Okay; so in a case like mine, perhaps “dependent” would be more appropriate than “addict?”
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Okay; so in a case like mine, perhaps “dependent” would be more appropriate than “addict?”
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Seems to me that the people who truly need pain medicine are damned if they do and damned if they don't .
There is a risk with any medical treatment/medication. I think trying to lay blame on any group is wrong. People respond differently to medication and therapy. Everyone involved in any treatment plays a role in making sure things are working as intended. Attempting to blame someone is just too much like the "progressives" and "triggered snowflakes".
Thank God I'm allergic to opioids. After a day or so my skin flushes / itches far worse than whatever pain I have.
Opioids KILLED my little sister.
There are some pretty arrogant folks here who'll never fully understand addiction because their system doesn't fire the same as an addict. That doesn't make one stronger in any way. They should be thanking God every night not playing self riotous arse!
I watched one of the strongest guys I know beg his doctor to help him get off them. He was on them from injuries sustained in Division One football. Six figure income and far from a looser!
Opioids KILLED my little sister.
There are some pretty arrogant folks here who'll never fully understand addiction because their system doesn't fire the same as an addict. That doesn't make one stronger in any way. They should be thanking God every night not playing self riotous arse!
I watched one of the strongest guys I know beg his doctor to help him get off them. He was on them from injuries sustained in Division One football. Six figure income and far from a looser!
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The strongest man I ever met was in a wheelchair. His strength was not physical but came from the inside.
The question posed here is why should someone else be held responsible for my addictive behavior? Should "Little Debbies" be held responsible for my addiction to sugar? No one from Little Debbies holds a gun to my head and makes me eat too many of their snack cakes.
The Oklahoma case appears to me to be an old fashioned shake down for money. How much of the money will actually be used to DIRECTLY help the addicts?
BTW, I suffered thru many years of watching one of my Uncles getting ON and Off of the Cocaine Train and Alcohol. It was painful to watch and it hurts because you want to help them but can't. Addiction to anything is serious but ultimately who is RESPONSIBLE?
The question posed here is why should someone else be held responsible for my addictive behavior? Should "Little Debbies" be held responsible for my addiction to sugar? No one from Little Debbies holds a gun to my head and makes me eat too many of their snack cakes.
The Oklahoma case appears to me to be an old fashioned shake down for money. How much of the money will actually be used to DIRECTLY help the addicts?
BTW, I suffered thru many years of watching one of my Uncles getting ON and Off of the Cocaine Train and Alcohol. It was painful to watch and it hurts because you want to help them but can't. Addiction to anything is serious but ultimately who is RESPONSIBLE?
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I worked in Healthcare for nearly 39 years as a Registered Respiratory Therapist with the last 24 years as a Director of Respiratory Care Services. All of my time was spent in Acute Care Hospital settings. My duties ranged from clinical care to management with added assignments outside of my immediate area of responsibility like Medical Waste and HAZMAT Coordinator; Paperless Charting Development; Safety, Medical and Pharmacy Committees.
From 1981 to 2009, I was responsible for insuring that my service areas were compliant with standards of care, state and federal regulations, legal requirements, and quality of care standards as described by the JCAHO and HCFA (now CMS).
As I recall, in the late 1980s or early 1990s, JCAHO and HCFA jointly developed Quality of Care Goals and Quality Improvement Goals (later years adding Patient Safety Goals) with which Hospitals and Clinics were required to document their compliance and track their performance.
Well, I think around 1994-5 these agencies came up with a Pain Management Patient Care Goal. To achieve compliance with this goal, criteria were established that set standards that all medical records reviewed were expected to demonstrate. Patients were issued a Patient Bill of Rights on admission where they were informed ‘they had the right to be pain free’.
Physician Documentation of Pain Assessment was required in Medical Records in the ‘History & Physicaal’, ‘Initial Assessment’, ‘Patient Care Plan’, ‘Progress Notes’ and ‘Discharge Summary’.
Nurses were required to independently document Pain Assessment in their ‘Initial Assessment’, ‘Nursing Care Plan’, ‘Nurses Notes’-and ‘Discharge Notes’. Ancillary Services providing direct patient care had virtually the same charting requirements as Nursing.
JACHO and HCFA (CMS) inspect and grade Hospitals and Clinics for compliance with numerous standards. They can be ruthless on facilities that don’t measure up to their standards. Accreditation is awarded for passing institutions. It is important because Medicare/Medicaid Reimbursements are denied for facilities that fail Accreditation.
Patient Surveys to insure Patient Satisfaction were implemented. Pain Control was assessed from the patient’s perspective. Data from these documents was fed back to evaluate Physician/Nursing/Other Practitioners Performance. This feedback mechanism coupled with the emphasis on documenting Pain Assessments and Interventions drove Physicians to increase the use of narcotics and opioids because patient dissatisfaction with pain levels negatively impacted their performance evaluations and careers.
I went through this whole conundrum because before the beginning and of the Opioid Epidemic it was the idea of the government’s HCFA/CMS and the JCAHO to use patient perceptions of pain control as an Accreditation Standard that caused the increased prescription rate for narcotics and opioids by Physicians. And he crux of this is.....patients reporting of their pain levels are unreliable! I’ve seen patients that are laughing and moving around freely report Pain Levels of (10) on a (1-10) Scale.
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From 1981 to 2009, I was responsible for insuring that my service areas were compliant with standards of care, state and federal regulations, legal requirements, and quality of care standards as described by the JCAHO and HCFA (now CMS).
As I recall, in the late 1980s or early 1990s, JCAHO and HCFA jointly developed Quality of Care Goals and Quality Improvement Goals (later years adding Patient Safety Goals) with which Hospitals and Clinics were required to document their compliance and track their performance.
Well, I think around 1994-5 these agencies came up with a Pain Management Patient Care Goal. To achieve compliance with this goal, criteria were established that set standards that all medical records reviewed were expected to demonstrate. Patients were issued a Patient Bill of Rights on admission where they were informed ‘they had the right to be pain free’.
Physician Documentation of Pain Assessment was required in Medical Records in the ‘History & Physicaal’, ‘Initial Assessment’, ‘Patient Care Plan’, ‘Progress Notes’ and ‘Discharge Summary’.
Nurses were required to independently document Pain Assessment in their ‘Initial Assessment’, ‘Nursing Care Plan’, ‘Nurses Notes’-and ‘Discharge Notes’. Ancillary Services providing direct patient care had virtually the same charting requirements as Nursing.
JACHO and HCFA (CMS) inspect and grade Hospitals and Clinics for compliance with numerous standards. They can be ruthless on facilities that don’t measure up to their standards. Accreditation is awarded for passing institutions. It is important because Medicare/Medicaid Reimbursements are denied for facilities that fail Accreditation.
Patient Surveys to insure Patient Satisfaction were implemented. Pain Control was assessed from the patient’s perspective. Data from these documents was fed back to evaluate Physician/Nursing/Other Practitioners Performance. This feedback mechanism coupled with the emphasis on documenting Pain Assessments and Interventions drove Physicians to increase the use of narcotics and opioids because patient dissatisfaction with pain levels negatively impacted their performance evaluations and careers.
I went through this whole conundrum because before the beginning and of the Opioid Epidemic it was the idea of the government’s HCFA/CMS and the JCAHO to use patient perceptions of pain control as an Accreditation Standard that caused the increased prescription rate for narcotics and opioids by Physicians. And he crux of this is.....patients reporting of their pain levels are unreliable! I’ve seen patients that are laughing and moving around freely report Pain Levels of (10) on a (1-10) Scale.
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I am very sorry to hear this, and I didn't mean to cause any grief here, or bring up bad memories. Perhaps many of us, including me, do not really understand the psychology of addiction. I simply feel that for most people, the choice to over-use prescribed opioids is on them, but then, there is genetics, family history, circumstances... a lot of things can play into someone taking too much and dying, in the extreme, or just getting addicted even. Depression? We know that seems to go hand in hand with alcoholism in many case, but I don't know about drug use, whether its prescribed or bought on the street. But, I suspect its much the same. Anyway, I'm sorry to have brought it up...but opioids are all over the news and I am curious what people think about the so-called crisis.
Doctors have been prescribing opioid pain meds for a long time; its just not a new problem. Look back at the time of the Civil War, all they had for serious pain relief then was opium or morphine, and you could easily buy legal opium-based products all day every day. Women sipped laudanum for their nerves...Salesmen in a wagon sold the stuff by the bottle; "Dr Jurd's Miracle Cure-All" and other snake oil concoctions. Think about how the effects of addiction hit the nation post-war then...many able bodied men, physically wounded and addicted to opium or morphine, thrown back into a tumultuous society. About that time, heroin was created, and from some reading I have done, it was supposed to help cure morphine addiction, much like some thought morphine would help cure opium addiction. Well we know how that worked out.
Some of our returning vets even today may be in the same place, just a century and a half later. We just don't always learn from past mistakes it seems.
https://methoide.fcm.arizona.edu/infocenter/index.cfm?stid=174
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My workplace does DOT Drug Testing and if the Test results indicate opioids you are responsible for having the prescribing MD contact the Medical Officer within 5 Days . The discussion becomes about the amount prescribed vs the levels found in the urine specimen. If the 2 do not match up then employment is terminated.
The addicts will Shop MD's and obtain several different prescriptions for the opioids or get another family member to get a prescription so they can take them. They will take several times the prescribed dosage and wonder why they failed the DOT drug test or wound up dead.
I'm addicted to sugar and understand that it is me who eats too much of it every day. It is not the fault of the people who make all the sugar products for MY addiction to sugar. They do not force me to eat it. In my case SUGAR is HIGHLY ADDICTIVE. Sugar can lead to health issues that cause pre-mature death.
I agree. Fault ultimately lies with the addicts themselves.....
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