Should doctors have to explain the addiction risk of pain killers and get a waiver signed?

NO, I don’t think we should be forced to sign a waiver in order to receive the needed medication. YES, I do think that doctors should be required to be MORE transparent with what they prescribe. Big pharma pays doctors for pushing their drugs & doctors lose site of their duty to their patients in exchange for the almighty dollar!!! Therefore, I feel that doctors should be held accountable for the lives that they ruin by pushing dangerous drugs on people when they are trusting & vulnerable.Even more, I feel that big pharma should be held accountable for the drugs that THEY manufacture & pay the doctors to push. Then again, we ALL know that is NOT going to happen!!!

I am glad I never had a doctor push necessary drugs on me.

Sure, that doesn’t sound like an unreasonable requirement. I too fear that opioids are going to become inaccessible to people who need them. I know many chronic pain patients who are terrified they’ll lose access to their meds and with them, their ability to function.

My dad has severe widespread chronic pain; no one has ever been able to diagnose its cause. He has been on tramadol for probably a decade or so, and he tried and failed to get relief from many alternatives before. His insurer has recently decided to stop covering his meds citing the opioid epidemic. It’s criminal. I understand that addiction is a real crisis, but some people really need these drugs.

That’s not the problem. The doctor isn’t the issue. (except for a very small number of pill-pushers)

It’s the patient who becomes addicted by choice. This won’t do a thing.

I don’t see that as too onerous a burden on the patient. We are required to sign consent forms for medical procedures, why not this? Full disclosure of risks needs to happen, but I definitely think waivers are a good idea.

If a patient is fully informed of the potential problems, (and therein lies the problem, sometimes) then a waiver is a much better idea than simply not providing what may be necessary medication.

We are required to sign at the drug stores when picking up controlled substances. I believe that it is a statement talking about addiction possibilities. I’m not sure how this would be more effective.

I used to live in Delaware. Doctors there are already unwilling to prescribe adequate pain medication because there is so much prescription pain killer abuse. I watched a dear friend with excruciating pain due to several medical conditions get laughed at by her doctor because she had the nerve to ask for adequate pain relief.

And that’s just Delaware. It’s happening everywhere. In some places and in some populations it’s worse than others.

I think that it’s addicted patients, more than greedy doctors, who are the problem.

@elbanditoroso …It’s the patient who becomes addicted by choice. and @Dutchess_III I think that it’s addicted patients, more than greedy doctors, who are the problem.

Therein lies a fundamental misunderstanding of the problem. As corporate medicine encouraged widespread use of opioid analgesics, addiction became commonplace, not by those seeking to get addicted, but because prescriptions were handed out routinely throughout the health industry.

Couple that with the rise of “pain clinics” where patienst with chronic problems were referred by their primary care physician, it is somewhat surprising the problem is not worse.

I have never been prescribed pain killers that were not needed. I would be highly suspect of any doctor who seemed to want to prescribe some for something I considered minor. The big pharma may want everyone taking them, but we can make our own decisions.

What I have heard about it is mainly that things have gone way too far in the other direction, where the government can even go after doctors who are responsibly assigning pain medication to some people who really need it.

@janbb I wasn’t aware of that. Is it a federal law?

@elbanditoroso Back in the 80’s there was a big push that patients won’t become addicted to pain killers if the patient needs the pain killers, and that doctors should be doing better at treating patients’ pain. For whatever reason most doctors had trouble thinking for themselves and believed it hook line and sinker. A lot of 45 year olds and older, I mean average people, not doctors, believe that schtick having grown up in it.

I don’t expect doctors to be able to guess perfectly which patient will need 6 days of pills after a surgery, and which patient need 15, but I have always been overprescribed pain killers after an event. Surgery, accident, you name it.

I’m sure part of it is the doctor doesn’t want to deal with an additional phone call coming into the office for a refill. Maybe it’s also about how insurance covers a prescription I don’t know.

I have never had a doctor warn me a drug is addictive when he felt I needed it I don’t think. If I signed something at the pharmacy I don’t remember it. On rare occasion when I have asked for Xanax, the doctors who wouldn’t prescribe it tried to lecture me about it being addictive. If they just looked at my Rx history they’d see I don’t take the stuff but maybe 10 pills every 6 years. Narcotics even less.

In Missouri, who recently enacted an opioid database (worthless), the patient has to sign a contract with the doctor to get those prescriptions. If they get in an accident, they are not allowed to get any additional meds from ER or dentists, etc….or the contract is void. If they do not submit to urine tests or appointments, the contract is void. Now insurance companies are also limiting prescriptions, so if you are on pain meds and benzo’s like xanax, you have to get a waiver before the insurance will pay for your script.

So to answer your question, I don’t think it would do any good to tell someone in pain, that pain meds are addictive, most already know it.

The biggest issue I see, is that many new doctors are being sent in and firing all their pain patients, so they don’t have to deal with any of the hassle, or the paperwork/ rules. A local low-income medical facility recently told my friends 84 year old mother that they didn’t want to give her addictive pain medication, and she cried and said addiction didn’t matter when you were in constant chronic pain. To me, that’s elder abuse and a violation of the Hippocratic Oath.

PS I have very strong feelings about this because of many personal experiences with loved ones and friends in my area. Whether you are old or dealing with cancer, or anything else, it’s all about the doctors and their opinions of your pain/ health status. Patients rights are no longer the driving force in medical care.

@LadyMarissa “Big pharma pays doctors for pushing their drugs & doctors lose site of their duty to their patients in exchange for the almighty dollar!!!”

There may be a few exceptional cases with kickbacks, but in general these relationships are highly regulated. It’s illegal for a pharmaceutical company to write an MD a check. They give out branded post-it-notes and other trinkets, but I guarantee MD’s aren’t willing to put their patients’ lives in danger just for a free Pfizer wall calendar. They can and do bring in Panera (or equivalent) lunches for the office staff from time-to-time, but these are also highly regulated. Honestly, drug reps do serve an important function by introducing MD’s to the latest advancements in medicine. Most MD’s are very busy and don’t have a ton of time to browse the hundreds of new drugs out there, so having someone present the scientific data and answer basic questions is useful.

I do think they can create more influence than they should (they get paid huge $ for a reason), but they also serve an important role.

@JLeslie “I’m sure part of it is the doctor doesn’t want to deal with an additional phone call coming into the office for a refill.”

That’s part of it, but the bigger part is how do you know when the request is legitimate? Pain is subjective so if a post-op patient calls and is still in pain after their 6 day supply is up, how are you supposed to know if they’re lying or telling you the truth?

@gorillapaws I was told blood pressure was a good way to check, as bp usually goes up with the pain levels-so you could have them come in and check that.

My doctor friend also told me that’s one of the reasons they prescribe pain meds for CHRONIC PAIN, to keep bp at normal numbers.

BTW, I don’t take any of these and detest pills of all kinds.

@KNOWITALL “bp usually goes up with the pain levels” I don’t think it’s that simple. There could probably be dozens of other reasons why BP might be high or low after a procedure that’s unrelated to the pain. Making an assumption that it’s related to pain, could also be very dangerous for the patient (e.g. it could be internal bleeding).

In our office, we’re very reluctant to prescribe opiates for post operative pain, but we only perform office-based procedures under local anesthetic.

@KNOWITALL I do agree that people with chronic or terminal pain should have access to whatever meds alleviate their pain and should be able to make informed decisions about their palliative care.

@gorillapaws I am only speaking on chronic pain, not brief periods post op.

Although, some surgeries, for instance multiple knee surgeries, can be long term problems regarding pain and pain relief. I see that quite often. Seems to me that the doctors advise surgery, then after a couple tries, they keep recommending more, and it never stops. My friends last knee surgery was over #20 and he’s wealthy and just wanted to play bball with his kids he adopted. Not sure why doctors keep recommending surgery and not fixing the problems, although I do understand the scar tissue, etc… Sometimes I’d rather them just tell a patient that it won’t get better and to live with it.

@KNOWITALL IMO chronic pain should be managed by a pain specialist. They’re in the best position to manage pain while limiting the risks of addiction. The whole thing is incredibly complicated. You want to be sure that the people who genuinely need opiates have access to them and you want to prevent people from becoming junkies.

Opiates for a back injury turned my best friend’s brother-in-law into a heroin addict and really messed up his life. I also had a grandmother who was on a Fentanyl patch in her nursing home because her back was so screwed up after a fall. They tried to do back surgery, but the surgeon had to abort it because she was too frail for the procedure. Those patches kept her comfortable for over a year.

@gorillapaws Correct, and a pain management doctor is much better than a PCP when it comes to the process. Much less complicated and accusatory. I always recommend anyone having issues to them.

My own PCP says he is overrun with ‘fired’ patients because he’s one of the only ones that’s been around long enough to not see a junkie in every single patient, like the newbies fresh out of school.

@gorillapaws I have only asked for pain medication once, and it was for my discharge from a hospital after an accident, because the doctor who wrote my discharge didn’t leave the script he told me he would leave for me. He told me, I didn’t have to ask. I had to argue with the doctor on call that I was going to be driving (be a passenger) on an 8 hour car trip to get home in the state I was in.

Finally, after fighting with him, which I find ridiculous, he wrote me the prescription. He wrote me 30 pills. I never asked for 30 pills. I filled 15, and I think I still have 12 left from 6 years ago.

All other times doctors gave me medication even if I hadn’t asked. I usually never fill it.

@JLeslie I tried xanax for a year and gave it up, everyone who’s ever heard that story makes fun of me. Pain pills make me horribly sick to my stomach, too.

Tried for a year did make me laugh. I took it once for 6 weeks straight when I was going through a very difficult time.

Since then, every 3–7 years or so I feel the need for a pill or two. It’s a magical pill.

@JLeslie I had a stomach ulcer when I was about 22 years old, I don’t handle stress very well. Mentally I do, but not physically.

Eh, I prefer old-skool valium over anything else, but I’m with you, every once in awhile it sounds good.

Have you tried the CBD products? Some people say that they work for them, not quite convinced myself, but everything puts me to sleep…lol

(What does a stomach ulcer feel like? What are the symptoms?)

@Dutchess_III Couldn’t keep anything down, just kept throwing up, finally had to go because I had some blood in my vomit. Only happens during high stress, but to me, it feels like a roiling/ acid-y stomach more than anything (I have it today btw.)

Thanks.