Peripheral Neuropathy Medications

What rights do patients have to receive effective pain management? What recourse does one have when every health care professional they are seeing refuses to treat pain effectively? Why are there so many people receiving strong opiates when they don't actually have any legitimate diagnosis to support the use of such medications. I personally know of at least 20 people in one small town who sell their medications because they never use them, they truly don't have pain issues, they lie to these doctors!

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Hello Debbie! How are you? I am very sorry that you and so many others are dealing with these types of issues and living with so much pain.

Unfortunately, you don't have any rights to pain management, since it isn't considered life-threatening. It's sad, but that's the way things currently stand.

Have you tried seeing a pain management specialist?

Does anyone else have any ideas or advice?

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Re: Verwon (# 1)

I beg to differ about patient rights. I've been on both sides now. Patients do have a right to expect pain relief if a practitioner has made a diagnosis that involves pain. Indeed, there are many medical and surgical procedures in the very least health care professionals have a moral right to treat. If you came in ready to give birth does the hospital have the right to not help you because the process is normal and not expected to end in death?

Bottom line, I'm sometimes embarrassed to say I'm an advanced practice RN when I read of how an MD can just fire a patient at will for anything. Yes, this may be the law in your state but I hope this opioid crisis will have everyone pay attention to all the fear based clinical changes occurring and not let anyone keep you from appropriate treatment because of their fears or limitations. Now, what is the logical conclusion that a person would be left with if they had excruciating pain and an MD says, I do not believe you. (or any number of excuses that do not rise to the patient's alarm) You should tell that MD the truth.

Truth is essential in so many ways to get correct health care. Spell it out for the professional that wants to send you home. Say something to the effect (make it your specific situation). "Dr. I feel you have a moral/ethical imperative to treat my pain. We have years of studies and documentation that treating my diagnosis with opioid pain medication is the right thing to do to prevent pain and ameliorate the distress it entails. If you do not think it is your obligation, then I am forced to notify you of what your decision means for my life. If I do not get this diagnosis promptly and adequately treated with what you've been educated to do and have done with your previous patients then, because I have exhausted all my energy and resources the consequences are dire. I will not go home and have a normal evening. I will be in an abnormal psychological state that predisposes me to the ultimate pain cure-suicide. I'll be at a high risk of dying because of your decision. Please do not take this as a threat. I do not threaten anyone. Otherwise, you would be defeating my purpose here even more. It's a fact that no person can be expected to be sent home from the last MD in town and believe the pain will change or go away. The body will take itself into its own hands to get away from this intolerable noxious stimuli whether the mind agrees or not. I therefore give notice, and expect a change in your position of not treating my pain. If I am not treated appropriately under medical guidelines then you sir.maam, will have consequences of your own of which you will be given no choice, just as you have given me.

Now, dear readers, settle down. Yes, this sounds over the top and just unthinkable. But, how much pain have you had in your life? What experience can you bring to this in order to understand why a patient would be doing this? If you think this is an outrageous behavior of a patient then you have not had enough pain to know why there can be no other deciion when this woman goes home untreated. How do I know this? I've seen it happen first hand. A neighbor of mine was also a nurse and had retired secondary to severe osteo bone calcium loss and had many fractures. She was on pain meds for a few years. She had just moved into my neighborhood to live alone, away from her dysfunctional daughter. The daughter and/or daughter's boyfriend took about half of her pain meds. (this is the cause of accidental overdose far more risky than how a chronic pain patient takes opioids.) Her MD referred her to a pain specialist in her new area. She only had a weeks worth of pain meds to last her. She was cranky, in pain, distressed, fearful of knowing how she'd have to really fight to get what is required. Well, we all know that it didn't end well. The pain MD wanted her to do a U/A and because of her persistent behavior (classified in drug treatment parlance as aberrant), check into drug abuse counseling before he can prescribe her anything. She told me she had this same problem where she had lived and she was fed up being treated like a drug addict. Nurses do not have a problem talking directly with an MD. It's a different difficult dynamic when a nurse or any healthcare professional becomes a patient. The nurse interacts as a nurse and not as a patient would, and this puts the balance off with the MD. The MD's ego, sometimes so fragile will push back hard in these situations. And so it was with my friend. She was so upset when she came home, she was inconsolable. She went into a rant with the apartment manager-giving her the brunt of her anger. The manager said she had 3 days to pick up and move out. She had no place to go. She OD'd that night on what she had left of her pain meds. No doubt this suicide, just like others is classified as an overdose because that bolsters those deadly statistics, gives the family an out for any guilt and focuses on the most vulnerable groups to clamp down harder on. The elderly and disabled are paying a heavy price in this epidemic that is rarely appreciated.

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