surprise urine tests. I had my most recent “pain contract” sprung on me quite suddenly after weeks of my doctor’s office lying to me about a tramadol prescription refill. Tramadol was only recently reclassified. For a hundred years it was basically considered an Nsaid because it provides basically zero high. In Oregon we have considered using marijuana based products for pain relief but despite being legal in this state the standard pain contract we are forced to sign to get medication strictly prohibit any pot use, and they screen for it. They don’t seem to care if I were to self medicate with alcohol instead, unfortunately we are not drinkers. So while we have to scrape by with barely enough pain relief it’s difficult to understand these places where people are tripping over something as strong as fentanyl.

What’s a pain contract? What type of insurance do you have? That’s really interesting and frankly weird about Pot, did they explain why?

Pot seems like it’s strictly better than opiates, in the circumstances where either is strong enough to alleviate the pain. I’m curious what percentage that is.

It’s technically a Schedule 1 drug with no health benefits and 100% illegal.

Thanks, Obama (seriously for once).

True but that isn’t Oregon’s fault. Medical MJ has been legal there for a long time, and recreational for a few years.

Urgh, chronic pain is the worst. I can’t imagine never feeling OK again, when there is no normal.

If you’re looking for loophole, which I assume is the case here, then that’s irrelevant. You’ve got a perfectly good legal reason: it’s a recreational drug as bad as PCP and has no medical benefits (according to the feds, who decide these things).

It’s bullshit, but then again so was treating acne as a pre-existing condition to deny some poor fuck cancer treatments.

It’s a contract they make you sign if you are going to be on any opioid long term. Basically if you want the script you have to agree to the terms which include drug testing to make sure you aren’t using anything other that what you were prescribed. I’m on Moda and my mother is with Kaiser. They don’t explain why. They don’t negotiate.

Fun fact, PCP is actually schedule 2, and viewed as less bad than marijuana by the federal government.

Maybe because it’s useful as an anesthetic for chimpanzees? I’m no drug-legalization fanatic, but I’m sure marijuana at least has some strange role in medicine like that that would justify making it schedule 2.

I didn’t know that was done. In some ways that’s a good thing. Although, I’m sure it is a hassle.

The pain becomes the normal. I have knee pain and lower back pain. Sometimes it’s bad, sometimes less bad. But it’s never gone. You don’t really ever get used to it. But it’s there, it’s my life now.

WaPo & 60 Minutes report:

A handful of members of Congress, allied with the nation’s major drug distributors, prevailed upon the DEA and the Justice Department to agree to a more industry-friendly law, undermining efforts to stanch the flow of pain pills, according to an investigation by The Washington Post and “60 Minutes.” The DEA had opposed the effort for years.

The law was the crowning achievement of a multifaceted campaign by the drug industry to weaken aggressive DEA enforcement efforts against drug distribution companies that were supplying corrupt doctors and pharmacists who peddled narcotics to the black market. The industry worked behind the scenes with lobbyists and key members of Congress, pouring more than a million dollars into their election campaigns.

Having “enjoyed” chronic, constant back, neck, and shoulder pain for most of the last 17 years, it’s a little difficult to convey. Concerned friends/colleagues often ask “Does it hurt today?” and while I appreciate the thoughtfulness that shows, it’s a little difficult to answer, because “I’m really only at a 3-4 today, so the 3 Aleve, 6 Advil, and 2-3 Excedrin I’ll take today should keep me totally* functional, as compared to the days when all that shit only takes me down to a 5-6 and I lose track of what I’m doing because the pain is so constant, so I guess I’m pretty grateful/okay!” is more of an answer than they’re looking for or will understand well.

* I mean sure, I’m still going to avoid picking things up off the floor, tying my shoes from standing, reaching high above my head, turning suddenly, or lifting anything north of 20lbs if at all possible to avoid making things worse than they have to be, but yeah, “functional!”

I forget if I posted this here before or not.

If you have chronic pain, and are looking for non drug solutions, check this out:

There is a mountain of actual scientific data spring the effectiveness of tens units for treatment of chronic pain. It’s not some weird witch doctor bullshit.

It’s cheap, and it will likely work for you.

Great reporting by WaPo and 60 Minutes.

I was thinking watching the 60 Minutes the incompetent Trump ain’t going to do anything to help.

Then the dropped the bombshell the Rep. Marino, the asshole who push the legislation to make it virtually impossible for the DEA to stop the drug industry from pushing legal opioids is Trump’s new drug Czar.

They maybe the most fucked thing I’ve seen Trump do.

I’d put Pruitt above that, but certainly this rates in the top tiers

They’re not particularly effective. Been around for a long time.

If you’ve got a bit of a dicky back or old man’s calf you will love it.

If you do have a genuine interest the biggest advances have been in neurostimulation. There is one by Nevro that uses high frequency stimulation that helps for lumbar pain.

But it’s invasive surgery and there is associated morbidity.

Into the future you will see some more meaningful advances in that field as some advances are made in the neurophysiology and much further off serviceable bio-nanotechnology.

You’d be surprised how slow this stuff moves. Neurostimulation has been around since the 70’s. It’s taken 50 years to up the frequency, including 10 years to engineer it and bring it to market.

I’ve got no idea how long TENS has been around for. Probably not long after Luigi Galvani LOL

There is a huge amount of scientific evidence arguing that they are in fact effective.
Here is one summary of research from the NIH

Both HF and LF TENS been shown to provide analgesia specifically when applied at a strong, non-painful intensity and HF TENS may be more effective for people taking opioids. Effective analgesia for chronic pain conditions may be limited by the development of tolerance to TENS if repeated application of either HF or LF TENS at the same frequency, intensity and pulse duration is used daily. Application of TENS electrodes at acupoint sites may increases analgesia and targeting the use of TENS during movement or required activity may provide the most benefit.

And yeah, TENS units have been around for a long time, although their cost used to be extremely high, on the order of thousands of dollars.