Opioid Overreaction (1 Viewer)

[Ramblin Wreck]

"You know, you really shouldn't take that chemo.  The side effects are horrible for you."

You've called me dumb and an idiot and you're comparing cancer treatment to pain medicine so you can play golf.   Well done in here. 

 

[bucksoh]

I work in healthcare as well... largely with pain docs.  In fact I am a pharmaceutical wholesale distributor for some of these very drugs.  These clinics had daily occurrences of scenes being made by patients demanding refills early, breaking into the cabinets in the examination rooms trying to find more, etc etc.  It wasn't every patient, it wasn't some miniscule % either.

I was aware you were in healthcare as well.  Which is why I was surprised to see the "irresponsible" comment from you.

I would have thought that you understand the truth is somewhere in the middle, as usual.  It is not an "epidemic", but it isn't a small problem either.

It is closer to epidemic than closer to a small problem.  Really makes me wonder if he is in health care.

 

[JerseyToughGuys]

Well, let's see.  I take about 40mg once every three days on average.  I have to take a piss test every 2 to 3 months to show I don't have a large amount in my system.  

Before we go any further, do you take Aetna?  

Also, do you not find it odd that you're accusing someone over the internet of possibly being addicted to something when you know nothing about that person?  Because, to me, that comes off as a little high and mighty.  Maybe even a little overreaching.  But you do you.

I didn't accuse you. I asked if you would even know if you were.

 

[JerseyToughGuys]

I do.  It's kind of confusing because I'm actually having trouble keeping track of whether you're my doctor or my English teacher now.  

Notice I keep answering your questions.  But you still haven't answered mine.  

What's the question?

 

[TheIronSheik]

You've called me dumb and an idiot and you're comparing cancer treatment to pain medicine so you can play golf.   Well done in here. 

I never called you dumb, GB.  Not once.  And I would never call you an idiot.  Let's get that part straight.

And the medicine is not "so I can play golf."  My medicine allows me to be pain free.  Without the medicine, I could not sit in a chair, ride in a car, sit at a desk, walk for more than a couple of yards...  All normal things that everyone else does.  On top of that, I can't do a lot of other things.  Golf is one of them.  

But when I take my meds, I can do all of that.  I can live a normal life like everyone else.  I don't take the pills to golf.  I take the pills so I can work.  So I can move.  So I can walk.  So I can live.  Luckily, that medicine is so great, not only can I do the essential things, but I can do the fun and recreational things.  It's a miracle drug!  

And my quote above was to show how ridiculous the "side effect" argument is.  If I had to deal with the pain without meds, I'm guessing at some point I'd put a bullet through my brain.  I couldn't imagine living with that much constant pain and being a burden on my family.  Not being able to enjoy everyday activities with them.  Just constant pain.  Horrible, horrible pain.  

Of course, on the plus side, I wouldn't have any of those pesky side effects.  Nope, not at all.  While I'm laying on the couch all day, writhing in agony, the one thing that will comfort me is knowing I wasn't going to have to worry about the side effects of those evil Opiods. 

 

[TheIronSheik]

What's the question?

What side effects are there I need to worry about?  I'm trying to determine if they are worse than constant, debilitating pain.  

 

[JerseyToughGuys]

I wonder if "irritability" is a symptom? 

 

[JerseyToughGuys]

What side effects are there I need to worry about?  I'm trying to determine if they are worse than constant, debilitating pain.  

Addiction

Dependence

Tolerance

Respiratory Failure

And constipation

 

[bigmarc27]

It cracks me up that people are are comparing Advil with Heroin. 

There is a component of pain relief, but it is very addictive and your tolerance will rise.  I work in healthcare data, I’ll just say be careful.  Every meeting I’ve had with a client in the past 3 years all have these three topics in common: diabetes, opioids, and ER. Those three are in literally every single meeting, because they are all huge issues with rising claimants, rising costs, and poor compliance. There is a direct correlation with opioids and inpatient rehabilitation admissions for substance abuse. It is not a small problem. 

 

[JerseyToughGuys]

What side effects are there I need to worry about?  I'm trying to determine if they are worse than constant, debilitating pain.  

40mg of what every three days gets you out of your constant debilitating pain?

 

[JerseyToughGuys]

@TheIronSheik If you've been taking 40mg __________ for an extended period of time with no tolerance problems or dose escalations, you are very VERY lucky. It's great that the miracle of morphine is working for you and you've been able to avoid the very serious downside to prolonged use.

You are not the norm.

 

[TheIronSheik]

I wonder if "irritability" is a symptom? 

Again, I'm sorry if I'm coming off irritable, GB, but being accused of being an addict (and I'm not referring to you, but by the masses), it tends to make you defensive.  And, I guess, irritable.

 

[TheIronSheik]

Addiction

Dependence

Tolerance

Respiratory Failure

And constipation

Since none of those (except maybe constipation) are guaranteed, I'll take pain free living every time.

 

[TheIronSheik]

It cracks me up that people are are comparing Advil with Heroin. 

Link?

 

[TheIronSheik]

@TheIronSheik If you've been taking 40mg __________ for an extended period of time with no tolerance problems or dose escalations, you are very VERY lucky. It's great that the miracle of morphine is working for you and you've been able to avoid the very serious downside to prolonged use.

You are not the norm.

I think you're wrong.  I think I am the norm.  I think the person who turns into an addict is not the norm.

Alcohol has some pretty nasty side effects, too.  And it can become highly addictive and lead to death.  In fact, there are more alcohol addictions, by far, than opiod addictions.  Why is there no push to ban alcohol?  At least opiods have benefits, whereas there is no benefit to alcohol.

 

[TheIronSheik]

40mg of what every three days gets you out of your constant debilitating pain?

On average.  There are some weeks where I have to take much more.  And there are other weeks where I barely take any.  But, yes, on average that's what I'm taking.

 

[bigmarc27]

I think you're wrong.  I think I am the norm.  I think the person who turns into an addict is not the norm.

Alcohol has some pretty nasty side effects, too.  And it can become highly addictive and lead to death.  In fact, there are more alcohol addictions, by far, than opiod addictions.  Why is there no push to ban alcohol?  At least opiods have benefits, whereas there is no benefit to alcohol.

Being in the Norm isn’t the problem, it’s that those not in the norm are progressing at substantial rates compared to every other metric. 

99% of people won’t be in a car accident today and that’s the norm, but of those that do if the % of accidents went from 20% being teens to 45%, that’s an alarming increase. 

Most people won’t become addicted to prescription painkillers today, but if that rate is increasing substantially for one particular type, it’s something that needs to be addressed. 

 

[TheIronSheik]

Being in the Norm isn’t the problem, it’s that those not in the norm are progressing at substantial rates compared to every other metric. 

99% of people won’t be in a car accident today and that’s the norm, but of those that do if the % of accidents went from 20% being teens to 45%, that’s an alarming increase. 

Most people won’t become addicted to prescription painkillers today, but if that rate is increasing substantially for one particular type, it’s something that needs to be addressed. 

So what's your solution?

 

[bigmarc27]

So what's your solution?

These pills never should have been pushed to market. That’s too far gone. For your future, you’ll undoubtedly be taking them for life because your tolerance to all other pain medication is shot.  If you want to be literal about it, you’re likely at some level of addiction now. If you stopped, you would surely have some form of withdrawal already and there aren’t pain meds that will work with you. If there are safer alternatives and you’re still able to make that jump, I would have that conversation with your doctor ASAP. 

Of course they work for you for pain management. They’re f’ing powerful as hell. It’s legal Heroin in pill form instead of finding a vein. 

 

[TheIronSheik]

These pills never should have been pushed to market. That’s too far gone. For your future, you’ll undoubtedly be taking them for life because your tolerance to all other pain medication is shot.  If you want to be literal about it, you’re likely at some level of addiction now. If you stopped, you would surely have some form of withdrawal already and there aren’t pain meds that will work with you. If there are safer alternatives and you’re still able to make that jump, I would have that conversation with your doctor ASAP. 

Of course they work for you for pain management. They’re f’ing powerful as hell. It’s legal Heroin in pill form instead of finding a vein. 

 

[Gawain]

These pills never should have been pushed to market. That’s too far gone. For your future, you’ll undoubtedly be taking them for life because your tolerance to all other pain medication is shot.  If you want to be literal about it, you’re likely at some level of addiction now. If you stopped, you would surely have some form of withdrawal already and there aren’t pain meds that will work with you. If there are safer alternatives and you’re still able to make that jump, I would have that conversation with your doctor ASAP. 

Of course they work for you for pain management. They’re f’ing powerful as hell. It’s legal Heroin in pill form instead of finding a vein. 

IDK, my dad has 5mg hydrocodones that he takes twice a week or so. Sure he'd be better off losing 80 pounds so his back wasn't bothering him so much, but I'd rather have him up and about outside. He's been on that for roughly 10 years or so.

I was in a car accident where I had an IV drip of Dilaudid while I was in the hospital and was sent home on 40mg Oxy 3X Day and 5mg Roxy 8X a day for emergent pain. Looking back, I was at least dependent and kicking the dope 4 months later cold turkey sucked.

 

[bigmarc27]

IDK, my dad has 5mg hydrocodones that he takes twice a week or so. Sure he'd be better off losing 80 pounds so his back wasn't bothering him so much, but I'd rather have him up and about outside. He's been on that for roughly 10 years or so.

I was in a car accident where I had an IV drip of Dilaudid while I was in the hospital and was sent home on 40mg Oxy 3X Day and 5mg Roxy 8X a day for emergent pain. Looking back, I was at least dependent and kicking the dope 4 months later cold turkey sucked.

I mean, that’s exactly what I’m talking about. Your dad can’t back off that pain med level at this point. His body is addicted. Im shocked his tolerance level is still the same.  It was tough for you after only 4 months. Even in that short span, I’ve seen many that needed step down therapy and inpatient or outpatient help in kicking the meds. 

 

[Gawain]

I mean, that’s exactly what I’m talking about. Your dad can’t back off that pain med level at this point. His body is addicted. It was tough for you after only 4 months. Even in that short span, I’ve seen many that needed step down therapy and inpatient or outpatient help in kicking the meds. 

Is twice a week 5mg Hydro enough to trigger dependence? I honestly don't know. My pop's taking one of the weaker drugs as prescribed without deviation and without increased usage. He's not doctor shopping or running out of meds early. If he could go back to ibuprofen (high blood pressure perhaps?) I imagine he'd make the change fairly quickly. 

Someone who has two beers twice a week isn't going to be classified as anything other than a social drinker at worst. Someone having a cigar once a week while golfing isn't going to get more than an eyeroll from his doctor. I'm not sure how using opiates in a limited role as prescribed is getting demonized here. 

I'd be interested in any literature you have that talks about OUD in twice-a-week users, who are using opiates as prescribed.

 

[James Daulton]

If the medication is working as prescribed and isn't being abused for its pleasurable side effects, what's the issue with taking them?

In TIS's case, the pain meds make his life tolerable, why is that an issue?

 

[bigmarc27]

Is twice a week 5mg Hydro enough to trigger dependence? I honestly don't know. My pop's taking one of the weaker drugs as prescribed without deviation and without increased usage. He's not doctor shopping or running out of meds early. If he could go back to ibuprofen (high blood pressure perhaps?) I imagine he'd make the change fairly quickly. 

Someone who has two beers twice a week isn't going to be classified as anything other than a social drinker at worst. Someone having a cigar once a week while golfing isn't going to get more than an eyeroll from his doctor. I'm not sure how using opiates in a limited role as prescribed is getting demonized here. 

I'd be interested in any literature you have that talks about OUD in twice-a-week users, who are using opiates as prescribed.

That’s a conversation for him and his Doc. I’m not a Dr, I work in data. Disease prevalence and cost type data - as an example that would be pertinent to this conversation I’d have claims data saying X% of this group were prescribed opioids post surgery, of those Y% eventually needed intervention leading to an additional cost of Z.  I do that for all health stuff - X% of this population are diabetics, those that are compliant with evidence based metrics of care incur annual costs of Y which is lower than those who don’t manage their condition by Z.

So, what I can tell you is that opioids are being prescribed more. They make people feel good. They are powerful. They also have a substantially higher rate of abuse and those that have been prescribed them have much higher utilization rates of inpatient and outpatient care and behavioral health usage is higher. 

 

[bigmarc27]

If the medication is working as prescribed and isn't being abused for its pleasurable side effects, what's the issue with taking them?

In TIS's case, the pain meds make his life tolerable, why is that an issue?

Maybe nothing, but for example if I told you that 1 in 5 would turn into Bubbles from the Wire compared to negligible numbers statistically from other forms of medication, where’s the benefit / cost point?  

 

[Gawain]

That’s a conversation for him and his Doc. I’m not a Dr, I work in data. Disease prevalence and cost type data - as an example that would be pertinent to this conversation I’d have claims data saying X% of this group were prescribed opioids post surgery, of those Y% eventually needed intervention leading to an additional cost of Z.  I do that for all health stuff - X% of this population are diabetics, those that are compliant with evidence based metrics of care incur annual costs of Y which is lower than those who don’t manage their condition by Z.

So, what I can tell you is that opioids are being prescribed more. They make people feel good. They are powerful. They also have a substantially higher rate of abuse and those that have been prescribed them have much higher utilization rates of inpatient and outpatient care and behavioral health usage is higher. 

You sure put yourself forth as some type of health and medicine expert with claims such as:
 

Your dad can’t back off that pain med level at this point. His body is addicted.

And 
 

For your future, you’ll undoubtedly be taking them for life because your tolerance to all other pain medication is shot.  If you want to be literal about it, you’re likely at some level of addiction now. If you stopped, you would surely have some form of withdrawal already and there aren’t pain meds that will work with you.

These aren't quotes that a guy in analytics makes. You're speaking in absolutes. So now I'm putting the question back to you. Is 2X a week low level opiate use guaranteed to be addictive? I can get the argument that people who use opiates for pain relief are more likely to become addicted than those who don't use opiates. I can understand that hydromorphone is going to lead to more abuse than acetaminophen. But you have now claimed two guys who are sporadic users of opiates, who use opiates as prescribed and who haven't had use increase over time are addicted. That's a harsh claim that you shouldn't be able to duck because of "data."

 

[James Daulton]

Maybe nothing, but for example if I told you that 1 in 5 would turn into Bubbles from the Wire compared to negligible numbers statistically from other forms of medication, where’s the benefit / cost point?  

I'd suggest that those people should be treated with something else.  But to take away helpful meds from the responsible 80% isn't reasonable or fair. 

If there are non-addictive meds with the same pain relieving properties, I'm all about using them instead. 

 

[bigmarc27]

You sure put yourself forth as some type of health and medicine expert with claims such as:
 

And 
 

These aren't quotes that a guy in analytics makes. You're speaking in absolutes. So now I'm putting the question back to you. Is 2X a week low level opiate use guaranteed to be addictive? I can get the argument that people who use opiates for pain relief are more likely to become addicted than those who don't use opiates. I can understand that hydromorphone is going to lead to more abuse than acetaminophen. But you have now claimed two guys who are sporadic users of opiates, who use opiates as prescribed and who haven't had use increase over time are addicted. That's a harsh claim that you shouldn't be able to duck because of "data."

I never claimed to be an expert, if you can find where I said that I’d love to see it. I do have data, data shows very clear correlation between powerful pain killers and future problems. If you want to disregard, that’s your prerogative. 

 

[bigmarc27]

I'd suggest that those people should be treated with something else.  But to take away helpful meds from the responsible 80% isn't reasonable or fair. 

If there are non-addictive meds with the same pain relieving properties, I'm all about using them instead. 

There are tons of pain med options. Others aren’t as strong, but are also substantially less addictive. So again, it goes back to what’s appropriate.  For someone who can’t remove himself from bed, maybe the risk is worth it. For others trying to shave a few strokes off their handicap, that’s a gamble IMO but to each their own. 

 

[JerseyToughGuys]

You sure put yourself forth as some type of health and medicine expert with claims such as:
 

And 
 

These aren't quotes that a guy in analytics makes. You're speaking in absolutes. So now I'm putting the question back to you. Is 2X a week low level opiate use guaranteed to be addictive? I can get the argument that people who use opiates for pain relief are more likely to become addicted than those who don't use opiates. I can understand that hydromorphone is going to lead to more abuse than acetaminophen. But you have now claimed two guys who are sporadic users of opiates, who use opiates as prescribed and who haven't had use increase over time are addicted. That's a harsh claim that you shouldn't be able to duck because of "data."

“Sporadic”?

perpetual

habitual

chronic

regular

those seem like better descriptors

 

[JerseyToughGuys]

It’s rather insane to me that we are arguing about whether morphine-based prescription pills aren’t / are incredibly dangerous. 

 

[JerseyToughGuys]

The thread title itself is kinda insane. An anecdote supplants a mountain of data, apparently.

 

[James Daulton]

Yea this country never over reacts.  That's why whenever I unwrap something that's in a plastic bag the bag has a warning printed on it not to put the bag over my head or it could be harmful to my health.

Nope.  We're a very thoughtful and reasonable country at all times. 

 

[bigmarc27]

The thread title itself is kinda insane. An anecdote supplants a mountain of data, apparently.

Anecdotes are always a big problem in healthcare. “My grandmother smoked and drank every day and lived til she was 95 but my uncle was in great shape and had a heart attack at 31.”

Well, yeah that happens. There are always outliers, but I wouldn’t make life choices supported by outliers. 

Edit: let me add that this is coming from Doctors. I work extensively with practicing physicians on research for best practices and other things. I wouldn’t want anyone thinking my credentials authorized me to make statements out of scope. 

 

[JerseyToughGuys]

Yea this country never over reacts.  That's why whenever I unwrap something that's in a plastic bag the bag has a warning printed on it not to put the bag over my head or it could be harmful to my health.

Nope.  We're a very thoughtful and reasonable country at all times. 

You are a dream juror for me and my typical clients. Fight the good fight!

 

[Terminalxylem]

I was not aware of it. It didn't come up in my Google search yesterday. Thanks for linking it.

Well, first of all, this tangent began when you posted this: "the data shows no long term benefit from using opioids for non-cancer pain". You didn't say the benefit is not shown to be very compelling, you said there was no benefit.

This is from the conclusion:

A small benefit is a positive benefit, so this study supports my response to you on your original statement.

Furthermore, the study outlines several limitations. Primary among them is the median of 60 days and the fact that not a single study went beyond 6 months. Thus, this is of limited utility in determining long term benefits.

This study also says the average dose across the patient population was 45 mg, which CDC defines as a low dose. It is possible that one reason for the small observed benefit was the low dose. This study offers very little information about other dose levels.

Facts from the study:

• Overall, 197,269 patients were prescribed opioids within the sample. 0.18% of them were diagnosed with OUD during the post-index period.
  
• The study used 6 categories. 6.1% of patients in the high dose, chronic group were diagnosed with OUD during the post-index period. No other group topped 1.28%, and all other groups collectively were at 0.16%.
  
  6.1% for the high dose, chronic group was based on 23 instances of diagnosed OUD among 378 patients in that group. That is a fairly small sample size, given that the study accounted for 568,640 individuals.
  

[*]Many limitations were identified in the study, including: "current Diagnostic and Statistical Manual (DSM) IV diagnostic criteria are likely not optimal for prescription drug disorders. That is, individuals on chronic opioid therapy will likely develop tolerance, and withdrawal if they stop using opioids (2 of the 7 seven symptoms for opioid dependence), even if they are using opioids as prescribed by their physician." This implies that the actual OUD rate was overestimated in this study.

Even if you ignore the dearth of data for long term opioid use in CNCP, the findings of the largest meta analysis I linked effectively shows no benefit - the magnitude of change was so small as to be below the minimum significant numeric difference on the pain and functionality scales. Moreover, opioids were no more effective than alternative treatments. This is a big reason opioids are discouraged for chronic musculoskeletal pain, my original premise.

As far as the dosing goes, that’s the best data we have. Assuming higher doses may have worked better is probably reasonable, but not a given, as more side effects would likely occur as well, including vomiting, which already was more prevalent with opioids. And potential for abuse (not just OUD) would also increase.

Opioids are great for acute, severe pain. And they wok for chronic cancer pain, too. Any other indication is dicey given the available data.

 

[Terminalxylem]

There is no "fix."  I could get surgery, but that might not fix it and could make it worse.  Back surgery is not something you just do.

On top of that, a simple pill fixes the issue.  Why would I choose to have a surgery if there's a pill that fixes it?  And I'm supposed to not do enjoyable things like hike and play golf just because some people might get addicted to a drug???  Do you know how ridiculous that sounds?  We have developed a pill that allows me to enjoy life like a normal person and you're saying I should stop doing those things?  I mean, no offense, but that might be the dumbest thing I've ever heard.

How did you determine no fix is possible, other than the opioid? Did you comply with physical therapy, exercise, attain a healthy weight and try maximal doses of non-opioid medications before arriving at that conclusion? Have you tried cognitive behavioral therapy, acupuncture or seen a physiatrist? Do you periodically try to taper off your opioid, as time has given your body to heal?

 

[Tau837]

It is closer to epidemic than closer to a small problem.  Really makes me wonder if he is in health care.

If you think prescription opioids are the root of an epidemic, how do you feel about NSAIDs, alcohol, and tobacco? Annual deaths:

• Solely from prescription opioids: 7K to 10K
  
• From NSAIDs (i.e., aspirin, acetaminophen, ibuprofen, etc.): 7K to 10K
  
• From alcohol: 88K
  
• From tobacco: 480K
  

 

[Tau837]

@TheIronSheik If you've been taking 40mg __________ for an extended period of time with no tolerance problems or dose escalations, you are very VERY lucky. It's great that the miracle of morphine is working for you and you've been able to avoid the very serious downside to prolonged use.

You are not the norm.

The percentage of those who are prescribed opioids who become addicted is very low. Sure, tolerance is an issue, but it is easily manageable. No offense, but you come across as someone who is not well informed on this subject.

 

[Tau837]

I think you're wrong.  I think I am the norm.  I think the person who turns into an addict is not the norm.

This. 1000x this. This is what those who haven't experienced it personally or via family don't seem to understand.

 

[Tau837]

Most people won’t become addicted to prescription painkillers today, but if that rate is increasing substantially for one particular type, it’s something that needs to be addressed.

 
Regarding the bolded, I'm not aware that is the case. Are you? If so, please share.

 

[Tau837]

If you want to be literal about it, you’re likely at some level of addiction now. If you stopped, you would surely have some form of withdrawal already and there aren’t pain meds that will work with you.

Dude, you have no idea what you are talking about. Dependence and addiction are not the same thing. Almost everyone who takes opioids long term becomes dependent. That is not the same thing as becoming addicted. If you don't understand this, do some basic research.

 

[Tau837]

I'm not sure how using opiates in a limited role as prescribed is getting demonized here. 

Because that is what the public has been led to believe by the politicians and the mass media, who generally have no idea what they are talking about. Many posters in here are just posting uninformed propaganda. 

 

[Tau837]

for example if I told you that 1 in 5 would turn into Bubbles from the Wire compared to negligible numbers statistically from other forms of medication, where’s the benefit / cost point?

But it isn't remotely close to 1 in 5. Your posting in this thread is ignorant and irresponsible.  

 

[Tau837]

Even if you ignore the dearth of data for long term opioid use in CNCP, the findings of the largest meta analysis I linked effectively shows no benefit - the magnitude of change was so small as to be below the minimum significant numeric difference on the pain and functionality scales. Moreover, opioids were no more effective than alternative treatments. This is a big reason opioids are discouraged for chronic musculoskeletal pain, my original premise.

As far as the dosing goes, that’s the best data we have. Assuming higher doses may have worked better is probably reasonable, but not a given, as more side effects would likely occur as well, including vomiting, which already was more prevalent with opioids. And potential for abuse (not just OUD) would also increase.

Opioids are great for acute, severe pain. And they wok for chronic cancer pain, too. Any other indication is dicey given the available data.

You are misrepresenting some of the facts. At least you have seemingly backed off some of your earlier statements that were more adamant that there is no benefit. See, we can actually improve our perspectives through discourse.  

 

[Tau837]

Angels pitcher died today, and too early to know why, but likely same reason it may be a good thing your friend didn’t get prescribed opioids. Getting hooked for an injury leads far too many on a downward slide to death. I’m glad they exist, but should not be prescribed lightly.

They aren't prescribed lightly. Read the thread.

Famous people die, and the reasons get sensationalized. If the Angels pitcher died from an opioid overdose, it is virtually certain that he was using drugs illegally.

 

[bigmarc27]

Because that is what the public has been led to believe by the politicians and the mass media, who generally have no idea what they are talking about. Many posters in here are just posting uninformed propaganda. 

I was going to respond to your comments on my post, but I can see here that it would be a pointless endeavor. Believe what you will. 

 

[Tau837]

How did you determine no fix is possible, other than the opioid? Did you comply with physical therapy, exercise, attain a healthy weight and try maximal doses of non-opioid medications before arriving at that conclusion? Have you tried cognitive behavioral therapy, acupuncture or seen a physiatrist? Do you periodically try to taper off your opioid, as time has given your body to heal?

Why would you ask such questions, as if you assume he did not try those things? This is the kind of stigmatization that pain patients who appropriately use prescription opioids face every day. It is inappropriate at best.

 

[Tau837]

I was going to respond to your comments on my post, but I can see here that it would be a pointless endeavor. Believe what you will. 

Based on your posts, I'm confident that I know a lot more about the subject than you, so I'm fine with that. I can see why you wouldn't want to engage on the merits of your posts.