Some docs ask for 'pain contracts' to ensure that patients are taking powerful opiads safely
Chronic pain — the kind that lasts for months or recurs regularly — afflicts more than a quarter of adult Americans. Treating pain can be extremely challenging, however, in part because it can't be measured with instruments. It's in the eye — or neck or joint — of the beholder.
Doctors often prescribe powerful painkillers called opioids, which are natural or synthetic versions of opium. Sometimes the prescription is for short-term, acute pain: If you've ever had a root canal or surgery or thrown out your back, you may have received a prescription for Percocet or Vicodin, both of which are opioids that also contain acetaminophen.
For people with long-term, persistent pain, often from musculoskeletal injuries or nerve damage, opioids may be the best option to manage their pain and enable them to function day after day.
But there's a hitch: Though highly effective, these drugs are dangerous and addictive. The chief danger is that they can cause respiratory depression: If too much is taken, breathing slows and may eventually stop. And because they cause euphoria, opioids are popular targets for misuse and abuse. In 2007, 11,499 people in the United States died from opioid overdoses, according to the Centers for Disease Control and Prevention
. That was more than the number of overdose deaths for heroin and cocaine combined.
To help monitor use of the drugs, some doctors ask patients to sign "pain contracts" or "opioid treatment agreements" that spell out the rules patients must follow to take these drugs safely. The contracts aim to discourage people from taking too much medication, mixing medications, or sharing or selling them, among other things.
19 comments:
I have had chronic pain for the past 14 years and have been on every pain medication that you can imagine. After several painful surgeries and months and months of physical therapy I was still in pain. I have been to every pain management Dr. in Salisbury and have nothing good to say about any of them. I have had un necessary injections, been over medicated and treated badly in general. I decided to come off of the heavy pain meds because I felt like a zombie and was still in pain. Not ONE pain management Dr. in Salisbury would help me come off of the medications that THEY prescribed for me. I ended up in the ER with horrid withdraws after days of suffering. Thankfully the Dr. I saw there prescribed something to take the edge off the symptoms while the medication worked itself out of my system. I am on my way to Annapolis to seek help with pain management tomorrow because the doctors in Salisbury SUCK! If at all possible stay OFF the heavy duty pain meds and before you sign that contract, read between the lines!!!
If at all possible, people need to stay off ALL meds!
These doctors anymore want to give you a pill for everything!
I've never been one to take medicine of any kind unless I absolutely had to. Maybe that's why I'm only in the doctors office once a year, usually it's a sinus infection.
Wake up folks, you take all these meds and it breaks down your body's immunity system so then you need another doctors visit and another med.
That's what these doctors are counting on!
Those darn doctors, why can't they immediately cure your degenerative, arthritic and bulging disks or spine instantly? Why can't they undo that car accident or fall you took that ruptured or fractured your vertebrae? I imagine a doctor in Annapolis will be able to cure you instantly!!
Of course they won't you idiot... But at least they're more reputable than the ones in this town. I take it you've never been in pain. Lucky you...
1:28 exactly what do you expect the doctor to do? There are only so many treatment modalities available--and you seem to have tried most of them. Your post sounds like someone who did not get the prescriptions they were looking for --"read between the lines" of a pain contract??? The contract just says you will not obtain narcotics simultaneously from more than one doctor to prevent abuse, overdose or fraud. So you object to only having one doctor prescribe potent narcotics to be safe then--you want the option to get many prescriptions from different doctors? Well newsflash pal, reputable pharmicists keep track as well and will question multiple narcotic prescriptions from multiple providers. Or are you planning on shopping in Annapolis for pharmicists too?
The only shopping I plan on doing is at Trader Joes. Can I pick something up for you pal??? Maybe something to help with that pent up anger you seem to have against people who seek pain management??? Maybe you're one of them but since you're anonymous I would have no way of knowing... When I started being treated by pain management doctors there were no contracts. Things have changed a lot since then which is why I said to read between the lines. guess I should have said read ALL the lines. My bad.
You are still avoiding answering what you expect from the physician. There is no anger at persons who need pain management intervention, just those that are drug seekers.Do you work or are you on disability?
11:03 I have been where you are and refuse to live on narcotics I have a spinalcord stimulator implant and it was the best thing i had done, Good Luck I feel your pain
Not that it's any of your business what I expect from my physician...but it would be nice to not live in pain daily. Maybe an alternative to narcotics??? I do not work outside of the home at this time as I am still recovering from a past surgery. Hope that answers all of your questions.
And NO I am not on disability not that that is any of your business either...
1:51 wow, you are heartless!
Not siding with anyone's previous comments, but wanting to add my 2 cents.....There are Ok doctors, good doctors and great doctors. The same is true for lawyers, professors, and accountants. I am speaking of people that hold professional degrees. The best and the brightest for the most part don't pick an area such as Salisbury to practice. The benefit of living on the ES is that we can have a better quality of life versus living in a metropolitan area and still be within a couple hours drive of the cream of the crop professionals. If you have a vision problem, Willis Eye Hospital is in Phila as is CHOP (children’s hospital of PA), Johns Hopkins in Balto., Walter Reed in DC as well as some of the country's best attorneys and accountants. I am not saying that the professional is Salisbury are not capable or competent, but if I need to hire someone to treat or represent me, I invest time and energy in researching who is the best person in the field to hire. If you don't, then you only have yourself to blame.
Trust me 5:54 I learned the hard way. We were new to the area and being treated in Salisbury was the ONLY option that I had so I took it. I had small children with no one to watch them while I drove all over the state of MD to be treated... If it weren't for my husband landing an amazing job here we wouldn't be here...
Astonesthrow, I completely sympathetize with you. Having chronic pain for the past 5 years and trying to get treated in this area has been a real challenge. Of course what I hate is automatically being associated with those who have "drug seeking behavior". I do everything in the world not to have to take the narcotics, ice, heat, ibuprofen, aleve, tylenol, etc. You name it, I've tried everything over the counter that you can get. Don't pay attention to anyone who is super critical of you. They have never been in that position and truly do not understand how awful it can be for those of us just trying to get up some days. I too have seen the pain management people here locally. I received a nerve block in my back and they partially collapsed my lung. After that I said forget this and start going to John Hopkins Hospital. I have seen the pain management physicians in Baltimore at John Hopkins. I did like the care better there. Unfortunately I was laid off from my job and couldn't afford the cobra payments. So I am managed here locally by my primary care physician. I do work now and finally have insurance back. After six months I will be able to go back to JHH and get a nerve block. As for anyone who says such hateful crap to you as that, you owe them NO explanation whatsoever. Even in the 5 years that I have been dealing with my issues, I have noticed a significant change. I think things got harder for those of us who do have chronic pain since the highly publized deaths, particularly after Michael Jackson's death. I have a pain management contract and I do follow it. I'm not one of these ones who go to 50 different doctors and gets scripts from all of them. Don't let the ignorance of stupid people make you feel bad about what you are going through. You know how you feel. Some days are better than others. Hang in there and good luck with your care. Wish you the best.
8:55 Thank you so much! :)
Are the posters here angry at the doctor for requiring them to sign this contract? Unfortunately a few bad apples (looking for drugs to sell) have made this contract a necessity.
I think there needs to be something like this. A friend of mine found herself in a bad situation with her daughter.
Because she didn't tell the secondary doctor about a medicine the main doctor had her on (the parent's fault), the two medicines worked against each other and ended up poisoning her and putting her in the hospital due to the reaction.
If you go to more than one doctor, each doctor should know what you're already taking! That's for YOUR protection.
Do we need a "contract" to do this? I thought that's part of what HEPA was for?
The contract is COMPLETELY Necessary! As well as using only ONE pharmacy. And for the jack ass who was giving me the Spanish Inquisition yesterday... I DID find a doctor in Annapolis today who "magically fixed me" he found something that my Orthopedic HERE missed. One shot of cortisone and I feel 80% better. I'll take that over pills any day thank you very much...
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