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Out Of Pain Meds

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If it had not been for a massive screw-up by a VA PCP who quit her job right in the middle of my appointment with her, I would be in the same boat.  She screwed up all of my prescriptions and I ended up getting a double batch of everything including narcotics. So, I have a buffer so to speak.  I am not one to misuse or abuse any medication especially the narcotics.   I have been on a regimen of opiate medications for the last 42 years with the VA.  I have never had a "dirty" pee in the bottle test in all of those years.

Years ago, I had a family doctor in a small Wyoming town go into a rage when I took my then current VA prescriptions to him to be refilled.  There were two separate prescriptions for Percodan (oxycodone and aspirin) and Percocet (oxycodone and Tylenol) among them adding up to almost 3000 tablets every three months.  The doctor was livid; and he asked me if I had actually taken all of the tablets.  Being young, dumb, and ignorant, I had taken them all believing they were "headache pills" (100%TDIU for chronic cluster headaches/cranial nerve damage considered to be the most painful condition a human being can experience) and told him so.  He canceled all of his other patients' appointments for the afternoon, made angry calls to the two VA doctors, the Wyoming Medical Board, our elected representatives, and my father who was a very good friend of his.  Then the lecture began.  For several hours, he explained all the things we know to be true NOW about opiates.  He walked me down the path that I would be on if I continued to take that quantity of narcotics--increasing addiction, liver and kidney failure, stomach ulcers, and the show stopper--they would cease to work at all and increase pain rather than decrease it.  In addition, he explained that they were doing me no good because by the time my blood level was high enough the pain had already passed. Naturally, he would not refill the prescriptions.

However, he did offer me an alternative.  He called in standing ER orders at the local hospital for an immediate massive demerol injection if I came in and requested it.  He wanted me to gut out the ones I could; and he would stop the ones I couldn't while we worked on a longer term solution.  The hospital balked at his orders, so he prescribed a 500ml bottle of demerol, a diluting liquid, and a case of syringes.  The local pharmacy filled those prescriptions.  He told me in no uncertain terms that if I abused this medication, he would never prescribe another narcotic medication in the future as well as inform the local pharmacies that I was known to abuse opiates.   I doubt that he would have done the latter, but he most certainly wasn't playing around. If that gentleman would do that today, he would be without a medical license; and probably facing criminal charges.  Having absolutely no faith in the VA and finding myself "between homes or the street," I did not cancel their prescriptions but didn't use them while under my verbal agreement with this doctor.  Every three months, several thousand more tablets came in the mail from the VA.  I would throw them in a drawer unopened and forget about them.  I have never experienced a "high" for these medications with the exception of Demerol which would have me pleasantly floating around the room for a while.

Less than a year later, the VA reversed my SC award claiming that the condition of "chronic cluster headaches" does not exist for me or anyone else based solely on a 10-minute Agent Orange registry exam!  I sent a copy of the VA letter to the three leading international experts on this condition asking for a rebuttal.  Not only did all three respond with blistering rebuttals that shredded anything the VA could produce, one, Dr. Lee Kudrow, insisted on attending the hearing I had requested concerning the reduction.  I had a "junk yard dog" for a DAV rep.  During the hearing, my DAV rep started pouring out the narcotic tablets on the table (more than 6000 total) as he spoke.  The point he was making (and most certainly did make) was that if the condition for which VA doctors had prescribed thousands of narcotic tablets did not exist, then extreme malpractice had been committed and the FTCA payout would be more than the disability comp.  The committee restored all of my benefits right then on the spot; AND the pills kept coming in the mail.  Circa1994, a non-narcotic medication for cluster headaches, sumatriptan, came on the market.  Unfortunately, that medication ultimately gave me two heart attacks (known possible side effect) in 2012, so I am back to looking for solutions.  Over the years, I have developed or aggravated other conditions--lower back looks like a train wreck, PAD, neuropathy--which are being treated with narcotics for now.  At VAMC Tucson, we were forced to call an answering machine to order narcotic refills.  Amazingly enough, the answering machine had the same business hours as the hospital-shutting down between 3:30-4:00 pm.  I am not certain if the answering machine also got bonuses and paid vacations, but I guess it wouldn't surprise me.  We are back to ordering them through the provider, pharmacy, MHV, etc.  I strongly recommend that when requesting narcotic medications that you have your provider include the phrase, "As Needed" to the prescription text.  For our newest generation of "drug abusing veterans," keep in mind that you can be arrested and convicted of DUI if you have narcotics in your system-WITH or WITHOUT A VALID PRESCRIPTION!

It is my opinion that we are going to lose this battle.  (I will be 68 yo in a month and a half, so maybe I will die before the battle is completely lost.) Too many careers, both LEO and criminal, have been made during the failed "War on Drugs."  I am constantly reading about the recent abrupt rise in heroin OD deaths resulting directly from the newest DEA crack down on opiate prescriptions and the doctors who write them.  How clever!  Deny veterans much needed medications thereby forcing them to purchase illegal and dangerous substitutes on the street; and then arrest and charge them with criminal possession/distribution of controlled substances.; and then put them in jail.  Here is the current trajectory:  Chronic pain patient>criminal drug abuser>incarcerated felon>veteran dead by suicide.  If you happen to go down this path in Arizona, it will warm your heart to know that you will be incarcerated in a private prison partially owned and operated by the former governor.

My last rant for 2015.  Happy New Years to all!

Semper Fi!

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Sorry for what you are going thru bud, but due to So many Vets Over Medicating and Taking advantage of the Pain Medications, the VA has to treat all Vets like this. I deal with alot of pain every day, but I can not take anything at all, due to my Crohns and 2 blood transfusions, so I figure is I can take the Pain 17 Surgeries later and more to Come, then maybe other folks will get on board. Just too many good Vets hooked on this stuff. Either way it makes it hard for Good Folks to Get their Pain Meds. Good Luck and God Bless

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Navy04, you wrote: "due to So many Vets Over Medicating and Taking advantage of the Pain Medications, the VA has to treat all Vets like this." 

One of my most important activities for the rest of my life is to strongly rebut any inaccurate/false statements which either unfairly portrays veterans as drug abusers or attempts to shift the blame for the overuse of narcotic medications on to the backs of veterans rather than at the feet of the medical professionals who prescribe them.  By blaming the actual victims, your statement does both; and it really infuriates me!  You are giving cover to VA malfeasance and criminal negligence!  In other words, you are the problem-not the solution!  Where is there any documented evidence of "So many Vets Over Medicating and Taking advantage of the Pain Medications?  There isn't any!  Yes, there are some examples (Candyland for instance) that have been blown completely out of proportion by the press.  VN veterans like myself are oh so painfully aware of just how damaging and demoralizing these grossly inaccurate characterizations can be! 

The entire drug Class structure is based on outdated religiously motivated puritanical moral opinions-not sound medical judgment.  Don't believe me?  Do some research on the criminalization of marijuana which will lead you to the history of cocaine and opium usage and subsequent criminalization. More damning is the fact that most of our current drug laws are grounded on antiquated racial bigotry as opposed to scientifically substantiated research.  Start your own research with: Harry J. Anslinger.

If a veteran "over medicates" because of the poor quality of, or lack of timely access to, VA medical care, it is certainly not the fault of the veteran.  The substance most likely to be used to "over medicate" is abundantly available and legal in all 50 states-alcohol.  Later tonight, mass over medication will occur all across the world with very predicable consequences, but until the inevitable carnage begins, it will be perfectly legal.

The VA does not "have" to treat all vets in any way other than to provide them with high quality medical care including prescribing appropriate dosages of narcotic medications necessary to treat a veteran's chronic pain.  Period. The VA is failing miserably at its Congressionally mandated obligations to veterans across the board with the grossly ironic exception of its administration of Veterans' cemeteries!   The VA did not become dysfunctional this year or last; it has been that way for decades.  There is such a dearth of personal integrity and courage in so many VA employees at all levels of that corrupt organization that some sharp US Attorney should bring RICO charges against many of the Directors and other senior executives.  The same can be said of our elected officials-R, D, and I, but unfortunately the US Constitution protects them from any consequences for their malfeasance except to vote them out of office.  Unfortunately, that does not appear likely.  Veterans have been voting against their own best interests for as long as I can remember.

People do not "Take advantage" of pain medications!  However, some most certainly misuse and abuse them; and some doctors prescribe them inappropriately.  Have you ever stopped to think why they might be doing this?  Might not it be because the VA health care they are receiving is woefully inadequate or just flat unavailable?  Might it be that their pain is the type that cannot be seen? It has been proven unequivocally that legitimate chronic pain patients are the LEAST likely to abuse or misuse pain medications AND they are the LEAST likely to become addicted!  Notably, long term chronic pain treatment using narcotics may provoke the development of a tolerance to a particular medication which can be mitigated by periodically substituting another medication; or taking a strictly supervised "drug holiday" during which no narcotics are taken for a predetermined period of time.  Don't take my word for it, do some investigation before making such unfounded and unsupportable accusations.  And while you are at it, look into the deadly drug cocktail the VA was handing out to this generation's veteran that was actually killing them rather than helping them.

If this post comes across as harsh and intolerant, it is supposed to be just exactly that!  I will not tolerate mental abuse of veterans any more than I will tolerate their physical abuse; and I will harshly condemn both. In my opinion your post, probably unintentionally, promotes the former.

I am very willing and able to engage anyone, regardless of position or credentials, on this subject at any time or place.  However, I am giving fair warning--come at me fully prepared with factually sustainable arguments, because I certainly am prepared!  I have suffered from the most excruciating pain known to medical science multiple times daily for 45 years.  The pain caused by my condition is so exquisite that it has led many others with this condition to commit suicide often not during an attack but just in anticipation of the next attack or, like me, a lifetime of attacks. This condition has effectively prevented me from leading a productive life even though I have been blessed (or more accurately--cursed) with an IQ higher than 99.9999923799% of humanity (tested by MENSA with results 16 standard deviations above norm using the Stanford-Binet scale) and almost total sensory recall (eidetic memory).   The condition abruptly ended my much desired career as a Marine officer.   It destroyed personal and romantic relationships. It destroyed opportunity. For example, I worked on a large scale project at subsistence level compensation--but with substantial equity in the finished project.  At a crucial stage in the project, I was experiencing 6-8 attacks daily and was unable to fulfill my responsibilities.  The other equity holders reluctantly gave me the ultimatum of either bringing the attacks under control within 3 months or lose my position and equity.  After attempting every (I balked at exploratory/investigative brain surgery) procedure and medication (some quite dangerous) known at the time to even remotely benefit people with my condition as an inpatient at the U of Washington Pain Clinic with no appreciable improvement, I lost not only my position and equity (ultimately worth several million dollars), but my opportunity to participate in future projects (one of which exceeded $1 billion) with these extremely industrious and talented people.  At that point, I became a vested NFL member--NFL=No Friends/Family left who could/would employ me.  Don't think for a moment that I am trying to impress you or evoke sympathy, because I am not.  I've learned to live with my disappointments;  and I have made another life for myself. Life gave me a gift that had the capacity of dissolving all of the bitterness created by being betrayed by the people I served. The point that I am making is that untreated or under treated pain can even destroy the lives of people with all the capability and benefits our society has to offer.  Pain robs its victims of the one precious thing in this world that cannot be replaced--time.  If prescribed and used appropriately, narcotic pain medications can prevent some of that theft.

I am sure there are tens, if not hundreds, of thousands other NFL members.  Our horrendously stupid invasion of Iraq coupled with our pathetic mismanagement of the war in Afghanistan is producing thousands more. Tagging our newest generation with the "drug abuser" label will only swell those ranks.  There are many veterans seeking answers here on hadit whether or not they join and post.  Please consider the damage a post like yours can needlessly inflict on them.  It is difficult enough to maintain self esteem without taking unwarranted hits from our peers.  Also, think of the effect that perpetuating the drug-abuse myth has on possible employers of these young men and women.

So, Navy04, chronic pain and its treatment by the VA, including the use of narcotic medications, is extremely personable to me as I presume it is to many other veterans on hadit and elsewhere.  Please be careful with your words--they have consequences!

Semper Fi!

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Vince: No idea regarding "Opiate Contract" and VA ER or Fast Track. If having chronic pain issues and no meds, I'd give it a try, what do you have to loose?

VA recognizes Acupuncture and "Essential Oils" therapy for Pain treatment. If your VMC doesn't have a Pain Clinic, request the referral from your PC or Specialist anyway. If you Bxxxx and Moan load and long enough, there's (1) person in one of your VMC treating departments that is tasked with seeing you get the treatment. This person will locate nearby treatment that will accept VA payment. Now, they may try to push you to the Vet Choice program first, but if you don't get your 1st appointment within a month, go to plan B - Bxxxxxxx & Moaning. It worked for me in 15, it will work for you.

Semper Fi

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Guay,

 

You are taking what I said way too far to the Left. I have multiple Triple Narcotics that I have to take that are not pain meds. I as well as anyone else had to Sign those Med Agreements. Not all Vets that take any form of med is a Druggy, or whatever you are implying that I said. What I only said, is that due to the Over Prescribing and Taking of Meds due both to DRs and People who do not take medication as Recommend or become addicted to them and take more then issued per DRs request. The problem that I see most of the Time, Vets will come to me and say, I cant Get my Pains, and they give me the DRs are sorry, or some idiot messed up my prescription. So what happens, I offer to help as I feel for their pain. Call the Local VA, or their Pharmacy and they said well the Patient has Requested his Prescription to be filled early, due to over medicating, or the Prescription as actually Expired and the Doc wont Renew without patient going in to be reviewed for treatment. So if a Vet is in fact wrong in both ways, then how is is the Doc or VAs fault. Just not enough people out there taking responsibility for their actions. It is the Old Kindergarten Effect, one kid messed it up for the rest, so we all have to suffer.  I have a little brother who has been an drug addict for 20 years, so this subject is very sensitive to me as well. Hope you all have a Happy New Year!!!

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Navy04, you wrote: "due to So many Vets Over Medicating and Taking advantage of the Pain Medications, the VA has to treat all Vets like this." 

One of my most important activities for the rest of my life is to strongly rebut any inaccurate/false statements which either unfairly portrays veterans as drug abusers or attempts to shift the blame for the overuse of narcotic medications on to the backs of veterans rather than at the feet of the medical professionals who prescribe them.  By blaming the actual victims, your statement does both; and it really infuriates me!  You are giving cover to VA malfeasance and criminal negligence!  In other words, you are the problem-not the solution!  Where is there any documented evidence of "So many Vets Over Medicating and Taking advantage of the Pain Medications?  There isn't any!  Yes, there are some examples (Candyland for instance) that have been blown completely out of proportion by the press.  VN veterans like myself are oh so painfully aware of just how damaging and demoralizing these grossly inaccurate characterizations can be! 

The entire drug Class structure is based on outdated religiously motivated puritanical moral opinions-not sound medical judgment.  Don't believe me?  Do some research on the criminalization of marijuana which will lead you to the history of cocaine and opium usage and subsequent criminalization. More damning is the fact that most of our current drug laws are grounded on antiquated racial bigotry as opposed to scientifically substantiated research.  Start your own research with: Harry J. Anslinger.

If a veteran "over medicates" because of the poor quality of, or lack of timely access to, VA medical care, it is certainly not the fault of the veteran.  The substance most likely to be used to "over medicate" is abundantly available and legal in all 50 states-alcohol.  Later tonight, mass over medication will occur all across the world with very predicable consequences, but until the inevitable carnage begins, it will be perfectly legal.

The VA does not "have" to treat all vets in any way other than to provide them with high quality medical care including prescribing appropriate dosages of narcotic medications necessary to treat a veteran's chronic pain.  Period. The VA is failing miserably at its Congressionally mandated obligations to veterans across the board with the grossly ironic exception of its administration of Veterans' cemeteries!   The VA did not become dysfunctional this year or last; it has been that way for decades.  There is such a dearth of personal integrity and courage in so many VA employees at all levels of that corrupt organization that some sharp US Attorney should bring RICO charges against many of the Directors and other senior executives.  The same can be said of our elected officials-R, D, and I, but unfortunately the US Constitution protects them from any consequences for their malfeasance except to vote them out of office.  Unfortunately, that does not appear likely.  Veterans have been voting against their own best interests for as long as I can remember.

People do not "Take advantage" of pain medications!  However, some most certainly misuse and abuse them; and some doctors prescribe them inappropriately.  Have you ever stopped to think why they might be doing this?  Might not it be because the VA health care they are receiving is woefully inadequate or just flat unavailable?  Might it be that their pain is the type that cannot be seen? It has been proven unequivocally that legitimate chronic pain patients are the LEAST likely to abuse or misuse pain medications AND they are the LEAST likely to become addicted!  Notably, long term chronic pain treatment using narcotics may provoke the development of a tolerance to a particular medication which can be mitigated by periodically substituting another medication; or taking a strictly supervised "drug holiday" during which no narcotics are taken for a predetermined period of time.  Don't take my word for it, do some investigation before making such unfounded and unsupportable accusations.  And while you are at it, look into the deadly drug cocktail the VA was handing out to this generation's veteran that was actually killing them rather than helping them.

If this post comes across as harsh and intolerant, it is supposed to be just exactly that!  I will not tolerate mental abuse of veterans any more than I will tolerate their physical abuse; and I will harshly condemn both. In my opinion your post, probably unintentionally, promotes the former.

I am very willing and able to engage anyone, regardless of position or credentials, on this subject at any time or place.  However, I am giving fair warning--come at me fully prepared with factually sustainable arguments, because I certainly am prepared!  I have suffered from the most excruciating pain known to medical science multiple times daily for 45 years.  The pain caused by my condition is so exquisite that it has led many others with this condition to commit suicide often not during an attack but just in anticipation of the next attack or, like me, a lifetime of attacks. This condition has effectively prevented me from leading a productive life even though I have been blessed (or more accurately--cursed) with an IQ higher than 99.9999923799% of humanity (tested by MENSA with results 16 standard deviations above norm using the Stanford-Binet scale) and almost total sensory recall (eidetic memory).   The condition abruptly ended my much desired career as a Marine officer.   It destroyed personal and romantic relationships. It destroyed opportunity. For example, I worked on a large scale project at subsistence level compensation--but with substantial equity in the finished project.  At a crucial stage in the project, I was experiencing 6-8 attacks daily and was unable to fulfill my responsibilities.  The other equity holders reluctantly gave me the ultimatum of either bringing the attacks under control within 3 months or lose my position and equity.  After attempting every (I balked at exploratory/investigative brain surgery) procedure and medication (some quite dangerous) known at the time to even remotely benefit people with my condition as an inpatient at the U of Washington Pain Clinic with no appreciable improvement, I lost not only my position and equity (ultimately worth several million dollars), but my opportunity to participate in future projects (one of which exceeded $1 billion) with these extremely industrious and talented people.  At that point, I became a vested NFL member--NFL=No Friends/Family left who could/would employ me.  Don't think for a moment that I am trying to impress you or evoke sympathy, because I am not.  I've learned to live with my disappointments;  and I have made another life for myself. Life gave me a gift that had the capacity of dissolving all of the bitterness created by being betrayed by the people I served. The point that I am making is that untreated or under treated pain can even destroy the lives of people with all the capability and benefits our society has to offer.  Pain robs its victims of the one precious thing in this world that cannot be replaced--time.  If prescribed and used appropriately, narcotic pain medications can prevent some of that theft.

I am sure there are tens, if not hundreds, of thousands other NFL members.  Our horrendously stupid invasion of Iraq coupled with our pathetic mismanagement of the war in Afghanistan is producing thousands more. Tagging our newest generation with the "drug abuser" label will only swell those ranks.  There are many veterans seeking answers here on hadit whether or not they join and post.  Please consider the damage a post like yours can needlessly inflict on them.  It is difficult enough to maintain self esteem without taking unwarranted hits from our peers.  Also, think of the effect that perpetuating the drug-abuse myth has on possible employers of these young men and women.

So, Navy04, chronic pain and its treatment by the VA, including the use of narcotic medications, is extremely personable to me as I presume it is to many other veterans on hadit and elsewhere.  Please be careful with your words--they have consequences!

Semper Fi!

i can tell you about the number of veterans who lived in the same apartment complex i did who sold their pain pills. always crying about how much they hurt. but not crying over the money they got. i think thats one of the reasons my va does periodic drug screens to make sure you are taking your prescribed medicine.

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