took Percocet... definitely an opioid... good stuff, understand why she wants more

I don't blame her. Not everyone in pain is able to get into pain managment.

or not.

It can be an issue with doctors trying to uphold the laws, too. Back when my father was terminally ill some asshole doctor was worried about addiction. Who cares if you die addicted as long as you are comfortable?

A patient who is on comfort care only, patient comfort is the only consideration. Don't know what that doctor was thinking.

I had a bad motorcycle wreck in south Florida during the height of the pill mill craze. After my doc weened me off of vicodin I checked out one of those places to see what it was about. They said, just bring in your MRI and $300 cash and we'll hook you up. I was thinking, "$300 for about $30 worth of pills?" I'm not paying that! I guess I was only physically dependent and not addicted. I do have to say that my favorite pain medication of all time is probably demerol. I don't think that drug is used anymore, but I had a shot of it in the hospital once. It was really really nice. Way better than the morphine drip that I was on right before it. My adage is that if it makes me feel really really good, I probably should tread very carefully.

These are serious, curious questions, the first about this statement: " I guess I was only physically dependent and not addicted."

It makes me wonder: How can a doctor tell the difference between Physically Dependent or Addicted?

The obvious is if you keep asking for more and more and more. The 'high' you experience from just one tablet quickly goes away, but it does work to numb/block the pain so you can use your hands and even do some housework or gardening (yes, I'm old and retired My mornings are wretched, but I'm in my mid-60s. I should still be able to physically do things without enduring the pain).

If one wants to get 'high', then they have to take more and more and more. I wouldn't be surprised if a lot of the ODs on the pill form could also be caused by taking way too much Acetaminophen.

Also, if taking an opiate as prescribed, and it allows you to get through the day without the constant pain (I'm speaking of arthritis, specifically, combined with sciatica which will probably eventually require surgery again - laminectomy ).

How is that different from me having to take high blood pressure medicine every day (probably for the rest of my life). So you take it daily, is that how they determine you are 'addicted' ? I just don't get it.

I take one opiate in the morning, and the other 12 hours later. Would this be seen as being 'addicted' ? (then am I also addicted to all the other daily meds my doctor has me on? - patches for hot flashes)

I understand that there are many many who abuse it, or people who just get it to sell it (heck, $300 for $30? ) - This just makes it a bad environment for others who do not abuse it.

I'm just really scared that all this pressure on doctors is really going to hurt people (like me) that are just trying to have at least a part of their days that are not blinded with pain.

And also amphetamines in the form of Ritalin and Adderall. Sometimes when a pharmacy is prescribing too much per the lawyers they will "run out" and not be able to fill your script. This is the world we live in now, thanks to the onycontin hysteria.

If I had truly been an addict, I would have plunked down the $300 and got the pills. It's not like I couldn't have afforded it. I still have pain every day, and would love to take the occasional opiate, but I don't ask for them. For me it was a clear sign that I was not an addict because I was able to walk away from it. I take BP meds every day as well and I'm in my 60s too. I used to play in bands for a living and worked with a lot of people who had drug problems. To me addiction is kind of like a form of hunger. Everyone has to eat, or they will die. For addicts, they have that same drive, but for drugs or gambling or whatever it is that they're addicted to. I'm scared about the pressure being put on docs as well. At some point I'm going to need to get back on opiates too. I feel as an adult over the age of 21 I ought to be able to get what I need at the pharmacy. I can buy a fifth of whiskey a box of cigars, a combat rifle and a motor vehicle that weighs well over a ton and can go 160mph, but I can't be trusted to use opiates on my own? Very strange...

may still be available, but limited to serious conditions where adverse /sensitivity reactions to morphine or hydromorphone prevent its use.

Europe and Canada (along with the WHO) largely excluded the use of these drugs in the early to mid-2000s, especially in the elderly, due to the risk of respiratory depression, kidney dysfunction, falls, and neurotoxicity. Oral use was likewise largely discontinued because even for healthy individuals, the doses required to be effective were sufficiently high to be neurotoxic, and even short courses dramatically increased the risk for abuse and addiction.

For hospitals, there remains some need for meperidine--especially in intractable bone cancer or in some acute severe pancreatitis cases, but it is very very hard to obtain.

If only more care were likewise taken with other opioids, including fentanyl and OxyContin early on...

What I heard was that it was causing some people to have strokes. I was only on it for a few days before they sent me home with vicodin. I had multiple fractures so I was in a pretty bad way when I got the Demerol. I hope I'm never in a position where I need anything like that ever again, but I'm sure glad it was there when I needed it.

...after a bicycle accident 50 years ago.

The morphine worked only in the sense that it made me want to listen to the Grateful Dead, suspending my understanding that they almost never played in tune. In an ICU as a patient, one loses appreciation of reality.

Wanting to listen to the Grateful Dead disabused me of any notion of wanting to develop addiction to opioids. Some things are better left alone.

The dead are a Category 3 band for me.
Cat 1 is for bands I personally like.
Cat 2 is for bands that aren't my taste but I get why others like the.
Cat 3 is for bands about which I'm baffled why anyone listens to them.

She has bursitis, the treatment for which is anti-inflammatories, corticosteroid injections, and physical therapy. Her orthopaedist did not prescribe her opioid medications, and I'm following his lead.

person myself I know I must take more frequent rests. My stamina is not what it used to be and I am a very healthy 85 year old. But pain exhausts me more quickly these days. Telling me I must go to the gym and work out for half an hour just makes me cranky.

Adhering to the standard of care does not always lead to widespread popularity. Not adhering to the standard of care is a good way to get dragged in front of a disciplinary committee.

And while pain itself is subjective and not reliably quantifiable, there are objective signs to look as such as blood pressure, heart rate and so on. Not to mention, it is always best to use the medication best suited to treat the underlying problem, as well as the symptom. In her case, non-steroidal anti-inflammatories for an inflammatory condition. They're not sexy, and they won't get you high, but they get the job done.

understanding of correct medical treatment of her situation prevents you from doing what she demands and she is free to seek the advice and treatment from other medical professionals (who will tell her the same thing). And be done with her. IMO, if she wants to receive appropriate care, she needs to accept this. I'm not saying you should lecture her. I just think she is wasting your time.

...my mother-in-law on maintenance doses of narcotics for all of the 30 years I knew him.

I actually am OK with it. She was one of the last Americans to have had polio and suffered immense pain from post-polio syndrome. Since most polio survivors are gone, assuming that asshole RFK doesn't bring polio back, many medical professionals are not acquainted with the syndrome.

My mother-in-law was a drug addict of course, but sometimes being a drug addict is justified. I believe it was in this case. She also suffered from osteoporosis, weak musculature and other problems, some of which were psychological.

Of course, all of this caused my wife an interesting upbringing, to say the least. My wife left home at 17 and was, as a result, an extremely mature woman at 22 when I married her, beyond her years, but probably because she really was deprived of solid parenting and had to raise herself.

It was dicey between us, my in-laws and us, but we managed our relationship eventually, to the extent that when they passed, I missed them both deeply and wept many times for them.

As the years pass, we are prone to understand them better and be more forgiving of who and what they were. It is probably the case that my mother-in-law was lucky to marry a doctor, although their marriage was a mess, mostly based I think on the fact that they were good looking when young, but otherwise they were incompatible.

I often muse to my wife that I don't know how she came out of that family, but I'm glad she did, as I love my wife very much.

My point, if I have one, is that pain, psychological and physical, sometimes both intertwined, needs management and finding the balance is difficult if not impossible.

First the “board “, then the dea

That's like hoping a diet soda offsets the calories in the chocolate sundae.

Fortunately, I've never encountered anything that I couldn't quit -- in fact, I don't even think about quitting, I just don't need it if there's only a little pain. Pain, at tolerable levels, is just information your body is sending you that something is wrong. If you react by "taking it easy" and it goes away on its own, there was no need for the painkiller. If you kill the pain, you're misinforming yourself on your body's condition. Too bad the body overreacts sometimes, and you can't just mentally switch it off, and it affects different people very differently. Evolution is not perfect, alas.