Comments on: Migraines and the stigma of chronic pain medication use http://www.kevinmd.com/blog/2009/09/migraines-stigma-chronic-pain-medication.html Wed, 15 Feb 2012 00:05:00 +0000 hourly 1 By: Jeremy Blakehttp://www.kevinmd.com/blog/2009/09/migraines-stigma-chronic-pain-medication.html#comment-115863 Jeremy Blake Wed, 28 Oct 2009 17:57:38 +0000 http://www.kevinmd.com/blog/?p=40316#comment-115863 Friend: I also suffer this disease and really painful, but based on appropriate medicines'm doing to get ahead, this medication oxycontin is good for pain but it causes anxiety and is dangerous if you can not control it, findrxonline visit a few months ago and in his article on oxycontin show that can be dangerous if not prescribed by a doctor and if one does not adequately control the sensations they produce, I really hope to have more news from you. Friend: I also suffer this disease and really painful, but based on appropriate medicines’m doing to get ahead, this medication oxycontin is good for pain but it causes anxiety and is dangerous if you can not control it, findrxonline visit a few months ago and in his article on oxycontin show that can be dangerous if not prescribed by a doctor and if one does not adequately control the sensations they produce, I really hope to have more news from you.

]]> By: ninguemhttp://www.kevinmd.com/blog/2009/09/migraines-stigma-chronic-pain-medication.html#comment-112987 ninguem Tue, 29 Sep 2009 16:18:32 +0000 http://www.kevinmd.com/blog/?p=40316#comment-112987 Also reports where death from OD on prescription opiates is up over fifteenfold in the last ten years. Also reports where death from OD on prescription opiates is up over fifteenfold in the last ten years.

]]> By: concerned, educated patienthttp://www.kevinmd.com/blog/2009/09/migraines-stigma-chronic-pain-medication.html#comment-112978 concerned, educated patient Tue, 29 Sep 2009 11:49:48 +0000 http://www.kevinmd.com/blog/?p=40316#comment-112978 50 Percocets daily is certainly excessive. On the other hand, anon 7:48, under treatment of pain is a significant problem, too. Your attitude is why so many patients with legitimate pain issues are frustrated and angry and may be moved toward two unhelpful extremes: giving up and ignoring the pain or getting inappropriately creative in drug-seeking.There was a research report not too long ago in which 6 weeks of under treated chronic pain was associated with structural changes in the pain reception areas of the brain and in the peripheral nerves as well.It's all about correctly diagnosing the patient's problem, crafting a balanced, comprehensive treatment, and proper follow-up (of course, you don't get paid to take a lot of time to do that!). 50 Percocets daily is certainly excessive. On the other hand, anon 7:48, under treatment of pain is a significant problem, too. Your attitude is why so many patients with legitimate pain issues are frustrated and angry and may be moved toward two unhelpful extremes: giving up and ignoring the pain or getting inappropriately creative in drug-seeking.

There was a research report not too long ago in which 6 weeks of under treated chronic pain was associated with structural changes in the pain reception areas of the brain and in the peripheral nerves as well.

It’s all about correctly diagnosing the patient’s problem, crafting a balanced, comprehensive treatment, and proper follow-up (of course, you don’t get paid to take a lot of time to do that!).

]]> By: Anonymoushttp://www.kevinmd.com/blog/2009/09/migraines-stigma-chronic-pain-medication.html#comment-112964 Anonymous Tue, 29 Sep 2009 03:34:27 +0000 http://www.kevinmd.com/blog/?p=40316#comment-112964 On the other hand, prescribing narcotic pain drugs is fairly common and routine for stuff like wisdom tooth extractions for which pain drugs should not normally be needed. Perhaps if such unnecessary drug prescriptions were not done, fewer people would become addicted, and the supply of "leftovers" that get sold to addicts will not be as large. On the other hand, prescribing narcotic pain drugs is fairly common and routine for stuff like wisdom tooth extractions for which pain drugs should not normally be needed. Perhaps if such unnecessary drug prescriptions were not done, fewer people would become addicted, and the supply of “leftovers” that get sold to addicts will not be as large.

]]> By: Erikhttp://www.kevinmd.com/blog/2009/09/migraines-stigma-chronic-pain-medication.html#comment-112960 Erik Tue, 29 Sep 2009 02:35:46 +0000 http://www.kevinmd.com/blog/?p=40316#comment-112960 It isn't the disease that causes the label - it is the behavior. If we see someone at 3 AM for their 14th episode of abdominal pain (14 negative CT scans, 3 normal MRAs, one normal angiogram and two non-diagnostic laparatomies in the last year...) who ran out of drugs after their pain clinic was raided by the DEA, then we will assume they want drugs, attention or both.Most ERs have no problem treating pain but we hesistant to feed addiction. We also see pain so frequently (and drug seekers even more frequently) that we're pretty good about noticing what it looks like vs someone who is lying for secondary gain. It isn’t the disease that causes the label – it is the behavior. If we see someone at 3 AM for their 14th episode of abdominal pain (14 negative CT scans, 3 normal MRAs, one normal angiogram and two non-diagnostic laparatomies in the last year…) who ran out of drugs after their pain clinic was raided by the DEA, then we will assume they want drugs, attention or both.

Most ERs have no problem treating pain but we hesistant to feed addiction. We also see pain so frequently (and drug seekers even more frequently) that we’re pretty good about noticing what it looks like vs someone who is lying for secondary gain.

]]> By: AnnRhttp://www.kevinmd.com/blog/2009/09/migraines-stigma-chronic-pain-medication.html#comment-112956 AnnR Tue, 29 Sep 2009 01:13:02 +0000 http://www.kevinmd.com/blog/?p=40316#comment-112956 I don't think you are alone in feeling uncomfortable over the story of a woman with "occasional migraines and other serious health problems who takes up to 50 Percocet pills a day." That doesn't sound normal to me!I watched a show about interventions more than 20 years ago. Some years later when a family member had a serious substance abuse problem I was reminded of the show and how there had been a way to get the woman help.It was instrumental in helping me to accept that my loved one had a problem that wasn't going to go away and to seek help for him.I don't know what the deal with chronic pain is because I haven't ever had it. What I do know is that getting the word out about intervention programs can be a lifeline to everyone involved.Although the show may have given people the wrong impression about people who suffer from chronic pain I think their overall message is worthwhile so I have to support their choice of topic. I don’t think you are alone in feeling uncomfortable over the story of a woman with “occasional migraines and other serious health problems who takes up to 50 Percocet pills a day.” That doesn’t sound normal to me!

I watched a show about interventions more than 20 years ago. Some years later when a family member had a serious substance abuse problem I was reminded of the show and how there had been a way to get the woman help.

It was instrumental in helping me to accept that my loved one had a problem that wasn’t going to go away and to seek help for him.

I don’t know what the deal with chronic pain is because I haven’t ever had it. What I do know is that getting the word out about intervention programs can be a lifeline to everyone involved.

Although the show may have given people the wrong impression about people who suffer from chronic pain I think their overall message is worthwhile so I have to support their choice of topic.

]]> By: ninguemhttp://www.kevinmd.com/blog/2009/09/migraines-stigma-chronic-pain-medication.html#comment-112954 ninguem Tue, 29 Sep 2009 00:55:29 +0000 http://www.kevinmd.com/blog/?p=40316#comment-112954 Fifty Percocets daily for migraine? The drug, or withdrawal from same, is probably causing the migraine.Heck, I'm surprised she still has a liver. Fifty Percocets daily for migraine? The drug, or withdrawal from same, is probably causing the migraine.

Heck, I’m surprised she still has a liver.

]]> By: anonhttp://www.kevinmd.com/blog/2009/09/migraines-stigma-chronic-pain-medication.html#comment-112953 anon Mon, 28 Sep 2009 23:48:25 +0000 http://www.kevinmd.com/blog/?p=40316#comment-112953 The vast majority of patients whom I see in the ER with complaints of a severe migraine and requests for pain medication are either malingers or drug-seekers with track records of shopping other ER's for pain medication. It's also quite common to see compliant patients suddenly slip into addition given a new stressor in their life, be it a new job, a new child, or another responsibility.No matter how much you may resent having the label of an addict as a patient with chronic migraines, I can tell you with utmost surety that you will have that label in every ER you go to in the country. The onus will always be on you to prove yourself as a known quantity and, indeed, an exception to the classic drug-seeking, malingering, chronic pain patient. The vast majority of patients whom I see in the ER with complaints of a severe migraine and requests for pain medication are either malingers or drug-seekers with track records of shopping other ER’s for pain medication. It’s also quite common to see compliant patients suddenly slip into addition given a new stressor in their life, be it a new job, a new child, or another responsibility.

No matter how much you may resent having the label of an addict as a patient with chronic migraines, I can tell you with utmost surety that you will have that label in every ER you go to in the country. The onus will always be on you to prove yourself as a known quantity and, indeed, an exception to the classic drug-seeking, malingering, chronic pain patient.

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