I just got out of the hospital after having surgery on my left elbow to remove a bone spur complicated by bursitis.
"You're going to be in quite a bit of pain for a while," my doctor said, just prior to releasing me from the hospital.
I assumed I was going to be prescribed something that would deal with the pain of having my arm cut open. However, when I got to the pharmacy to pick up my prescription, I found all I had been prescribed for pain was Motrin.
At first I thought the pharmacy had made a mistake. But there was no mistake. I asked the pharmacist it he couldn't call my doctor and get me something that would be more effective – like Vicodin, which is what I've always gotten in the past.
The pharmacist kind of half-smiled and asked, "Don't you know about the new ban on Vicodin?"
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I told him I didn't.
What I found out didn't bode well for getting Vicodin, let alone something stronger like Percocet or OxyContin.
Last week, a Food and Drug Administration, or FDA, advisory panel voted to impose stricter controls on prescriptions for drugs like Vicodin, which contain the opioid pain reliever hydrocodone. The new rules ban prescribing of more than a month's supply of hydrocodone-containing drugs and prevent refills without a new visit to a doctor. Prescriptions cannot be phoned, faxed or emailed, and physician's assistants and nurse practitioners aren't permitted to prescribe the medications in the states in which they have limited prescribing powers.
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The FDA is acting on the assumption that drugs such as Vicodin and OxyContin – which are currently being abused by people who don't have legitimate needs for these drugs – are going to be abused by everyone. Those who voted against the new drug ban said it would simply lead to the illegal use of these drugs, which will then command a higher price on the street.
The bottom line is: People who want to get painkillers are going to get them regardless of whether or not the new ban is imposed. And while they are busy making an across-the-board ban on these drugs, the FDA is completely overlooking the needs of people with chronic pain, who will now be denied relief from conditions like arthritis, joint and bone problems and many other conditions where the pain cannot be relieved without the use of painkillers.
For example, my mother-in-law is not even able to get out of bed each morning because of the pain she suffers from a torn rotator cuff. Nor is she able to dress herself, because even the simple act of putting her arm through a shirtsleeve is so unbelievably painful.
I also now have to reconsider my decision to have surgery to repair a torn rotator cuff, which I was scheduled to have later this month. My doctor told me straight out that I am going to be in an "unbelievable" amount of pain for anywhere between eight months to a year. I will not be able to dress myself, and even the simple act of making a meal will be impossible without the relief that would be offered by the use of even a standard painkiller like Vicodin.
The FDA is now being flooded with letters from chronic pain sufferers, who are now going to deal with their suffering from the lack of pain killers, which – up until a few weeks ago – were available with a simple prescription from their doctors.
The letters consisted of poignant testimony from people who currently rely on painkillers, which presently afford them the relief to carry out the tasks of leading a normal life.
One man wrote of his wife:
"She has been in excruciating pain every minute of every day of her life for the past 20 years. [The pain was caused] by a butcher of a doctor who drilled a pin through her radial nerve during a routine operation to fix a broken wrist. He left the pin in, despite her pleading of pain for six weeks. To take the pain pills away from her would lead to her death from suicide because the pain would be unbearable."
Another chronic pain patient wrote, "Without the medicine I am currently being prescribed, I would not be able to work and would end up on disability."
A third pleaded simply, "This is barbaric! This does not help all of us who deal with chronic pain. I am sick and tired of addicts screwing up MY health care. Find another way!"
Finding another way, is, unfortunately, exactly what addicts tend to do when faced with these kinds of barriers, which may lead them to take more dangerous illegal substances. A recent letter in the New England Journal of Medicine found that when a substance was added to OxyContin to deter abuse, only 13 percent of prescription drug abusers continued to rely on the drug as a primary high, down from 36 percent. Heroin use among them, however, doubled.
And some who opposed the changes noted in testimony to the FDA panel that OxyContin, a stronger painkiller containing oxycodone, which is similar to morphine, has always been subject to the stricter Schedule II prescribing rules, yet it is widely abused and credited with launching the opioid prescription drug epidemic. While we don't know what effect the new restrictions will have, we do know that the changes alone won't address the reasons why some people seek opioids in the first place. Chronic pain patients should not have to suffer to fight other people's addictions.
"More people are now going to be suffering from pain," said Dr. Sean Mackey, chief of pain management at Stanford University Medical School. "More people will be seeing their doctors more frequently and running up health-care costs."
The government needs to keep its hands off our bodies. If my doctor wants me to have Percodan, and he and I are aware of the risks, yet believe it's necessary after a painful medical or dental procedure, I should be allowed to use it. This should be between me and my doctor.