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Opioid epidemic


Scarlett
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I know we have talked about this some. Someone very close to me texted me at 5:30 this morning to tell me he was going in to detox because his long term meds had been cut off with out warning and he was very very sick.  And that his choices were detox or to buy on the street.  

 

Is this really happening?  Are people who have been prescribed opioids for 14 years being cut off without warning?  

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In some cases yes. And not all doctors can/are able to prescribe methadone or similar. So yup. 

 

 

That is....inhumane.  I tend to not believe people even if I do offer sympathy....but then I thought maybe it is true.  He says our small home town is ripe for becoming overrun with heroin addicts.  He has avoided that path but he is really teetering on the edge.

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Yes, it is happening. :( And thus the heroin epidemic has been spawned, and the epidemic of deaths from overdoses of pills is spreading.

 

I wish your friend the best. If you live in a medical marijuana state, he may want to consider using it instead of or in adjunct with the narcotics.

 

Edit: saw your update. If he's mentioned the word heroin, tbh I would be scared. There are new meds that help break the narcotic cycle that are better than methadone. And he needs therapy/talk/outpatient rehab as well after the short term detox. I'm not a fan of AA or Narcotics Anon, but something.

Edited by Sandwalker
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Yes, it is happening. :( And thus the heroin epidemic has been spawned, and the epidemic of deaths from overdoses of pills is spreading.

 

I wish your friend the best. If you live in a medical marijuana state, he may want to consider using it instead of or in adjunct with the narcotics.

 

 

Ugh I feel sick.  And soooooo thankful that my dh doesn't handle opioids well.....he has several chronic conditions that have allowed him to be prescribed opioids over the years, but we just sort of stock pile them just in case he needs them.  He rarely takes them.  So glad he never got addicted.

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Ugh I feel sick. And soooooo thankful that my dh doesn't handle opioids well.....he has several chronic conditions that have allowed him to be prescribed opioids over the years, but we just sort of stock pile them just in case he needs them. He rarely takes them. So glad he never got addicted.

Lock them up with teens in the house, please. Or throw them out.
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Lock them up with teens in the house, please. Or throw them out.

 

I was just going to say exactly the same thing.

 

It is not safe to stockpile opioids. That's how they get into circulation. Doesn't have to be your own kids. Could be their friends. Prescription drugs, often stolen from people who have a legitimate prescription, are the gateway for many addictions, especially in young people.

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Lock them up with teens in the house, please. Or throw them out.

 

 

This thought has crossed my mind.....but honestly the two boys we have..... I would be shocked if it ever crossed their mind to take these drugs.  I need to talk to dh about how we store them. We are careful when we have workers...and heaven forbid my brother came to visit they would be taken from the house....

I hate to sound so naive...God I hate drugs.

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This thought has crossed my mind.....but honestly the two boys we have..... I would be shocked if it ever crossed their mind to take these drugs. I need to talk to dh about how we store them. We are careful when we have workers...and heaven forbid my brother came to visit they would be taken from the house....

I hate to sound so naive...God I hate drugs.

I think of it as storing vials filled with wads of $20 bills (or poison darts) and store accordingly.
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I just read this article recently

 

https://www.washingtonpost.com/news/to-your-health/wp/2018/01/31/a-town-of-3200-was-flooded-with-21-million-pain-pills-as-addiction-crisis-worsened-lawmakers-say/?utm_term=.495c3a5268b4

 

I know people have some chronic pain issues, but I think that the prescriptions have gotten out of control. I know a family dealing with this and I have watched so much happen to that person and their family. They are now a family of addicts who lie, steal, and cheat to get more pills. The spouse got addicted and the young adult child as well. There have to be some other options?

 

Not to belittle anyone's pain as I know some people do need them. I am just questioning the scale of it all and what other options we have as a society.

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I think of it as storing vials filled with wads of $20 bills (or poison darts) and store accordingly.

 

 

Well, if you are suggesting our boys would steal drugs from us and sell on the streets.  No.  I am positive that would not happen, not with the current way they are living.  My brother?  yes.  I think he would steal from me with no conscience at all.  

 

We are very open about all of this stuff and I in fact read all of the texts about person in detox to my ds17.  

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I was just going to say exactly the same thing.

 

It is not safe to stockpile opioids. That's how they get into circulation. Doesn't have to be your own kids. Could be their friends. Prescription drugs, often stolen from people who have a legitimate prescription, are the gateway for many addictions, especially in young people.

 

 

Well I guess you guys will have to trust me that our life is not set up that way.  Our boys don't have friends hanging out here anyway.  

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I just read this article recently

 

https://www.washingtonpost.com/news/to-your-health/wp/2018/01/31/a-town-of-3200-was-flooded-with-21-million-pain-pills-as-addiction-crisis-worsened-lawmakers-say/?utm_term=.495c3a5268b4

 

I know people have some chronic pain issues, but I think that the prescriptions have gotten out of control. I know a family dealing with this and I have watched so much happen to that person and their family. They are now a family of addicts who lie, steal, and cheat to get more pills. The spouse got addicted and the young adult child as well. There have to be some other options?

 

Not to belittle anyone's pain as I know some people do need them. I am just questioning the scale of it all and what other options we have as a society.

 

 

Oh exactly.  I never felt this person needed the drugs he was taking.  But I am not cruel enough to cut someone off from that with no warning.  He is happy tonight.....in detox with meds to manage his withdrawals....I hope he will stay clean.

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Yes, it is happening. :( And thus the heroin epidemic has been spawned, and the epidemic of deaths from overdoses of pills is spreading.

 

I wish your friend the best. If you live in a medical marijuana state, he may want to consider using it instead of or in adjunct with the narcotics.

 

Edit: saw your update. If he's mentioned the word heroin, tbh I would be scared. There are new meds that help break the narcotic cycle that are better than methadone. And he needs therapy/talk/outpatient rehab as well after the short term detox. I'm not a fan of AA or Narcotics Anon, but something.

 

 

Well I am scared.  But he is far away and not in my daily life. And he specifically told me he had never used heroin or any iv drug and he believes he never will.  I think his decision to go into detox, in a woman's center in a small town is evidence of his determination.  

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I've wondered about this. I have elderly relatives that have been on opioids for years. 1 or 2 a day(I have no idea on the dose) for chronic pain. They aren't getting high, but I'm sure they are physically dependant. It seems immoral to yank that away from them. I've also heard of people being made to recover from surgeries with just Tylenol because the doctors are so hesitant to prescribe opioids.

But I know there's an epidemic of people getting addicted and abusing them, lives and families being ruined. It's such a complicated issue.

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We're considering moving across the country to have access to medical marijuana for this reason. I have a very cut and dry, obvious condition that causes chronic pain, ie I'm not someone just claiming I have a vague pain somewhere for some unknown reason. My doctors acknowledge that I'm in a lot of pain, that they should be giving me opioids, but they can't risk doing it. Especially as a long term treatment with no other solution. So I'm in constant pain. Last night, I was sobbing on the floor for half an hour, unable to move.

 

I love our home. DH loves his job. We don't want to move. But medical marijuana may be our only recourse. We're going on a trip this summer to a recreational state to try it (I'm so boring, I've never smoked marijuana). If it makes a big difference, we might just have to move for that reason alone. (We live in the South, in a state that still has dry counties. We'll be the last to legalize it.)

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Could this be why some elderly people become targets for break-ins? I always assumed it was for cash, but medications are the same as cash on the street for desperate people. 

 

I would say it's a possibility.  I have very dear friends whose house was broken into and prescription drugs stolen.  She had just had surgery, and people assume with surgery comes prescription pain relievers.  It has nothing to do with how you set up your life.  Desperate people will find a way.

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We've been watching our neighbor spiral into terrible addiction. It's so sad and so hard to watch. He blew out his knee, maybe 5 or so years ago. Got prescribed long-term pain pills, not sure exactly which ones, but narcotics. He tried to get clean, maybe a year and a half ago - did the methadone thing and has been doing worse and worse over the past year. 

 

He looks like he's aged about 20 years in 12 months, he's OD'ed numerous times and almost died at least once from an OD. He's been in and out of detox. He looks like he could die at any moment. The ambulance has been to his house 3 times since Christmas. He's gone from being a great neighbor who helps out the elderly people at the end of the street and plows everyone who doesn't own their own plow to staggering up and down the street begging for money.  

 

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We've been watching our neighbor spiral into terrible addiction. It's so sad and so hard to watch. He blew out his knee, maybe 5 or so years ago. Got prescribed long-term pain pills, not sure exactly which ones, but narcotics. He tried to get clean, maybe a year and a half ago - did the methadone thing and has been doing worse and worse over the past year. 

 

He looks like he's aged about 20 years in 12 months, he's OD'ed numerous times and almost died at least once from an OD. He's been in and out of detox. He looks like he could die at any moment. The ambulance has been to his house 3 times since Christmas. He's gone from being a great neighbor who helps out the elderly people at the end of the street and plows everyone who doesn't own their own plow to staggering up and down the street begging for money.  

 

 

They say that with more than 3 weeks use you are at great risk of becoming addicted.  I really cannot even comprehend that...I have seen dh through 4 or  surgeries that required opioids....but he weans himself off asap because he HATES the way they make him feel.   My understanding is that some people LIKE the way they make them feel.

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Well, if you are suggesting our boys would steal drugs from us and sell on the streets. No. I am positive that would not happen, not with the current way they are living. My brother? yes. I think he would steal from me with no conscience at all.

 

We are very open about all of this stuff and I in fact read all of the texts about person in detox to my ds17.

No I didn't mean your boys, I mean anyone could break in, a friend of yours or your sons could be curious, a plumber unclogging the drain... These things are like bombs. It's a disgrace of our health care system and its dependence on pharmaceuticals.

 

"For the CDC study, scientists analyzed prescription data for almost 1.3 million non-cancer patients who were prescribed opioids for the first time between 2006 to 2015. What they found was disturbing: People who had a one-day prescription of opioids had a 6 percent chance of being on the drug a year later, those who took opioids for 12 days had an almost 25 percent chance of still being on the drug a year later, and those with a monthlong prescription had a worrisome 30 percent chance of continuing to be on prescription opioids a year later.

 

Patients in the study were only meant to be on opioids for the short-term and suffered from things like pain from surgery, fractures, or headaches—but they ended up seemingly forming a long-term dependence..."

https://www.self.com/story/how-to-avoid-opioid-addiction-when-youre-prescribed-pain-medication

 

Edit: forgot to post link

Edited by Sandwalker
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Around here, he could seek help via subutex clinic. I don't mean he would get the medications for his pain, but the idea is subutex would stabilize the addiction to opiods component legally. If his area has lots of addicts, I imagine it also has clinic(s).

And subutex is actually a pain medication, so can help in that way, too.
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For people who need access to drugs for chronic pain, they have special pain clinics, at least around here. 

 

They are getting fussier about what they give post-surgery because some doctors just think everything needs the biggest, strongest meds, and for some patients, ONE Rx is enough for them to be addicted. I know anecdotal information is not the whole story, but I personally know more people who get prescribed stronger meds than they WANT and have to argue with the doctor than people who cannot get pain relief. It's unreal. I do have a family member in healthcare who frequently finds other practitioners' prescribing patterns to be way too free and easy with opiates. It's changing with provider databases that track what you prescribe. Some practitioners are realizing that they can actually prescribe a super small number of tablets vs. a full bottle. Many prescribers are not the same people who follow up later, and that disconnect doesn't help.

 

Around here, there are many, many paths to explore before they yank prescribed drugs from a patient whose been taking them, but they are cracking down on who gets them in the first place. One big problem is that doctors get dinged when patients are unhappy. I think this can be conquered over time, but it's like when people get mad because you won't give them antibiotics when they have a virus. 

 

There are a lot of drugs for pain control, but doctors often use only a tiny fraction of them without really thinking through what else they could give.

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They say that with more than 3 weeks use you are at great risk of becoming addicted. I really cannot even comprehend that...I have seen dh through 4 or surgeries that required opioids....but he weans himself off asap because he HATES the way they make him feel. My understanding is that some people LIKE the way they make them feel.

Some people become addicted, and don't feel normal unless they have the drug. Your husband is one of the lucky ones who has taken them without incident.
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My mom has been on opioids for over 25 years. It's not right that the doctors continue it but I have done all I can by meeting with her pain doctor, etc. The reality is they won't force the issue with her, and she won't willingly wean off. The government might end up forcing the issue. At this point the worst thing would be if she had a major injury like a fall because there would not be anything they could give her to treat the pain.  It is very frustrating. While she is responsible for not asking more questions about her treatment and seeking a diagnosis for her pain, I do think the pain doctor is responsible for applying a short-term solution (opioids) to a long term problem. Opioids are not designed to treat long term pain and they should not be used to treat it. 

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No I didn't mean your boys, I mean anyone could break in, a friend of yours or your sons could be curious, a plumber unclogging the drain... These things are like bombs. It's a disgrace of our health care system and its dependence on pharmaceuticals.

 

"For the CDC study, scientists analyzed prescription data for almost 1.3 million non-cancer patients who were prescribed opioids for the first time between 2006 to 2015. What they found was disturbing: People who had a one-day prescription of opioids had a 6 percent chance of being on the drug a year later, those who took opioids for 12 days had an almost 25 percent chance of still being on the drug a year later, and those with a monthlong prescription had a worrisome 30 percent chance of continuing to be on prescription opioids a year later.

 

Patients in the study were only meant to be on opioids for the short-term and suffered from things like pain from surgery, fractures, or headaches—but they ended up seemingly forming a long-term dependence..."

https://www.self.com/story/how-to-avoid-opioid-addiction-when-youre-prescribed-pain-medication

 

Edit: forgot to post link

 

 

Thanks.  We are VERY careful about who we allow in our home.  It is something I always think of.  I am not blind to the possibilities.  I have never used drugs but I do know a fair amount about addiction and how easily it can happen.  With alcohol too.

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My mom has been on opioids for over 25 years. It's not right that the doctors continue it but I have done all I can by meeting with her pain doctor, etc. The reality is they won't force the issue with her, and she won't willingly wean off. The government might end up forcing the issue. At this point the worst thing would be if she had a major injury like a fall because there would not be anything they could give her to treat the pain.  It is very frustrating. While she is responsible for not asking more questions about her treatment and seeking a diagnosis for her pain, I do think the pain doctor is responsible for applying a short-term solution (opioids) to a long term problem. Opioids are not designed to treat long term pain and they should not be used to treat it. 

 

 

This is my loved one.  He had an accident almost 20 years ago that disabled him....but I don't believe he has needed all the drugs he has continued to take all of these years.  It just stops really working after a while anyway doesn't it?

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Scarlett, if nobody in your family is going to use these pills, why do you even have them in the house? And no matter HOW you set up your life, you can still be the target of a random break-in. Why are you arguing about this? Is it going to physically harm you to take them to the pharmacy to be disposed of safely?

 

Edited by Tanaqui
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I don't believe he has needed all the drugs he has continued to take all of these years.

 

Was he disabled in a way that causes chronic pain? If so, he might still need them.

 

Is it a physical addiction? If so, it will be painful to go off the drugs. Once you're addicted, your body feels like it DOES need those drugs. Sometimes it can be dangerous to go "cold turkey".

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They say that with more than 3 weeks use you are at great risk of becoming addicted.  I really cannot even comprehend that...I have seen dh through 4 or  surgeries that required opioids....but he weans himself off asap because he HATES the way they make him feel.   My understanding is that some people LIKE the way they make them feel.

 

They make different people feel differently. They make my mom loopy and anxious and nauseous. I on the other hand very much enjoy how say, vicodin makes me feel. Regular codeine just makes me sleepy (and doesn't work well...I'm an ultra rapid metabolizer so it wears off too fast), but hydrocodone, like in Vicodin, makes me feel all happy and relaxed and wonderful. Like a glass of wine only way better. It makes everything warm and fuzzy. My husband takes it and just gets sleepy. So how addictive it is probably depends on how it makes you feel. 

 

I won't lie. I've often been silly and said it's a shame people are talking about legalizing recreational use of weed but vicodin never will be, because it would be my drug of choice. But in all seriousness, I'm careful about taking it because I really really do like how it makes me feel. More than I should. 

 

That said, I've still got some from when i had a tooth pulled forever ago. I save them and use them only when really needed for pain. I've never used more than a day or two of them. 

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Scarlett, if he's not going to use these pills, he has no need to have them in the house. And no matter HOW you set up your life, you can still be the target of a random break-in. Why are you arguing about this? Is it going to physically harm you to take them to the pharmacy to be disposed of safely?

 

 

He keeps some one hand in case of a flare up.  He needs that.  We don't have some sort of stock pile...

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Was he disabled in a way that causes chronic pain? If so, he might still need them.

 

Is it a physical addiction? If so, it will be painful to go off the drugs. Once you're addicted, your body feels like it DOES need those drugs. Sometimes it can be dangerous to go "cold turkey".

 

 

I am not sure.  It is really hard to say.  I feel like my dh is MUCH more physically disabled than him......but my dh powers through where as this other person seems to give in to it.

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He keeps some one hand in case of a flare up.  He needs that.  We don't have some sort of stock pile...

 

 

but we just sort of stock pile them just in case he needs them.  He rarely takes them.  So glad he never got addicted.

 

So I don't know which of these quotes is true, but you're the person who said you have a stockpile. Not me.

 

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So I don't know which of these quotes is true, but you're the person who said you have a stockpile. Not me.

 

 

Well, I said I was exaggerating about 'stock pile'....I would have to go searching to see how much he actually has.  He gets a Rx everytime he goes to the doctor but doesn't always fill it because he has some on hand already.

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I am not sure.  It is really hard to say.  I feel like my dh is MUCH more physically disabled than him......but my dh powers through where as this other person seems to give in to it.

 

You're sounding really judgmental here. You're not this other person's doctor, and you're not in his body. You don't know what's going on that makes life easier for your husband.

Human bodies are variable. What is easy for some people is hard for other people. That's just the way it is.

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Scarlett, if nobody in your family is going to use these pills, why do you even have them in the house? And no matter HOW you set up your life, you can still be the target of a random break-in. Why are you arguing about this? Is it going to physically harm you to take them to the pharmacy to be disposed of safely?

This.

 

Don't keep unused opioid in your house.

 

Why in the world would you keep them? If your husband has another surgery where he needs them, or an injury, or some such his doctors can prescribe the appropriate medication at the time.

 

Can you explain why you have kept extras on hand?

 

They really do need to be taken back to the pharmacy.

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I have one elderly family member who has been in a low dose for many many years for a genuine severe pain issue. They are being almost totally cut off with very little hope of anything for pain

 

 

Then I had another family member have surgery that was fairly involved start out with Tylenol 3. That wasn't enough so the doctor went with a larger amount of big guns meds when a smaller amount of a mid level med would have been enough.

 

One dentist wanted to give one of my kids 20 Norco for having crowns. I refused and 2 Advil was plenty and that was only needed for 2 doses.

 

I see a lot of disconnect between the pain level, how long the pain is expected to last, and the amount/type of meds being used.

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This is my loved one.  He had an accident almost 20 years ago that disabled him....but I don't believe he has needed all the drugs he has continued to take all of these years.  It just stops really working after a while anyway doesn't it?

 

Other than the tolerance that develops to medications ("diminishing returns"), some can also get opioid-induced hyperalgesia (https://www.ncbi.nlm.nih.gov/pubmed/21412369). If I understand it correctly, it reduces your pain threshold. I have read somewhere that your body can actually produce more pain receptors. I am not sure if that is correct or not.

 

 

"The difference between acute opioid tolerance and OIH is conceptually easy to understand, but the two are clinically difficult to separate. OIH is defined as the increased sensitivity to painful stimuli as a result of opioid use. Tolerance is defined as a requirement for increased doses of an opioid to achieve the same analgesic effect. In clinical practice, the development of either of these phenomena will lead to increased pain, with the usual consequence of escalating doses of opioids. Whether the increased opioid requirement is caused by lowering the pain threshold, as in OIH, or by decreasing the potency of the drug, as in tolerance, the clinical effect is the same. They appear to have a dose–response relation and as such the magnitude of tolerance or OIH in the setting of high-dose opiates is increased."--http://anesthesiology.pubs.asahq.org/article.aspx?articleid=2474170

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This.

 

Don't keep unused opioid in your house.

 

Why in the world would you keep them? If your husband has another surgery where he needs them, or an injury, or some such his doctors can prescribe the appropriate medication at the time.

 

Can you explain why you have kept extras on hand?

 

They really do need to be taken back to the pharmacy.

 

 

I thought I already explained.  My dh has several chronic conditions that sometimes flare up and require meds for the pain.  He absolutely needs some on hand.  Not so easy to run to a specialist an hour away in the midst of a crisis....so I have no qualms keeping some on hand.  At various points in the 7 years I've been married to him I have noticed he has a bottle of 30 pills only partially used but 3 years old.  So that is the level of 'stockpiling' and usage we have going on here.

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I have one elderly family member who has been in a low dose for many many years for a genuine severe pain issue. They are being almost totally cut off with very little hope of anything for pain

 

 

Then I had another family member have surgery that was fairly involved start out with Tylenol 3. That wasn't enough so the doctor went with a larger amount of big guns meds when a smaller amount of a mid level med would have been enough.

 

One dentist wanted to give one of my kids 20 Norco for having crowns. I refused and 2 Advil was plenty and that was only needed for 2 doses.

 

I see a lot of disconnect between the pain level, how long the pain is expected to last, and the amount/type of meds being used.

 

 

Me too.  I had an emergency appendectomy and I was only given a high dosage of Ibuprofin or some such.  I took a few doses of it....Really I was fine.I gave birth naturally with no pain meds.  As I am sure many here did.   

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You're sounding really judgmental here. You're not this other person's doctor, and you're not in his body. You don't know what's going on that makes life easier for your husband.

Human bodies are variable. What is easy for some people is hard for other people. That's just the way it is.

 

 

I know this other person very very well.  I don't think I am being judgmental.  I have intimate knowledge of both situations and the other person is an addict.  Always has been, since early teens.  So regardless of actual injuries I know he is an addict.  

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They say that with more than 3 weeks use you are at great risk of becoming addicted.  I really cannot even comprehend that...I have seen dh through 4 or  surgeries that required opioids....but he weans himself off asap because he HATES the way they make him feel.   My understanding is that some people LIKE the way they make them feel.

 

My friend did a series of articles on opioids for our local newspaper. With some people, it can take as little as one prescription. 

 

I can't take anything narcotic - I stopped taking Vicodin after my emergency c-section after 1 pill because it made me so nauseous and loopy feeling. Robitussin w/ codeine and Tylenol w/ codeine both make me sick as well. 

 

DH, on the other hand, can take any of those without side effects and they act as intended. The cough syrup stops his cough and helps him sleep when he has bronchitis and he's taken narcotic pain relievers in the past for gout. Thankfully, he doesn't have an addictive personality type and will take only when he needs it. I think we still have 1 leftover T3 in the medicine cabinet from his last gout attack a couple of years ago. 

 

Other people can become quickly and thoroughly addicted. I bet within the next few years, scientists will figure out which genes in the body allow for the addiction and which genes make people get sick when they take the meds. 

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