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I am suspicious that a relative is addicted to prescription pain killers. I know he has taken quite a few in the past. I've seen a few other things that make me think that could be the case.
One thing that seems very strange to me is he has frequent surgeries for a variety of ailments. In the past year or so, he has had his appendix out, two hip surgeries, and just this week, back surgery. This guy is only 35.
Is it possible that someone would make up reasons to have surgery to get more painkillers? Would doctors fall for this? Or are they trained to both recognize when someone is making symptoms up, and/or ensure that a surgery is really necessary before committing someone to it?
I find it hard to believe that any physician would do surgery on someone when it isn't necessary. First you need blood work. Then X rays. Then maybe a CAT scan, then make an intelligent decision as to whether this surgery will help or hinder the condition. What physician is willing to put a person thru surgery (or even suggest it for that matter) unless absolutely nothing else will work. In addition, insurance won't pay for needless surgery. Is the person a multi millionaire? And docs are well aware of pain meds that are addicting and often limit the amount you get after surgery. JMHO
Some people do doctor-shop to get multiple pain prescriptions. A "DOPL" can be run by his doctor which shows all his prescriptions. All you can do is suggest it to his primary doctor. You will never know the results but it might help him.
One thing that seems very strange to me is he has frequent surgeries for a variety of ailments. In the past year or so, he has had his appendix out, two hip surgeries, and just this week, back surgery.
i think you need to look at the reality of this.
they don't remove a healthy appendix. it had to have been
severely infected. and if it burst, it would have been a very
serious threat to his life.
two hip surgeries? sounds like replacement? and if so, the head
of the femur was bone-to-bone against the acetabulum (hip
socket). that is extraordinarily painful. like every single step
he took was like torture.
back surgery? that could have been a number of specific
problems. like, did he have a discectomy? laminectomy?
fusion? this is very serious stuff.
don't know what your loved one's money situation is, but these
procedures are not cheap.
if he was pill shopping through surgery,
that's pretty extreme, and would involve duping
significantly educated people who have
specific criteria to perform surgery.
that said, it doesnt mean that he's not over-using his meds
post surgery. he very well could be.
but, can you blame him? that's a lot of pain to endure.
The thing that is strange to me, is he can be literally fine one day, and in need of surgery the next. Two weeks ago he couldn't leave the house and couldn't walk. Then last week, he was working out in the gym. Then he suddenly needed back surgery and is back to convalescing at home with pain pills.
I actually haven't verified he has had all these surgeries -- just taken his word. Last night he said he couldn't leave his house because of his latest surgery. He said he was going to take some pain pills and stay in for the night.
A couple months ago I was over there and he seemed very agitated -- not just in pain -- until his wife brought him his pain pills. Then within seconds, all was fine. Another time he posted on Facebook something to the effect of "life is good with a diet Coke and a percocet"
Nowadays, doctors tend to perform surgery only as a last resort, since all surgery has risks. Generally, a doctor is unlikely to agree to surgery unless other less invasive means have failed, and the benefits of the surgery outweigh the risks (e.g a hip replacement will only be attempted after physical therapy / rehab have been unsuccessful.) There are indeed physicians out there who will perform "less necessary" surgeries, but I think this is becoming less common, as liability issues become more common.
Your loved one may indeed have a substance abuse or dependence problem, but this problem may be mutually exclusive (for the most part, anyway) from the problems which necessitated his surgeries.
I am suspicious that a relative is addicted to prescription pain killers. I know he has taken quite a few in the past. I've seen a few other things that make me think that could be the case.
One thing that seems very strange to me is he has frequent surgeries for a variety of ailments. In the past year or so, he has had his appendix out, two hip surgeries, and just this week, back surgery. This guy is only 35.
Is it possible that someone would make up reasons to have surgery to get more painkillers? Would doctors fall for this? Or are they trained to both recognize when someone is making symptoms up, and/or ensure that a surgery is really necessary before committing someone to it?
Why do you care so much?
As I tell "concerned family members", "Everyone loves Dilaudid. It doesn't make [patient] an addict. I'm sure you love your blood pressure medication. Or your antihistamines. The fact that the [patient] needs opioids is no different than the meds that you need."
Of course, I would only say this with patient's consent and I would strongly advice patient of other methods before a face-to-face confrontation in the doctor's office.
Drug abuse/diversion is the most talked about issue in medicine. Whenever a doctor goes to a continuing education conference, I am sure they attend at least one talk on this very subject.
The thing that is strange to me, is he can be literally fine one day, and in need of surgery the next. Two weeks ago he couldn't leave the house and couldn't walk. Then last week, he was working out in the gym. Then he suddenly needed back surgery and is back to convalescing at home with pain pills.
I actually haven't verified he has had all these surgeries -- just taken his word. Last night he said he couldn't leave his house because of his latest surgery. He said he was going to take some pain pills and stay in for the night.
A couple months ago I was over there and he seemed very agitated -- not just in pain -- until his wife brought him his pain pills. Then within seconds, all was fine. Another time he posted on Facebook something to the effect of "life is good with a diet Coke and a percocet"
Quote:
The thing that is strange to me, is he can be literally fine one day, and in need of surgery the next. Two weeks ago he couldn't leave the house and couldn't walk. Then last week, he was working out in the gym. Then he suddenly needed back surgery and is back to convalescing at home with pain pills.
I have no idea what is his condition is so I cannot really comment. All I can say is all illnesses have a progression. Example: Say you tear your ACL skiing. You'll be in great pain the day you tear your ACL and you'll have considerable swelling. You'll go home from the ED and they'll give you Norco or Percocet and tell you to elevate and ice your knee. Swelling will subsidy- but not disappear. Your baseline pain will diminish- but not disappear. In a week, you may be able to walk better- but you won't be running. When you see the ortho surgeon at his office 2-4 weeks later, you may feel much better than you did when you tore your ACL, but the ACL is still torn and needs to be taken care of. "Taken care of" could mean surgery. Get it?
I'll dissect each one of your judgmental points:
Quote:
"Last night he said he couldn't leave his house because of his latest surgery. He said he was going to take some pain pills and stay in for the night."
Back surgery takes time to recover from. Around the clock opioids are typically prescribed for 1-2 weeks following ortho back surgery and prn opioids (i.e. when you need them, in other words, when the around the clock opioids you take 2-3 times a day aren't working because your pain level has a spike) for a week or two longer than that.
Of course that doesn't mean he is an addict because he has been receiving opioids for x weeks.
Quote:
A couple months ago I was over there and he seemed very agitated -- not just in pain -- until his wife brought him his pain pills.
Pain affects your entire mental and emotional self. This is textbook.
Quote:
Then within seconds, all was fine.
Oral opioids (with the exception of buccal or sublingual tablets, e.g., Actiq, Fentora or another Fentanyl derivative that are RARELY prescribed in this case) do not work for at least 20-30 minutes. He could have felt better instantly because he is suffering but he knows that within a half hour, his pain will subside. There is no "rush" with po opioids.
Quote:
Another time he posted on Facebook something to the effect of "life is good with a diet Coke and a percocet"
Lots of people post lots of silly things on facebook. Usually people do this to illicit a reaction. Perhaps he wants sympathy. Being physically ill is demoralizing and one can feel alone a great portion of the time (go talk to a senior who has chronic hip pain and lives alone).
It would be more alarming--though not damning--had he said "liquor and Percocet".
I would highly recommend you support your family members in their illness rather than labeling them as a drug abuser. You are not their doctor, nor are you his SO. People recovering from major surgery need support, not passive-aggressive attitudes around them. If you must, tell his SO your concerns, in a non-condescending way (this will get back to the patient) and leave it at that.
Some people do doctor-shop to get multiple pain prescriptions. A "DOPL" can be run by his doctor which shows all his prescriptions. All you can do is suggest it to his primary doctor. You will never know the results but it might help him.
I have no idea the acronym of which you used, so I googled: DOPL is Utah-specific. Any doctor can run a DEA query for their patients to see what controlled substances they are prescribed. This is the preferred method (though some important data is left out).
I have no idea the acronym of which you used, so I googled: DOPL is Utah-specific. Any doctor can run a DEA query for their patients to see what controlled substances they are prescribed. This is the preferred method (though some important data is left out).
Good point. Most of the tracking for prescriptions is handled by individual states, and many sates do not yet have a tracking system in place.
As far as I know, the DEA does not track all controlled substances for all patients. They relay on states to do so instead. If I am mistaken, please provide a citation.
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