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  • Referral to Addictionologist!?

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    Old 02-21-2012, 01:15 PM   #1
    SCScandidate
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    Referral to Addictionologist!?

    I've been taking a variety of narcotic pain meds, Cymbalta, OTC pain meds and have now had a neurostimulator implanted near spine for 15 months, all for back pain from three back/neck surgeries including low back fusion. My pain doctor has referred me to an addiction specialist. I don't believe I am showing signs of drug seeking behavior. I do ask about different pain meds because I want relief. I am worried about what the future holds for me.

     
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    Old 02-21-2012, 04:19 PM   #2
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    Re: Referral to Addictionologist!?

    Have you had any trouble in the past with running out of your medication early? Or having trips to the ER to get medicine? Or failed any urine tests? Or going to more than one Dr. for your opiates?


    If not, than I would be asking the Dr. flat out...why does he think your are addicted to your medicine?

    A few other questions...is this a Pain Management Dr. with a background in Anesthesiology? Have you been seeing him for a long time?

    If the answers to the first question above is yes, than he should absolutely be trained to know the difference between tolerance/dependence and addiction.

    Addiction is showing the behaviors I listed in the first paragraph...As well as either buying/selling your medicine on the street, going to different Dr.s trying to get narcotics...

    Most every single person on opiates long term will build a slow tolerance to them...as well as the word "dependence" only means that our bodies are used to medicines and if we stopped them abruptly, it would be very uncomfortable and cause withdrawal symptoms.

    So...addiction is a psychological need for pain meds when one does not have pain..

    Again..if you have been seeing this Dr. for awhile...I would have asked him right then and there to explain in detail why he thinks I need this...

    Now...if his plan all along has been saying to you that once the SCS is in place and is giving you pain relief...than we want to taper you down and off the opiates....than that could be a reason he is sending you to someone to taper off...

    Or...if he is a GP or someone who is not well trained/versed in narcotics and pain mgmt. he may be thinking that because you are dependent...that you need a Dr. who treats with pain medicine...

    Didn't you ask him at all about this when he told you? What did he say?

     
    Old 02-22-2012, 04:13 PM   #3
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    Re: Referral to Addictionologist!?

    Hi SCS Candidate, It's very likely the doc is just coving his backside. The PM clinic I have been going to for the last decade, starts all new patients with a psych eval with the on staff shrink, I've taken the MMPI 4 times in the last 15 years so I wouldn't take it as a sign of anything but changes in policy with the present trends in PM. I also did a psych eval prior to having my intrathecal pump implanted. Medtronics recomends a psych eval for all their devices including the SCS

    Just because a doc is an anesthesiologist or a neurologist doesn't mean they are trained in addiction and other psychological factors that may be part of someones pain issues. The whole addicted Vs dependence argument sounds great when coming from a true chronic pain patient but when an addict is using the same argument it doesn't realy matter what term they want to use, their usually isn't a difference and addicts learn the same terms pain management patients use to obtain their drugs, to justify them and to justify their tolerance or dependence. You can be dependent and have psych issues, genetic or other pre existing issues that turn dependence into addiction very rapidly. It's not always one or the other, it may be the exact same thing, What patient is really qualified to evaluate their own psych disorders? Untill an addict is ready for help, they are quite fluent in PM terms and knowledge and can make that argument as well if not better than most CP patients. Quality of life, depemdence not tolerance, etc etc. Once they cross into addiction, tolerance, dependence etc is all just part of their addiction and their is no distinguishable difference. They aren't lieing when they say they have no quality of life without their drug because of the withdrawal and detox, does that mean they should stay on meds they dont need . When every patient is using the same terms to describe how their pain effects them, then the anesthesilogist, DO, neuro's and Physiatrist' need a specialist to sort the difference out because they dont have the specialized training just as someone GP doesn't have the training to prescribe high dose potent opiates. Their is a whole other thread about how things are presently changing and Ive been n the other side of the coin where no pain meds were prescribed to anyone before the invention of OxyContin, duragesic or anything other than MScomntin which was developed decades earlier but resserved for cancer patients only, even then the stories of people dieing in agony because docs didn't know or were afraid tothey would turn their terminal patient into an addict. It wasn't pretty back then and all the abuse with no checks and balances will take us right back to the dark ages, Which were a mere 15 years ago.

    The idea that these meds are safe just because they were prescribed by a doc is why we have the problem we do.
    Good luck Dave

    Last edited by Shoreline; 02-23-2012 at 04:15 AM. Reason: spellling

     
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