Apr 18 2009
Drug Seeking Behavior and Pain
I’ve heard it said that you should write what you know. Well, I’ll give it a shot. Today I had surgery for a hernia woo hoo! I was thrilled, I was laid off from my job not long ago and it left me with out health insurance. But for the 1st time in my life the President actually did something that directly helped me. To continue my coverage with COBRA would have cost me $270 a month, there was no way I could do that. But Mr. Obama passed a Stimulus bill that puts up 65% of that $270 which meant for $96 I have insurance again. I had no idea how I was going to get my surgery then poof; Mr. Obama to the rescue. I guess? I’m rather of the opinion that I should have never been facing such a dilemma in the 1st place. Whatever; at least I got cut on. But that is not what I came to talk about. (If you don’t want to read for a few minutes then dismiss me now because I can not get this into bullet points and make it cogent)
Drug Seekers;
Ok now as some of you may know I spent a good deal of time working in the ER, well, we had patients come in that were called “seekers”, this was not because they were wandering philosophers it meant they wanted dope. (Really who doesn’t; from Jesus to coffee most people need some kind of fix to stay right) Now “seekers” had a lot of different presentations, too many to mention but everything from a brother faking a cough so he could get “drank” (cough syrup with codeine) usually mixed with 7up to make a tasty cocktail, too a mother who was frazzled by her kids and needed a “mothers little helper”. There was no reason, need or accurate way to determine the validity of 80%+ of the cases, it might be clear to you that some guys a junkie but we didn’t have a bed for him, if he went on the street he would just steal your stereo to get high or he might get really fuckin sick and wind up back in the ER BECAUSE he didn’t use. I mean sure they were “seekers” many were “seeking” because they were in real pain. But once “most” docs got the idea they were seeking; they would get real tight with drugs. This was one of my pet peeves, who the fuck were we to decide whether or not someone needed pain control? I saw people with chronic pain conditions that the MD would refuse to write meds for because they had been in the ER last week for the same condition and got pain meds… DUH they are in chronic pain. Just because you wrote meds last week doesn’t mean they have any left. I had many an argument with MDs over just this kind of bullshit.
Ok back to my surgery today, while in pre-op I and been advised that the doc would likely write me for some Vicodin for post-op pain. Now, I’ve learned a bit about drugs in my time in the ER, I know what good pain meds are, I’ve also had a bit of trauma being a motorcycle rider for years, so I have tasted the good stuff. And Vicodin don’t really excite me in terms of quality of pain relief or how I feel when I’m on the shit. I don’t really like it, but its very commonly used because its “not too good” the good stuff can tend to bring customers back for more. So the MD comes in to see me, gets out his pad and says he is going to write me some post-op pain meds. Well, with out missing a beat I say, “I’m very fond of Dilaudid (it’s the best; ask for it by name the generic hydromorphone is fine too but good luck getting any, they save it for heavy trauma and cancer kind stuff ‘usually’) But with out any reaction the brother says ok, and writes me a reasonable dose and a reasonable supply. Needless to say I am happy and shocked. Now, not only is my pain under control but I actually feel good. The Vicodin would have been enough for pain but I would have felt like shit on it, Vicodin just gives me an icky heavy drunk kind of feeling I don’t like. Dilaudid on the other hand makes me feel great, it knocks my pain out and I feel mentally clear, physically comfortable and overall good as hell, plus I don’t feel drunk. Anyway I was very happy with the care I received and the respect shown to me by writing a script for my “drug of choice”, many docs would have just laughed me off and said I bet you would like that. And then write me for the Vicodin.
I know we have a “War on Drugs”, and I know that feeling good is bad, and that people can become junkies/dopefiends/alcoholics/crackheads. Choose your loser title but I also know that drugs save people’s life and can greatly reduce stress and pain and if used comprehensively they can enhance a person’s quality of life tremendously. But it is the Medical Establishment and the Federal Government who get to decide which drugs a patient/citizen is allowed to have. So what is all this talk I hear about living in a free country. “We the People” don’t have the right to deal with our suffering or pain with out some bureaucrat’s approval, that doesn’t sound like freedom to me. I have known some good docs that do care what kind of drugs work for the patient and actually listen to them, in fact I met one today. But they are not as common as you would think. Further more, I know when I have a splitting migraine that if I could go the drug store and choose my med I could in a matter of seconds knock my pain completely out… But in this land of the free that is not my right, I have the right to suffer, or I have the right to take an over the counter med that likely wont work and if it does it will take 45min-2hrs, or I have the right to go bang up a $350 ER bill, and risk being labeled a “seeker” if I ask for the drug I know works and makes me feel the best. The medicine that would help my headache would cost a few bucks not a few hundred. What a fuckin racket, the term racketeering comes to mind. Yup drug laws strike me as basic racketeering. There is no “War on Drugs”, that is just another cultural myth masquerading as sound public policy, but one that is being up held with the full force of the Police, Prisons and the Medical Establishment. Mighty handy for the National Security State, wouldn’t you say? Maybe it’s just me.
But you know what, I have seen a lot of people in pain, all kinds of different pain and all kinds of different people, I have watch well dressed white lady’s bag a good load of dope from a doc who wont write the same thing for a black man with shabby clothes, it had nothing to do with pain and everything to do with prejudice. Many times if a man can’t cop is pain meds in the ER he will just go cop them on the street. And is much more likely to get shit that kills him or get shot in a deal and come right back in to the ER now with a Jones and a bullet to compliment the pain he was already in when he showed up the 1st time or maybe he’ll just be dead. Pain is entirely subjective, only the person in the pain knows what they are feeling. I have snapped a femur so I have felt some pretty fuckin intense pain. But When I’m in pain at an ER they ask me to rate my pain… Well compared to my femur fracture I’m really not in that much pain if the femur break is 10 on the scale scale if 0-10 I RARELY ever get close to 5 but while 5 is a low number for the doc 5 hurts and who the hell is some doc to say I need to deal with 5 instead of getting a drug that would make me feel better? And if I don’t even need a doctor, who the fuck is the DEA to be telling me I can’t legally go purchase what I know will work and would be cheap, clean and safe to buy and to use. Nah I’m calling Bullshit on the entire drug debate. This is my life. I don’t want the Feds or Doctors deciding what is best for me, Oh I want a doctors advice at times but often I don’t need it, I know what’s going on, I don’t need his advice I need his permission, and many times they aint giving that permission up, instead they will choose for me. Brothers and sisters; that aint freedom.
Insane amounts of money are being made on this “Drug War”. The “Prison Industrial Complex” is growing by leaps and bounds due in large part to this “War on Drugs”. The number of cops on our streets is also on the rise and has been for decades. People aren’t getting shot over meds they buy over the counter or even drugs they get from the pharmacy. But to sell those same drugs in the street means a lot of cops get shot, a lot of children can buy with-out any ID, a lot of children are getting caught in the cross fire of this “Drug War”. The amount of drugs on our streets has not been reduced by all this killing, but profit margins have remained high. There is a secondary gain provided to the National Security State; more cops, more prisons, more wire tapping and all the kind of stuff that comes from government intrusion into our lives, hmm if you added a war on terrorism to this mix you might just be able to “surround everyone with everything we have”, folks the emperor truly has no clothes.
The racket is a good one and it’s well played but it is a racket none the less. Go read the Kerry Commission Report, try “Dark Alliance” by Gary Webb or try out Kiki Camarena’s story, and put two and two together. There is no “War on Drugs” the war is on us, the war is on our civil liberties and our Constitution. People are in pain, people take drugs, always have always will, drugs create some social problems and they solve some social problems. But drugs are not the problem; the problem is that people are in pain. And the culture is sick. In this day and age most people would never suggest that an alcoholic be locked up just for being an alcoholic. But a dope fiend, well that is a whole other story, but you know what, an alcoholic is a dope fiend, only his dope is legal. Sick people need medical care not prison. Smell the coffee folks, drug policy has nothing to do with what is socially healthy or sound for our culture it is part of a labyrinth of laws that excuse government intrusion into our lives. And it is highly profitable for those who can bring them into the country successfully. But the price of street drugs would crash if you could get them in the pharmacy. Don’t forget Bill Casey the Director of the CIA, he said he loved the Iran-Contra Operation because it allowed the “company” (the CIA) to do things off the shelf, meaning they didn’t have to apply to the congress for funding to support the contra war. That is huge, especially when you read the Kerry Commission report and find out that the CIA was up to their necks in dope dealing while working with some pretty nefarious fellows from Manuel Noriega to Danilo Blandon dirt bag extrordinare. Things are what they seem they are; things are not what we are told they are. Drug laws are a ruse. And we have been duped.
And right now I’m in a good bit of pain so I am going to take my meds and try to get this lengthy piece of blog crap posted and get some sleep, Sorry it was such a long posting I doubt many of you will make it through.
Great post. And yes I read the whole thing. I agree with your earlier comment, that the Mexican gangsters are not new. They are however bolder, and engaging much more on our side of the border. Maybe its the press but I’ve got some friends in AZ who say things are a different recently. In any case I think your work in the field has given you a good eye for the inherent lies in the drug business.
Vaughn,
thanx for reading me brah, and for your kind words. We do have a war on our hands but its just on us not drugs and I think the more that people talk about it and find common ground the better chance we have for progressive change. It will be interestings to see what happens the next few years.. The current government of mexico is maybe even less ligitimate than the Bush admin was. Theirs was a stolen election.
LMAO-Only you, my good friend, could turn a hernia op into a diatribe on “Big Brother.” First of all; I hope you are feeling better and that your recovery is a quick one. On a personal note; I will gladly pay for the shipping (overnight express) for a few of those Dilaudids. LOL. I understand how some docs have reservations about prescribing opiates. I became addicted to them myself but that’s on me. To summarize: I need both knees replaced, an arthritic back akin to that of an 80 year old, permanent nerve damage to my right foot, and a right shoulder that has required two surgeries to date (I have had 6 knee ops). That being said; you’re absolutely right-nobody can tell you how much pain someone else is in. The problem with pain meds is if you don’t take them as prescribed, or even if you do, you develop a tolerance over a period of time that results in the need for stronger doses or simply larger doses. When the doc refuses, many take to the street to find what they need. A natural progression is oxycodone to oxycontin to heroine. Please don’t try to refute that because I can cite a minimum of 100 cases of people I know. It is a slippery slope and one that I don’t think falls into the parameters of the “War on Drugs”. It’s an issue between you and your doc-I don’t see how the government has anything to do with that particular scenario. OK-I have babbled enough. Feel good my brother and drop me a line to let me know how you’re doing.
Tailback,
The DEA and the feds decide what I can have or as you said the doctor, this is regulation, selling pharmaceuticals is big business too but the point is why should I have to sit at home with a migraine if I could buy some Dilaudid for a few bucks. I don’t need no mommy, if I become a dope fiend that’s my business if I use it for pain it’s my business. But doctors and politicians decide what “dope” is legal. But dope is sho’nuff legal you just have to get someone’s permission. It’s stupid to have someone sit at home with a headache that’s making them want to blow their fuckin head off and not be able to get meds that would fix it at the store. To go pay the ER 350bucks to get a shot of Demerol and phenegren. I know what they do, Why do I need anyone’s permission? I am not child. In 12years the most messed up I ever saw anyone mentally was secondary to alcohol DT’s baby worst case scenario but I can buy that alcohol crap on any corner and don’t tell me people don’t crawl into a bottle because its so damn convenient and its about the most powerful and damaging recreational drug there is, point is it’s the individuals right to live their life the way they see fit and why should anyone’s access to pain control be a matter of getting permission from anyone. You have no idea how many suffering people I have seen that doctors refused to write pain meds for, they were in real pain. Fuck that, society is not here to mother people, sure provide rehab or treatment, but its bullshit that someone hooked on narcotics is a criminal and someone hooked on alcohol has a disease. For years I hardly ever had a drink cause I don’t like booze but hey this dilaudid is pretty tastey. And who’s life is this. A man should be free to move of his own volition. Especially when it comes to pain control. And for that matter we both know, mental pain can cause people to do stupid fucked up shit. Smoking a joint often cools people out. Much more so that getting drunk I don’t see stoned people getting in fights I see drunk ones do that kind of shit. But still the main point is that as a citizen I should have the right to access to whatever meds I see fit. Look I have seen some doctors give CRAZY fucked up care. The individual should have autonomy. I never signed on to theses rules and I don’t wish to be included in them. They are forced upon me. I don’t take kindly to being forced or refused wrongly, nor do I care to watch it, and in 12yrs I saw so many people have their pain ignored because the MD didn’t give a fuck. The MDs control is a matter of government regulation or control of those substances. I don’t wish to “trust” someone else to give me what I may need I can decide just fine thanx.
Respect haha I got diluadid nana nana na
Bottom line; Chemical dependency or addiction is chemical dependency or addiction and it doesn’t matter if its Alcohol, heroine or Diluadid to treat “alcoholics” as medical cases but heroine addicts as criminals or even pot heads as criminals is entirely inconsistent public policy and hypocritical. Chemical dependency/addiction is a medical condition period. People with medical conditions should not be treated as criminals.
You make some good points, I once had a self made dependency on many things, and I agree that we should at least be listened too. Many doctors are of the assumption they know it all and now what helps. When I had my shoulder torn in Iraq, I flat out told the doctor I had formerly been dependent on strong meds and his little morphine shot wasn’t going to suffice for them to pop my shoulder back in. He didnt listen but after the third shot and I was still fending him away when he went to grab it, he realized i wasn’t joking.
Of course, After about 35 minutes or so those four shots of morphine kicked my tail and I was out for about three hours..lol
hated,
Actually I’m an atheist but I still like the joke. Hey thanx for reading and commenting
Yes I think the difference between most doctors and god is that god doesn’t think he is a doctor…
Agree wholeheartedly. I’m in chronic pain, now 41 years of age, and it has taken until VERY recently that docs don’t take one look and decide I’m a drug seeker.
You’ve said you’re not a big fan of codeine, (which I can understand…) but did you know that in, say, the UK, you can get a (very low dose, presumably) of codeine OVER THE COUNTER?
BTW, in the UK, prescriptions are rate-capped at $12.50 or so EACH no matter how much the drug supposedly cost. And guess what, the big pharm boys are still making money at that rate.
We are getting royally screwed in this arena and many others. Funny how my fellow Americans think we have it better than everyone else. We don’t.
I hope you’re all better by now.
serene,
Thanx for your comments, I’m sorry to hear you are in chronic pain, I hope they give you the goodstuff, dilaudid/hydromorophone or maybe something close. Yes I did relize that you can get codieine otc in the UK and Canada and Mexico too if I’m not mistaken. I mean I understand that by holding off the good stuff the MD has somewhere to move up to if the pain control doesn’t work, being stash with the dope is not the sole reason they hold off on giving the good stuff. At least its not always the primary rationalization. I’m still a bit sore, I ate the diluadid in 2days, and then he only gave me low dose vicodins and who really neeeds all that tylenol? Anyway I see him tomorow and will ask for more diluadid just because I like it. I don’t expect to get it but hey, its great to have on hand. Knock a headache out like nothing OTC. Be well sister. And again thanks for reading my stuff.