Why Doctors Treat Patients as Drug Addicts


Fact: Doctors want to help people.

Fact: Some people take advantage of doctors.

A doctor in Oregon shares this case: I had an old man with cancer. He kept complaining of pain as I was increasing his opiate pain medication, OxyContin. I was at, I forget, about 40 mg four times a day or some fairly substantial dose. I ran a urine drug test. Negative for oxycodone, which was what I was giving him. Turns out his caregiver, who was the old man’s son, by the way, was stealing every single narcotic pill I was prescribing and selling it. OxyContin is a dollar a mg on the street. So, the scumbag son, stealing his cancer-ridden father’s pain medicines, was clearing $40 a pill, 4 times daily, 365 days a year . . . 40 x 4 x 365 = $58,400. . . Potential of nearly 60 grand a year doing this to his father. And yes, I called the police and adult protective services.”

Fact: Oregon is #1 in the nation for non-medical abuse of prescription painkillers.

Oregon is a progressive state. We’ve been on the forefront of compassionate use of pain medication. We were the first state to decriminalize marijuana and among the first to allow its use for medical purposes. Oregon was the first to legalize physician-assisted suicide and to require a prescription for pseudoephedrine to decrease meth production.

“But why are we #1 for abuse of painkillers?” I asked at a mandatory course I attended on the safe use of opioid pain medication. I learned that being so compassionate with prescription painkillers can backfire. Sometimes a doctor’s compassion is met by indifference, manipulation, and lies. After these experiences, even the most caring doctors start to distrust patients.

Leila, a patient, shares: “I was brought into the ER by ambulance after a car accident. I had been left on the backboard for five hours, and I [previously] had major back surgery. I was in so much back pain that I was crying. I was only treated for whiplash. The next day, as I was screaming in pain, my husband took me back to the ER, where I was treated as a drug addict and told I couldn’t get anything for my pain.” 

Fact: Some patients need pain medication. 

Fact: The U.S. is 4.6% of the world’s population, yet we consume 80% of opioid painkillers. And we’re still in pain. Lots of Leilas receive inadequate pain therapy. While lots of scam artists make a living off prescription painkillers.

Anyone have a quick and easy solution? 

Pamela Wible, M.D., is a family physician in Eugene, Oregon. She believes patients and physicians need to get real with each other. Watch her TEDx Talk “How to Get Naked with Your Doctor.” 

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180 comments on “Why Doctors Treat Patients as Drug Addicts
  1. Doc says:

    Doc’s often create addicts because of the reflex prescribing of narcotic pain medications before other methods are tried. The interesting point is that narcotic pain meds are not so good for chronic pain, better used in an acute setting, and yet so many people are using them for long-term pain management. Side effects can lead to severe GI problems over the long-term. Alternatives include 1) finding the source of the pain first. is it neuropathic? Is it ischemic? is it musculoskeletal? Does it have a psychiatric component? What aggravates it? What are the stressors? Does it have an inflammatory component? Auto-immune? 2) looking at the modalities best suited to both acute and long term types–there may be different and even overlapping treatment choices. 3) there are so many other modalities to consider, from rest, ice, elevation, to massage, manipulation, physical therapy, ultrasound therapy, accupuncture, NSAID’s, aspirin, antidepressants, steroids, TENS, biofeedback, surgery, heating pad, hot bath, antacids, vacation, martial arts, swimming, friendship, capsaicin, Ben Gay, vaporub, cough drop, hot tea, laughter, art, reading, detox, self-esteem, hope, a good night’s sleep, weight loss, weight gain, addressing OSA, GERD, hormones, drinking water, dietary changes, anti- inflammatory diet, gluten free, anti-histamine, gabapentin, mucinex, chloraseptic, lidocaine patch, NSAID patch, toradol, a new mattress, a new pillow, somebody to talk to, less TV time, more exercise, better nutrition, quiet time, serving others, gardening, writing, dreaming, painting, music, plavix, bypass, laminectomy, naps, hugs, human touch, sex, good food, abstinence, meditation, group therapy, individual therapy, financial security, a good job, recognition of activity limitations by age and health, strengthening to change limitations, acceptance of imperfection, expectation adjustment, a nap….. Why are we so quick to dole out opiates?

    • Sandy says:

      I love the response by Doc. She/he obviously is treating the whole patient and allowing time with the him/her to determine the best course of treatment. Unfortunately, many offices do not allow the resources/time/patience for this type of comprehensive treatment to occur. My daughter would like to become a physician – I surely hope she sees every person as a whole and reacts the way Doc did, above. Thank you.

      • stuPiDlaimperSon says:

        Sure isn’t right to cut persons medical perscripton do to federal government law now taking over health care . Here is an idea lets all NOT DO ANYTHING because it won’t be you next no joyfulness not you . I’m sorry but this will Not be you they start at the grandma and gramps unless Ofcource they pay okay . You and your children ️Hahahaha

    • Adrienne says:

      I totally disagree with the statement that narcotic pain meds aren’t beneficial for chronic pain. The findings in recent studies, over a ten year period, has concluded that OTC NSAIDS are more dangerous with long term use than narcotic pain meds that integrate NSAIDs. Liver damage, gastrointestinal damage, & renal damage has been proven in long term use of NSAIDs. There are also studies that have shown over & over the addiction rate with narcotic pain meds is around 3-8%. Doctors NEED to understand that addiction is a disease that not everyone has & more education on the facts of addicts vs non addicts is a must.

      Second, there are more people than not, including myself, that are “sensitive” to serotonin inhibitors & re-uptakes in which we expedience the violent mood swings & severe physical side effects, ie Gabapentin caused me to go from extreme anger to crying fits inside 15 mins of each other, Cymbalta caused me to drop 20 lbs in 3 months. I’m also sensitive to hydrocodone & oxycodone more than 7 mg inside 2 hours I start vomiting. ESI & Facet Injections don’t always work & they’re not FDA approved. In fact, the steroids used a specifically state not intended for ESI… lol at your Kenalog.

      I live in pain daily. I haven’t been able to walk more than a few blocks since I was 28… so what do you suggest for my back issues?

      Finally, people buy script narcotics due to the simple facts that either 1) they have chronic pain & docs are afraid of the DEA or have attitudes that pain meds are for short term use or 2) they are unfortunately in the midst of a disease. With that being said…. If one wants narcotics one can get them with or without a doctor, remember heroin is a huge epidemic.

      No disrespect intended, I’m just sick of getting that answer of “well just live with it”. I refuse to!

      • Pamela Wible MD says:

        Guidelines are just guidelines. Always best to treat the individual patient like an individual. That requires time. Doctors need time to care.

        • melanie gutierrez says:

          I agree with u but I pray to find a doctor that cares enough to run all the tests n get to know everything possible to properly help me get my life back as I have a life filled with pain I wake up in pain n my day ends even worst Ive suffered for years n now have much more conditons in my older years I have migraines arthritis both types n chronic neck n spine n hip pain from two prior serious car crashes along with other conditions I may have fybromyalga IL find out soon but I hurt so bad that I vomit violently when my head hurts from my neck n the back of my head n I cry everyday I barely tap a bone n I fall to the ground crying in pain n I pray for God to send me a doctor who can help me whatever way that gives me a pain free life or atleast a livable life cuz I tired of suffering cuz of the “dopeheads” who just want a high n the money grubbing dealers loosers who feed that need!!..sorry to say that in such a way but its the truth!!…God bless!!!

      • patty says:

        well said

      • timothy says:

        In ref. to Adrienne’s reply….I could not agree with you more. I have had rsd, since march of 2000 and have tried everything from physical therapy to non-opiate medications. The first two years I was misdiagnosed and in so much pain I would not sleep for two to three days at a time and when I went to the emergency room I was treated like a drug-seeking idiot. The doctor I have been with for the last 10 yrs treats me like a patient, not a drug seeker. We have tried every non-opiate therapy known to the medical profession,,,with no luck! I was put on a long lasting opiate and then hydrocodone for the break-thru pain and I was able to work, go to the grocery store
        with my wife and watch my kids have fun. I am not saying that addiction is not a serious issue, what I am saying is …There are chronic pain patients out there that need long-term opiate therapy. They gave me back some of my life that pain had taken away.
        thank-you & good luck.

      • melanie gutierrez says:

        I definitely agree with the fact that sometimes there is no choice but to obtain the pain relief thrue “less than ideal resources” due to doctors reluctance to prescribe adaquate pain medicine n completely disrequard cronic conditions that they have medically proven thats pain is so severe that its debilitating .I suffer this everyday of my life.I cry from the pain n pray out to God to please stop my pain I have arthritis n migraines n severe cronic neck spinal n hip pain from two prior serious car crashes I wake up in pain n end the day even worst.I have gotten headaches so severe that I vomit violently n not just migraines but headaches from the pain in the back of my head n neck n I cant get help anywhere since I moved to the city I used to be treated with hydrocodone years ago in my hometown by my doc who knew me all my life but when I moved its been hard to find a doc who really cares to really study my case so he can truelly help me n my only desire is to have my life back n this pain has taken my life so I know what pain does to a persons life n me n many others suffer because of loosers who misuse the medication that is intended for true pain when the pain is worst than the risk of medicating because anything u consume will forever effect ur body these medications r toxins so they should b avoided if at all possible but for us that have a real true need due to conditions that r so severe they disrupt our lives or in my case makes life so painful that I cant see reason to go on n if I wasnt a cristian whos more fearful of facing the Lord for taking my life then I would have long ago cuz this painfilled life is so horrible Im trusting the Lord that one day he will help me n send me a doc who can see the truth with the smarts God blessed him with n so he can help me n yes I do pray for healing n I do know God can heal me but for some reason I do have these conditions n that is a medical fact n because of “dopeheads” who wanna just get a high I suffer along with many others…N UNTIL A PERSON HAS LIVED A LIFE FILLED WITH DAY N NITE PAIN THEY WILL NEVER GET IT!!!!!….PS Im sorry to judge but those r the facts n its not rite for innoscent to pay for others who do wrong!!!

        • sunnydays says:

          I feel so badly for you because I AM in a similar situation.
          I have multiple poorly managed health issues that ballooned up as I was put on state run ‘charity care’ and used as a test rat. They gave me so many pills (that I wisely did not take), that after 2 years, I just gave up after seeing a doc/resident with no results, and with them refusing to explain my diagnostic test to me in an honest fashion. I’d been violently screamed at for trying to contact my appointed “PCP” to get heart medication filled, and had my purse taken by an ER doctor who wanted to look through it for drugs. Illegal drugs? NO! They wanted to know what medications I WAS taking because they wondered why their little test rat wasn’t dead yet. I learned WHY they where demanding and threatening and false charting calling me an addict when no illegal meds or alcohol/tobacco, could be found in my system each time I had to make each miserable ER visit. ER visits that were caused by apathy & contempt, because I was ill, which cost me my job and apparently my respect as a human being as well. A disinterested resident a-hole (who marked me up as having a psychiatric illness because I was in pain and he could not figure out why, nor did he care), told me why my medical records and diagnostic charts were falsified and denial of polite attitudes that civil human beings use, and lies directly to my face by healthcare ‘professionals’ were ALL happening because I was not supposed to still be alive. I cost the system too much to bother to help. They knew what was wrong. They knew everything and now my ROLE was to be, ‘what it looks like when a patient is about to die from XYZ’, to all the clever little nightmare resident doctors in training who actually felt proud of their mistreatment and dehumanization of all the lowly losers that couldn’t get into medical school. I wonder how many of them could have become particle physicists? NONE. That is why these nicely pampered mostly upper middle class jerk-offs decided they would be doctors and learn how to have a sense of entitlement that doctors in China are being murdered for. After that ER incident that occurred after my “PCP”, neglected to even contact me as my heart medication ran out and the ER was the last resort. I decided if I was to die I’d rather do it in my own room at home while I still had a home. With help of relatives I got a little help. I’m not dead yet but all the doctors are trying with lies and false charting. I know something is likely very wrong as I am very ill, but no doctor or RN or anyone in the lie factory of being blacklisted for needing medical care and being in pain every day, is going to do anything but let me die of renal/heart/liver/pick an organ – failure.
          I’ve started to laugh though when ever I start to cry because, in death I’ll never be lied to ever again, or deprived of adequate pain medication, or find myself praying to help me or let me die fast and with as little pain as possible, or be blamed for everything that I never had any control over; because, scapegoating and bullying a patient is far easier for a doctor (who is more of a sociopath), to deal with the police DEA who are lazy bullies, yet are more antisocial/psychopaths, (or dogmatic clods) which trumps any doctor’s BS about being intelligent. Not intelligent enough to learn to stop the cycle of high school drama and learn to be a reasonable adult. I have to side with something a person pointed out to me in the Bible. It was not directed at me thankfully, but still it was worth noting; for people who like to play god with other peoples lives, instead of striving for symbiosis. He showed me a verse that remarked about all the things God hated and the one thing mentioned twice was god’s hate for liars. At this point I can clearly see why the biblical account of God hated lies and liars. The damage they do reaches too far to be worth any benefit. It’s two steps back one step forward.

          • Jake Awake says:

            I feel I should say this. You have just made more judgments about so many people than anyone I have read about on the web. It seems you have had some bad treatment but I suggest it is your ‘manner’ that is creating so many problems for you. Negative karma just produces more negative Karma. Leave this hospital and start again.
            Change your attitude and how you view other humans.

          • Carrie101012 says:

            I’m sorry this happened to you. I can tell by the sentence structure that it is difficult for you to get your point across and have had troubles for a while. I don’t know if you will return to this page, but, I did notice that after all the pain and physiological and psychological torture you seem to have endured it was very unkind and HYPOCRITICAL of Jake Asleep :o) to try to lecture and hassle you about Karma when he doesn’t have any apparent knowledge on the subject. I hope you can see past your pain and know that not everyone in healthcare has sold out and even though right now is difficult Being in pain doesn’t mean that your experiences are not valid. Just keep good faith. Also, for all of the pain sufferers please know that your pain is not your fault nor do you deserve it. I say this having a year ago lost my mother to lung cancer and as an LPN I had to cut back the hours I worked to ensure she was cared for. She never smoked or drank and to watch her over many months go through a great deal of fear and pain where she was always a strong woman made me angry and sad. She near the end became very depressed which made her irratable and bitter- SIDE NOTE: CHRONICALLY AND TERMINALLY ILL PEOPLE ARE DEALING WITH SO MUCH THAT TO EXPECT THEM TO BE NICE AND CATER TO YOU WHEN THEY CAN BARELY HOLD THEMSELVES UP IS … well lets just say… bad Karma. My mom snapped at me as I tried to care for her and later, in tears, she apologized and wanted me to know she loved me. I lost her in May of 2014 and, YES, getting her pain meds filled was a mission EVERY TIME. The health care profession IS failing pain patients, and I’m sure Sunny knows not all of us are willing to just tuck tail and let them suffer or else she/he would never have bothered to post on a DOCTOR’s website. I found this site looking for hope that the doctors who DO have a lot of power in America have some heart and courage and kindness. I apologize for “Jake Not-so-Awake’s” rude and un-empathetic remark. I also wish the pain sufferers all the best. Remember, you are important and for every bad egg their is someone else trying to right that wrong. Peace to each of you.

      • jean2lr says:

        I totally agree. I am sick of ppl with no REAL pain having meds thrown at them while ppl with true pain are forced to suffer. I had most of 2 vertebra removed. It never would have happened if the dr. had no assumed I was a liar and wanted drugs. Now I have pain the is excusiating. I am expected to deal with it on 2 10mg methadone a day. This does not hold me but it is better than nothing which is what I’ll have if I push the dr. Drug addict are good liars. Since I am not lying the drs assume I am because I don’t talk to them like addict do. I am in pain. I feel the dr. should ask me question but thats as far as it goes. If I don’t take the conversation and keep telling him I am in pain he leave the room and the visit is over. What is wrong with Dr. There has got to be an answer to this problem.

        • Jake Awake says:

          You say the Dr assumed you were a liar. Did you ask him if that is what he thought? We can’t know what people think, we need to ask them to really know. You also say you don’t talk to Dr’s like drug addicts do. How do you know how drug addicts talk to Dr’s? Have you asked any drug addicts how they talk to Dr’s? Part of the problem is with you. Change how you view the world and be clear about what you want and things will change. Ask for what you want and get Dr’s to tell you what it is they think. Never assume.

          • Dea says:

            Jake Awake, just shut up and go to bed. Oh, you can’t sleep without your pills? Hmm… do you need a better attitude? 😉

      • Betty says:

        A good friend of mine help lost her son to suicide because of his chronic, unrelenting pain from of serious spinal injury. He had several surgeries, each one less successful than the last, until he could no longer bear the pain. He was barely 40. Nothing helped him. I’m sure she would have gotten heroine, or marijuana, or anything if it would have helped him. I would have. I lost a cousin several years ago who chose a shotgun over daily back pain. I have a bad hip that bothers me, but I know it’s nothing compared to what some people deal with. Chronic pain is demoralizing, depressing, and saps the will to live right out of you. It’s unfortunate that some people abuse drugs. People have always abused drugs and always will. Instead of punishing those who legitimately need them, maybe we should come up with a better system to treat those who abuse them. Let’s concentrate on helping everyone who’s ill, and stop making everyone a criminal. Maybe we’ll all be able to treat our pain, one way or another.

        • Pamela Wible MD says:

          Bravo Betty! Wise words.

        • Kris says:

          There was a well known doctor ( who has since died) who was an oncologist. He treated their pain appropriately. He met a lady at social event who said to him, “I wish I had cancer then maybe I could get adequate pain relief.” He eventually started treating patients with what she had, interstitial cystitis or whst they also call painful bladder syndrome. I have that plus a bunch of other medical problems. He described the difference between an addict & a normal patient with chronic pain. An addict uses drugs to “zone out” & and escape their problems. A person in chronic pain who takes pain killers wants to improve their quality of life & be able to enjoy some semblance of a life. I’ve bern in chronic pain for 10 years. Thanks to a wonderful doc, my pain is controlled enough that I’m not curled up in fetal position crying. But if my doc quits or retires, I’m screwed. My life will not be worth living & I will give up. I went thru 2 years physical therapy & psycotherapy. I have allkinds of splints & medical gadgets. Pain cream, etc. I also developed severe fibromyalgia. I’ve tried 13 different anti-depressants & I react adversely to all of them. I have been on same dose of meds for 2 yrs. I am very careful. I can’t take generics so we haveno extra money for anything. No more trips,eating out, etc. Do MDs realky think this is how I choose to live? 25% of people who have chronic pain started with acute pain that was inadequately treated. Patients with fibromyalgia have twice the amount ofsubstance “P” that carries pain signals up to the brain. I still have chronic pain but at least I’m not curled up in fetal position crying except for very bad days. I’m sick of others telling me what works. I’ve been thru accupuncture, chiropractors,TENS unit & many other things. Thru trial & error I know what helps & doesn’t. I know there are chronic pain patients that are so over medicated, their words are slurred & they can barely stay awake & yet they ask for more drugs. I’m not like that. Look at the individual & listen to them! Then treat accordingly.

          • Nicholas says:

            Have you tried a sacral nerve stimulator or intrathecal pump? What about heparin instillations? What are you doing to treat more than the pain? IC sucks. My wife has dealt with it since her first pregnancy 15 years ago. She was on disability for many of that. You need to be proactive with the doctors. Start with a urologist that does the interstim by medtronic. Even if they decide you don’t need it, chances are that they can offer you the most choices. You also need to watch your diet. Acidic foods and beverages, and alcohol are hard on your bladder when your lining is inflamed or absent. You also should find a pain doctor. My wife’s OB sent her to one during her second pregnancy (we were told she couldn’t get pregnant). She used to be on 4 different narcotics every day, now she just takes norco (percocet was changed because of the drug seekers) when needed. Last resort, they can sever the nerve to your bladder so you don’t feel pain or even remove it. Those are extreme options my wife wouldn’t even consider. With her interstim and intrathecal medication pump, she came off disability and has worked the last 5 years.
            Good luck

        • sunnydays says:

          They already KNOW they are murdering us. They do not care, and they pretend a mistake was made when any complaint arises. False sympathy and then they keep doing evil to others deliberately for their own benefit.
          For the abusers in the DEA and in ‘healthcare’ The same measure of control and lets say, self defense, is needed. The higher the chain of command you hit the less godlike they are. Talking will get you nothing but false sympathy and a knife in your back as soon as you turn it.
          Alternatively, learning to block, lure and break them, is just as effective, if not more so. If you can begin to hit them where it hurts, using the only thing that they fear, SOCIAL DISAPPROVAL ON A MASSIVE SCALE THAT IS A SERIOUS THREAT TO THEIR INDIVIDUAL POWER. Begin creating restated laws releasing control back to the general public in terms of drug purchase, production, education and use, social stigma on a massive scale to abusive docs and Gov. agencies, while making clear demands of what you need done with an intransigent attitude towards compromise, you can get your point across even better.
          When was it that Pharaoh was so disheartened he let go his slaves? His first born son was killed, (don’t kill people’s children, it’s wrong), but the point is that stabbing at what these people hold closest (power via social manipulation and noncompliance with a group that is too small not to squash) is a good way to make the point that they are NOT allowed to touch your well-being unless they want they same misfortune to befall themselves.

          • Jake Awake says:

            And another person mind reading.
            How do you know what they know? You need to ask people what it is they are thinking. You need to ask people what it is they do and do not know.
            We can only guess what people are thinking.

          • Carrie101012 says:

            Jake, You are obviously not a good advocate of pain patients, so shut up already!

        • Kendra Williams says:

          Way to go Betty! I’m a 34 year old mother who has multiple autoimmune diseases, on to of IGG DEFICIENCY, which means I have no immune system. Obama care cut my insurance down to where I cannot get my infusions anymore for either issue. I have Rheumatoid Arthritis, lupus, Behcets disease and multiple other arthritis in my spine etc. I am going through severe withdrawal symptoms because of the DEA and people who abuse medications that I need but they are investigating my doctor trumping up charges, I pray anyways, he had a sheriff working at the front desk. Now I am suffering, can’t get a pain management doctor and my medications were due February. I’m angry at the physicians we put our lives and trust in, they turn on us the moment we get sick. I had a stroke at 16 and went downhill from there, before that was female problems that a Gym actually told my mom I was making it up, imagining it because of child hood trauma. Come to fine out I had polycystic ovarian disease, endometriosis, and a cyst that ruptured at 14 and almost killed me. So tell me after I’ve tried about every drug on the market, that I asked for any of this, and thst I don’t deserve to play with my children and live life comfortably until a cure b is found or better treatment??? This story isn’t just about me for there are so many of us that would give ANYTHING TO LIVE AND FEEL “NORMAL” I wasn’t supposed to have babies but GOD blessed me with 2 of the most wonderful children, they would love to see what mom I could really be, wanted to be!

        • Anacabana44 says:

          I was diagnosed with RA at the of 7, I have leg spasms, chronic migraines and my SI joints hurt me so badly that I often can’t walk. Those are the worse of my many problems, the problems that introduced me to opiates. Had I had any idea whatsoever that I was walking straight into hell, I would have declined each and every prescription. For 3 years I was unaware I had a problem, I mean I truly didn’t know, not until it was too late. I’m not sure when it happened but I had transitioned into this completely different person who woke up every day full of dread trying to remember weather or not I had drugs. Prescriptions were now only another source, out of many sources I had found along the way. My fear of withdrawals drove me to all those moral compromises, and withdrawal itself lead to the most desperate and pathetic of times, many many times over. I can barely stand to think about the things I’ve done just for 5mg to stop the sickness, things that the real me would never do. My life no belonged to me, I had no control. And that wasn’t because I had convinced myself that I had no control in attempts to justify doing drugs, like many people think addicts do. I literally had no choice, as the withdrawals are so unbearable that I would rather die then to ever go through them again. Yes, it’s that bad. 6 years of use, the last 3 years extreme abuse, with last year being the absolute worst year of my entire life. The most pain I’ve ever had, including the emotional pain which is this whole other aspect that’s damaging in a way that only an opiate addict would understand..guilt, self hatred, regret..all together, it’s the ultimate darkness. It’s been 91 days since I’ve taken any opiates, don’t ask me how I did it cause it sounds ridiculous..all that matters is that I did it. I escaped, and now I am free. Those words, “I am free”, make me choke up every time I say them. So, yes it’s unfortunate that people abuse drugs, and yes there should be a better system for recovery. I am someone who “ligitimately needs them”, and I am in recovery. I know that everyone is different, different problems different pain, but I also know that it doesn’t matter who you are or what you have, ANYONE who is prescribed opiates is subject to addiction, and after being on them long enough, addiction/dependence is inevitable. That doesn’t mean it’ll happen in such extremes like it did with me, but it doesn’t mean it won’t either. And statistics don’t mean anything either, as so many people who got started on prescriptions have not admitted their problem to their doctor and most likely never will. It’s a sad sad world, and my heart breaks for everyone in it. I’m back to my regular pain, and I’m grateful for it. I’ll always be grateful for any kind of pain because it’ll never compare to the pain and suffering that comes with opiates. This is way longer than I had intended! Sorry about that 🙂

      • wendy says:

        I have been through Hell due to this system.
        God Bless. Mark my words that I will make a difference for others that are suffering at the hands of this System. When your in chronic Pain and there is NOWHERE TO TURN. Even in the judicial system you are innicent until proven guilty. Something has Got to Give here.

      • Jason says:


      • stuPiDlaimperSon says:

        Thanks I refuse to be ABUSED !! Pls advice as to how I can fight this and stay strong while I do it

      • Bonnie says:

        This is my life right now. I’m tired of being treated like a liar. How many hoops can I jump through before someone realizes that I’m not trying to get high, I just want to be able to function from day to day and be able to keep my life from falling to pieces! My doc prescribes me nothing at all. I shake and moan all day and especially all night. I never sleep; 3 hours every day or 2 I consider being better rested than “usual”.. idk what to do anymore. I’m living day by day and I fear the moment that I am living hour by hour, minute by minute, etc. I sound and feel like I am insane. I’ve just been holding in so much and when I stumbled upon your words somehow…….. you just made me feel not so all alone in this, and safe to express my frustration. You can’t do that with the doctor because in his eyes, that’s how an addict would behave. I should think someone like an educated doctor( after several visits and lots of testing and PT) would realize his patient really isn’t conning him and is very genuinely in need of a better quality of life.

      • Bartleby says:

        Thank you, my pain is far to overwhelming to use such words…Well said.

    • Tammy says:

      You obviously have never suffered from chronic pain……I have exhausted ALL of the repetitive stuff you wrote! After four years opiates are the only thing that works in acquiring some quality of life!

      • Jake Awake says:

        These pills work for me also. I have tried to change them but the pain comes back. I mix the patches with two other meds. Good luck!

    • Avealina says:

      Doc – While it’s nice to see someone considering the whole, you also fail to see the other side of the coin. I’m a younger chronic pain patient, I have run the gambit of everything out there to assist with the pain, before resorting to opiates. I have been through massage therapy several times with several different therapists, physical therapy 7 times, 5 chiropractors, too many doctors in too many specialties to count, MRI’s, EMG’s, EEG’s, EKG’s, just about every blood test they can think of to check for just about everything under the sun, and still I have no confirmed diagnosis, worsening pain and other symptoms, and stacks of medical records. I follow my doctor’s orders as closely to the letter as I can possibly do, and yet I rarely see any improvement. Over the years, I have had increasing sensitivities to medications that previously helped, even if only minimally, and the only thing I can take anymore that doesn’t give me side effects that are worse than the symptoms, and actually helps me to live some semblance of a normal life, are the opiates. Oh and before I get the folks who swear by and say I need to try MMJ, I’m allergic to it, and have already tried it, thanks! I can understand why some doctors are hesitant to trust me, but to completely write me off, before even seeing me, is what really bothers me. I have over 10 years of medical records and drug tests to monitor my system levels of whatever opiate they have me on, that prove I am NOT an addict and take my meds responsibly. I have NEVER sold a single pill or tablet of my pain medications. We really need to find some middle ground in all this!

      • Angie says:

        There is no difference between people with pain and street addicts . It is sad that the healthcare system in this country is incomplete. Everyone is quick to hand out pills verses treating or teaching pain management. Pill addiction is different because its a brain disease . Most patients don’t understand the medication s have side effects. Talk to your pharmasist read the info in your script . In some cases pill addition leads to heroin addiction. Take responsibility quit acting like a middle schooler smoking pot for first time

        • anonymous says:

          You obviously know nothing about those who need meds foe pain etc.All medications have risks and side effects. They want people off addictive drugs and give them meds that work like taking candy. Or give anti depressants that cause worse problems and side effects I’m done with all the crap of people doing whatever they want then when it comes down to controlled substances they wanna step in and say that these drugs are a sin and that nobody should take them and they’re out doing something wrong or getting drunk. I dont drink by the way. There has got to be balance and not a knee jerk reaction to everyone who asks or requests meds for pain.

        • jean2lr says:

          what? This makes zero sense.

        • Angela says:

          Dear God I pray that I one day am in a position to knock people like this ignorant, clueless person spouting obvious nonsense about taking responsibility and stop acting like pot smoking middle school off their smug pedestals. Diagnosed with Avascular Necrosis both hips at age 34 as a perfectly healthy person with no history of trauma, issues or history related to the disease. Left hip replaced healed fine. Ten years later right hip replaced after signs of symptoms. WHOLE DIFFERENT STORY. Refused to heal. From onset of pain to now, three full years after replacement, pain is worse. Too much to write but the way I have been treated???? OH MY GOSH!!!! I have had one replaced already so been through the whole procedure, pain meds, physical therapy, etc. Not an addictive person here. Clearly evidenced. My scar even different…totally raging, feverish, inverted, changed shape of my bottom…the changes I have had to go through, the shame, the agony, literally begging to die, not able to walk, not work, need medication and can’t get it because I am not believed…had to do my own research with doctors I am paying out of pocket by borrowing money from friends because with that disease it’s hard to get insurance and the doctors pooh pooh me out the door and I cannot walk?? Chronic pain does ore than demoralize and depress you…it kills your strength, your will, your being a human, and you then understand drug addicts have it BETTER than you in the United States of America. I was suicidal and before I took my life I got on the web and found an Avascular Necrosis support group which saved my life that night. They literally gave me the will to fight another year because what this person above STILL does NOT wrap their brain around is the word CHRONIC! Understand this means ALL THE TIME…that means there is NO BREAK which means a woman in labor actually gets a break. We have the strongest minds of anyone I know because being bedridden and enduring torture requires a level of place you have to go to in your mind the body can’t handle. One day I tried to imagine how to explain this and the fact is unless someone experiences it they can’t comprehend it so it is easier for them. Stick your finger on a flame and keep it there. You can’t do it. We chronic pain sufferers couldn’t at first either but we had to learn how to deal with torture to go door to door asking WHY and to find help. I wasn’t asking for drugs. I wanted to know why I was still in pain. But I was treated like I wanted drugs and no doctor ever so much as gave me any type of nerve test, test for infection, absolutely ZERO just co-pays and monthly bills. On my own FINALLY found out I suffered nerve damage in my hip replacement surgery which damaged all the surrounding nerves around the hip joint, running along the sciatic nerve which gave me the burning back pain in ADDITION when I never had back pain before my hip surgery. My story is a mild case compared to many out there and I am one determined sister heated and on fire to do something about this starting in my home town of Los Angeles. Nothing ever gets done with things like this until it hits a celebrity (like Michael J. Fox with Parkinson’s). I’m going to holler, scream and bark for every single second of my agony until someone of influence hears the voices who are saying in this country we WILL re-evaluate the way we deal with chronic pain. I was 10 minutes from taking my life over this and no way is this ok for as many go through it. Screw the ignorant pathetic commenters who all change their tune when they go through what we have (if they survive).

          • Anonymous says:

            You are so right. Addicts recieve often times repeated, free, treatment and even housing. Along if course with drugs to help them through pain and agony of detox, and relapse. It’s a widely known fact that many addicts abuse this system when they can not get a preferred substance with full intent to use again.( I would not abolish the system,even with its flaws because better something than nothing) Yet we, as you said so elequently, get no respite ever, ever, ever, ever…..ad nauseum.. Your comments are inspiring. Since I’m awake all night anyway I cruise the Internet looking for similar stories just so I don’t feel so alone. Chronic pain truly tests your soul to its core.. I believe that there is always a silver lining. Chronic pain has made me a strong, compassionate and patient individual. I truly know myself inside and out; like you said the mind has no choice but to transcend the body to survive, and when you reach for the light in those darkest of places you know you have the strength to deal with whatever life can throw at you. I pity people who make such comments, ignorance and arrogance are worse vices than any drug known to humans.

        • Anonymous says:

          Yes, this group is very informative and supportive. Comments like yours have no place here. You speak of middle schoolers and then leave an uneducated and childish response. You speak of studies yet list no references, I suspect because you are just regurgitating general knowledge to people who already know about addiction. We know because the only way we can live our lives to any degree of comfort are with drugs that are highly addictive and we have to be so careful. If you truly know anything about what you are talking about, I should not have to tell you that there is a difference between drug dependence and drug abuse. Clearly the people here do not fall in to the latter category, we are dependnet on the drug because we are using it for what it is intended. None of us would choose to pay that much money long term, or endure the side effects of taking such meds long term if the other options we had tried had worked. However Idk why I even try to explain; I would never wish such a thing on anyone, but statistically you or someone you love will be affected in some way by chronic pain due to illness, and or injury. I have a feeling your ideals will not hold up so well then.

        • Bartleby says:

          Excuse me, a pain patient who never smoked pot as a teen, nor did drugs. Is on long acting opiates for decades or years, that’s your dismissal of such a situation? Why not say, Whatever and get it very with. Do you also preach taking your meds on time as prescribed or no?

      • Jake Awake says:

        I note you said: I follow my doctor’s orders as closely to the letter as I can possibly do, and yet I rarely see any improvement. This is stupid behaviour. It is not working out! Why are you suffering like this? Complain or find another Dr.

    • DR Ahmed Adam says:

      Hi Doc, your long glib suggestions of a variety of treatment modalities to try, is an insult to patients suffering from severe, chronic daily pain. I am a medical doctor; I am no longer able to work; I have (among other conditions) severe spinal stenosis, prolapses in the cervical spine, lumbar spine, two subdural-bleeding in the brain (from falling); I am wheelchair bound; stay awake at night with severe pain; been shot in the chest and leg; have accelerated osteo-arthritis, brittle bone disease and pituitary infarct; what infuriates me is when I ask my Physician for pain prescription and he says: you are a DRUG ADDICT!!! Really? Doctors are morons if they treat genuine pain sufferers with the same paint brush as recreational drug abusers. I am not a recreational drug abuser: I am in PAIN. For those Doctors who do not have the compassion regarding pain, let me remind you about the Oath that we both took: FIRST: Do no harm; why is it easy for a Dr to prescribe a Drug for Diabetes or Hypertension for LIFE, but refuse to prescribe pain medication for Life? I curse every medical practitioner who makes a joke out of a patients suffering and insults a person in genuine pain; I hope your kids suffer from non-ending pain and you look on in misery knowing that you cannot do anything for them. Dr Ahmed Adam, South Africa

      • Pamela Wible MD says:

        I am very sorry for your pain. I spend > 60 minutes with patients, do house calls, and treat everyone as an individual deserving kindness and respect. I have no children by choice (So unlikely that my children will suffer non-ending pain) I chose not to have children so I could care for others. Lashing out at me or generalizing to all doctors or wishing others’ children suffer from non-ending pain is not helpful in moving this conversation forward.

        • Ahmed Adam says:

          Hi Pamela, my irritation is directed to the first post above from someone called “Doc” 30th March under your comments, and not to you; if it came across that way, then I do apologise. The very fact that you made the effort of highlighting this major problem, illustrates your heightened sensitivity and compassion towards your patients; further, I am glad that you treat patients on an individual and holistic basis, and spending sufficient time with them ; my Dr starts hurrying after about 10 minutes which can be quite annoying whne I have been waiting for more than an hour (sometimes 2 hours) in his waiting room (even though I am on time); I sincerely hope that there are more compassionate doctors such as yourself, and that the Corporate Medical Aids or HMO’s do not condition doctors towards learned helplessness and forget why they became doctors in the first place. Keep up the good work and may all that is good for you come to you in great abundance, best regards, Dr Adam, South Africa

          • Incredulous says:

            Dr. Adam,

            I completely agree with every single statement you made. I wouldn’t have made the comments about cursing anyone else, and I realize that, thankfully, someone’s offspring can learn to have characteristics differing from their parents, for the better. I time and time again grow so frustrated that doctors seem to have been so complacent when taking that oath of, “FIRST DO NO HARM”. I feel as though that ought to be emblazoned in bold on every single text book, chanted as an incantation at least daily all throughout medical school, and stamped on every official piece of documentation from all medical boards because it is just that important.

            Dr. Wible,

            You come across as an astute, compassionate physician, which unfortunately seems to be a minority these days. You might realize that many of the facts and figures tossed around with respect to narcotics and drug abuse are manipulated and don’t give an accurate portrayal of what the real issues are which need to be addressed in society. Every time a statistic is quoted which states that there have been so many prescription related drug overdose deaths, the second half of the equation is never publicized. The missing portion of information is withheld that the overdose victim also consumed other prescription medications and alcohol in over 75% of the cases. There is never any information shared on how many patients take their own lives because they have had their medications reduced or withheld. And the stories like Leila happen very often all across the country and have been happening for many years.

          • Richard Oberg M.D. says:

            First I agree with Ahmed Adam exactly and thanks Dr. Wible for the contact and support here. I won’t repeat the above (or below) but I have a lot to say about all of this best not in this format. I’m a 30 year senior in-house hospital staff pathologist with 22 years of bad psoriatic arthritis and my Mayo Clinic trained dermatologist wife has bad Ehlers-Danlos HM. We’re both recently totally disabled with serious chronic pain issues. If taken appropriately opioids work in the long term (for me over 18 years while working full-time) and make life tolerable. Anyone who says to the contrary is simply uninformed or doesn’t have a serious chronic pain issue. If pilates or some such works for you good – they worked for me too when my biologic meds were effective and when chronic pain wasn’t as much an issue. The data posted to sites such as the CDC and a current negative Consumer Reports article are complete nonsense and easy to rebut – too easy actually. The data is seriously flawed, easily refuted, and totally biased toward a negative outcome. I’d love to have an opportunity to present some of this and show how utterly absurd supposed ‘data’ against chronic opioid use doesn’t make any argument at all and is a good example of statistical misuse. Needless to say things in our area are getting worse not better and I really empathize with anyone in this situation. It’s difficult to be miserable when you know it’s unnecessary. Hopefully more to say later.

      • Trika says:

        Dr. Adam
        First Id like to say that I never post on these forums at all but I felt compelled to after reading your post. I couldn’t agree with you more about everything you said. I have multiple Sclerosis, multi-level ddd, spinal stenosis, fibromyalgia, carpal tunnel syndrome, bulging and herniated discs with tears, tibial tendonitis in both legs, have went paralyzed 3 times, once from the neck down for about 24 hours in January or 2006, then in June of 2009 my left arm for 5 months and when that got better in February of 2010 my right arm went paralyzed for about 6 weeks. I went into the ER one night back in April of 2011 in excruciating pain and it was a pain I had never had before. The. ER doc said he wouldn’t help me even though he just diagnosed me with shingles, because he had looked at my MAPS and said that I should have pain medication at home which I did but they were not helping. He did not care and sent me out of there knowing how painful shingles is, I was in a fetal position crying in pain like I have not done since giving natural birth. I still can’t believe he did that to me til this day. I never wish ill on anyone, but AS YOU SAID I have to hope that one day he will get shingles as bad as I had them and hopefully think back to what he did to me.. AS YOU SAID ABOUT THE OATH TO DO NO HARM I believe what he did to me was inhumane. Sorry for the long post and the. Missed punctuations,but this. Is a new phone. And I am so sorry for you. And what you are going through.

        • Trika says:

          Also my husband reminded me that he also sent me home with a blood pressure of 189 over 116. That alone says he didn’t care if I lived or died, in his eyes I was just another drug seeker who happened to have shingles.. Just horrible!

        • Rhea says:

          Trika, I too have been mistreated too many times to count. I was in my mid 20’s when my severe pain started. Endometriosis, ovarian cysts, bad gallbladder, unknown internal bleeding where I would vomit blood and need transfusions..finally after 5 years got properly diagnosed with a genetic bleeding disorder, hernias, surgeries to correct mistakes that were made, the list goes on. But I have had 25 surgeries so far and I’m only 30 now. I was put in pain management after about 10 er visits and no one could find out what was wrong with me. Well after trying surgery after surgery things got worse in a few cases. After a lapor I had worse pain than when u went in. Wound up in the er over and over and the drs would not treat my pain..they did nothing. Turned out the surgeon while closing me up entrapped a major nerve. So finally had that removed with another surgery. Another time I had an ovary removed bc of a torsion and I couldn’t pee afterwards. The Dr still discharged new after not going to the bathroom once in 2 days. My belly looked pregnant and I’m only 100lbs. I couldn’t even move without crying. I went right down to the er after I was discharged. That er Dr just said I wanted iv pain meds and nothing was wrong with me. So as they were shoving me out the doors my labs came back showing my kidneys were shutting down..surprise surprise an ultrasound showed fluid in my abdomen and once they put a catheter in they got 3 liters of urine out of my abdomen. Yup I had a perpherated bladder. And no one believed me till it was almost too late. So surgery again. Than the same with my gallbladder. I was vomiting nonstop for months with so much pain, actually had a positive hyda scan and the drs still wouldn’t remove it bc they thought I just wanted another surgery for the meds! Than finally after 6 months if dealing with the bad gallbladder my husband convinced a Dr to take it out. By that time it was grey and infected..during that surgery they noticed my appendix and pelvic organs we’re all bleeding and had to take most of that stuff out. Than shortly aft er that surgery I started vomiting blood everyday…no answers for a year. I was hospitalized for 4 months needing blood transfusions weekly, unknown number of endoscopies, transferred to 3 hospitals with no answers. And finally the last hospital they brought me to the GI Dr couldn’t figure out why I was bleeding so he accused me and my husband of doing it to myself. So I had a sitter for a week. Of course I wasn’t causing this to happen but he still thought I was just drug seeking. Finally I was down to 80lbs and had gotten 3 staf infections from the picc lines so my husband was going take me out bc no one was doing anything for me. The day I was gonna leave a genetic Dr from a children’s hospital saw me abd within 5 mins knew what I had!!! Best day of my life. It was the most severe rare case of HHT he had ever seen. So I was put on the correct meds and got better. But to this day the HHT caused most of my organs to bleed so I had a full hysterectomy too. I finally found a fantastic facility with a PM Dr who has me on the right pain meds bc I still suffer with pelvic/abdominal pain from all the botched surgeries and when I do have a bleeding episode I can’t even function Bc of the stomach pain so I end up in the er still from time to time Bc from vomiting I can’t keep my meds down. Luckily the hospital I go to has drs who know my whole story and know that I’m Not there for the drugs. But there are a few who still just refuse to control my pain..they have given me non opiates after my PM Dr tell a them not to and I’ve almost died 3 times from allergic reactions to those meds. Seratonin syndrone, throat closed and more bleeding. And still those few drs knowing everything I have been thru is legit still believe I am just addicted to them. Which yes my body is dependant and tolerant of these drugs now but that doesn’t mean I’m an addict. Its frustration when those drs don’t understand what we go through. And at this point in my life, I try not to let it bother me bc I know what’s going on and if they want to judge us go right ahead, but I only care about one person judging me and that’s God. So I now take my struggles and experiences and help others. Help encourage those dealing with pain that you can get through it with God as your strength and I’m telling you guys, don’t stop looking for a Dr who listens and don’t stop until you find a diagnoses. Your life should be lived to the fullest! It took me traveling all around the states to find my drs. I probably saw 100 plus drs. And to be honest not even a quarter of them truly listened to me. Its sad. But the good ones are out there, the few who’s minds haven’t been tainted from the abusers of the system. So keep searching friends. Good luck and many prayers! If I can get through all I went through and that wasn’t even half of it, you guys can rise above too and not give up! Life isn’t fair a lot of the time, and I wish there was a better way to convince those drs what the truth about living in pain is all about, but you can’t unless they have lived it themselves or truly care about their patients!

          • Rhea says:

            Oh and I did try every possible thing before pain meds. Like TENS unit, nerve blocks, vaginal nerve shots, prob every non narcotic med plus nerve drugs, PT, acupuncture etc…I just didn’t want to be a 20 some year old on narcotics for years. But now having a great Dr he explained everything so much more clearly for me to understand the meds.

        • Nicholas says:

          Pretty much every pain doctor in this country requires their patients to sign a contract that they will not get meds from any other doctor. Did you call your doctor? My wife’s pain doctor will increase her meds or give her something different when she has surgery by another physician.

      • Angela says:

        Here here! I am so sorry Doctor for you. I agree with you about the other diseases and the other issue is the cost. Why does it cost 2.00 for antibiotics and $300 for pain medication for a legitimate, long term pain patient with a medical diagnosis that is clearly debilitating thus drastically limiting that patient’s quality of life? I love my country. We have some issues I would like to see dealt with before I check out of here to make what I have gone through mean something more to me than meaningless, mind-numbing agony, depression and torture. I feel for you!!

    • joey farison says:

      The thing is though…the examples you said doesn’t have a good track record…the ratio of your examples compared to opiodes success and your examples don’t even remotely come close to narcotics. Most people don’t have the time to spend on alternative treatments week after week on something that more than likely won’t work? Every adult has pain and you have trust sometime the patient just knows what will work in his own body. We’re people in pain and not addicts or druggies…

    • Edith Burris says:

      You forgot Turmeric. I have Fibromyalgia along with thousands of others who struggle every day for a pain free day. All the thing you suggested ,we are doing to get a hours worth of freedom from our pain. I don’t want to be addicted to any kind of medication but I do know at times I need something strong if nothing else just to get a full nights sleep. There is a big problem with pain clinics making addicts of people because they give too much and want it taken every few hours every day. I have been seeing a pain doctor for 7 years and we have an honor system. He gives me 10 hydromophone 2mg a month and I show him 2 or 3 of them when I got back. I take it when I need it most. I know this method will not work with every one , but it will with some. Most people with fibromyalgia die by their own hand because the pain becomes too much. I believe the medical field needs to do more to understand the mind set of the patient .We are not all looking for a pill, we just want relief . Turmeric work good for me with the every day pain. Visit http://www.myFibroteam.com you will get a better idea of what is going on in the “pain world”.

    • Bartleby says:

      I have Chronic Primary Erythromelalgia on b other hands, both feet. Tha t s a start of a list.v One in 2.5 million have this rare gene mutation…Do I deserve Narcotics? Also Chicken skin, Rochea, cystic pustules acne, piles, VPN, full peripheral neuropathy. Severed tendons, scar tissue. Was in 3 fires, hit by 4 cars, went o very a bridge in one. That’s the cherry….I don’t get the. Have, because of the irresponsible Doctors I meet monthly. What’s your opinion oh Judge of a Plant User? Any thoughts other than statistics and things that do not apply to me? Geuss especially at my habits, shame perhaps. Tool so often used to treat pain…. Thoughts ? I’m not being sarcastic or rude, this is sincerely. I read your ideas. Mine are Long Acting Opiates are good medication. Like a gun is good at killing. It’s the patient who must take p resonance responsibility, and a Doc should do what they day they would, not lie.

    Dear Everybody,
    First a test question, and true story, which I will answer shortly: You have nine cats in your home. You and your husband smoke and you notice the cats are developing breathing problems and then one is diagnosed with and dies of lung cancer. What would you do now to make your home a healthier place?
    The other day I read an article in USA Today discussing the fact that married couples lived longer healthier lives than single individuals their age. What led me to write this is not any problem or disagreement with the results of marriage but the conclusion the doctor reporting it came up with: They are healthier because they have someone who cares about them telling them what to do. As a married man I can’t buy that one. Yes, my wife tells me to drive carefully and I do because I love her but once I walk out the door how I drive, what I eat, exercise and more are not because she is watching me and instructing me.
    Next: Married men also have a lower incidence of lung cancer than single men who smoke the same amount.
    Next study: Women with malignant melanomas of same site and stage as a comparable male group had better survival statistics than the men. The conclusion by the doctor blew my mind. Estrogen and progesterone must be protecting the women.
    Next study: After a heart attack the twelve month mortality rate was 5% in homes with a dog and 26% in homes with no dog. What do we conclude now based upon all these closed minded medical conclusions that do not relate to people but attempt to be scientific?
    Our conclusion based upon their wisdom: If estrogen and progesterone was the reason women with melanomas had a better survival rate than men then sleeping with estrogen and progesterone must be what is protecting men who smoke from lung cancer and heart attacks.
    And the reason living with dogs increased survival statistics must be related to the fact that when their owners did unhealthy things like eating fatty foods and not exercising they growled and threatened to bite them.
    I hope you are smiling because I am kidding and it is not because of mechanical causes that these statistics are revealed. When the instructions to take care of yourself come from someone you know loves you it can and does make a difference, because they are not criticizing you they are educating you, but first we need to feel loved and cared for and about before we take their words seriously. Relationships are what it is about. Men are human doings while women are human beings. Men die when they quit work or can’t do things and women stay alive to nurture others. I am constantly trying to get the men to become aware of the importance of relationships with pets and people and life and women to see that they need to relate to themselves also and not just live a role, such as Momma, which leads to their demise when the kids leave home. So develop a relationship with yourself and work with your new self and love and care for that new self as if you were your own child too. So when the kids leave home there will still be reasons to survive for the wage earner and mother.
    In a sense it is about hormones because our internal chemistry is altered by our relationships. Growing up with love is a major factor in health. Not because your parents are telling you what to do every day but because their words are hypnotic and they remain within you and when they are therapeutic also you are constantly hearing them in your subconscious, as well as, conscious mind and making healthy choices. Self-love coming from being loved leads to self-care and a healthy life.
    The effect of a lack of relationships is not understood by many doctors but is by the poets and song writers. I have mentioned W. H. Auden’s poem Miss Gee. The doctor in the poem examines a lonely woman and that night over dinner says to his wife, “Cancer’s a funny thing. Childless women get it and men when they retire. It’s as if there had to be an outlet for their foiled creative fire.”
    Now what happens when we don’t love ourselves? Nine hundred years ago, Jewish philosopher and physician, Maimonides said, “If people took as good care of themselves as they do their animals they would suffer fewer illnesses.” It is amazing how little people learn over the years.
    Now to get to the question I began this column with. What do you think the woman who wrote about her experience and her husband did? And what would you and your husband do when you realize you are killing your cats due to your smoking in the house? This story comes from a full page letter to Cat Fancy Magazine, written several years ago, detailing the emotional impact the death of her cat had on the couple. Here is their solution: “Doug and I now smoke in the yard. We love our cats more than the convenience of smoking indoors. We are not killing our cats anymore. We hope you are not killing yours.”
    The magazine didn’t publish my letter about the fact that Cat Fancy Magazine feels it is okay for people to kill themselves as long as they care for their cats while doing so. But it is sad also that people love their pets more than themselves and many don’t die in order to care for their pets. So the relationship is therapeutic but how about getting to know yourself and having a relationship you can enjoy with yourself. When you do you will find you are never lonely, even when alone. Not to mention that there is also another level of relationship that is always there to support you when it is a healthy relationship and not about guilt but related in a therapeutic way to your spiritual connections and faith.
    What I have learned and what all health care practitioners and people in general need to know is what Jung had to say and psychology knows. “We have known that there is an unconscious as a counterbalance to consciousness. There is an unconscious psychic reality which demonstrably influences consciousness and its contents. All this is known, but no practical conclusions have been drawn from it. We still go on thinking and acting as before, as if we were SIMPLEX and not DUPLEX.” He goes on to discuss the fact that if we ignore the psyche it would create a disaster just as our ignoring specific organs of our body has consequences which affect the whole body. As we have become more empowered over nature the mind has become more prominent and the head dominates. But we must remember there is a unity of psyche and soma within us and they must both be paid attention to.
    So we and our health care practitioners must treat both our intellect and our experience; our psyche and soma. Our duplex must be accepted and acknowledged as part of what we are living. The seat of faith is not consciousness but spontaneous religious experience. When you have a relationship with God it keeps you from dissolving away in the crowd.
    What struck me is how few men and doctors are aware of this and make it part of their lives and professions. When you ask men to draw a picture of themselves many just draw their head. Yes, some women are thinkers and draw a large head too attached to their body. When medical students are asked to draw themselves working as doctors the majority draw themselves sitting behind a desk with a diploma on the wall behind them. That is why I started to write this article. Their conclusions about why people do well are not related to a person’s duplex make up but only to their simplex intellect.
    So folks wake up to your multiple personalities and that your mind, body and spirit are all within the unified creation which you are. In a sense you are like the planet earth with many components, residents and environmental factors which all have an effect on the health and wellness of the entire planet. Just like global warming cannot be treated in a simplistic one solution way because every part of the body earth is showing symptoms of the change so our bodies manifest what changes are going on within our duplex make up and unconscious mind.
    Your parents didn’t commit suicide because you were a failure as a child. Pay attention to what lies within you and respond to it so you live your healthiest life and develop relationships which enhance your life and give it meaning.
    Peace, Love & Healing,
    Bernie Siegel, MD

    Happiness is not in strength, or wealth, or power, or all three. It lies within ourselves. Epictetus

    • Carrie Currier says:

      First let me tell you Dr that I am smoker and I cannot stop see while everyone is talking about drug addiction please let’s not forget one that is totally legal nicotine over the years nicotine has become even more addictive then it was when I started over 38 yrs ago now I have been an addict of other things I have been clean off of drugs for almost 20 yrs I quit an extremely abusive relationship but the one thing I cannot seem to quit is cigarettes I know very well what its doing to me and hate myself every time I light up BUT tried patches gum vaping cold turkey nothing nothing works my anxiety will become so bad I cannot talk to people it is very extreme what I feel I beg please put me in the hospital till it goes away no they wont I am on medicaid so let me tell you not a lot of compassion out there NO ONE WILL HELP ME MEDOCAID WONT PAY FOR IT AND I CANNOT WORK SO I CANNOT AFFORD THE COST SO WHAT DO YOU SAY TO PEOPLE LIKE ME we must remember its not as easy as you think it is SO WHAT WOULD YOU SUGGEST DR

      • Pamela Wible MD says:

        If your main issue (driving the smoking habit) is anxiety then treat that first. A good therapist or even a meditation program can help. Vipassana centers often offer a free 7-day silent retreat. Look around. Keep the faith.

  3. Julie Greene says:

    Pamela, I know of far too many people who have experienced pain and have been receiving inadequate treatment for it. I don’t know one single person who goes to a doctor for the purpose of selling the drugs they receive. This is a tiny minority. A doctor should take a patient’s complaint seriously. I feel it’s highly abusive for a doctor to call a patient a liar. Only once have I ever had drugs stolen from me, decades ago, and very few pills were taken. I have learned to take precautions since then. Even those in dire poverty with kids to feed understand that to sell drugs to someone means that stranger could be harmed by those drugs. Most people are morally together enough not to go the drug dealer route. I know of many people who go to doctors and because some x-ray or surgical procedure is too expensive, they are told, “It couldn’t possibly hurt that much,” and they are either wrongly sent to shrinks or given painkillers as substitute for quality care. In this way, people are brushed aside. That’s just a form of calling the patient a liar. Do these doctors have any conscience at all? It’s sad when I see patients taking poisons such as psych meds or painkillers because of medical neglect.

    • Pamela Wible MD says:

      Call me naive. I had no idea so many patients were diverting prescription drugs. I try to err on the side of trusting what patients say – even though I have been lied to, manipulated, and even had prescriptions forged. Still I want to wake up every day and believe that I am sitting next to a patient who really does want a long-term relationship with a family doctor built on trust and respect.

      Here’s an old but good article: http://www.kevinmd.com/blog/2011/04/treatment-chronic-pain-puts-doctors-win-situation.html
      And a comment by a Dr. Easton worth reading:

      I do have priorities. Some of them include maintaining my medical license, being able to make a living and provide for my family, staying off the Fed’s radar, avoiding prison time, and not contributing to the massive increase of opioid diversion rampant in our country. Prescribing chronic opioids to patients with difficult-to-verify diagnoses increases my risk of all of those problems I hope to avoid.

      Do you really think that there is so much more pain today than there was 30 years ago when opioid prescribing rates were very low? I don’t. I do think that many doctors hand out opioids like candy, and this is contributing to the addiction, diversion and overdose deaths.

      I realize that doctors have a broad range of opinions regarding opioids from chronic, non-malignant pain. I happen to be one who feels that opioids are rarely appropriate in this situation, despite the aggressive lobbying by Purdue Pharma and others during the 90s.

      I have had patients who have died from taking their friend’s Oxycontin and methadone. I try very hard to not contribute to my patients’ accidental deaths. I don’t want bottles of Lortab being sold out there with my name on the prescription bottle.

      • Avealina says:

        This is a very good point made by Dr. Easton, Dr. Wible. I, as a pharmacy professional, can completely sympathize with everything this doctor is saying. As a pharmacy professional, I have a responsibility to help keep opiates out of the hands of those who would seek to abuse them and/or put those pills into the hands of those who would abuse them. I can also see things from the perspective of a Chronic, Non-Cancer Pain patient, too. I can see things from the perspective of someone who’s completely frustrated with trying just about everything out there, aside from back surgery and probably a few other less common treatments, with little to no success. I know some out there would say that nothing else has worked because “I didn’t want it to,” and that in a way, I want to continue to play the victim. I promise you, this is not the case, and we are not all addicts!

        I used to take Neurontin (gabapentin) and Zanaflex (tizanadine) and the combination of these, helped for a few years. However, I was switched to Lyrica (pregabalin) when it first came out, and had to switch back to Neurontin when I had lost insurance and could no longer afford the Lyrica. The following years resulted in doctors swapping back and forth between Neurontin and Lyrica, based on preference and my ability to afford the medications, but for the last 4 years, I have not been able to take either, due to me becoming chemically sensitive to this class of medications, to include having an extremely severe reaction to Topamax (topiramate). By day 6 of taking this medication AS PRESCRIBED (prescribed by a Pain Management doctor I was referred to by my PCP), in combination with Zanaflex and Klonopin, which were both prescribed by my PCP and taken only AS PRESCRIBED, knowing I was prescribed Topamax, I found myself in the ER, barely able to walk, barely able to speak my own name, and friends, family and even people I didn’t know stopping to ask me if I was alright, if I was drunk or stoned, and/or thinking I was an escaped mental patient. The ER doc wrote me off as a drug addict before ever meeting me, and discharged me with only a referral to a drug treatment program. This was one of the biggest insults the medical community has ever given me. This is not the only medication that I have grown sensitive to. I have become sensitive to almost everything I am given, and in most cases, the side effect are far worse or I have some of the worst, rare or almost unheard of side effects of the given medication.

        I do try to respect that most doctors do not become doctors to become jaded, that they do not become doctors to deny people care and treatment they need, nor do they become doctors to cause other’s harm. However, I do certainly believe the DEA has stuck their noses so far into doctor’s practices and told them what they should or can give their patients, and has made them so fearful of using their own judgement, that many just refuse outright to even deal with opiates at all.

        Do you know of any way that I can better communicate with and prove to medical providers and to assure them I’m not an addict? I have also had the problem of running into doctors that see the medications I take, and automatically reserve themselves to not wanting to actually give me a diagnosis. I have many diagnostic tests that show increasing degeneration in my spine from arthritis and stenosis, that my peripheral nerves and their functioning are degrading and/or not functional at all anymore, and blood tests that are not conclusive or do not point to any specific disease. I’ve been told by a Neurologist in 2010 after a series of MRI’s on my brain and spinal column, that were not conclusive to have any lesions that could be attributed specifically to Multiple Sclerosis, and the records that state him having told me that because he couldn’t be sure the lesions seen in the MRI’s were attributable to MS, that he couldn’t officially make the diagnosis, even though I otherwise have a textbook case. I have had rhuematologists say I have textbook presentations of either Rheumatoid or Psoriatic Arthritis, or Systemic Lupus. Yet with all the documentation of these, I can get no doctor to take me seriously or give me a confirmation. My point is, if anything else worked for me, I would gladly NOT take the opiates!

        • jean2lr says:

          I wish there was a magic drug that would work that was not an opiate. I’d love to take that. Opiates are all the work for me. NSAID make me vomit blood, steriods make me hurt worse in the long run. I can still fell where the needle went in me with the steriods and that was 10 yrs ago. Find me a dug that works and I’ll be the happiest person in the world. Until then give me pain meds please!

      • JenC says:

        Has anyone considered (cause I never see this mentioned anywhere) the increase in pain prescriptions/people in pain are all the baby boomers( many many, it was a “baby boom!”) are now aging, getting those painful disorders, it’s more a numbers issue. I wouldn’t be surprised when the boomers are mostly passed away, a lessening of those prescriptions will occur. One problem, it’ll be attributed to the “drug war success,” not a reduction of a really big generation.

        • patty says:

          it will be sooner than later because when we can take the pain no mere ….. we kill ourselves and then they say we committed suicide! WTF Nothing is said that we could not get our prescriptions filled that we have been taking for some time while at the same time doing random urine testing! Heave HO ….. Over the bridge i go

  4. Leslie Relle says:

    Well said Doc. That’s a long list. I found a good doctor but have often found that doctors would trivialize my physical problems. They would give me a medication for depression or anxiety and basically leave me to deal with the physical problem. It is not only opiates that patients get dependent on. There’s alcohol. In my many many years living with traumatic brain injury I have seen many many other patients and many doctors who readily prescribe or take psychiatric meds for symptoms of brain injuries. We are often treated as if we are mentally ill, which in fact we can become when our needs are ignored and we are not able to care for ourselves. Advocacy is difficult to find and there is not enough rehabilitation for us.

  5. Renaldo says:

    You obviously haven’t worked in an ED/UC where many addicts maneuver or had a pt return to the ED with a weapon in their pocket, demanding to see the doctor who did not give into the thug’s “pain”.
    Bottomline, people know 4 types of answers to there pain problems: oxy, percs, Vic’s, and codeine 3s. That’s what they know and don’t care about other kumbayh modalities of pain management. You don’t give it to them, they will complain or return with weapons to set the issue straight.
    Let’s not forget the boss who sits you done and tells you what a mean doctor you are for treating the complainer like a drug addict.
    I’ve never made a drug addict but I sure have contributed to their pocketbooks.
    I use clinical reasoning and acumen to assess every pain encounter. I even rx some kumbayh methods. Never vacations though, as most pt’s want to be pain free before the go.

    Happy dancing bunny day!

    • Pamela Wible MD says:

      I hear you Leslie. And TBI (like many other issues) is impossible to handle in a 10-minute office visit. My doctor friend says it is worse than drive-through medicine. Sometimes it feels like vending-machine medicine.

    • Pamela Wible MD says:

      I have not worked in an emergency room and I can only imagine what happens there. No happy dancing bunnies. They come to my office. I do think that good patients who follow the rules are clueless about the real problems in the ED. I do not doubt you for a minute Renaldo. I worked in clinics where drug addicted patients sat in the parking lot and called every nurse and doc in the place trying to get refills on narcs that he “lost” or had “stolen.” We all refused. Didn’t make ya feel safe leaving work roaming through a dark parking lot looking for the car.

    • Hey Renaldo. I agree with everything you said. Pamela asks for a solution. I wish I had one.

  6. Sonder Twyful says:

    Sorry, Doctor, but you just made my head explode!
    I am 60+ and have taken 140mg morphine (extended release) for almost 5 years. I can’t tell you the number of doctors and nurses who have treated me like SCUM of the earth as soon as they see my meds list. They don’t talk to me. They don’t ask me questions. They don’t examine me physically. They ask me how long I have taken morphine but no one ever asks me about the 10 years in which my doctor and I tried every conceivable drug and treatment OTHER than morphine. I have been told that I MUST be an addict based on my high daily dosage. (Dependence does not equal addiction.) I face ugly discrimination and bias on a daily basis because of a drug I need.

    What no one considers is that morphine is just one part in my daily routine to control my pain. They do not see almost ten years’ worth of therapies/drugs/etc that my doctor and I tried before we decided to add morphine to my pain management program. They do not see that morphine was my absolute last resort. I also do/have done the following:
    * Use meditation/biofeedback to help relieve pain
    * Swim, yoga, and walk daily
    * Heat/ice (which ever feels better) for relief
    * Work with mental health professionals (psychologist/psychiatrist/therapist) in learning new coping mechanisms
    * Attend occasional physio-therapy sessions (as they become available)
    * Take CME courses on pain management
    * Read medical journals non-stop in the areas of pain/drug research in the hopes that there will be a breakthrough so I can be “cured”.

    Prior to introducing morphine into my regimen, I could not walk unassisted and I frequently needed a wheelchair. The morphine gives me a quality of life not found with other drugs/therapies. Yet, because I take this one drug, I am branded a threat, a nuisance, a time-waster, etc.

    I was a highly paid, well-respected intelligence analyst and top cybersecurity advisor for our government. My reputation means a lot to me and I work for people’s respect. How am I supposed to respond when I’m treated so shabbily? I always dress nicely. I always address the medical professionals with respect. All these doctors and nurses would have to do is call my doctor or pharmacist. I have overheard medical staff whispering about my doctor and they further spread their nastiness by implying that my doctor must be a Candy Man.

    I completely and totally understand how a doctor might become jaded about patients’ requests for “strong drugs”, but that does not give you the right to treat me badly. Every guideline says I must be treated with respect and that my request for help should be given all consideration.

    Last, but not least, I think all doctors and medical professionals should remember this when they are confronted by an “addict”: PseudoAddiction
    Resulting from poor pain management, typically evolving from improper treatment of chronic pain symptoms. Perform a complete pain assessment and review the recent analgesic history. Pseudoaddiction improves with the provision of adequate analgesia, including opioids. In contrast, associated with a substance abuse disorder will not change.

    • Pamela Wible MD says:

      I am so sorry this has happened to you Sonder. If doctors had more time (and energy) to truly care for their patients, we could avert these misunderstandings. We all absolutely need a trusted doctor who can oversee our treatments and make certain patients are not suffering needlessly. Unfortunately, as my next blog indicates, many doctors are at a breaking point with despair, depression, and suicide: http://www.idealmedicalcare.org/blog/physician-suicide-letters/ And many doctors start off very caring, but they are under appreciated and overworked and worse. For many, it is hard not to become jaded. The good news is many physicians are breaking away from abusive employers, contracts, working conditions and choosing to start ideal medical clinics so they can really be doctors again. You do know all we ever wanted to do was help people.

    • jon says:

      Sonder, it’s a catch 22. The more you try to explain your pain issues,the more it can sound like a ‘story’ to some doctors. I don’t know if bringing in the paperwork of all the things you have tried will help to eliminate some of the hurtful comments you deal with. You have gone above and beyond what most people do and the fact that you are educating yourself is impressive. Maybe the professionals, doctors and pharmacists, who disrespect you should walk in your shoes to see what your quality of life is without that medication.

    • Kimber Harper says:

      I see that this post was written several months ago – but am hoping you might see this anyway. I want to say a million thanks to you for this. I am having a really bad week dealing with my chronic pain issues – – I am 48 years old and have been dealing with chronic pain issues since I was 17, at which time I was diagnosed with Chronic Interstitial Cystitis. I have been very depressed lately as I have felt like I am also treated like an addict much of the time when I do seek pain medication. I have 30 years worth of stories to tell – detailing every treatment I have tried -and feel my history is completely dismissed and that I am disrespected so often – and especially by pharmacists , ER physicians and nurses. I have never abused any of my pain medication in any way yet feel as if that is how I am viewed as doing. To be honest, the treatment I have received by these so called professionals has caused my depression to worsen much more than the actual disease and pain itself. These last few weeks in particular have been hard as I have had to make several ER visits due to kidney stones — I have passed one, had one surgically removed and am getting ready to have a third surgery next week. Anyway — as I am being treated by a pain clinic for my IC — each time I have gone to the er for kidney stone pain I was sent home. No diagnostics were done to determine what was going on. They just assumed I was drug seeking after hearing my history and sent me home on three different occasions … I finally went to a different ER – they diagnosed the stones – referred me to a urologist who did my surgery and is getting ready to do another (as I said , one stone I passed on my own). But bottom line is- over a two week period I made those 3 ER visits and was sent home in excruciating pain — I thought I was going crazy – I knew the pain was terrible but couldn’t get them to see that it was something beyond my normal IC pain which is bad enough. Anyway – this was just one in a very long line of stories- same song different verse. It has affected my self esteem and made me feel so worthless. At one time during the last few weeks — I had taken a prescription for an opiate to the pharmacy – it was stronger and the frequency increased above what I normally take as it was temporary and was going to be used until I could get my stone surgically removed. The pharmacy tech took the script — the pharmacist returned to the window and gave it back and said they weren’t going to fill this and were not going to treat “patients like you” — I was stunned. I just drove away and took it elsewhere — and cried for hours. .. And I am not a crier normally. Anyway – I will stop my blubbering now. I just needed to know that it wasn’t just me — that there were others out there who have been treated in the same manner …. Not that I would EVER want anyone to be treated like this .. I guess it’s just that I need to know I’m not alone. I feel so bad for you and for all the others on this thread who suffer from any type of chronic pain — and who have to deal with being treated with such a lack of respect. I am sending out prayers , positive thoughts and much love to everyone. .. And thank you Sonder Twyful for sharing your story … And for all others on this thread who have taken time to share their stories.

  7. Sonder Twyful says:

    Oh, and PS … those of us who truly experience chronic pain know that we will never, ever, ever be free of pain. We don’t ask for drugs to be pain-free; we ask for drugs that will bring the pain down a notch or two.

    • linnietea says:

      I agree with you 100%.I’m a veteran,my doctor 19 years ago (14yrs) +5(1each yr) had done everything possible to find a solution.every medicine possible,tens unit,biofeedback,pt,braces,a scooter-some medicine made things worse and other medicine caused adverse reactions.I asked for Cymbalta at it’s debut,it almost killed me,(one minute I’m sewing,the next I’m on a psych ward bandaged not knowing what happened-the police telling my daughter it looked as though someone had been massacred,so much blood)because I’d had a hx of depression,suddenly now I’m forced into the pain clinic having a phoney diagnosis so the Dr could say I didn’t qualify for the medicine;what makes it worse is in February of this year,the same pain clinic doctor who threw me out 4 yrs ago,redefined my legitimate established dx of peripheral neuropathy(from military job) and( TKR-cancelled/ due to NP misdiagnosis of bronchitis when instead I have CHF) I can’t take the medicine that is offered Lyrica,Cymbalta s as of September 29 after having been treated all these years- I now am receiving no treatment for pain.The doctor justifies this stating my diagnosis doesn’t qualify me,YET for 20 years there was never any question about the diagnosis.I’ve never asked for early medicine,never go to emergency room,always was trusted until three years ago.I was told this was to protect the patient in case a new physician attempted to change things.instead,it has caused the opposite,doctors treat us as criminals.While marijuana is legal,chronic pain pts are being treated less than dogs.My dog’s veterinarian is more humane.I was dismissed from psychiatry and psychology with a clean record on the diagnosis of GRAVES DISEASE was made known but the physician continues to write about the psychotic female patient wanting drugs.He has refused anything for pain,in spite that I can’t take the prescribed medicine.

  8. Mary DeForest says:

    I had part of my nose and lip cut out and soft tissue in between removed. I was sent home without any pain killers. I jammed my arm into my rotator cuff, and I was sent home without any pain-killer, etc.

    My problem is that I’m allergic to acetaminophen, so I refuse Oxy, Vicodin, etc, and they call me a dope addict. I don’t cry or beg. I use self-hypnotism. I ask for one 10 mg codeine to get me through the first night, and they call me a dope addict. I miss the 1970s, where they gave me codeine. I don’t understand why they want me to become sick, besides being injured? I have surfers’ ear, loose my balance, fall, faint, bad tinnitus, severe nausea, loose lots of my hearing. I have to sit up slowly. I have to turn my head slowly. Hang onto a wall or person when I try to walk. I’m disoriented, loopy.

    Isn’t it bad enough to have part of my nose and lip gone and have my mouth swelled almost swelled shut? And not be able to suck anything from a straw, because part of that muscle was cut out?

  9. SteveofCaley says:

    Pain management is an area where the collapse of personal medicine becomes most evident. I would expect that it would be hard to fool a long-term physician, and most patients would be ashamed of themselves. In the days of the dinosaurs, it was widely acknowledged that a patient whom one has seen for less than three years is a “newcomer,” and they are difficult to treat because they are so new. Today, in most practices, 3 years is a lifer.
    Chronic pain, like depression, often causes a systemic impediment of many routine activities, and impairs the patient in ways that are not always obvious.
    I find that drug-seekers talk about drugs, and people with chronic pain talk about pain. We set goals not measured in degree of pain alleviation, but restoration of function. Those with chronic pain KNOW that it cannot be taken away, but it can be minimized in significance.
    As medicine becomes dehumanized, the type of suffering which is most exquisitely felt by humans becomes trivialized. There is no difference between a “dope-seeker” and a genuine sufferer in factory medicine. If you are not human, you do not have a right to claim human problems. Suck it up, says the system. Sufferers are merely discards waiting to be processed. Are we proud of this?

  10. I like the way you ask for a solution. By asking everyone maybe someone will have a good idea. It’s certainly a conundrum.

    The only idea I have is to redirect addicts to a special clinic where well trained therapists can tell the difference between a drug addict and a patient in dire need of pain medication.

    Another idea is to have a webs site database where patients with a true need to use opiates are registered after going through some kind of evaluation. Then in the emergency room if they are already registered they can be given pain meds.

    Neither of these sounds like a good solution to me though.

    It seems to me Pamela is asking for her readers to come up with solutions.

    • Pamela Wible MD says:

      We do have a drug monitoring program where pharmacists and other medical providers can check to see if a patient is getting multiple narcs from multiple docs (doctor shopping drug seekers) and that does help. http://www.orpdmp.com

      • patty says:

        yes …. almost every state has now, including Florida! So please explain to me why i still have my prescription for my fentanyl patch in my purse and can find no pharmacist that will fill it! I am too embarrassed to tell you how many times and for how long I have gone without my medications since the first of the year! I am working on an exit plan! It is bad enough to suffer from pain but when you have a doctor that gives you a prescription and pharmacists playing god …. it is time to go! 57 and out! Please explain for my children deserve that much!

    • David Se says:

      LOL I love that you come up with a few ideas, and immediately realize they not so good

  11. Pam,
    For me, it takes time, relationship, an ability to trust my own gut, and an acceptance that all humans are capable of all behavior given the right circumstances. The most important of these for me is still time, intentionally designing my practice to allow time to hear out the source of the pain; time to explain the options and their responsibilities including an up front conversion how we can establish trust; time to assess response and adjust.

    The astounding increase in all prescribing is inversely proportional to the shrinking amount of time the system allows prescribers to spend with their patients. The need to “do something” is part of a doctor’s psyche. In the last 75 years, the public expectation has become that we need to be able to “do something” about everything. Unfortunately, the easiest way to satisfy those needs in the typical 7.5 minute office appointment is to write a prescription or make a referral to a more expensive doctor.

    The associated personal, financial, and spiritual costs are crippling, no matter what drug we are talking about.

    Docs, especially primary care docs, I gotta tell ya … hold the line. Reclaim your time with your patients. Find a way. Stop the treadmill. Give up cursing the system and find a way. The cavalry isn’t coming. The sky is always falling. Do the “something” that you and your patients really need.

    • Pamela Wible MD says:

      Agree 100% Cory! How do you suggest docs reclaim their rightful time with patients?

      • Pam, that’s the important question, isn’t it? We did it with my bricks and mortar practice by starting very small without debt, with an exam table and computer. We intentionally watch our overhead like hawks, so that catering to the overhead does not drive our clinical decisions. our founder started this as a micro practice in 1992 and we have done what we can to maintain that ethic throughout. Overhead, like debt, limits us all and turns our patients into a means to an end instead of our soul-enriching mission.
        Stop running to catch up. Stop, breathe, think! what can you stop doing to regain joy? It wont be the same thing for all docs, but consider asking your patients what THEY need, read Pam Wible and Idealmedicalpractice.com, consider your technology, go back to paper if you have to, or go the opposite way and get free Practice fusion EMR on an iPad and start doing nothing but home visits and cash. If you stay with insurance companies as your primary payers , never outsource your billing. get a bulldog of an accounts manager and put him/her under your roof so they are directly accountable to you. learn the language of coding and play the game better than the insurance company does. link arms with other independant docs so you dont feel like a lonely island.

        But most importantly, link arms with your patients. Don’t play God. Tell them you need them, because you do! Primary care docs get out of bed because relationship matters to us. Keep going back to the patient-doctor relationship as the source of your work-life strength and joy and make your decisions accordingly.

  12. Anonymous says:

    Being treated as if I am abusing drugs has happened to me twice:

    1st time: about 20 years ago I went in to the ER with Hives. Allergic reaction or just over stressed at work but they came on fast so it scared me. The ER doc kept asking what drugs I took.
    My response: None.
    The doctor kept insisting that they couldn’t help me if I didn’t level with them about what I was on.
    I had taken NO drugs!
    Benadryl finally stopped the hives.

    2nd time: It was after my stoke. The doctors did 3 different drug screens. I was furious that they did them without asking and then charged me for them. I didn’t find out till I was reviewing my medical bills. The money wasn’t a big deal but I kept telling them I wasn’t on anything.
    I WASN’T on anything.

    With the exception of alcohol, I’m a straight-laced, button down guy. So it was odd to me that 20 years ago and then again 2 years ago someone would look at me and think drug user.

  13. Chey Cobb says:


    I think the crux of the current opiate problem is that very few doctors have actually received the appropriate level of education on the subject, but they still accept people with chronic pain as patients. These type of patients are tough to treat and they require a lot of time and attention from the doctor. The doctors who accept such patients, who are not aware of this fact, soon become overwhelmed with the required work. Those doctors are very quick to blame the patient and are too quick to label a difficult case as an addict. Even though that doctor is not a pain specialist, his word will be accepted as if he were an expert – simply because he is a doctor.

    Doctors need to be very careful before labeling a patient as an “addict” because it can have very serious consequences if the doctor is wrong. Even if addiction is “suspected” and the doctor makes note of that in the patient’s record, it becomes a formal statement in a legal document. Insurance companies and employers can access that patient’s record and can (and will) deny a claim, refuse employment, or terminate employment if they think there is an addiction problem.

    While I sympathize with doctors who have to deal with this dilemma, guidelines DO exist, but few doctors (or nurses) follow them. If they are not trained in pain management, maybe they don’t know about them? I don’t know but the guidelines can be easily Googled, so ignorance is not a good defense.

    Guidelines: First of all, if the patient says he is experiencing more pain than he can handle and that he needs a higher dose, he has a right to be believed. Secondly, do another physically examination of the patient. You should always check for changes in physical condition. Finally, assess the patient’s addiction risk. Just think of it as a differential diagnosis … If you have given the patient what you consider to be “adequate” medication and he still asks for more, maybe he really IS in that much pain! What else could be wrong? Ask yourself WHY he’s asking for more meds. If his opioid addiction risks are low, why would he lie? (The funny thing is, if a patient’s pain is adequately controlled, he doesn’t bother the doctor anymore!)

    Working with pain patients involves a good risk management. Do a risk assessment (how likely is the patient to be an addict or become an addict?). Then you create a Risk Management plan with appropriate goals and actions of of both you and the patient. (Require urine tests and a pain contract.) Document everything. (CYA!) But remember, there will always be some failures – as there are with any patient’s condition. The only way to completely avoid failure is to never accept patients with chronic pain.

    There are a couple of standard checklists that can be used to assess a patient’s addiction risk. One is called SOAP and the other is COMM. Here is another (but I don’t know it’s formal name – http://www.jaoa.org/content/113/8/620/F4.large.jpg). Go over these WITH the patient and then you can tell him WHY you think he is an addict or a drug seeker. You honestly cannot do this on just a gut feeling.

    And, if you find that a patient has become addicted, the LAST thing you should do is to turf him out on the pavement with a kick in the pants and a surly grunt. It’s not only unethical; it’s illegal. You are a physician and your first action should be to offer help. If the patient refuses help, then you can make plans for termination at a set date. You need to give the patient time to find another doctor and you should at least give him one last month’s worth of his usual prescription. These are not my ideas. These are the guideline from the American Medical Association. (http://www.clinicaladvisor.com/dismiss-a-problem-patient-in-10-safe-steps/article/241629/)

    Again, I am really sorry that the state of things has become so stressful that both honest patients and honest doctors suffer. Personally, I think the current attitude is nothing short of hysteria. While addiction is a huge problem, I would like you to consider the following numbers. Then tell me which addiction is “epidemic”.

    Pain-related statistics
    * 116,000,000 chronic pain sufferers
    * 16,500 annual opioid-related deaths
    * 135,500,000 alcohol abusers
    * 75,000 annual alcohol-related deaths
    * 35,400 annual motor vehicle deaths
    * 31,600 annual gun-related deaths
    * 38,300 suicides
    * 597,700 annual deaths from heart disease

    Thanks and I apologise for taking up so much commenting space on your blog. As you can see, this topic is a hot button for me. I’m just trying to help and the present level of hysteria is only hurting people more.

    • Pamela Wible MD says:

      Thanks Chey – Appreciate your thorough research and comments. Sensible. Time consuming in an assembly-line office, but doable with the right tools in place.

    • Kathryn says:

      Thank you so much for the information and links!

      Don’t forget NSAID related deaths. No one seems to agree on a number. The most reliable statistic I could find without spending days looking for a trusted source is 16,000 per year. That was according to The Arthritis, Rheumatism, and Aging Medical Information System. They also estimate 100,000+ hospitalization annually due to serious complications resulting from NSAID use. Lower numbers are right around 7500 deaths annually, but that official stat is almost 15 years old.

  14. a.patient rural nys says:

    I had been under care for a few years with the same dr. I have been choric ill, following what I felt was a viral infection, 08. I have severe spine issues and a nerve damage…. I have been thru a number of treatments that did more harm than good, trying to manage symptoms. I went from riding my bicycle 400 miles in a summer a couple of years ago to now some days not being able to walk well.
    My dr. and I in my opinion worked as a team… after trying many treatments my symptoms were managed fairly well with a lose dose of controled medication. While not finding a cure at least some of my painful symptoms were managed. I never found a need for more, more , more… followed all instructions . I was on contolled medication for a couple years. my disease progresses and out of the blue, he stopped treating me, even when he said I sick.
    I was abandoned by this dr. no notice, no chance to find care. I live in a rural area. After a month of trying to get treatment I finally get a letter back dated a month saying I had 30 days , ample time to find a physician. He sent me the letter after the 30 days had gone by. I had done nothing wrong but am forced to stopp cold my medication and suffer more… Trying to get my records… nightmare.
    I turned to my neurologist who was currently working with me. He would not help and I was not allowed to even make an appt. with him. The office manager, his wife, came out and told me that if she had known I would ever say my pcp abandoned me…. they would never taken me as a patient. I dont get to see my neuro again for about 5 months after telling office manager I was going to use urgent care. You couldnt believe the things she said to me….
    My neurologist has fired me now to. saying I have no options for treatment. I tried one thing. When I look at my records from a couple of months ago I had many treatment plans for his multiple sclerosis diagnoses. now I have none. I have worsening symptoms and suffer. They ingnore my suffering.
    At the time of my last visit he got much information incorrect as to pcp name, and he in my progress report states incorrect information about medications. He kited this report to my other doctors who are not even involved in this care. can you say blacklisted… I think it.
    I have done nothing wrong. I didn’t misuse my medication. I have nothing to hide.
    continuity of care…would be nice. Abandonment stinks. Cold stopping medication dangerous. Medication would be welcome. A plan would have been welcome. I do all I can on my own to manage… I don’t need to jump thru hoops… I am legitimately ill. now i am worse. no one will help. I have had no help sense last fall. I have been labeled. now i need a new neurologist too. help would be welcome. I’m looking for a doctor whonis partner in my healh care not a dictator.

  15. Pamela Wible MD says:

    From Anonymous Doctor:

    “I see a lot of pain problems in the ED and most are legitimate. But, you learn over time who is trying to seek an extra high for the night or for funds to pay for another habit. It’s unfortunate people are treated poorly by some health care providers. I remember as a teen, I got a severe sunburn on my back. I went to the ED and the nurse told me to go away and take motrin.I cried for 2 days until a 6 pack took the edge off.

    I had a really nice guy come in one night to the ED, c/o lumbar back pain etc etc….Long story short..he got a few percs and departed.1 month later, I got a letter from the county coroner stating my pt died of an overdose of pain meds and if I had any questions, to call. My name was on one of the many pill bottles he collected around the state. Young guy, mid 30’s.

    Had another guy come back to the ED with a gun in his pocket because I didn’t buy his “pain” story. And get this this, I gave him something legit that would have controlled his pain in the first place. I never carried a weapon with me before that, now I do.

    So, yea, the people I see may be on one side of the bell curve, but many are not. But can the bleeding hearts blame us for being suspicious, and for doing the things we do?

    Anyway, thanks for the free counseling session.

    How much do I owe you?

    Ahh, just bill me!”

  16. La empatía es la capacidad de caminar en los zapatos de otro hombre . Cuanto más tenemos la menor empatía que obtenemos por lo tanto cuando el paciente dijo que no podían trabajar = no se puede ganar dinero = incurrirá sufrimiento personal (tal vez no ser capaz de alimentar a los niños ) porque habían conseguido una lesión en la espalda , el médico no puede sentir empatía porque no pueden visualizarse a sí mismos pasar hambre en una sociedad desarrollada .
    Eso es lo que el paciente estaba diciendo , pero el doctor no podía caminar en los zapatos del otro hombre . Para el médico de la lesión en la espalda no era un gran problema, que el paciente era enorme .

    • SteveofCaley says:

      Yo lucho, sufro, no sé muy bien la lengua. Ellos saben que me importa. Ellos entienden que lo intentaré.

  17. r58black says:

    Unfortunately, when it comes to chronic pain management one bad apple does spoil the whole bunch. Until there are laws protecting pain management providers who follow proper required, not recommended, protocols this endeavor puts a health care provider at risk for losing his/her livelihood, his/her house, his/her family, etc. Unfortunately, according to the Oregon Medical Board one is required to treat pain so there is an obvious contradiction which has been sharply underlined by the fact that the Oregon Medical Board has essentially been on a witch hunt against pain management providers in 2013. Hindsight is always 20/20.

  18. Adrienne says:

    I am on the neglected patient side of the fence. It has very little to do with the criminal activity of others. As someone else said, the criminals are the minority, and is more anecdotal evidence than actual fact. Sure, you can find multiples of addicts and dealers in any given state, but there is no way to measure the statistics due to the hidden nature of criminal activity.

    I suffer a life-threatening illness and have lived with chronic pain for most of my life. I have always been treated fairly and promptly by medical professionals until my insurance changed under the Affordable Care Act and I was forced onto Medicaid. Since then, I am treated as almost sub-human and am constantly denied narcotic medication. To note, I have chosen a pain management regimen without narcotics only because I believe they are band aids for open wounds, often causing more problems. They mask the symptoms short term but fail to treat the underlying illness and still, are often over-prescribed, which leads to dependence and ultimately, addiction. No, thank you! With that said, sometimes the pain gets the best of me and because it is worse at night, I have no choice but to visit the ER. It hasn’t replaced my PCP but recently I have had more severe symptoms following a major upset in my life, and stress makes my condition a lot worse.

    Following the insurance switch, I have not had so much as an IV injection in the ER for pain that can’t be placed on that little smiley face pain chart on the hospital wall. With Medicaid, I might be given 100mg of Tramadol orally. And if I’m lucky, the ER doctor will send me home with a script for 10 pills of Ibuprofen 800mg. Prior to the switch, I was receiving Morphine and Demerol in my IV. I was thoroughly evaluated, examined, complete with lab workups, and was kept for hours for all of this to happen. Now, I am not even given a gown, there are no exams or labs, and I am released within an hour or two, and most of that time is spent in my room alone. Prior to, the nurses stayed with me as their time allowed or were checking on me throughout the night. The doctor came in with updates multiple times, whereas now, I see him/her once. I am still in pain when I am released. Before, that was unheard of!

    The demeanor of these medical “professionals” has changed also. The tone of their voice, body language, obvious disdain in my direction, etc. is opposite of what it was when I had good insurance. There are exceptions, of course, but for the most part I am treated as if I am there to get high. I could be crying, at my last visit I was literally screaming! And my vitals backed me up; it was very obvious that the pain was legit and I was not faking. Yet, I received no real help and the doctor actually made a point to -tell me- he “[does] not hand out pain medicine for headaches.” Really? That was -one- symptom, which was a migraine and side-effect from a new medication. I had other, more pressing and painful symptoms causing me distress that weren’t addressed at all. The statement and tone confused me because I had never had a doctor talk to me that way, it was extremely disrespectful and he made it very obvious that he thought of me as an addict there to get drugs.

    Where is the logic in that? It doesn’t make any sense whatsoever. Unless someone is “pill sick” and desperate, which is the only scenario I can think of for motivation in choosing the ER over a dealer, what’s the point? Wouldn’t it be counter-productive and given the secrecy of addiction, what addict would open him/herself up like that? It’s equivalent to walking into a police station and shooting an officer.

    Without going into my personal medical history, I’ll just say that I suspect the issue of poor medical treatment nowadays has more to do with money than anything else. Considering how many patients doctors and nurses see in a day/night, what is the chance they have the time to stop and think about a patient’s motivations for being there other than what he/she claims? They may go home and discuss something that “stuck out” or “seemed off” to them that day with a spouse, but these people are too busy to make snap judgments about Patient B because of Patient A’s insistence on receiving one medication over another.

    And speaking freely here, when the compassion is overridden or altogether replaced by self-righteousness and judgment in the medical profession, it might be time to reevaluate life’s path because that person is harming more than helping at that point. I don’t care what a doctor or nurse has witnessed in his/her time, there is common knowledge going into the medical field; the expectation is to see and experience the “darker side” of humanity.

    • Pamela Wible MD says:

      Adrienne ~ Thank you SO much for sharing your story. It is most fascinating and reveals a darker side of medical practice in which patients are treated according to their financial means. Not sure what state you are in but I know that in California Medicaid only reimburses $11 per office visit. If Medicaid is not reimbursing high enough to even cover the light bills, then Medicaid IS a HUGE problem. Still, I would hope that doctors and nurses would treat everyone as individuals deserving care and respect no matter what their social class. By the way, I choose to accept any patient regardless of their insurance, BUT I do not accept all insurance because I refuse to be abused and undervalued. I would rather see patients for free than be disrespected by these onerous and low-paying third parties. Just saying. . . All this abuse from third parties just trickles down to patients. Please watch this video: https://www.youtube.com/watch?v=7_7hL456T8k Many doctors are trying their best in inhumane work environments in which they are bullied and abused.

      I am so sorry that you have suffered as a result. Completely unfair and extremely sad.

    • Kathryn says:

      Adrienne, I can relate. I’ve had Crohns all of my adult life. One doctor offered treatment of symptoms with low doses of oxycodone. After about a year, I just couldn’t take anymore of them. I just didn’t like not feeling like myself. I only took a max of 20mg a day, and didn’t even take them daily. Yet I have a terrible fear of throwing up. I had seen House and heard horror stories about quitting cold turkey, so I asked for help in tapering down. My doctor decided that because I couldn’t just quit, I was clearly an addict. He didn’t label me as such, but he certainly wasn’t kind about it. I was just scared to death of throwing up. My husband wanted to punch him in the face, but this wouldn’t have helped matters. I wasn’t out of meds, I just asked how to get off of them without throwing up. That’s all I was guilty of. Chronic pain is awful. I believe a patient should be offered treatment if they want it. Quality of life and ability to function should matter more than how many idiots will overdose and die because they took too many of the drugs they lied to get. I recently experienced my first migraine. Oh my Lord! I hid under a blanket for 4 days and wanted to die! I sympathize with anyone who suffers these regularly! Mine was a side effect of the fancy epidural steroid injections. I knew better. Every fiber of my being was screaming no, but I had no choice. In order to see a surgeon, I had to have the injections. I was desperate for relief anyway, so I figured if they helped even a little, maybe it would be worth it. Never again. Injection itself was fine, but the week that followed of nausea and a migraine, no, never.

      On the insurance note, I have experience from both extremes. When we had plenty of money and I had a 6ct diamond solitaire on my finger and the best of insurance, I was still treated like crap. Like yes, those paramedics that brought me in with 60/40 BP just did it for fun. They were in on my drug seeking scheme! Drat! Can’t believe the docs caught on to that one! As if.

      Having no insurance I got treated like total crap still. After a suspected stroke, which prompted a full chopper ride to the nearest hospital, they did nothing upon my arrival in the ER. I don’t recall, because I wasn’t conscious when they picked me up and only have what my husband and kids recall to go on. Medics and flight crew said cerebral vascular event. My daughter also recalls hearing someone say my pupils were unequal and sluggish. The ER did no tests, they didn’t even leave the IV fluids in or monitor me. They told my husband that it must have been a drug interaction. He asked how my 400mg of ibuprofen could interact with itself, they had no answers for that, but assured him I was fine. Yes, he wanted to punch all of them in the face.

      I had Medicaid long ago. Much to my surprise, I was actually treated with dignity then. I still can’t figure that one out. They would offer me pain meds when I stated that I wasn’t in pain. I mean, sure, maybe other people would be, but I had always been terrified to take them, goes back to my fear of throwing up. At that point in my life, I had never had them and was afraid of them.

      I currently have insurance, a plan we pay for, and it’s the same old crap. I know that being female has something to do with it. I’m not a feminist by any means, but I have noticed a huge discrepancy in how pain is treated in men compared to women. I’ve come up with a term for this. Estrogen induced exaggeration of symptoms. I mean, I assume that’s the equivalent of what they’re thinking when I show up in their office.

      I often don’t refuse torradol, even though I know I can’t have it. I’m tempted to take my allergy to aspirin off my list of allergies, too, even though I am allergic. I’m not supposed to take any NSAIDs because of the Crohns, but I said that once to a doctor, and he said it wasn’t true. I’ve decided I’d rather risk a flare or bleed than have them think I’m just trying to get pills. Truth be told, I hate the pills. I want the problem found so I can know what I need to do to fix it, that’s all.

      Sorry about your experiences. I know how you feel. It’s frustrating. I want the sob story documentaries and prime time pieces on patients who are in pain and can’t get it treated. All of the abusers whine about it to any camera in sight, victim this and victim that. BS. People like you are the victims of the misguided effort to control liars and criminals. People like you need to be heard. Stay strong. I know it’s hard.

      • Pamela Wible MD says:

        Thank you for speaking your truth. Curious if you are treated differently by male vs. female doctors? A diagnosis of estrogen-induced exaggeration of symptoms may be more likely to happen with male docs? I also have a theory on why you may have received better treatment on Medicaid. May be that you had a new doc fresh out of training who was more idealistic and loving by nature and not burned out. If you come across these docs stick with them. 🙂

    • Julie says:

      Adrienne ~ I so feel you on this. I had a very similar experience in the ER when I had a recent flare up with my multiple herniated disks in my lower back. I couldn’t even walk or stand due to the fact that a nerve was being aggravated by the problem. My right leg was numb and began to ache unbearably when I tried to stand. I think the treatment I now receive is reprehensible. I don’t think that a doctor should concern himself with abuse of medication unless there is evidence of it. If I started asking for more and more, or running out early and trying to fill my script early, or showing visible signs of intoxication or fiending for it, then I would understand. I don’t think that someone else’s behavior should cause me to be punished or treated so rudely. I also don’t think doctor’s that treat chronic pain have any business forcing their patients to undergo psychiatric evaluations as though they are mentally ill. They aren’t qualified to make the determination that a person needs that kind of evaluation. They also do NOT have the right to ask me about very personal information not pertaining to my condition. I’ve been asked to fill out a form asking if I have ever been sexually abused or if I am depressed among many other inappropriate questions. This behavior is unacceptable and someone should start a class action law suit for the total invasion of privacy and discrimination.

      • Mom123 says:

        I had been going to a Psychiatrist for over 10 years, who was not judgemental, listened to my concerns and improved my quality of life. He retired and my life has been completely turned upside with the new Psychiatrist, who took over some of his patients, of which I was one. I was taking Vyvanse (controlled substance) in addition to antidepressant and anxiety medicine. To make a long story short, it became very apparent, while under her treatment, Doctors have the ability to use medicinal manipulation to rid themselves of patients and of any liabilities, forcing a person who needs the medicine to find care elsewhere (thereby possibly making the patient look as though they are “doctor shopping” or go to ER (whereby you run the risk of appearing to be very depressed, in pain and might look so bad, they assume you are a drug addict). When I called into this Dr. office to put me back on a medicine I had been taking for years as I told them how depressed I was getting, her nurse’s reply was this. “If your that bad, maybe you need to go to the ER?” This is what happened to me. She accused me of everything under the sun, including having a history alcohol abuse (I believe she was reading another patients file as she returned a call leaving a voice message for another person on my cell). That’s a hard pill to swallow when you know you don’t drink and have never been a drinker in your life. However, she notified me a month later that was her reason for discontinuing the controlled medication, giving me no time whatsoever to find a new Psychiatrist. Two of my family members had to accompany me to my appointment to set this false record straight. Doctors, like her, are too busy trying to find out how they can rid themselves, of any liability and time consuming acts like (the need to be physically in office to sign a script under Federal Law) to the detriment of patients. I call this act, “medicinal manipulation,” of which pain doctors are also highly likely to be committing. Those of you, who are in great physical pain, I can empathize. My severe depression can be utterly debilitating if not treated properly. Good psychiatrists and most psychiatrists are very hard to get into where I live (they are not taking new patients.) I have not went into full detail of the utter nightmare I’ve endured since being under the care of this Psychiatrist, who also conveniently has the ability to deny a patient from looking at their own medical records. I beleive this tactic can also be abused by Psychiatrists, as a means of hiding any potential negligence on their part. It has become very apparent that these Dr., know exactly how bad one might be suffering, but, nonetheless, use medicinal manipulation to protect themselves. Always check out their reviews as well as the reviews of the hospital they work for. Had I known what I know now about both, I would not have let this woman treat me. But they are in a position to do more harm than good, especially Psychiatrists. In my opinion, that is the real crime being committed. If one Psychiatrist claims suspicion of substance abuse (of which you know you are absolutely not) and that same Psychiatrist also has the capacity of withholding medical records as well as urine test results (humiliating to have even be submitted to that one) and (tests that would also prove you are not in any way, shape or form a substance abuser) but instead could prove they were negligent in your treatment – what does one do? I read that Doctors are the third leading cause of death in this country. After my nightmare with this woman, I strongly believe it to be true. With the growing problem of abuse of these medications, more Dr.’s will be utilizing medicinal manipulation and it’s only a matter of time before Doctor’s are at the very top of the list of the number 1 killer in the US, instead of heart disease. I call it “medicinal manipulation” by those who hold the magical pen to write out a controlled prescription, even to someone they know legitimately needs it. Don’t think for a minute, your medical records can’t be altered to avoid negligence on their part. They also know your in too much pain or too depressed to even get dressed to even think about taking any legal action regarding it. When you feel you need to have an advocate or family member to accompany you to a Dr visit to dispute absurd claims, there’s a problem. I believe those of us, including myself, who are forced to live in pain, hopelessness need to be protected by making medicinal manipulation by Dr.’s a crime as bad as drug abusers and drug dealers. Ps: I’m a stay at home mom who doesn’t drink and never has nor have I ever used illegal drugs in my life. I just want to feel good and focus again to help my kids with their homework. I take my prescriptions exactly as prescribed. And if the unthinkable can happen to me, then there’s a serious problem.
        If taking your medication as prescribed is deemed drug abuse, then I’m at a loss of how to respond anymore. I would like to know if Doctors get paid anymore if they prescribe controlled substances and pain medications people really need? If they don’t, there is absolutely no benefit, just potential liability for them to prescribe them. Perhaps this also plays a large role in their decision making for patients??
        My current status: My new psychiatrist is probably going to treat me based upon some falsity in my 10 year psychiatry record (of which I have been deprived to even see. How can you dispute something you cannot see? When you are wrongly accused of such things, or even “labelled” possible substance abuser, it will carry over to the next physician and physician after that and become a cycle of mistreatment by Doctors. Not good scenario in my eyes.

        • Mom123 says:

          After viewing the video posted regarding abused Doctors and doing a little investigation, on my part, of employees views of the “entity” this Psychiatrist is working for, the picture becomes clearer as to why she would have made detrimental decisions, not in my best interest. The real problem is stemming from the very top of the food chain – The owner and management of this entity. The majority of employees comments are overwhelmingly negative, stating “Nightmare” to work for. “Beware” Some even claim that the entity needs to be shut down and investigated for insurance fraud. This “entity” is also holding my 10 year medical records and Psychiatric notes hostage. How do you fight this, without opening up your your entire very personal past history?

  19. Kathryn says:

    I have a solution. Maybe we should allow the people who choose to lie to obtain the medications in order to get high to suffer the consequences of their own poor choices. I did not choose to get injured, yet I am suffering because no one wants to prescribe anything.

    See the problem? The bad guy only suffers as a result of his poor choices. The little old ladies with debilitating pain from hip arthritis didn’t choose the arthritic joint. I fell down a flight of stairs in my home. Arguably the only choices that led to that were choosing a 2 story home and choosing to go downstairs to check on my 3 year old daughter who was crying. In all fairness, we tried to find a rambler, but one large enough for our family of 6 didn’t come on the market before our previous lease was up.

    Just as guns don’t kill people, pain killers don’t cause a person to lie, steal, or otherwise behave badly. Those are choices. Addicts or not, it is still a choice. What bothers me the most about it is that people who use them for purposes other than relieving pain seem to have no trouble acquiring them. It baffles me. I wonder what I am doing wrong. Am I too female? I already know the answer to this one.

    Hold people accountable for their actions, or at least let them suffer the consequences. I’m not talking about doctors here, but patients who abuse the system. Take liability off of the doctors when it is clear that a patient knowingly obtained multiple prescriptions from multiple providers.

    Another thing. The NSAIDs that they were all too eager to give me have caused kidney damage. I just became aware of this last week and am awaiting further testing. I also know that the NSAIDs have a very real likelihood of causing a Crohns flare. I have been enjoying the last 2 years of remission. The first time in my adult life actually. So the thought of that is not pleasant. Yet I take them because they help a little bit.

    I finally did get in with a surgeon and have surgery scheduled for next week. My primary wouldn’t so much as order an MRI or refer me anywhere. I did seek out PT 2 weeks after the injury on my own in an attempt to mitigate whatever damage was done and possibly help with pain and disability caused by the damage of the fall.

    It isn’t just refusing to treat the pain in patients with legitimate causes of pain that is the issue here. Because we are assumed guilty until proven otherwise, we often times go undiagnosed for long periods. We don’t even seek medical attention when we should because we are used to them assuming we just want drugs. Truth be told, if I wanted drugs, it would cost less and be far less humiliating to obtain them from one of the people diverting their prescribed ones. I only go to the doctor if I think something is serious or doesn’t respond to conservative treatment.

    And in case you’re wondering, the surgery being performed is a 3 level fusion. The thecal sac was completely compressed at 2 levels, which explains the radioculopathy. I also have extensive stenosis, scoliosis, and I don’t even remember what else. The surgeon I’m seeing is quite conservative. Even he was shocked at how bad things were. He was even more shocked by the lack of any diagnostics or treatment. And the icing on the cake? An incidental finding, if you want to call it that, bilateral AVN in my hips. Yes, I saw my doctor after the pain started waking me. That was 2 years ago. His diagnosis? “Just bursitis.” This was after he had prescribed me corticosteroids for the previous 2 years.

    I apologize for the lengthy comment, but I think that people in the medical profession need to know that the consequences are far more than just untreated pain. I don’t even know how to bring the issue up with my current provider or any potential new ones. I’m afraid it will just tattoo ‘drug addict’ on my forehead if I do.

    Thank you for what you do. I wish I lived closer. I’m only one state away. After the back is fixed and I can tolerate driving again, I just might have to come visit. I would travel any distance for quality care. Again, thank you for caring about your patients, as well as the patients of others. It gives me a glimmer of hope.

    • Pamela Wible MD says:

      “I would travel any distance for quality care.” I have a patient flying in from Europe to get a physical because she can’t find a caring doctor. Solutions: 1) Humanize medicine as in allow doctors to be human—to cry, hug, love their patients, to get adequate sleep and exercise and meals so they can actually be present and healthy for their patients. 2) Fix the guilty-until-proven-innocent medical culture. There will always be “bad eggs,” but why hold the 99% of good people hostage to the consequences of the 1%? Happens ALL the time. Look at how doctors are treated by Medicare for example: http://www.idealmedicalcare.org/blog/i-love-old-people-but-i-will-not-accept-medicare/

      This is not health care. Not sure what to call it. But it is not health care.

    • Bob Stuckrath says:

      After my visit to Riverbend ER for a dislocated and broken thumb. I strongly suggest you try and reset it yourself and embrace the pain.

      Why would anyone rip their thumb apart for a couple pain pills?

  20. Kay says:

    I’d like to share my experience. I read your article, Dr. Wible and a few of the comments.

    Speaking from the perspective of a chronic pain patient: I find it difficult to ‘pity’ doctors who routinely stigmatize their patients regarding opiate pain medication. An ‘incident’ happened to me with a new doc I saw recently in an effort to establish care. I was handed a form during this appointment, titled, “Low Dose Naltrexone In Opiate Detoxification”. He asked me to read it if I wanted too, then to let him know what I thought and if I was interested, that he would start me on the medication. At first, I was offended and always in the back of a chronic pain patient’s mind is “Here we go again…he/she thinks you’re an ‘addict'”…this time was no different. Aside from his pontificating that he had nothing against opiates for patients, he contradicted himself, ultimately.

    I did take the information home and I did read it. I research every suggested treatment or medication given to me, prior to trying it, as I’ve had several SEVERE side effects from medications I’ve taken in the past. I read up on my illnesses and any new therapies/meds that come out that might help me. I have mental health issues, as well as physical health issues. PTSD is one of my issues. I’m easily triggered by subtleties that appear to be abusive. I see nuances that others might miss. This does not escape me when seeing providers either.

    Anyway, I read about the medication and was absolutely THRILLED. I couldn’t believe it! Opiates have side effects that are bothersome, to say the least, but Naltrexone in ultra low doses can actually reduce tolerance and can help the opiate work better by taking LESS and over a longer period of time. I was so excited about this, I contacted the doctor’s office, shortly after my med refill, explained to the receptionist what info was given to me at the last appointment and that I would like to set up an appt to get on this medication right away!
    I got a phone call the night before my scheduled appointment. I was told that I was just given a med refill and that I was not going to be getting more! WHAT???? I was told that I would NOT be seen until my next med refill and that I could find another doctor if I wanted too.

    I never said ONE WORD about a med refill. Not one. I was very clear in my explanation as to what I wanted and what information had been given and that my provider asked me to let him know what I thought and that he would start me on this medication if I was interested.

    I was extremely upset and very angry. This triggered my PTSD and I reacted. I called their office and let them know, AGAIN, exactly what I had said before and where the hell did they get the idea that I was interested in a refill when I had JUST received one? They have my records and know me to be consistent. I’ve not done anything to warrant this behavior. Ever.

    I was so upset, I shared it with my therapist. She shared openly with me regarding stigmatizing by doctor’s toward patients who are on OHP. “This happens within my own profession too. You are not the only client I’ve heard this from this week and it’s only Tuesday”…..

    Not only do I suffer the stigmatization of living in poverty and being disabled, but I also suffer because I take opiate pain medications for pain. This phone call was made to me based upon a staff presumption. I was not asked for clarification, if this individual who set my appointment had any questions. This kind of stigmatizing is very emotionally painful to me. I plan to move forward with my complaint to the proper entities. I have experienced stigmatizing before, but never to that degree. Never to that type of unprofessional level.

    My therapist validated for me, something I knew all along. It goes both ways, Dr. Wible. It’s frustrating when doctors portray themselves as victims, particularly when they know the stigmatizing and/or engage in it. The reality is that many of us are victimized and the provider is in a position of authority and violates trust immediately with accusations prior to getting to know a patient in the first place. How can a patient be expected to trust a DOCTOR whose holds these perceptions? Trust is broken from the very BEGINNING. To say that doctor’s hand out opiates like candy, at least from my experience, is not so. They’ll hand you a dangerous anti depressant or anti psychotic before they’ll give you opiates for pain relief. I’ve tried a plethora of medications, often with horrendous and even dangerous side effects. I have had GI bleeds from Ibuprofen.

    I had a manic/psychotic reaction to steroids in oral form. While I was pain free for the first time in two years, I was too manic to enjoy it. When I asked a neurosurgeon how many patients have manic reactions after INJECTIONS, he told me 15%. I asked if there was an antidote to this: “No, there is not, but wouldn’t you rather have a little mania then pain?” You’re joking, right? It was very, very frightening experience and his attitude was shaming and demeaning. Chronic pain patients are often met with these attitudes, are not told about potential dangerous side effects in efforts to pull them off opiate pain medications (intrathecal use of steroid injections is NOT approved by the FDA and many patients have severe side effects from the shot and are told its something else because not all was revealed PRIOR TOO receiving the shot). And let’s be real here: these shots make thousands of dollars PER injection and ‘pain management’ docs can cattle call these patients, with many patients getting these shots PER DAY.

    My options are limited and until a surgeon will code my back pain for surgery, my life will continue to be limited. I do many other things and have tried many other therapies to deal with excrutiating back pain and sciatic flares. But I know that if I had private insurance, I’d not be treated as I am. In fact, it’s quite possible I would have already had back surgery. There is also stigmatizing of the poor, OHP patient in that it’s assumed that these patients are uninformed. I am one who IS, and that too, has been met with defensiveness and SHAMING in return.

    Providers are limited when it comes to the care given with a patient who has OHP, insofar as testing and therapies that insurance will not cover, yet patients like me, who are active in their healthcare, are assumed to be lazy, drug seeking, diverting or non compliant in some other way.

    But the stigmas and sometimes outright emotional abuse delivered to chronic pain patients by providers is more than unprofessional and uncalled for. This is both a societal and narcissistic perspective shared within the medical/mental health community as well as exploited and manipulated in society. I’ve personally witnessed some doctor’s who thoroughly enjoy their ‘authority’ over patients like me. Living in the kind of pain that I do everyday, and knowing that opiates are NOT a cure all, is frustrating. I do NOT like being on these medications, but without them, I’d be bedridden. My quality of life has deteriorated over the past two to three years now.

    I know many other chronic pain patients who are more than compliant. I understand that there are some who are not, however, to lump all chronic pain patients into one category that casts a negative light upon all of us, is unfair and unjust. Too many times I’ve heard and/or read a chronic pain patient in their frustration say, “It’s a few bad apples that give the rest of us a bad name.” No, it isn’t. That’s what people want us to believe. What it is is psychological and professional laziness. To get to know a patient takes time and they should be given the benefit of the doubt unless proven otherwise.

    There is so much more to this than categorizing and stigmatizing the chronic pain patient population (particularly those who are poor), that underlies those who DO struggle with addictive behavior. Applying labels and stigmas is easier than it is to take the TIME to find out what is going on with a patient. I often feel that chronic pain patients are exposed to unnecessary witch hunts, exacerbating health conditions via stress and psychological problems like depression and anxiety.

    It’s difficult enough for me to deal with my many issues everyday. If a chronic pain patient can find a doctor who will LISTEN and get to know them, they have found a real gem, because in my opinion, those providers are less and less common. Many chronic pain patients are also trauma survivors, yet are treated as if their issues, unasked for, without choice, are THEIR FAULT. Providers lack empathy and compassion when dealing with these patients. It’s very frustrating when the patient has a genuine desire to be well. I don’t know many who do not have that same desire but to go to a doctor is a nightmare every time.

    If your house and your corvette are more important to you than patient care, you’re in the wrong business. (I say ‘you’ editorially), but often I feel that providers are more concerned about their licenses then patient care. Add a provider who has a perception problem about chronic pain patients, and the professional relationship with the patient is all but destroyed. I wish that providers would utilize more honesty within themselves and choose NOT to serve this population while holding these views.

    Thanks for a very thought provoking article.

    • Pamela Wible MD says:

      I am so sorry you have suffered through so much as a result of seeking health care. Many doctors and nurses have compassion fatigue. We are sometimes the social safety net for a culture that does not seem to value caring for one another. Hard to place all of that “need to care” on people who are already maxed out and many with PTSD from their medical training. No excuse. Just explaining that most of the people you see in health care started with the best of intentions and a love for humanity.

      • Bob says:

        Then it is time for them to move as far away from humans as possible. Their burnout is expensive, cruel and unhelpful. Forcing a human being to suffer though unbearable pain is disgusting. THEN implying that it’s the victims fault for having intense pain. I suppose we are all drug seeking trash. We are treated as such.

        I have no compassion for a burnout doctor
        enjoy my agony. None whatsoever.

        They make great money and get high on watching their patients suffer.

        • Pamela Wible MD says:

          Lashing out at others will not solve this. If you are interested in a real solution we would train doctors and support them (emotionally & spiritually) in their healing work. Many docs have PTSD. Many have had suicidal thoughts and plans. You are unlikely to get the care you need from someone who is plotting their own suicide: http://www.idealmedicalcare.org/blog/physician-suicide-letters/

          Being compassionate can work wonders for us all: http://www.washingtonpost.com/national/health-science/when-doctors-commit-suicide-its-often-hushed-up/2014/07/14/d8f6eda8-e0fb-11e3-9743-bb9b59cde7b9_story.html?tid=pm_national_pop

          • Sam says:

            What about the patients who commit suicide because they can’t take the physical agony anymore? I know many people who are on that edge. I’ve been there, too. What about us? Do we just keep being labeled and denied?

            These days, I put my battle armor on when I do go to the doctor. And given the issues I’m having tonight, once I do go back to the ER (thank goodness I’m in a new city), I’m letting them know that if they don’t intend to treat my pain, just discharge me and give the room to someone they care about. If I lose my life, I’m definitely writing something for someone to find blaming those who have denied me a better quality of life based on the actions of another.

          • Pamela Wible MD says:

            I’m working on all of this 24/7/365. Doing my best to help patients AND doctors. Divide & conquer or pitting one party against the other is not going to be the best strategy. I wish the paradigm shift could be accelerated (and it could be if we could bust through the media glass ceiling on some of these issues).

        • Sam says:

          Bob, I totally feel you. I am so tired of hearing about the burnout of these “professionals,” who do not know what it’s like to have these illnesses. The only people on this thread of comments that I’ve had any compassion for are the pain sufferers. Our situations are complex and require more than just a cursory glance and a few drug tests.

          I am 33. I had a stroke when I was 25. I’ve been in constant pain since, and have recently learned that I have autoimmune issues. I’m developing arthritis as well. Most days I just stay indoors. Winter is horrible. I’m depressed. I have a child on the Autism spectrum, who I can barely care for because of my condition. I get very little help with him.

          After I had my stroke, I was alternating between no insurance and crappy insurance for years. My only recourse was the local ER. FROM DAY ONE these people had me on dilaudid via IV, coupled with three other drugs. They gave me this for years (so sorry Dr. Pamela, but when the left side of your head is exploding at 4 am every three weeks due to a calcified blood clot that is not asymptomatic and wasn’t removed because you didn’t have good insurance…you’re going to go the ER)…before labeling me an addict.

          Those horrid nurses used to whisper when I came in the ER. “There she goes.” Since it was the only health system I had been a part of since my stroke, and through all seven of my hospitalizations since then, they knew the content my records. They had everything, and refused to perform a few computer clicks into their own system. The last year I had to deal with them was awful. The whispers and comments were just too much, as if we didn’t know what room we were in. They share the same record system as my PCP, so they started sending them my ER records, saying I was just depressed.

          In June of 2012, I went to the doctor with autoimmune symptoms. This woman told me that I was just depressed, and to just see a shrink. She only did blood work after she made me cry. When they came back showing high levels of inflammation, she calls me back, and then I go from being that psycho lady to “my friend” and “my dear.” I wish I had reported her and gotten her fired. To this day I hate going to the doctor. What’s the point? Something’s up now, but I’d rather be half delirious before going. At least then there’s enough tears and screwed up vitals to convince these people that I’m legit.

          I lose sleep every night over pain. I’m told to take Advil. I don’t even keep that mess in my house. Better to take skittles. That might actually have an effect!

          If doctors are nurses are so burned out, QUIT. There will be someone fresh to take your place. Meanwhile, I’m on disability, and really need to get all of my health problems figured out, but since depression is one of them, I’m written off. Let’s hope all my glaring mental health problems are enough to get me through my review in three years, because I cannot work. I want to, but I cannot. Not as a single disabled mother of a disabled child with no help, no respite and no therapy. I’m still trying to get all that lined up for my child. He needs all sorts of help, but because he has medicaid things are crawling at a snail’s pace.

          It makes me not want to live, and I’m angry with doctors. They just legalized marijuana where I live, so now if you smoke that, you have to deal with the secret drug testing and the offers of tylenol if you ever have pain. And you have to wait four hours before you get anything else. I’m sick of it. I’m so sick of it.

          -Stroke with calcified, symptomatic subdural hematoma. Most are asymptomatic, mine is not. Due to the pain, I can point to where it is. Doc who doubted me once was surprised after the CT scan.
          -So-called silent seizures, which present with ictal headaches.
          -Autoimmune issues
          -The big, bad “D” (depression). I didn’t ask to be abused, and didn’t ask to develop this, so I’m tired of it being the focus of an ER doc, or even a PCP. I have a therapist. Consult with them if you’re that curious.
          -PTSD (again, I didn’t ask for the abuse)

          I think that it’s good for patients to lash out. We just need to start doing it in the faces of these people who are ruining our lives. I’m so afraid to go to a new doc now, I wait and wait until I’m bent over, and then I get a strong NSAID, and very few tests. I even went in this last time saying I needed the TESTS, I’ll wait for medication of all kinds. But no. I’m depressed. Go figure. You live in pain. My life is done, and I haven’t even hit middle age.

  21. Tori says:

    Tonight I sat with blood dripping down my legs listening to a charge nurse explain to me why I was mistakenly treated like a drug addicted. Te plea was that I have some compassion and understanding for the doctor who made the mistake.

    But here’s the thing. I didn’t go to school to be compassionate to doctors and be empathetic to doctors…. They went to school to be empathetic to me. Anyone else see the simple moral problem here?

    By the time I left I had insisted that my doctors from Emory (who told me to go to te Er ASAP) be called. They were. And I got an apology from the nurse and nervous excuses and a half ass apology from the doctor.

    Stop treating everyone like they are drug addicts. So the personal down the hall might be… But if you aren’t mature enough to walk out of that room and treat people with respect being completely disconnected from the drug addict… You don’t deserve your title and you need to go into family practice where you know your patients on a personal level.

    I am going to destroy this mans career. You can’t expect grace when you give none.

    • Pamela Wible MD says:

      I am so sorry that you experienced this treatment. My plea is that you not take the eye-for-an-eye approach. Doctors are suffering from PTSD, burnout, depression—even suicidal thoughts—at a very high rate. It was never your doctor’s intention to hurt you. We did not go into medicine to be mean and disrespectful to our patients. Our training and the system destroy our souls and we have a sense (not unwarranted) that there is nobody that we can turn to for psychological help without undermining our careers. We had compassion when we started our training. It was beat out of us. Please try another approach. Write a letter. Mediation. Something. You could make a big difference for future patients and for this doctors if you try a compassionate approach to resolving this pervasive problem. Feel free to e-mail me as I have lots of ideas. I know you may not be in the mood to be the bigger—more empathic person now and patients are not required to care for their doctors who have caused them unintentional pain, but I beg you to please see the bigger picture. Doctors are abused and bullied relentlessly in this profession. Some can take it and keep smiling and fake it. Others can’t. I have been through years of therapy to reverse the scars inflicted upon me by my healing profession. Your doctor was obviously suffering from compassion fatigue. There are specific ways in which you can help him regain his compassion. It is not through destroying this man’s career.

  22. Brandi says:

    I too am a chronic pain sufferer but from Arthritis. I think your statement on being “Burned Out” is a cop out with all due respect. I have had a pc doctor who is now in their 70’s i see no burn out and truely loves the patients and takes time with them. I agree with all who made statements about being treated like we are drug addicts. It’s just to humiliate the patient and let’s be honest before we we start pretending ok? Most doctors today are trying to save their own hides instead of what the patient really needs. I live with pain from morning until night sometimes of i’m lucky I have a few ok days. Pain medications help me live a live of somewhat normalcy and help mobility. The new PC doctor i am seeing now took and put me on stronger pain meds so i do not have to take as many it was her suggestion NOT MINE! I was very leery on going on anything stronger and more leery of her prompting me to call her if i change my mind. Up till then i had refused until i thought it over and was happy that i didn’t have to take so many a day. Four months later i call them for a refill and got this weird message ” The doctor want’s to talk to you about your pain medication, and well you haven’t been in …in over six months”. My jaw dropped , i said hello what?? I did not have a good feeling about this , the receptionist demeanor changed since i called for an appointment , she was quick nasty and i felt like i just committed a major criminal act! I have never abused my medication or had two different pharmacies with which i pick up all my medications. Someone lied !, i always keep records on store of when i went to my P C and when i have appointments and times and dates. I keep these for my own protection. I have no clue what happened and am about to find out as soon as the rolls 25th around and do not understand why someone would deliberately do and say that. I cannot even begin to describe the humility and the feeling like i wanted to just jump into a huge hole and have it swallow me up. When i asked as i probably shouldn’t have “why does the doctor want to talk to me about my medications?” I was told “you just have to talk to her when you get in ok?”. The bottom line is that i’m stuck without my medication and cannot go back to my other primary care doctor now for fear of being branded as a junkie. Why is this so happening to innocent people? People who really need professional help with pain? I would like some of the doctors that treat patients like criminals and pill seekers to slip into our skin for a week or more, maybe a month and see what we have to go through on a daily basis! If your job burns you out , then seek out a new profession, do not condemn us before you even get to know us or pretend to know what we are going through! The thing that hurts the most is the betrayal , she offered and i had a gut feeling about this as to say no but it made perfect sense to me at the moment i decided that less was better . And doctors wonder why they are not trusted ….come on please! This is a classic example , my head is still spinning from this and i am stuck with no answers why . I agree with the posts put up about the doctors hold the power and they know it , to either help us suffer or not suffer. Maybe one day looking back some doctors here will read our posts and be in the midst of the worse pain they ever felt in their entire lifetime! and have to go through all the madness of sleepless nights and agony over and over again and their be no help for you as like with us. I have had a lot of doctors over the years and can count on one hand two really caring ones . So much for statistics.


    • Pamela Wible MD says:

      Thanks for writing Brandi and for sharing your story. Most doctors when they fall ill find that it is a huge wake-up call. They are thrust into the other side of this dysfunctional disease management billing system (hard to call it a health care system). Seeing things from the patient’s perspective is certainly an eye opener and creates a level of empathy that is hard to come by otherwise. I am so sorry you are suffering and hope that a solid relationship with a caring primary doc will help set things straight.

  23. James of Santa Rosa, CA says:

    Pamela, I’ve been on this site for many hours now. Read every letter about physicians and suicide, viewed your getting naked with patient’s TED talk, read many of the blog post and especially the comments sections.

    What I’m not seeing in these stories of pain is cannabinoid-based therapeutics and the value of the endocannabinoid system on homeostasis. Why not?

    If I recall correctly a quote from a D.O. (Dustin Sulak?) who recommends cannabis to his patients said this: ” My patients don’t just tell me that cannabis works for pain, they SHOW me by using it to replace their narcotic medications.” This appears to be a trend in medicinal cannabis states and I’m wondering why NONE of these patients on your blog have received information about full extract cannabis oil and the other cannabis-based medications.

    Schedule I nonsense doesn’t impress me much because with the right ratio of THC-to-CBD there’s a version of full extract oil for ANY age and if homeostasis is the goal, almost ANY condition.

    I’ve just spent the last year using PogoFrog.com as my entry portal to PubMed and research studies on cannabis-based therapies. Anecdotes from thousands of patients, foreign studies, GW Pharmaceuticals and their research on whole-plant cannabis ALL add up to a safe replacement for most uses of narcotic medications just for starters. NIDA was responsible for discovering the endocannabinoid system though you wouldn’t know it from them or the U.S. govt.

    People and physicians say getting high isn’t medicinal. Well, I’ve got news for folks, a little positive attitude and distraction can go a long way in dealing with pain. And, for EVERY patient who may not be prepared for psychoactivity, bring on the CBD and make sure it’s in equal or greater amounts than the THC content.

    I was on M.S. Contin for 17-years. I used full extract cannabis oil to withdraw and detox three months ago on my own decision without being asked by my physician. I also refused Clonidine as I wanted to go with a cannabis-only result. I had zero nausea or diarrhea and symptoms were minimal. I also use the cannabis oil as a replacement for EVERY Big Pharma medication I used to have prescriptions for.

    Based on solid evidence and multiple studies cannabis can replace narcotic analgesics, NSAIDS, anti-depressants, Lipitor and on and on. So, why aren’t any of the patients writing to you being exposed to cannabis-based therapy. With CBD in the mix it can and should be “cradle-to-the-grave.”

    The LD50 of cannabis seems to fit the oath…first do no harm… and by that standard should NEVER be a last resort, but the first try BEFORE prescribing narcotics and the bleed-to-death NSAIDS and gabapentin.

    I would imagine allopathic-trained physicians would think I’m an idiot and just interested in getting high, but let me leave your doctor readers with four vocabulary words they all should know about cannabis:


    While those terms are based on cancer that’s just four examples on what DATED allopaths are missing out on if they don’t use the endocannabinoid system in their practice. I’m totally disabled, on SSI don’t own a car and I bicycle everywhere. I couldn’t do that without cannabis.

    The first comment on this post from Doc was AWESOME except for TWO things. Too many Big Pharma, bad solutions with sided effects (NSAIDS, gabapentin, etc.,) and NO mention whatsoever of cannabinoid-based therapy.

    I’m used to getting shit from people for advocating for cannabis so feel free to pile on if you disagree. Western medicine NEEDS to get over it’s fixation on single molecules and synthetic versions of WHOLE-plant cannabis, yesterday! People who are suffering needlessly could and should be helped by proper care and feeding of the endocannabinoid system.

    I’d love to give you a big hug for you reek of compassion. Take care of yourself.

    I use cannabis primarily for neuropathy and osteoarthritis. For neuropathy NO Big Pharma medicine comes close. Doc, you can take your gabapentin and………..

    Final note: CBD-only legislation is NOT in the best interests of patients. There’s only a small subset of pediatric epileptics that benefit from Charlotte’s Web that basically THC-free. GW Pharmaceuticals has locked onto a 1:1 THC-to-CBD ratio as the most therapeutic ratio for everything except their new Investigational New Drug Epidiolex which is basically similar to Charolette’s Web variety.

    We can wait for expensive synthetics from Big Pharma OR we can start helping patients NOW at less cost.

    • Pamela Wible MD says:

      There are many plant remedies and “natural” approaches to a wide variety of ailments that doctors never discuss. Why? We are not trained in these treatments. We fear straying from the dominant path due to lawsuits (you are deemed guilty if you “stray from community standard” = what doctors in your specialty generally do in your community). Also, since there are legality issues, doctors fear breaking the (federal) law—even in states where medical marijuana is legal. Most docs are employees on salary. They are told what to do and what they can not do by their employers. The only docs I know in Oregon who approve of medical marijuana for their patients and sign off on the paperwork are independent docs like me.

    • B.D. says:

      I have been prescribed opioids since 1997 and would very much like to withdraw from them using medical marijuana. Could you recommend articles I could read, websites I could visit, in a search for usable information? My dream is to be off of these drugs but not to be in agony every subsequent day of my life. It sounds as if you’ve accomplished this. Any help would be greatly appreciated.

  24. James of Santa Rosa, CA says:

    I’ve pushed my congressional critters as hard and as often as I can in an attempt to change their support for Schedule I status. If rescheduling cannabis was in your power, where in the CSA;’s five-tier system would you place it, and why?

  25. Char says:

    I have been treated like the scum of the earth to where I am to the point where I have given up all hope, and go through days wondering if I would be better off if God took me home instead. I have GAD and my anxiety and panic attacks are severe. I am given everything BUT what is designed to treat my symptoms. I have gone on for years and years in severe distress. My life has suffered significantly. My relationships have suffered significantly and I have very little going for me now thanks to doctors with benzophobia. I have been talked down to, yelled at, screamed at, accused of drug seeking when all I want is relief for my severe anxiety and panic attacks. I have been on so many drugs that cause chronic and unpleasant side effects (some of them dangerous) that I can’t begin to count them all. NONE of them have worked. I have nearly taken my life because I just can’t go on like this, ended up in the hospital only to have the chief of psychiatry give me klonopin which was the only thing that helped, but I could not get as a new patient. When the script ran out, that was it! Any new doctor, when I mention this treats me like scum of the earth and I have been basically going without my symptoms treated for over 10 years. This takes a serious toll on a person, not to mention my blood pressure and heart from years and years of chronic anxiety. I am a Godly woman, and abusing drugs go far from my path with God. The bible states the drunkard will not make it into heaven. I take my relationship seriously with God. Yet, doctors treat me like I am scum, not worth it, liar, drug addict and have been called names you will not even believe what has been said to me… because I dared to mention that was the only thing that has helped my anxiety.

    I have tried the natural route too, with very limited success. I take valerian root, I walk, I do exercise and could go on and on and on… but that does not completely control it. I watch my diet, and what I consume and am considered a health nut by my friends and community and my church.

    Yet, the anti benzophobics would rather me suffer and prescribe me worthless meds… I am at the end of my rope. There comes a point where a doctor does more harm than good and in my case, I can testify for hours on the damage that has been done to my life because of some of these doctors. I HATE what the drug abusers have done to those that really do need these meds. Because of them, I suffer and each and every day is a struggle just to make it through one more day. The doctors don’t care and the system is broken. Big pharma pushes these awful drugs that do not work just to make money and the doctors listen to the drug reps more than the actual science behind it all. If you go to any anxiety forum, just look at the amount of people suffering because of this. I thought it was a doctors oath to do no harm, yet, by letting me suffer year after year, in such torment it is harm. I need something that works like a diabetic needs their insulin. They prescribe SSRI drugs that make people dependent on them and withdrawal is hell, but they just change the name from addiction and withdrawal from those drugs to “discontinuation syndrome”. The system is broken and doctors don’t care… or should I say, a few do but I can’t afford those ones.

  26. Jo says:

    I’m to the point that I need counseling of some sort after years of being treated like crap and/or like a criminal, I Just want to get on with my life and be able to take care of my responsibilities. I am sooo tired of walking out of a pain clinic feeling dirty, and crying because the doctors treats me like an idiot and criminal, I’ve fought hard and for a long time to recover this body, I’ve followed every rule, law, and decision from the doctors to the point of letting them destroy my pancreas, skin and who knows what else due to allergies to the nasty meds, shots and all the painful therapy and machinery for traction etc. etc. not including being radiated over and over even though docs know that deterated discs don’t reverse. I get tested once a month by one doctor and blood tested every three months by another, I am clean clean clean for years upon years, didn’t even take an aspirin before that truck hit me, I have proven my self over and over no matter how difficult it’s been, and it accounts for nothing, I am tired of being treated like scum of the earth, you should hear some of the illegal and horrible ways docs and nurses have treated me and the things they have said to me, and how those pain clinic doctors get such a kick out of making sure the patients know that their quality of life is held in their hands. those doctors scare the daylights out of me, I hate them and I hate the chronic pain, and thanks to the rotten nasty way patients are treated, I walk out of the doc office feeling lower than scum, no wonder why so many people seek out self medication. No one ever pats me on the back and says wow you have really fought to get your body and mind working better, and wow, you never abused your pain meds, in fact you refused many of the dangerous ones and faced horrific pain head on. I’m crying now, I’m soooo sooo tired of it, when will it stop?

  27. Linda Q says:

    Glad to have found this site; some consolation in knowing I’m not in this boat alone. Have had 4 joint replacements, unsuccessful back surgery, and 7 broken bones in the past 5 yrs, can barely walk with a cane or walker. Current orthopedist thinks everyone is a drug addict and only prescribes 30 pain pills at a time so I have to call in once a week for refills. Thanks also to Texas’ usual hysteria over any kind of drugs, hydrocodone can no longer be called in at all! I’m trying to recover from a severe fracture of the humerus and reverse total shoulder replacement (8 wks post-op) and am in virtually constant pain, trying to do physical therapy. I am SO sick of being treated like a junkie and tramadol is not cutting the mustard. Does anyone endure 5 major surgeries trying to stay mobile just for the drugs??!! I need to take these drugs to try to have a life, not to escape from it like the morons who OD taking them for fun.

  28. Jim says:

    I have been reading every entry and am floored at how bad the problem is. Am also a new chronic pain patient – learning, even fearing the path that is coming.

    I had a severe muscle injury in my last overseas combat deployment (2010). We’re about half way through the flotilla of specialists, but it is starting to look like fascia related or nerve pain after the muscle group healed. And I hate it. It’s like I have an invisible gnome stabbing me in the muscle all…day….long… He even wakes me up in the middle of the night with occasional spasms.

    I’m also learning the huge effect this has on productivity and fatigue. A few years ago I was indestructible. Multiple combat tours. 18-20 hour days without a shrug. But after a full day at the office with the “pain gnome” I’m asleep on the couch in like 30 seconds.

    Enter the wonderful adventure with doctors. Yes, the spectrum so far has been wide. Some docs have been awesome – working through various specialists to get an answer. Some have been arrogant sycophants who assume anyone without a gaping wound is trying to play them. One year I got a really bad case of strep – blisters and all. Painful as hell. The doctor had a med student in the room giving him a lecture as he went through the exam (Lesson #1, I NO LONGER consent to having students in my exams) actually saying “See his response to that? This is a lie because the pain usually does XXX and YYY. Patients like this usually want codeine so they can go get high and sleep.”) [I made a request to never be seen by this jerk again].

    So now we’re getting to the uncomfortable point (and age) where I will probably need pain meds. I have no issues with following a well-ordered regiment and WORKING WITH THE DOCS TO MINIMIZE THE RISKS. I understand that there will be a moving target somewhere between over-medicated and pain-reduced. And I’m noticing the exact behaviors a previous poster noted. ANY doctors I’ve discussed pain problems with become immediately suspicious. I try to keep the discussion focused on the pain reduction goal, and they relax a little. I also tell them directly that I am a professional engineer with a Top Secret clearance, that I CANNOT afford to step out of line. I’ve noticed that helps a little as well.

    Some run away like a Monty Python sketch it’s so funny. Like how dare I waste their time with this pain drivel. (These are the kind who refuse to discuss any medications, but prescribe physical therapy to torture you with. Yeah, went through that one, got the bruises and tee shirt). These are doctors I try hard to avoid because they are cowards, interested in their own careers than the patient. Look me in the eye and professionally discuss the options.

    Some are actually happy to discuss the pain, but also end the conversation with “I don’t prescribe pain meds.” Hey, at least I get an honest stance. These are usually Urgent Care docs. (Learned this after being rear-ended a few months ago).

    I’ve learned the value of a consistent doctor-patient relationship. They will get to know you, and will respond properly when the time comes to discuss pain relief.

    Finally, I’ve learned the value of being prepared with summarized yet detailed documents (X-rays, MRI/CT images that show the injury in question), and how important honesty and making it VERY CLEAR that your goal is reducing the pain, not the meds. “I brought you this to show that this is a legitimate injury. Here’s a copy for your file [AKA Here’s something for your protection / top cover].

    You have to be very careful here because the line is thin. Too much detail and they immediately retreat into thinking you are a manipulative addict. Too little detail and you risk wasting the 7.5 minutes of valuable time on something ineffective or entering in a useless circular discussion of “tried that”, “That too”, that will probably end up with a wasted appointment.

    In my state the effects on legitimate patients is serious. The addiction rates are skyrocketing because people simply cannot get care and go off to self medicate on their own. Doctors live in constant fear of the state narcotics cops. They raid offices with total impunity. We had a recent groundbreaking case where a doctor was tried for Murder II because several patients died. Yes, Murder II. He eventually got a plea deal, but the message to was clear.

    Some relatives of mine here had a close friend dying of pancreatic cancer. In order for her to receive end of life pain meds, she was required to attend group therapy for chronic pain. Yep, you heard that right. Three nights a week, the last six months of her life (Instead of spending it with her family) she was at group therapy sessions. “I’m dying. If I don’t attend these sessions, I’ll die in pain.”

    So now that I’m staring at a chronic pain situation, I fear the worst. It’s like we’re going back into the 1850’s where the only help you’re going to get is a salt-water soaked, leather-covered stick and a shot of rot-gut whisky.

    I am angry at our government for taking the easy way out. Ignoring that 80% of the overdose death statistics they cite are patients REALLY OFF THE PATH. They are either not being treated for pain, or recklessly ignored all sanity taking 10x the prescribed dosage (and mixing it with alcohol).

    They use grossly general statistics (like total numbers instead of rates – our population in the USA has doubled in the last 20 years). Of course you’re going to have more deaths.

    They sometimes include liver toxicity deaths from the APAP, children who get to teh bottles and poison themselves, and suicides in the numbers. [Note that the addition of child proof containers drastically reduced their numbers in the 80’s]

    Most damning – they ignore the fact that almost all patients following a well-regimented and customized treatment plan DO NOT become addicted and go on to lead productive lives.

    Do I want to take pain killers? Hell no. I don’t enjoy the altered states and worry about my liver. I cannot enjoy a beer with friends after work. It up-ends a lot of things.

    But I do enjoy even a brief relief from the pain when I get home from work. I get better rest for the following day and don’t walk like a pirate.

    Is relief for the pain so hard to ask?

    • Pamela Wible MD says:

      Excellent summary Jim! Be Honest. Bring chart notes documenting prior tests & treatment plans. Develop a long-term relationship with one doctor who has your back. That’s all you need. Good docs are still out here. And all docs wanted to be good, but some just got battered into PTSD and worse by their training & abusive workplaces.I’m trying to change things. 2015 should be a year of great positive change in health care. 🙂

  29. Vanessa says:

    I know that I for one, am fed up with living with the pain of migraines and lower back pain. I am fed up, as a nurse, that I constantly give opiate pain meds to drug seekers, yet I as a nurse cannot get the same. I have tried everything for my pain, yet the strongest my doctor will give me is paracetamol 500mg/30mg codeine. I have taken this for several years but my body is getting used to it now and it takes more doses to be pain free. It offends me that as a nurse, I look after other people, yet now that I need help my own profession basically gives me a big “fuck you” and treats me like some piece of shit junkie. Several months ago, my husband tore his rotator cuff and was in agonising pain. He has now had surgery for it, but up until he had the surgery last week, the past 4 months he has attended his doctor’s surgery and asked for strong pain relief because he had tried all other options and his doctor said “no because opiates are addictive”. Yet his surgeon has given him scripts for oxycodone and when my husband told his surgeon that his own doctor refused to prescribe oxycodone, he was quite taken aback.

  30. Vanessa says:

    Just a further note – I have tried everything, such as the panadol/ibuprofen combination, tried them on their own, Tramadol, Panadeine forte/mersyndol forte, i’ve tried amitryptiline. All I am asking for is the same human right as every other human being in my town – the right to be pain free! I am so tired of having patients come through my ED and wards who have prescribed opiates for their various issues. It’s not like I haven’t tried different things the past 6 years. I’m fed up with looking after everyone else yet now that I need help my own profession refuses to help.

  31. Malone Hayes says:

    I would just like to state this I suffer from CRONIC cluster headaches everyday! I have been with the same Doctors office for over 27 years same doctor for 25 until 3 years ago when my Doctor retired. His partner never liked me he always thought I was taking to many narcodics and when my doctor was gone and he had to fill my meds he told me he would not be refilling this many again!, well from the first meeting with him I went through total hell and withdwrals because I new he was going to cut me way down! He did he wanted to cut me into more then half. I was taking 320 oxycodone a month yes that was a lot! He cut me back to 180 6 day. Witch really works pretty good for me. I take them now as needed because I don’t like the feeling anymore of being so high the pain is gone but I can’t do anything because I’m so messed up! Every time I goto see him “every three months now” I feel scared!! I’m almost 60 yrs old now till me why should I be afraid of going to see my dam doctor? He NEVER HAS ASKED ME ONCE!! How my pain is! Never asked me anything about my head! We talk every time about me and what’s up with my life and always about my last visit review but NEVER ABOUT MY PAIN! How often they come how long they last nothing. Anyway I’m worried he will just take them away if I till him I take them the way I need to not the way he tills me. And that wouldn’t be a good thing! I take at least three a day just so I don’t get sick but If it comes I take the 6 some times I’ll take 8 if it don’t go away! Some times I take 5 but the thing is that these doctors think they are GOD!!! and have control over our lives because they control us with pills! It’s so wrong how they hold them over our heads and we have to worry about loosing them if we don’t go along with what he says! I just gave him a nice Invica watch 375.00 watch the last visit we had a month ago. I should be going back to see him in nov like the 21 or something but he called me this morning and told me I just want to be straight with you I feel like your pain dosent require as many pain pills as I’m giving you and that when you come in I will be cutting you back. I said ok doc it is what it is but could we wait until after my vacation before we do this? He said nope friday when you come in! Friday my appointment is in nov I tought I was just getting my refile? So I have been planing for over 8 months and he’s fully aware of it that I was going to Philippines to get my woman and kids! In December for Xmas and new years. So he’s going to put me through all this getting used to a low dose now wow have a great time Malone!.
    These doctors have no idea the feeling of not having your meds they say you’ll be fine it’s just like having the flu! Bull shit! How about you take 5 a day for lets say two months then lets say you just stop taking them! 😉 you’ll be ok just like having the flu remember! Maybe then they would get a little understanding as well as respect for the people who by the way don’t ask for the medical problem they have and sure as shit don’t ask to be turned into a addict! It’s not fun taking this shit! It’s not fun knowing that if you want to go some place you have to make sure you have your pills you have to gard them with your life cause if you don’t you’ll either get sick as shit or one of your so called friends will steal them! Also I sure as shit didn’t asked to have this pain everyday of my life! Can’t hold a job because the boss don’t understand your a person to and you have kids a life bills just like everyone else! And it’s really not your fault you have these things! Doctors don’t think or give a shit that your life is nothing like there’s first you don’t have millions and live like a king?! They don’t stop to think that this not only affects you but your KIDS! There school events you can’t go to because the friends moms and dads and the other people will look at you because of how your owing and sounds your making to help deal with the pain they will look at you and say to each other he’s high or he’s on something what’s wrong with Clifts dad? Bla bla bla! They don’t give a shit that if you do have a job the heart ship you had to go through so that people and boss accepts you and understands your problem! Because your a great worker and nothing you can do. They don’t think nor do they give a shit! But what they do care about is this?? Your appointment! If you fail to show up oh there pissed off! If you don’t give them a 24 hr notice well you pay that none show money 125 at his office but wait? For those of us that have cluster headaches we don’t know 24 hrs in advance if we will have a headache on that day at that time??? , so what do you say about that? It’s all about that money! Think about this people they book patitents every 15 minutes ok so that’s 4 people per hour! X that by 7 one hour for lunch!! , then let’s look at the $225.00 per visit my doctor gets! That’s 28 people per day @ 225 = $6,300 a day X 5 days and look why give a shit people have to come to the doctor and they no it!! Anyways 6300 X 5 = $31,500 a week people! But wait don’t get up and leave if your there on time even 15 min early but they are 30-45 mins late do you think it’s ok to leave hell no!! They don’t care that you have a life things to do maybe get back to your lucky to have job so you can get your little chump change to take care of your kids!
    Bottom line is they suck and they don’t give a shit about you me just about them selves .

    • Pamela Wible MD says:

      I’m so sorry. These doctors mostly all started out as young medical students wanting to help humanity. They have been injured by the system and are functioning poorly now with empathy burnout. And it sucks.

  32. C. James says:

    All these stories sound so familiar. I never had any health problems as I was always a strong athlete through college. But one day on my way home from work I was struck by a drunk driver. I had to have 3 levels fused in my low back, my right knee replaced, and a plate and pin put in my left leg. The pain is awful some days. I have continued to work out light and walk to stay in shape. I don’t want to go on disability and enjoy my job. My company forced me out as I was leaving to do rehab. I could get no legal recourse. I was always an outstanding employee moving up through the company and traveling the US and World to do jobs but it didn’t matter. I took early retirement and continue to travel for different companies as a consultant. It is really hard to get your meds and travel. Some countries will not allow their doctors to prescribe opiates such as the middle east and their people suffer. I usually am gone for as much as 3 months at a time. I now have a wonderful doctor who takes fantastic care of me. But now things are changing. My doctor is a neurologist as most of my pain is nerve problems from the damage. The DEA is changing the rules again. Now they will not allow anyone except Pain Management specialists to write the prescriptions. So now I have to find a new doctor and it is so hard on the Gulf Coast to find a doctor who will write for 3 months at a time. Again, I am someone who does not nor ever has abused my meds but it is heck to find a doctor without having to drive 2 or 3 hours or more. The DEA does it again. They shouldn’t even be involved at all but they continue with their restrictions. No doubt this is going to hurt my doctor’s practice but they don’t care. I am working in a country where I can get the meds but they only write for 2 weeks at a time. I have to see the doc every 2 weeks and get a new prescription written. Absolutely ridiculous. I had the perfect doc in the perfect situation but here I am starting all over again!! HELP!!!!!!!!!!!!

  33. Jeff says:

    The author attempts to rationalize blacklisting due to drug abuse of drugs that doctors prescribed in the first place. Has the OMB ever decertified a doctor in their long useless history?

    I am a blacklisted patient and was blacklisted because I won a illegal lawsuit filed by healthcare providers due to non payment. I tried to reason with the hospital and doctors as they billed me for things I did not get and left me with an autoimmune disease as a result of malpractice but they refused.

    I am also blacklisted for presenting the symptoms of MS. One of those symptoms is irritability. Doctors are not bright enough to recognize the symptoms and then deny a patient medical care for being sick. A Oregon attorney general refused to run for re-election after he gave a press conference and stated the legislature would not allow him to prosecute the illegal collections practices of doctors and hospitals.

    Notice the pattern of doctors causing the problem and then punishing the patient for having it? It does not get any psychopathic than that but doctors are number 8 on the list of occupations that attract them.

    Nothing short of a ballet measure that includes prosecution of the CEO if it is policy and the doctor for whatever happens to the patient as a result. Attempted murder would be the charge in my case. Add to that ANY special liability protection for anything medical as that is a violation of equal justice and just another example of corruption. How many of you know half the hospitals in the US are owned by the Catholic church and 1 out of 6 lose their homes to corrupt medical billing?

    I bought a microscope, did my own lab work, bought drugs used in agriculture since no prescription is needed and cured my own seborrhea, MS and cancer. All of which they stated was incurable. The corruption in the US medical system goes beyond eugenics, it is mass murder based on my knowledge and experience on this matter.

    It is time for the people to band together and rise up. We all have a dog in this fight.

  34. Nick says:

    Hi id just like to put my 2 cents in here. First if you want to stop people from diverting or abusing their meds. DO PILL COUNTS!!! Frequently.. People who abuse or sell their pills will not have enough if you count them once a week randomly. Me and my fiance both have disc protrusions in our back and she has them in her neck (i believe I do too but cant get an MRI because my doctor is incompetant). Her doctor refuses to treat her because she is 24, they offer her no other options to control the pain other than thats too bad, just deal with it because at 24 we will give you no type of opiate pain medications. Yet when i was 22-24 (im 28 now) I could get hydrocodone without a problem. If she has the pain and tests to confirm it there is absolutely no reason for her not to get medication she needs to work and live a semi normal life except the governments meddling in everyones business. So we have both resorted to buying heroin or pain meds off of people we know for when we are in pain mind you, not to take constantly just to get high. Yes heroin can treat pain, especially when you have no other options. Yes we have been to many doctors in our town. In january hopefully we will have the money to send her to an out of state pain clinic to get her treated.

    How is it fair that people who are young are made to suffer with horrible pain, or forced to go to the streets just to get enough relief that they can work? Is this what our doctors and government wants? Now you seem like a decent doctor who cares. So to protect yourself and help your patients, pill count them, atleast once a week, you will find out whos selling or abusing them very fast. I was kicked out of my pain doctor because I told him to stop sexually harassing my fiance or I would report him or press charges. The next time I came in he gave me a urine drug screen, which he never did out of the 3 years I went to him. Then some how it comes up positive for morphine (which I did not take when i was receiving treatment.) Isnt that funny?

    There are not enough doctors who care so many many patients are forced to lie when seeing doctors. My pain doctor did not listen to me when I told him certain medications were making me sick ect…. so i just gave up on telling him and I started just telling him what he wanted to hear so I could get my treatment and relief from my pain.

  35. In pain says:

    Bullshit to all you know it all docs, I have been in SEVERE CRONIC FUCKING PAIN FOR A YEAR, I have a ruptured / destroyed disk in my back, I have to beg my dr for a 7.5mg hydrocodone I have had EVERY FUCKING SHOT, steroid, epidural, all of it, going through this shit for over 10 years!!!!!! My fucking genius Dr actually tell me ITS HARD for me toWRITE A PRESCRIPTION??? WHAT???? Is your fucking hand broken??? Did you not learn to make those letters in grammar school? WTF?? You just DONT WANT TO PRESCRIBE THE MEDS ! PERIOD!!!!! I don’t have trouble writing!!
    What the fuck is your problem with writing?? All you Drs are worried about is the Govt looking at YOUR BOOKS and calling you on it, that is the bottom line , that is it, COVER YOUR ASS NOT YOUR PATIENT.

    • Gregg Crow says:

      AMEN!!! I could write a book about this.
      I just got dropped by my doctor because of a small trace of marijuana in a surprise piss test. I have more wrong with me than right, have endured 6 surgeries on my back in 4 months, Tardive Dyskinesia from neck to shoulder from one of the drugs this quack ass had me on, for which I had to have nerve blocks, and ultimately surgery to destroy the nerves, but it was only about 70% effective. My knees are shot – doctor told me just to use them until I couldn’t take it anymore. Peripheral Neuropathy with ridiculous pain. A failed lumbar fusion – I hurt so bad I wait until my wife and kids go to bed and just sit hit holding my dog crying every night it hurts so Goddamned bad. I have PTSD, and a whole host of other shit. Bottom line is that my body is shot. Doctors could at best moderate the pain down to maybe 7, so I sought out help from the streets about a year ago (and it took a long time searching, and a lot of danger acquiring). On the first hit I could feel the Dyskinesia ease up and my shoulders just completely relaxed. I only smoked 3-4 hits and I was sufficient for the rest of the day. This Christmas my wife helped me against better judgement (she works in a marijuana paranoid occupation, so for her to be seen out trying to get me some help…all I can say is God, please love her). It was more potent than what I had been able to get gouged for before, so I only needed one, and maybe two hits to relieve the pain. I have no problem telling anyone that I was augmenting my opiate drugs (which are killing me) with marijuana. Then again, it is nobody’s business – neither Dr. nor DEA.

      I literally feel like I had someone going through my trash to find out any dirt on me. Oh yeah, the best part, this Bill, rule, policy…I don’t know what the hell to call it other than a Civil Rights violation…is supposed to be about opiates. Well the doctor that dropped me treated me for something completely irrelevant to my pain. My PCP prescribes my opiates. I expect that to come to an end as well.

      To the Physicians who may read this. You have literally left us out to hang….a lot of us…with no recourse regardless how bad the suffering is, and regardless of the abrupt withdrawal from the drugs that you put us on. To all of you, there will be hell to pay in your futures. If there is a God, surely you will be damned to hell.

      And yes, I do wish bad on you and your families, and hope that you encounter a health situation that fucks you like you fucked me. I pray to God you have a family member come down with a situation that leaves you to hang like I have been left to hang. I pray to God for it! I want you to suffer. Either personally, or for a loved one. I think that will be my new daily prayer for all doctors.

      Burn in hell!
      So I was dropped on the spot. No weaning down of the prescription poison, and from everything I read, no doctor will take me on again.
      I am totally disabled and just waiting for the day they fuck that up for me.

      That will be the day the PTSD takes over, and I can’t be held responsible for what comes from it. I will be out of control, and violent doesn’t even begin to describe what a breakdown is like. I think evil is a better descriptor.

      I say to fucking hell with Allopathic doctors, and if I can hold out for legalization, I will never see another Allopathic again. I hope they all lose their patients. With as many people for legalization today, that just could happen.

  36. Too Young says:

    So I’m a 21 year old female, before my pain started at age 18 I played lacrosse, soccer, did rock climbing, snowboarding and back country backpacking. I’ve had my appendix rupture and doctors told me it was period cramps and sent me away. It took two days and 4 doctors to find one who would actually do a blood test and then a cat scan and then surgery. I’ve had my share of hard hits to the head where I lose memory, see different colors, and couldn’t stand up. I’ve also had only 2 migraines but both made me lose my vision for a day or two, lose function in my hands, and see auras. I never took any kind of pain medication except for the 10 days after my appendectomy. I don’t like taking any kind of medication. I never went to the doctor unless I knew something was wrong; and even if I did know something was wrong, I’d wait to see if it’d go away. I put off going to the dr for 7 days after breaking my wrist snowboarding. I have a very high tolerance for pain. So when I woke up one morning and within a few hours I was in the fetal position bawling my eyes out i immediately went to the dr.

    I’ve had chronic pain for 3.5 years. It’s at the bottom, back left side of my head and the top of my neck. It feels like someone hit me with a baseball bat every morning when I wake up and again at around 6pm every single day. The surrounding muscles will painfully spasm nearly every day too. I can no longer go to school, work, go out with friends, or even run errands. I have tried a heating pad, cold pack, massage, ibuprofen, Tylenol, exercise/yoga, gluten free diet (and numerous other diets), physical therapy, psych therapy, acupuncture, Botox, steroid injections. Everything I have tried makes my pain worse. Massage, exercise and any type of needle make my pain jump from a normal 6 to an 8. I saw 6 different PTs I finally found one who knew how to stretch my neck muscles to get my range of motion back. I would go three times a week for 8 weeks. when I came back after not going for 4 days (still doing at home stretches) I was just as stiff and had nearly no range of motion as the first day I started with him. I made no progress.

    I have had 3 MRI’s showing nothing until my most recent one showing slight degeneration in my neck. I had a neurologist do an EMG and she told me it was extremely abnormal especially for someone my age (18 at the time) and that she finally believed that I was in a lot of pain. But said she didn’t know what else to do besides steroid injections and couldn’t help me any further. Every dr I saw told me I was too young to be in this much pain, that I was exaggerating. I’ve been called an addict (when I’ve only be prescribed 30 days worth of 5mg lortab one time every year for the 3.5 years). I’ve also had a dr accuse me of having Münchausen syndrome because they’ve never heard of anything like this.

    I went to several pain management places but they wouldn’t accept me as a patient because I was too young, or they wouldn’t know what to do. I found one who told me he wouldn’t give me pain medication but that we could try radiofrequency ablation. It would cost me several hundred dollars with my parents good insurance. He was the only dr who seemed genuinely concerned about me and the pain I was going through. I had hope for the first time. When I came out of sedation… I have never felt pain that severe. I couldn’t talk, think, or hear anyone talking to me. When I could actually form a thought I tried asking if they had tried to cut my head off. All of my neck/shoulder muscles contracted and they had to reinsert my IV to give me some kind of muscle relaxers and took me back into the procedure room to give me more numbing shots (I forget the name). My dr was didn’t know what was happening but he didn’t give me any pain medication to take home. My mom had to drive me home (an hour away) while I tried not to scream out. After a week of vomiting, agony and a total of 15 hrs of sleep in 8 days he prescribed gabapentin which brought my pain down to an 8 while I felt like I was drunk on it. He made me get off it after 1 month and my pain was at a constant 9. It’s been 5 months from the procedure and I still haven’t recovered and that dr told me there was nothing else he could do.

    I went to see my gp’s nurse practitioner who immediately gave me lortab, a lidocaine cream, and referred me to a neuromuscular disorder specialist. I have an appointment with them in February. She is the first person to even mention that to me. Most dr’s said I was lying or recommended a neurosurgeon (there’s no way in hell I’m doing surgery). I can finally ride in a car without crying from pain (I promise I don’t cry easily) because of the pain medication. I’m going to go to nurse practitioners or PA’s instead of doctors from now on (besides specialists). They seem to listen more.

    I am so sick of doctors not listening to me or not believing me.
    There needs to be a program for doctors to be evaluated if they are burnt out and hindering people’s health. Then take a leave for 6 months or a year while doing some kind of bedside manner training? I don’t know. But things need to change. We are paying doctors and insurance companies thousands of dollars and they don’t even try to help us most of the time.

  37. Craig says:

    I’m tired of reading all this bullcrap ,that they cant help you or they cant prove nothings wrong , well let me break it down for you
    professional motorcross racer for over 20 yrs ; when i wasnt racing i was scuba diving , riding bikes working out “Cardio” like crazy. my brain had developed by the age of 29 with not 1 drug issue but I had a addiction alright it was adrenaline from living life.
    this want take long, threw racing professionally shit happens ,
    ‘1’Left humerious compound fracture 2 surgeries with a rod in arm .
    ‘2’ right clavical broken 4 times
    ‘3’ left clavical broken 2 times
    ‘4th’ and most of all , mri finding the conus at the L1 level what ever that is “conus’ there is a moderate compression of the L2 vertebra.
    ..ther is a mild annular disc bulge at the L1-L2 and L2-L3 level resulting in moderate encroachment upon the thecal sac. what ever that is.
    L5_S1 level demonstrates a broad base annular -disc bulge resulting in moderate encroachment upon the thecal sac. what ever that is.
    annular disc bulge with discongenic osteophyte formation at L1 L2- L3L4 level. old compression fraction on L2 “from another crash”
    L5_S1 level demonstrates a broad base annular -disc bulge resulting in moderate encroachment upon the thecal sac. dont ask me why they put that on the report 2times
    ” broke 3 bones in left foot but it dont hurt.
    Now someone please tell me either i stupid ,witch i must be i kept racing but that was my drug
    so why cant they help me untill i can come up with $ for surgery b/c BC/BS want pay shit on it b/c there not in there so called network
    I would never hurt my self but cant live like this , back injury is over 20yrs old and i have hurt the whole time
    but the doctor dont no how to read or right but he can count his $ at the end of the day

  38. Lee Baxter says:

    Doctors aquire little training in addiction, yet, so many patients suffer from a history/current addiction problem. No one should live in chronic debilitating pain – there are other alternatives that doctors should be open to – and ways to treat a patient compassionetly – the whole patient – family & address the pain issue. If an addict’s pain is not addressed – he/she will find a way to do it…. no one should live in pain.

  39. Angel says:

    I’ve been a pain patient for 22 of my 33 years. I have lupus that is eating away at my brain and spine, resulting in seizures, anklyosing spondylitis, ulcerative colitis and a side dish of erythemyalgia with chronic osteomyelitis. I’m on Seattle’s Eastside. Last year my doctor lost his prescribing abilities and I was forced into the system of being at pain clinicians mercy. I used to get my pain medications once every 3 months. Now I’m forced to go every month for my medications with random pill counts random drug screenings etc. Today I left my pain doctors office in tears. I’ve had a hard time coming to terms with the fact that I will never be normal no career no nothing because of this broken body. To be treated as scum like I was today breaks me down so badly I lose my will to continue. At this point I’m considering the assisted suicide. No one deserves to be stripped of their dignity and condemned to a life of pain because certain people misuse their medication. For the life of me I cannot figure why anyone would want to take these medications if they didn’t absolutely have to. Doctors and the law makers need to figure it out because people like myself are tired of it.

  40. brian says:

    most illogical people don’t want to hear the simple solution… LEGALIZE ALL DRUGS! Immediately the majority of drug induced crime would disappear as well as the prostitution that goes hand in hand with lining the black market pockets by keeping the prices artificially high. if people(especially addicts) were able to get drugs for cost they most likely wouldn’t go broke and lose everything they have supporting their habit. arresting drug addicts is just giving somebody a record for the rest of their life not to mention the ridiculous profits illegalization creates. studies show that no more and actually less addicts would exist in a society with legal drugs

  41. Dave Smith says:

    I have had trouble finding a doctor who will even treat me. I’ve called several clinics in town and the doctors all refuse to take me as a new patient because I take opiate pain killers. I’ve tried to explain that I recently had a serious back injury and I’m working to wean off the meds. They don’t care. So I have no doctor to see. If I get sick I have no idea what I’ll do.

  42. Gary Cox says:

    I have been taking some kind of opiate for over 12 years & my doctor seems not to have any problem prescribing them. I have Fibromyalgia , degenerative disc disease, knee replacement & revision, hip replacement & a few more not too severe issues. She is a physiatrist & treats for chronic pain in some of her patients although she wouldn’t take new patients for treatment. At 61 years of age the ” State of Ohio ” et all have starting to treat me as an elderly person. Even my insurance company feels the same way. I am subject to drug screening through random urinalysis with no problems. Even still I smoke a little cannabus on occasion and this time will show up on the drug screen test. My question is , can my doctor cut me off of the Norco ( hydrocodone / Tylenol ) or by state or federal law have to ween me down from the Norco or is it her discretion.

    • Pamela Wible MD says:

      I do not believe there are state laws regarding weaning rates. Every case is handled individually.

  43. Lorretta says:

    Hello everyone,
    It has been very insightful and helpful to read all of your posted comments. I’m a 38 year old female. In 1998 I had to have my gallbladder removed as well as my appendix. I also suffer from anxiety and insomnia. Then in 2010 I was diagnosed with fibromyalgia, and pre- cancer cells on my cervix. After several treatments of trying to remove these cells my test kept coming back positive. I underwent a partial hysterectomy, removing everything except my two ovaries and Fallopian tubes. 2012 I started having excruciating pain related to my sciatica nerve. They did an mri, ct scan, bone scan and a nerve conduction test, which looked like it was about 100 years old. However my mri test showed I had scoliosis and arthritis. In which I was told that none of the two would be causing the degree of pain I have been in. I have been injected with different steroids in my back, with no avail. I have trouble walking at times, and I’m not able to sit or stand for any length of time, because of the pain and numbness that radiates from my left side/buttocks all the way down to my toes. I have had some physical therapy, massage and have seen a chiropractor. The massage has worked the best, however it only last for a few hours and it is out of pocket expense. I was given narcotics for awhile, which I will admit they in fact help me. Doctors have shot me completely down from taking any narcotics.. I have never abused/ sold and have no history of addiction. They have also tried me on several different nerve pain medications such as Lyrica, gavapentine, cymbalta, and several others which did not help and caused terrible side effects.I’m also prone to gastritis and have had bleeding in my stomach, so I’m not suppose to consume medications that contain aspirin. the doctors seem to frown on this as well, like I’m refusing anything but narcotics. what can I do it is the truth. 2013 I was experiencing what I believed to be kidney pain, went to several specialist they all said no. Yet finally after trips to the emergency room and three cat scans later they found,I had a crushed renal vein/ left kidney. I then had to have a permanent renal stent placed because of “nutcracker syndrome” it is pretty rare. I have been given narcotics for the all the surgeries I’ve endured thus far. I just had another surgery a week and 1/2 ago for the removal of my left ovary/ small cyst and Fallopian tubes. The surgeon prescribe me enough pain killers for a total of three days. Which I did not know she was going to do beforehand. However she did tell me I should be ready to go back to College within 72 hours. Since this procedure I have been in extreme pain, nauseated,weak and I feel like my hormones are out of wack. I have called the surgeon and she told me to sleep it off. I have been to the emergency room twice and they gave me a shot for pain and nausea meds. My surgeon called the emergency room and told them not to give me any narcotics to take home. WHAT!! I do not understand, The emergency room staff was empathetic, however she tied their hands. How can this surgeon have such power! The surgeon is now claiming that she believes the surgery was unnecessary and I pushed her to do it. Tell me something, why would a surgeon take out a healthy organ?? No I did not push her to do it, I even relayed to her that if this is not necessary or the cause of my pain, I do not want to have it done. So far I have had to miss a total of 13 classes, which is grieving me deeply, I guess I can say goodbye to my honors. I have been able to submit a few assignments via e-mail, still this is all very distracting. Last night I noticed that I’m now slightly bleeding. I just do not understand I have real physical issues but am made to suffer for what? I have been so dehumanized by doctors it is unreal. They don’t say “hey I think your a drug addict” however that is how I’m treated. There should be some middle ground here, for doctors and their patients to figure out a plan that will work best. I apologize for such a long post, but truly this is only a small part of what I have been going through. I have much empathy for all of you….

    • Gary Cox says:

      Did you sign an agreement with your doctor that states that he/she can be the only one to prescribe you any pain Meds? I had to being treated for chronic pain. The state of Ohio I live in is causing me a lot of grief as well as my ins. company. Things are bad all over to get pain Meds thanks to the irresponsibility of usually younger people abusing, selling and overdosing. This makes doctors pill-count or just not prescribe. I feel for you but there is no clear cut answer ( except who cares you are in so much pain ?) Obviously nobody in your case. It could be your state’s interference keeping anyone from prescribing you opiates which always work for me as well. There is a one reason why doctors don’t or won’t prescribe opiates, however they have forgotten the term ” medically necessary “.

      • Lorretta says:

        Hello Gary,
        My PCP will not even give me the option for a pain contract/agreement. She conveyed that she is not prescribing narcotics to patients. She has sent me to other doctors, urgent care and the ER. for pain management. Which in turn has only made me look like a “drug seeker”. I have been with my PCP for 17 years and she knows very well that I’m in pain and have five medical issues that are “chronic”. The past three years my medical issues have been out of control.

        I had to fight for over a year to get my kidney issue resolved. After several E.R and urgent care visits, I finally was diagnosed with a very rare condition “nutcracker syndrome”. Which is a crushed renal vein that was stopping blood flow on the left side of my pelvic area.I told several doctors it was my kidney, but my blood tests all came back “good” finally three cat scans later an E.R. doctor found it. However it would have been revealed sooner with a closer look, it was apparent on all of the scans.
        unfortunately this is only one example of what I have been going through, to try and get some “relief”.

        Recently I have asked to be referred to a new PCP, with hopes I will finally get the help I need. It saddens me after being with her for 17 years that I have to do this. She knows me best and knows I’m a straight shooter.

        I know rules and regulations are changing from state to state, and are putting pressure on doctors not to prescribe opiates at all. It baffles me however, if a minimal amount of narcotics are able to help with quality of life and functionality, why is it so difficult to get a prescription. I have no problem signing a pain/contract and having pill counts.

        I agree with you, I believe that because there are countless individuals who abuse “narcotics”, it has caused immense strain and frustration for those who do not.

  44. lisa says:

    I fell off a horse at the age of 13yrs young the horse was galloping a tar road n I was on the back, I don’t remember a lot other than coming out of a comma well I remember getting a shot of codeine which I had a allergic reaction I don’t know if this is what induced the comma, I hit the road pretty hard..well I have a traumatic brain injury from it n the doctors told my mom that I would have many health issues and BOY was he right I’ve had several laporoscpies, MRI’s, cat scans list goes on I have been in real pain it feels like all my life.. I went to the doctor n expressed all going on with me I had a cervical fusion n that is when the real pain was unbearable yes they gave me pain killers then just shut me off so I was forced to go to street drugs n low n behold I’m labeled as a drug addict even though I did all they said …I know I am not explaining this all because it is hard to with the TBI it is hard to write down my thoughts but I don’t think I should be labeled as a addict when I have legitimate mental and physical health issues what do they expect ppl to do ???? They need to come up with a better plan because I have done it all and would love not to be on anything BUT CAN’T LIVE IN THE PAIN I AM IN….????

    • Lorretta says:

      Lisa, I’m so sorry and empathize with your situation. I haven’t resorted to any street/ illegal drugs. However, I’m finding and understanding why some individuals do. I still have hope and am praying for some help. There should still be some empathetic and understanding physicians left. I also understand that physicians are under pressure w/new regulations and so forth, which in turn, unfortunately reflects on the patient.

      Some physicians are overworked and so forth. As a person who tries not to attribute blame and see the good / (the other side of the coin). I know physicians are human too.

      Although I’m very frustrated w/ how I have been treated and being in constant pain. My aggravation gets me no where. I really wish there was some way to have a professional trained licensed physician, who could help mediate a doctor/ patient relationship.

      I have been w/ my PCP for 17 years and she has only helped me 1 time w/ pain relief. She has actually told me to go to emergent care for help. However in doing this, I now realize that it has caused some issues. This process made me look even more like a drug seeker.

      It is awful, I thought she was helping me but really she was not. It is sad….
      I hope you find a doctor that will address all of your needs w/careful consideration, in order for you to get some relief!!

  45. Havenot ha a drink since
    9)3(09 been taking strong opiates for bout 4 yr,s ,always been a addict
    Had a major back an neck surgery 3 mon,ths ago an still have pain, i want to rehab them both an all the doc seem to worry about is get me offed, then i don,t feel like rehab. Not allow to bend or twist for 3 more month,s, feel like im going cracy, suicidal. What do i do i need help please

    • Pamela Wible MD says:

      You need a family doc who can spend enough time with you to develop a safe long-term treatment plan.

  46. Anonymous says:

    I got an idea. What you need is simple. Doctors need to spend more time with their patients in order to actually figure out what is wrong with them. A 10, 20 even 30 minute session is not enough for anything but a sore throat. My solution: Force doctors to bill HOURLY for their care and at rates similar to that of psychotherapists. I guarantee you doctors would get bored enough to actually do some work if they were stuck with a complaining patient for a whole 45-60 minutes.

  47. Marie says:

    I have a family member who is was diagnosed years ago with a very painful condition that will never improve and will only become worse. The many major surgeries and other procedures that were performed are all well documented. After many trials, only a particular narcotic pain medicine has been able to ease the suffering . Yet, so many doctors that could prescribe the medication ignore the facts and say this person is only a drug addict. The ones that do help only do so temporarily because they say the patient should be enrolled in a pain management facility. The pain management centers at the hospitals or town clinics always say they won’t prescribe narcotic medications except maybe to late stage cancer patients. They seem to operate more like rehab clinics. It seems that more doctors are choosing not care for the truly ill and would rather deal with patients who have minor or non-issues. The stress from living daily with pain is huge but, included with the constant uncertainty of whether care will no longer be available causes the stress to be enormous and overwhelming for the real patient. So much so that suicide becomes a very likely alternative.

  48. Marie says:

    As far as a solution that is quick & easy or not, Doctors need to read the patient’s documentation as well examine the patient. If the patient is searching for a diagnosis then the doctor can give recommendations or order the appropriate test and exams. A patient’s condition cannot be dismissed just because he may “look good”. It is not difficult to determine who is a real patient. Some possible reasons for poor care have been mentioned on this topic such as doctors who get burned out or develop prejudice. The care providers should vacate their positions as long as needed and seek help if they cannot overcome so as not become abusive to patients. I have seen some doctors behave bizarrely and become abusive which brings me to suspect if they themselves are the one with possible drug addiction or mental issues. Is there a mandated evaluation for those in the medical profession? In my community the drug seekers mostly fill the hospital ER and admitting beds as well as the walk-in clinics. They are seen waiting outside while socializing with their sodas and cigarettes most any days of the week. Without them the hospital and clinics would be nearly empty of patients. I understand the hospital and clinics are businesses and they need customers. The people who are really ill have to wait with the drug seekers and hopefully will be seen before they become worse. It would be wonderful if there was a better way to find the real doctors who want to provide care for the real patients.

  49. joyfull says:

    I’m not a medical provider, but I have worked for many, still do. I have worked in high end clinics that rarely take medicaid, or medicare, usually only if they have been established patients who aged into medicare or fell on hard times and ended up on state. That’s so they don’t have to change pcps. I now work in a clinic of 95% Medicaid. My previous Dr was one who treats the whole person, not the symptoms. Unfortunately it does take time, both in the visit and length of time years, to know you well. Soooo many chronic illnesses do come with a reason. Yes symptoms of chronic diseases like ms, bi polar, add, afhd, and FIBRO. honestly the tests and meds are expensive but she all but cured over 50% of fibro patients. I have fibro, I’ve had multiple surgery I’ve been wheelchair bound I have scoliosis I suffer from major depression, tested off the charts almost foe 3 out of 4 childhood diseases that are with you for life, to which my immune system fights against constantly so I’m exhausted ALL the time. But , I have a drive too provide for my family, I have goals, I never use my small amounts of pain vikoden, or oxy I’ve been prescribed after surgerys. I learned from her why so many Americans have so many medical problems #1 food, every one knows the food groups we know how we should eat. But… also antibiotics, kill you gut. Yeast overgrowth due to these killing your good bacteria. yhe yeast takes over causes tiny Microscopic holes whivh allow food particals to get out of your gut and into your bloodstreem and uour body fights the invader and tags it as enimy. You eat this seamingly healthy food, for me bananas, eggs, pinaple, mushroom, wheat, coffee, brocolii, orangse, dairy and more so everytime I eat one of these it gets out of my gut my body atacks, causing inflammation which causes presume on nerves, which cause pain etc also extremely fatigue. I 0 even had my appendix rupture, turn gain green, and form a pocket around the pus, extreeeemmmmm pain, doubled over etc. Finally went to hospital never took or asked for pain meds. I was IP for 6 days I know pain, I know depression, I know chronic pain. I choose to function. I choose to push, I choose to refuse to be on government aid due to my overwhelming discussed on government mandaded, ridiculous taxes. We had patients from all over including other states. They because she will help you.IF you try. We took new medicaid patients they didn’t follow treatments. They wanted disability and literally to come in every 2 days for a question. Now I schedule all Medicaid and over half want pain meds. To function. Alot if what my parents “have I’ve had/have. But they don’t work and want thier drugs. Over 50% of the population are medicaid. Yet no Dr can pay for the facilities and staff being paid $20 per visit by medicaid. 1 hour of Dr time, MA’s time front office ect. $providers can pay employees etc on $35 per visit. Yet people don’t get it. No more welfair, depend on yourself, that way people like myself who run church, work, etc findraosers, food drives, adopt family get to give, no forced on me. I’m never nit in pain. But I work to pay for others who are given an annual value of more than I make a year. A ND ye s I know some need help, but NOT 50% +.

  50. S C says:

    I was injured at work when part of a machine exploded and a piece of shrapnel, an inch and a half in diameter, shot through my abdomin at high speed and lodged in my psoas muscle near my groin. Luckily the piece missed my aorta but destroyed my small intestines and severed my femoral nerve and part of my genital nerve. Since then, I have had shoddy medical care due to the fact that workers comp insurance companies do not want to spend money. Currently in pain management along with psychological treatment for PTSD and depression and anxiety disorders. Also seeing a urologist for sexual and urinary disfunction. Although the pain management doctors know I have real need for opiates, I am treated like a drug addict by the insurance company. From time to time they will deny payment on the narcotics forno other reason than the adjustor thinking that I don’t need them. She is not a doctor nor does she have any medical training. And the result of suddenly being taken off an opiate drug that I have been dependent on is horrible withdrawal symptoms. My doctors say it is cruel and criminal to play with someone’s medical treatment like that. I have severe groin and abdominal pain, also shooting nerve pain down the inside of my thigh and around my knee all the way down the back of my calf muscle. I have been taking oxymorphone ER 20 mg twice a day and fast acting oxymorphone 10 mgs four times a day for breakthrough pain. Along with psychological therapy, I have been tolerating the pain and able to work part time at my job. I have been asking my PM doctor for alternative treatment to narcotics and have had several rounds of sympathetic nerve blocks that do not last very long. We are discussing other treatments for the future. In the mean time, I continue the on again off again approval process from the insurance company with sometimes yes and sometimes no for the medications, which I know are quite expensive but make daily living tolerable. I never ask for higher doses and I am regularly screened through urine tests to make sure I am in compliance. ie taking my prescribed mess and not using street drugs. Still being treated like a drug addict by the we insurance company. I am at their mercy and am tired of going to the ER every time they cut me off so I started paying for the meds myself. This put me in trouble with my credit card company. The meds cost $980 per month and I over extended myself.
    My concern is that the doctors are aware that I have real needs for the medications but the insurance company is afraid of the costs and treat every patient that needs opiates like a drug addict. There is nothing I can do but sue the insurance adjustor for cruel and unusual treatment of a patient. If it’s possible. Nobody has to live in my skin but me and my pain doesn’t take weekends off nor does it take vacations.

  51. Longtime Boy says:

    Hi all here is my concern, I to have experienced the issue of being treated like a drug addict when trying to get relief from chronic pain. 1. ive been to the ER several time over the past 4 yrs due to the same kind of pain. I have 2 hernias that are poking through on both sides of my groin. I have 3 herniated disc in my back most days i wake up in so much pain im screaming bloody murder. when i go to the ER all they are allowed to write is a script for 6 to 20 pain killers and they think thats suppose to last you a lifetime. All i get told is find a primary care doctor but heres the thing with that I dont have medical insurance and cant afford it even through my job. Doctors dont understand that and get highly upset. Even the payment plans are extremely high when you do see a doctor out of the ER. Im not saying that doctors should just jump in and write a script, what im saying is if your a doctor and someones comes into your office or the ER and they say i am in pain im having it here and here and here and you as the doctor run test and perform procedures and you can initally see hey this persons test come back with something not right i can see why they are in pain at this point be more sympathetic and not so harsh. Ive always said when i get treated like a druggie by a doctor I hope the day comes that you never have to deal with chronic pain see how well you live your life without pain killers and see whos a druggie or not. I dont abuse them by no means when i do get them but ill tell you what i dont have a problem with taking them (the right way) if it helps me to do the things i need to do to enjoy a funfilled life. Doctors are losing their bedside manners when it comes to being the one that the public relys on. all im saying.

  52. Sia says:

    Then again, at the end of “The Boy who Cried Wolf”, a wolf really does come. I get why the villagers didn’t believe him at the end but it doesn’t change the fact that the wolf was still there.

    That little fact (the wolf is there) translates to being mindful of the the extra complication that addiction and painful conditions are not mutually exclusive.

  53. I am sick and suffering in NYS. My total medical care got abandoned over what the CEO said in my termination letter was a “Mutual disagreement over a controlled medication agreement. I can define agreement.
    They gave me 30 days “ample time” to find a new doctor. They sent me this notice days after the 30 days had expired. I write about this on my website http://www.mycrownofthorns.org. Check out the audio of some of these doctors, my termination letter is there too. This is the tip of my iceburg.

    I was forced to stop controlled medications that I had been taking “cold turkey”
    and got violently sick and one of the medications takes months to clear your system.
    I needed decreasing dosages if i was being forced to stop. Why was i forced to stop ? I am sick. Not only was medication taken away abruptly so was 100 % of my medical care. How the heck does this make a bit of sense. I am HORRIBLY sick at this point in time. This did not help me, in fact it made me much much worse… no one cared.

    That was the end of 2012. I still have no doctor. I have seen some that I was lucky enough to make it thru their screening process. I then have found that I will got no help for anything I have ever been diagnosed with and I will not be helped at all for any pain issues. I need to learn to get used to it.

    I have made complaints. NYS does not care about patients. I am really very ill and have no care. The local urgent care told me they would not treat me when my BP was 181 and i felt crappy.

    I am label with this drug agreement stuff… labeled as disgruntled and labeled as delusional because I thought I might have a virus. Apparently he never checked my record he requested from my neuro.

    I got blacklisted and have no care. I suffer every moment of the day.
    My gut feeling my old PCP could use a some help… I bet he was bullied. I worry about him even though he let this happen to me. He said “he needed a job” lucky him
    I need a doctor … last i knew i needed surgery.

    I don’t think i have RMMS – i think it autonomic neuropathy. I know I SUFFER every moment of my life and have no help .

    A good care giver would be welcome.
    I am working on rights for patients, in NYS we have zero rights. NONE no one is accountable… yet.
    I will work for us all team human

  54. T M says:

    I injured my back off the job about 14 months ago. I did everything I was medically ordered to do to try and recover. I went through PT, chiropractors, steroid injections, nerve blocks, ablation. I had MRI’s, X-rays, CT and I am now scheduled for more X-rays and a Nuclear Bone Scan. I have also been treated intermittently with opiates. I have a PCP and a Neurologist. My PCP was prescribing an opiate for pain management as all the procedures I have had done so far have not provided relief. Approximately 8 days ago she decided that she was no longer going to prescribe pain medication to me. Out of the blue, I was not given a reason why she decided to stop. I did not abuse my medication, and I actually took less than the prescribed dosage. Since then I have been in severe pain, barely able to walk, sit or even lay down without severe pain. I finally went to the ER, and once there I was told by a triage nurse that she thought I was a drug seeker. I told her that I had never mentioned anything about narcotics and she said ” good, because you’re not getting any”. Needless to say I was shocked by her attitude and her assumption that I was a “drug seeker”. I was so embarrassed that I left, with my husband pushing my wheelchair because I could barely walk. Since then, I have been refused treatment by several physicians because I have back pain and had been taking pain medication. I am also law enforcement. I never imagined that I would be treated this way. I am also labeled as “doctor shopping”. Not once did I ask any clinic that I called if they would prescribe an narcotic. I just wanted my pain to be treated. I wanted to be treated like a human being. Not once did anyone offer an alternative or give me the chance to ask. I cannot imagine what other people are going through that have long term chronic pain and then have been denied treatment. I’ve seen my fair share of addicts, but now I have a new understanding of why. It’s easier to get it on the street than get it prescribed legally by a physician. The crackdown on legally prescribed pain medication for legitimate reasons has only created more addicts on the street.

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  56. pain patient labeled addict says:

    By the time anyone reads this I will probably be dead. I can not live with this pain anymore. I won’t bore anyone with the details as I know nobody cares anyways . peace…….

    • Pamela Wible MD says:

      There is so much pain in our dysfunctional health care system. I am working 24/7 to help heal our suffering doctors so that they can be real healers again. I pray that you can find a wonderful family doctor who will care for you. That is what we all need.

  57. Martha Donohue says:

    People who are against opiates are people who have never experienced real PAIN! People without pain need to stop judging people who take painkillers & mind their own business! Why should anyone care, if someone else takes painkillers? Again, mind your own business & don’t let it bother you if other people take painkillers – they’re not hurting anyone by taking painkillers! And if they take too much and they O.D., well then, that’s their own fault! The government (FDA & DEA) keeps trying to stop people from taking HELPFUL medicines which BENEFIT people with chronic pain – it’s so stupid! Why don’t they focus on drugs that are REALLY dangerous, like the ILLEGAL kind that is sold by criminals?!!! Stop worrying about whether doctors prescribe pain meds for their patients & let the doctors do their job! If someone is in pain & the doctor wants to give them pain meds, that’s not hurting anyone. The stupid feds don’t understand that pain meds give many people a BETTER quality of life!

    • kathy says:

      I believe that president Obamas father ? Had multiple sclerosis. The president had spoke of this and how much he admired his father for providing for his family. His father persevered and still made it to work each day while relying on a crutch or cane to enable him to do so. I wonder if he needed pain meds at least more than once in his condition. Im inclined to think this may have been the case. What would the president think or do if his father was denied his very needed pain meds and labeled as just another chronic pain complainer just looking to misuse his pain medicine or maybe he is selling them to those (you know) who live on the other side of the tracks. Horrible ignorance and possibly blatent discrimination.

  58. Angel says:

    I’m a WA state pain patient. The system is broken. The statistic regarding Americans taking more pain meds is flawed. Most South American countries folks rarely have access to even basic medical care as well as the majority of rural china and you get the drift. Healthy people don’t seek out medical care. Having been in pain management since age ten I’ve seen literally it all. The changes are not for the better. The doctor patient relationship now becomes adversarial the moment the word pain is mentioned and forever damaged when a pain contract is introduced. Addicts forever will always get their fix but those truly hurting will be the ones that continue to suffer. Punishing sick people and their providers is not the answer.

  59. Paul DIRISIO says:

    Lets cut the crap….Drs. are not what they used to be.
    They are trained and told to make hospitals money..It’s a business. It’s not about the patient anymore.. Also..Real patients are suffering because of drug of addicts trying to get scripts.. Don’t punish the people that need pain meds because of the drug addicts.. If a doctor can’t tell the difference, maybe he needs more experience and training..

  60. Jake Awake says:

    I suffer with severe pain but my point is about what you all can do to reduce how much you suffer. I need all of you to know that talking negatively, acting or and thinking negative thoughts about ANYONE creates negative karma for YOU. Karma does not take into account your personal justification for negative thinking EG: they deserve it, they treated me bad. Try and be as kind as you can to everyone, if people are rude or treat you wrong, move on and forgive them. Karma will take care of them. (That is not your job) Remember, if you keep doing the same thing, you will continue to suffer because all you create is negative karma. Try something new. Wishing you all only well.

    • Carrie101012 says:

      Jake, I do not believe you are a pain patient or that your pain is severe. I read All of your posts and mainly you seem to want to attack pain patients for doing something that is cathartic which is voicing their feelings.
      You aim to shut them up using ?Karma? as your shield of choice and with a false sense of good will and piety you proclaim that they must shut up or risk YOU labeling them as NEGATIVE when you are actually just aiming to bully people and stigmatize them. You’re full of it and I hope people can see that.
      Get lost!

  61. Rob says:

    Why should doctors get to decide who does and doesn’t deserve pain relief? Who told them to act like DEA investigators? It isn’t their job to catch criminals or turn patients into suspects. If I go in an tell a doctor I am in pain, he should treat me for it, especially if he intends to charge me for the appointment. Is their point that only they are allowed to make money dealing opiate pain meds? Take away a prescription pad and they have a lot in common with drug dealers.

    The simple way to stop people selling opiate pain pills on the street is to make it legal and take away that huge, profitable illicit market. You can’t sell a 40 mg pill for $40 if I can buy it over the counter for $1.

    Btw, doctors treat addicts far worse than anyone else. Never tell a doctor about a history of addiction or one day, you might be the one crying in pain while some nerd in a lab coat tells you that you can’t be given anything to ease your suffering. Who made them god.

  62. lynnea says:

    I am so sick of this. I either have pain meds and work or live off others. I am so constantly worried about being demonized, labeled and never telling soul I’m on them
    My husband gave up on the labeling and worrying so now on disability. I have to work

  63. Carrie101012 says:

    The lies that I was !instructed! to tell patients who depended on opiates for chronic pain relief in my job as a hospital LPN simply to update my CEU’s was what assured me that the “powers” controlling healthcare in north america were rotten from the top down. I was told to tell patients things I knew where not true and attribute every symptom they had to any opiate use they may be maintained on no matter how small the dose. RN’s can assess patients and I’m only an LPN but I was supposed to back-up every RN, ARNP, PA, MD in the idea that people with chronic (even terminal) pain needed to never take opiates if they wanted “get better”. What terminal pain patient was going to “get better”. Something is rotten here. Please America, DO NOT DRINK THE KOOL-AID!

  64. this is bad says:

    I understand the need to remember no bad language or open attack on other posters who express their feelings, yet I posted here to a person making some sour remarks to every other pain patient and for some reason the ability to reply to them is a non options. I doubt this will be printed but I feel if Dr. Wibble is moderating not entitlements should be given to certain posters so no retort is possible. Dear Doctor Pam, Why is this? I feel a lack of honesty here. Sorry that’s just IMO.

  65. ladagosta says:

    I have been in chronic pain since a head on collision in 1995 in FL. I was stalled from surgery for the first 5 years after the surgery life seemed to improve until scar tissue developed leaving me in more pain than i was prior to the surgeries I had a double fusion in my neck and a lumbar laminectomy and titanium cage inserted in 2000, since 2003 my life has spiraled downwards until I hydrocodone was administered and then replace with lortabs and then finally fentanyl patches after many years of injections and therapy none of which helped manage the severe controllable pain I am managing on the patch now and have been with many withdrawals monthly and then finally last year the laws changed and the sudden stops or interruptions ended now here we go again .. last month I was told the perscription no longer needed to be hand delivered that the doctors office can call them in beginning April 2015, seems the pharmacy is not aware of this as today was my day to pick up the prescription.. not available and not called in and they said I have to hand deliver the script.. what on earth is going on. I have done everything they tell me to do even the sudden jump in the car and get a drug test done 2 months in a row why are we treated with no regard to live our lives as anyone else free from pain,I did not ask to be hit by a car and ruin my life i did not ask to be placed on these drugs all i ask is that I have the same option of living my life pain free. Same as anyone else. drug addicts seek help and stop preventing those who need help from acquiring it, my best to all who suffer daily as I have for 20+ years . I am still waiting for my number to be called and end this daily pain, but until it is called there is a reason I am still on this earth, I want those years to count for something other than being stuck immobile.

  66. Sherri says:

    I broke my ankle five years ago. I have a non union and there is a lot more damage in my ankle from this fracture. The doctor told me I had two options, to be on pain medication or to have ankle replacement or fusion surgery. I have been living in total agony with this. I have asked my doctor for medication for the pain as I have been unable to get my needed surgery. But I am turned down for that. I cry all the time from the pain. I cannot do anything I love to do anymore. I can not walk much. It is also causing back issues and my other leg has bursitis from over use. I have to wear a brace every day and I cannot get any help. I have even thought of suicide because if all my life is gonna be pain why should I keep having to suffer. I watched some people go to the doctors I was going to. They would come out with pain killers they did not need and would then sell them! I cannot get any help at all! I just do not know what to do!


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