In 1996, Steven was in a car accident that left him with a skull injury and multiple vertebral and other bone fractures. He was hospitalized for several weeks and basically had his entire face rebuilt and rods placed in his back, while other bones were screwed back together.
Needless to say, Steven experienced severe pain. He was treated with the vast spectrum of pharmaceutical aids including hydrocodone, oxycodone, and hydromorphone.
Steven, who had never had a problem with substance abuse or addiction, became physically dependent on opioids to manage his pain.
He never lost his medication or shared it with another person. He consistently went to his doctor — his own family internist — who filled his prescriptions like clockwork. To stay in compliance, his doctor’s office would occasionally request a Urine Drug Screen. These were infrequent and never resulted in any ‘surprises’ or illegal substances found.
Nowhere to Turn for Pain Meds Prescriptions
Last year Steven’s doctor told him that the time would come where he could no longer continue to prescribe his pain medications. This news was inconvenient and a bit worrisome. Steven had spent years with this doctor, so the idea of changing doctor’s offices to one that could prescribe his medication was a little frightening. What if there was a glitch and his prescription was late? Steven knew the horrors of withdrawal. He had experienced it only once since beginning pain management. He forgot to pack his medications and left for vacation. It never happened again.
Steven didn’t know that all over the United States doctors were having this same conversation with their patients. As the massive body of the Opioid Epidemic-iceberg was emerging, urgent steps were being taken by the government to attempt to put a dent in the unanticipated consequences of years of overprescribing addictive pain medications.
Steven said that his post-accident life had revolved around the next dose of medication. He tried to cut back or go just a little longer in between taking a pill. But he was in a perpetual state of taking the meds and then experiencing the physical need for them. He hated going to the pharmacy to get his prescription, feeling judged and labeled as an “addict,” then worrying someone might be following him to his car to rob him.
Rules for Doctors Prescribing Opioids
The CDC created the CDC Guideline for Prescribing Opioids for Chronic Pain, providing recommendations targeted to primary care providers. The recommendations focused on treating chronic pain like Steven’s, outside of active cancer treatment, palliative care, and end-of-life care.
The new guidelines included lower dosage recommendations due to evidence that shows even relatively low doses of morphine milligram equivalents can increase a patient’s risk of overdose. This document also shifted focus to all patients on opiate medications, rather than just those considered “high risk.” They placed more emphasis on checking state prescription drug monitoring programs and having impeccable and thorough notes on all patients receiving treatment. They also added specific recommendations on discontinuing opioids in situations where risks outweigh benefits.
Under this new regulation, many doctors were found to be non-compliant; many lost their privileges to prescribe opioids. Primary care offices around the country were making the decision to stop providing pain management treatment and leaving it to specialists who were better positioned to deal with the more stringent regulations.
Steven’s doctor made several attempts to connect him with a pain management specialist. Even if he was able to make it through the 5 month waiting period, many offices did not accept patients who were on the doses of medication that Steven was taking. He had to face the reality that his method of pain management was apparently no longer accessible.
This is when Steven discovered the Coleman Network. With fear and resentment, he signed on for a 4-day Accelerated Outpatient Detox. This was eight months ago. Now, Steven is pain free and sober, living the life he has always wanted, and always deserved.
If you are physically dependent on your pain medications and concerned about being abruptly or eventually cut-off, give us a call. There are a lot of people out there who are taking this leap. You, too, may be amazed at the taste of freedom like that which Steven enjoys.
Joan Shepherd, FNP