Page 5 of 11 FirstFirst 1234567891011 LastLast
Results 41 to 50 of 106

Thread: My Pain Doctor in WA state Raided, I am without my meds! Help!?!

  1. #41
    Junior Member
    Join Date
    Apr 2007
    Location
    Pacific Northwest
    Posts
    18
    In summary, neuropathic pain is a very common and unsolved problem. In Germany, one study alone identified over a quarter million people who have neuropathic and suggested that this population is not being adequately cared for. Several studies provided some insight into why tricyclic antidepressant drugs are toxic and how amitriptyline may slow gastric emptying........ Finally, the field of central pain management is beginning to understand and accept the use of opioid therapies for neuropathic pain.

    Treatment of Neuropathic Pain Disorder: A Review of Recent Studies
    By wiseyoung

    Neuropathic Pain: A Review of Recent Publications
    by Wise Young, PhD MD
    W. M. Keck Center for Collaborative Neuroscience
    Rutgers University, 604 Allison Rd, Piscataway, NJ 08852-8082
    15 December 2008
    Last edited by jbpara; 08-10-2009 at 04:18 AM. Reason: reference added

  2. #42
    Junior Member
    Join Date
    Apr 2007
    Location
    Pacific Northwest
    Posts
    18
    Dear Rev: please don't patronize me; I've been a pharmacist for over 35 years who has tried all medications, and other modalities. I am not having a problem with my prescriptions, including an opiate, but only posted the links to clarify a previous question about Washington state narcotic prescribing issues. I've been in pain 33 years after being shot by a robber in my pharmacy, and am well aware of end of life issues and advanced care directives. I am retired for ten years now, after losing my employment after the neurosurgeon who removed the bullet in my spine in '75 tried an unsuccessful second laminectomy ten years ago, and prescribed MS Contin. I applied for a DREZ lesion but was not a candidate because of such a high injury for a para.
    Last edited by jbpara; 08-10-2009 at 04:26 AM. Reason: was logged off before finishing

  3. #43
    Junior Member
    Join Date
    Apr 2007
    Location
    Pacific Northwest
    Posts
    18
    Please do not be so quick to repeat the claim that opiates do not have a place in the treatment of SCI neuropathic pain. Many of us with long-term injuries have had to listen to this DEA-fueled propaganda, and now that a recent review article has documented that there is both a place in first-line therapy and as an adjunct, there is no need to make people with new injuries suffer from chronic pain as us old-timers were forced to do. At least I have temporary relief, and perhaps if it were not so difficult to get prescribed could get beyond breakthrough pain days. Unfortunately, MS Contin does not last 12 hours, and an increase in dosing intervals would probably reduce these horrible pain episodes. jb


    Wise Young: Treatment of Neuropathic Pain Disorder: A Review of Recent Studies

    Treatment of Neuropathic Pain Disorder: A Review of Recent Studies
    By wiseyoung

    Neuropathic Pain: A Review of Recent Publications
    by Wise Young, PhD MD
    W. M. Keck Center for Collaborative Neuroscience
    Rutgers University, 604 Allison Rd, Piscataway, NJ 08852-8082
    15 December 2008

    A case for opioid therapy of neuropathic pain. Allen [9] made a plea for rationale multiple drug therapy of neuropathic pain, pointing out that opioids will never replace tricyclic antidepressants and anti-epileptic drugs as the first line therapy for neuropathic pain but that opioids are now full established as effective second- and third-line therapies. In 2006, Dobecki, et al. [9] pointed out that neuropathic pain is a very common condition, affecting nearly 1.5% of the U.S. population. The US FDA has approved five medications for neuropathic pain, including gabapentin, pregabalin, duloxetine, 5% lidocaine patch, and carbamazepine. Other agents with proven efficacy in multiple randomized placebo-controlled trials include opioids, tricyclic antidepressants, venlafaxine, and tramadol. All the these agents have been recommended as first-line therapies for neuropathic pain. So, the field has moved in the last few years, from a budding recognition that some drugs may work for neuropathic pain to formal acknowledgment that they are first-line therapies.
    Last edited by jbpara; 08-10-2009 at 05:20 AM. Reason: typos

  4. #44
    jbpara

    I know I am just going to make you angry, because you are already angry and may probably think I am coming down on the side of those who won't free up opiates where they would be helpful. I am glad MS Contin helped you. I am very sorry to hear you were shot in the spine and you have been through some terrible experiences. I also respect the profession of pharmacy. They are very smart individuals. I am not against anyone taking anything that helps. I have cited Ron Melzack's article in Scientific American on the principle that people in severe pain do not become addicted to opiates.

    However, I once again hope that we will be specific about neuropathic pain. Central pain is a very small percentage of those with neuropathic pain. Diabetes is by far the largest group, but that is PERIPHERAL neuropathic pain. The cord is excitatory. Therefore, one would expect that peripheral neuropathic pain would respond because opiates quiet the cord. However, the brain is INHIBITORY. Therefore anything that inhibits an inhibitor may cause disinhibition. Disinhibition means that if you quiet the inhibitory part of the central nervous system, there is a possibility that the pain will not be helped and may even get worse.


    Hence, my earlier post that we have to write and think specifically.

    I personally spent a large amount of money to try to get help, any help, for severe burning dysesthetic central pain over my body. Part of this was to be given IV opiates. This trial went to extremely high levels, such that anesthesia had to be on hand to prevent my death since they were pushing it so hard. It was kind of an experiment at one of the leading university pain centers. I felt NO RELIEF whatsoever from opiates. What I experienced is valid for me. My experience may spare someone the broken heart who is hoping for relief and finds that opiates do not help.

    On the other hand, if dosages are at the right level, since opiates may sedate a person, there is a potential that sedation will help the pain, including central pain. It did not do this for me, but I am convinced that for some, it does have this effect. However, there is fair evidence that other drugs may be better sedatives.

    I believe in access to pain meds for whoever needs it. I think these matters are best left to the judgment of pain doctors. However, my belief in that principle does not change the fact that nearly everyone, from S Weir Mitchell during the Civil war to Dejerine in 1905, to Riddoch in 1940down to the present has come to the conclusion that opiates don't cut it for severe central pain. This position is also the position at the NIH. Frederick Lenz at Johns Hopkins has postulated this may be due to disinhibition. One leading author on the effectiveness of opiates at high doses, who was at Harvard, felt he was getting some results for a time, but I notice that his recent articles do not follow the same line of thinking. Therefore, there must be balance in these posts. I believe opiates do help peripheral neuropathic pain. I only wish they had done more for CENTRAL neuropathic pain in my case.

    Post SCI pain frequently includes pain which is normal pain. Of course opiates are helpful for that kind of pain and should be available. Post SCI pain is not an exact synonym for central pain. You mention that you were hoping for a DREZ. There is a little argument about this, but the kind of pain for which DREZ is done is commonly considered to be peripheral neuropathic pain. Therefore, one would expect MS Contin to help you. Since the dorsal root ganglion cell bodies are OUTSIDE the cord, the anatomists I have talked to feel it is peripheral nerve injury pain, although it seems there would be a little crossover, since it would be likely that if the dorsal root ganglion is injured, there might be some injury to the cord proper.

    However, when we talk about the brain inhibiting or modifying pain, at cord level, we are mostly talking about interneurons, which are CORD structures, which come down from the brain to inhibit signal mostly. I am unaware of anyone who thinks interneurons have cell bodies in the DRG. However, DRG science seems to change almost monthly, so I may be wrong about that.

    "At level" pain falls into the same category. Strictly speaking it should be predominantly peripheral, but some have very severe at level pain, mixed with lesser pains from lower down, which are central pain. I am not sure what you call that. The DREZ is not a recommended procedure for pure central pain that I am aware of. You remember the editor of New Mobility who had the DREZ for central pain but did not have a good outcome.
    Last edited by dejerine; 08-10-2009 at 06:19 AM.

  5. #45
    JB,
    I'm sorry if you felt I was patronizing you - I didn't intend that at all. I won't post again.
    Last edited by Coleen; 08-10-2009 at 04:41 PM.

  6. #46
    I would hate it if it happened to my pain DR but it never would. I've been useing him for 15 years. He has lost a lot of business because he is strict. He caught his patients abusing, selling or the big one, going to other Dr's for pain meds. That's a no no for a pain Dr.
    I do and know many sci people that take valium. One friend takes one in the morning and one at night. I take a 10mg at night to calm down my legs and to help me fall a sleep.
    My GP will not give out a lot of pain meds every month. He will send you to a pain Dr.
    There are a lot of Dr's around here in Louisiana and Texas that are getting busted. Mostly for oxicotin. There are so many people that have nothing wrong with them that are hooked on pain meds. It's crazy.
    Mary
    I want to Rock you Gypsy soul and together we will flow into the Mystic.
    Van Morrison

  7. #47

    Angry DEA - Closed Dr. Office

    I have been seeing a Pain Dr. for 2 years and the DEA closed the office up until furthur notice. I was under a pain contract. Well what about all the people that we seeing this DR. I am out of pain meds and told from the office to go to the ER and they said there is nothing they can do.
    I was seeing the Doctor monthly and getting my scripts. I called the Pain Clinic they are telling me I need a referral well it takes time to get a Primary at least 1 month to get into a Primary. I called the DEA very upset and told them you are heartless, they said go to the ER or Detox I am not a junkie. I told them the ER is telling people there is nothing they can do. I need my meds to function on a daily basis. How can they get away with this is beyond me. I am wondering if we can get a class action law suit against the DEA. Life without meds is life in bed - no work - no life. I was out of work last week for 4 days could not move. I have a friend that has given me some meds until I can find a Dr. -- Can the DEA do this? Is this legal? To leave people that have been on a controlled substance for years with no meds? What is the DEA issue. There is no covering Dr. for him. Is there supposed to be someone covering for this Doctor? They need to give everyone a chance to get another Doctor, in the meantime we all should have been given at least scripts for a month until we can get another Dr. I feel so bad for the Dr. he was a caring Dr. he was the kind of dr. that would not give meds without proof of a problem.
    I am in desperate need of a Dr. to get my meds. I am in Mass area and if anyone can help with this please send me a response. THE DEA ARE HEARTLESS PEOPLE THAT THINK WE ARE JUNKIES... WE HAVE REAL MEDICAL ISSUES WITH DOCUMENTATION (MRI'S, ETC)TO PROVE IT!!!!!

  8. #48
    Unfortunately, the DEA isn't responsible for getting you medical care. They're responsible for preventiong violations of the law. So I don't think there is any basis for a lawsuit.

    That said, even in you WERE a junkie (and I am not saying you are) it could be dangerous to suddenly stop your medications.

    You don't have a primary care doctor? If they are willing, any doctor could prescribe you the medications you are already on temporarily.

    Ideas:

    Perhaps ask the ER to just refer you to the pain clinic.
    Try asking for the hospital social worker.
    Try going to a urgent care clinic, and see if someone will give you a referral.
    Call all sorts of primary care physicians, and ask for the first available appointment. Ask to be called if there are any cancellations.

    Sorry you're going through this.

  9. #49
    I know of a Pain Dr. in Covington, near Kent, WA. Am I allowed to state the name of the clinic? Or the doctor's name?

  10. #50
    Quote Originally Posted by fallNApart View Post
    I know of a Pain Dr. in Covington, near Kent, WA. Am I allowed to state the name of the clinic? Or the doctor's name?
    Yes. It's ok

Similar Threads

  1. Aaarrgghhhh!
    By Max in forum Pain
    Replies: 0
    Last Post: 10-14-2003, 12:57 PM
  2. Replies: 1
    Last Post: 03-22-2003, 07:30 AM
  3. Putting pain it its place
    By antiquity in forum Pain
    Replies: 0
    Last Post: 12-30-2002, 08:47 AM
  4. Replies: 0
    Last Post: 10-06-2002, 10:00 AM
  5. Escaping from chronic pain
    By antiquity in forum Pain
    Replies: 0
    Last Post: 10-01-2002, 03:30 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •