I'm in recovery but in pain, can I take...

[SableZen]

Discussion/opinions?:

We see questions about wanting or needing to take a narcotic from people in recovery constantly, and almost invariably they are difficult to answer and usually receive relatively few responses when the physical problem is severe. However, when the physical problem that people want relief from is not *perceived* as being too severe by other people... the responses are relatively abrupt and numerous. But is the person in either circumstance any different from wanting some relief? How can we be certain when we tell someone with nasal problems that may be resulting in debilitating headaches or migraines that their problem isn't as painful as someone that just had 10 pins put in their leg after an automobile accident? We can't I don't think...

I faced this question myself recently with a kidney stone. I was fortunate enough that my episode was short enough I could get by without an opiate... but honestly, I really would have taken an opiate if the pain had hit me like it had the times before... I just would have advised the medical providers that I have 'a history' and would like any prescriptions to be non-refillable and short in duration.

Just looking for a reason to use an opiate as part of an addiction or looking for a solution to a migraine problem is the same thing as far as the brain is concerned no matter if you look at it psychologically/behaviorally or medically. But not for how people view themselves, and how other people respond to them and their problem.

I just don't think it's a matter of reaching some mystical level of awareness (i.e. 'waking up' or 'not making excuses') to prevent someone from making the decision to take a narcotic again. It's about recognizing that there will be times when it will seem or be logically tempting to use an opiate for a real problem... and coming up with better solutions. Asking for help in this area is beneficial. Hearing 'it's your mind playing tricks on you' is not.

[CadillacJack]

We better agree, because we will disagree frequently, no doubt.
Best wishes

cj

[ready2help]

I think the people that get the most from a forum such as this one are those that are open-minded and accept challenges to their belief system. For the addict and/or alcoholic, the belief system is the basis for an inability to get clean and/or maintain recovery.

Thanks everyone for discussing these topics. And when necessary, we can agree to disagree, right?

[122 Tactical Fighter Group]

As a for real pain patient and an addict I feel your discussion was great and i am glad that you posted it -

[SableZen]

Agree totally with your words and everyone else that responded. Things to think about...

I was hesitant to post this question in the first place as it would probably make some people look over their shoulder and wonder if they were being attacked for specific responses. Which wasn't my intention. I'm just in the middle of trying to make sense of my own behavior and ideals...

[CadillacJack]

I  certainly do understand your position, and as the person in this case stated a more concise cause of the ailment, it gave me reason to apologize for being so blunt, in the first place. I still would have strenuously object to using an opiate that happens to be at hand. In my opinion, they should not have been on hand in the first place. I think you make some valid points, but I have to go with the information given, and that seemed lax at the time. As far as a doctors visit goes, or even an ER visit, would have been an effective way to deal with the situation. I am blunt. 30 years of running crews of boilermakers, pipe fitters & welders in heavy construction have made me that way, further than nature already had. I do not apologize for my style. It's how I am. Again, in this case, even with the additional information posted later, I would have to advise against taking a pill. It still won't fix the problem. We on this forum are here to keep each other from using, as far as possible. If an alcoholic told me he had a bad case of nerves, or some sort of pain, I would be just as remiss in tell him "OK, take a drink". The analogy is close. Again, no hurt intended Telling people it's OK requires much more information than the first post offered. And yes, I agree, it is an important topic. I my be hard, and many times wrong, but compassion can bite you just as deep, and just as often.

cj

[worried878]

And some people/newbies or recently clen/ may really not realize how easy it is to become a full time user again after taking a pill for a headache etc...narcotics are not by any means the drug of choice for migraines or sinus headaches...my brother who does not abuse has suffered his whole life with migraines and i dont think he has ever even thought about taking narcs for them...recently they put him on elavil 10 mg nightly and it has helped tremendously...i think many addicts think of narcs as the answer over any other treatment...and the general population does not...that is because we are different....for instance my mom has had 2 root canals in the past few months and never even thought about taking narcotics for it....some feel like this is an absolute must after a root canal...people also have different pain tolerence as well i guess...anyway some people need to know how important it is not to choose narcs for pain as a first choice because they really do not know how dangerous it is during recovery...so they ask and may not be looking for excuses to use at all...but i agreew ith cj...i would rarely say...yes..take the narcs

[SableZen]

I would agree with what you said and how you said it. It makes sense when it's put in the light that, no an opiate is not going to address the specific problem effectively (even if it seems like it might).

A person definitely isn't crazy or drug seeking for thinking it might be helpful though, especially if they are unfamiliar with migraines. And pointing out exactly what you said is helpful (especially with Imitrex and Demerol) and addresses that. It's to the point and more accurate advice than concentrating on the past addiction exclusively.

I just think that jumping to the conclusion that because an opiate won't help = classic drug seeking is very often an incorrect assumption. One that we tend to be too ready to make, and jumping to that conclusion exclusively while ignoring everything else a person is saying (exactly like a lot of doctors will do, which pisses most of us off) is definitely ineffective (my opinion only) at helping someone make an informed decision to help themselves.

Imagine calling a doctors office, start explaining your problem about [whatever ails you] to the receptionist, and then stating you have overcome a problem with opiates in the past, but as soon as the 'a' word is out of your mouth, the receptionist says 'your mind is playing tricks on you' and hangs up... without even mentioning or addressing why you called in the first place. It happens all the time, often less directly, but because of the stigma attached to the 'a' word, and it's pointless. Acting along with that stigma could just as easily encourage someone towards using an opiate again without medical supervision (textbook 'abuse') as it is to dissuade them, especially if that person is on the fence about it ('what other option is there?' mentality). What if cigarette smokers were responded to in the same way? They certainly have just as much of an addiction as anyone else (minus the physical withdrawal severity). Yet we respond to a nicotine addiction (or even alcoholism) MUCH differently and people are encouraged to discuss it during doctors visits...

Again, I'm reiterating I am not making personal attacks. Call me a care-bear if you must (lol). Just feel it's an important topic to discuss and the responses are helpful for me.

[CadillacJack]

I'm familiar with, and responded to, the post this discussion seems to be concerned with. The stated problem was sinus problem, apparently cause for migraine. I know people with severe allergy problems, as well as people with acutely severe migraine headaches. In neither situation is an opiate pill an often prescribed solution. A the case of a severe migraine, if imitrex or similar drug doesn't work, a shot of demerol is required. I've never heard of, or known of, a person being prescribed an opiate for the relief of a sinus problem. In the case of a severe headache, brought about by sinus pressure, there are other ways to deal with the trouble, other than resorting to opiates. An opiate probably will bring little, if any relief to such a problem. So, does a person rationally tell another to "go ahead and use" in the given scenario? I can't see a "yes" answer to the post you question responses to. As another stated above, if I an truly hurting that bad, I'm not going to ask permission. I trust my own head farther than to do that. In closing, I do not believe that a person should say "okay, go ahead" in such a given situation. If you've ever really known a person who suffers from true migraines, then you also know an opiate pill will not relieve it. Neither will it relieve a stopped up sinus. So the answer to this question seemed obvious. Seek the correct medication. I stand by my opinion that in this given situation the ADVICE, which is the only thing anybody could give this person, is no, don't take narcotic pain pills for this problem.

[ready2help]

Interesting topic, for sure. SZ, it is encouraging to hear that there is attention being paid to the obvious overlap in addiction medicine and pain management. Finally. I guess we can all consider ourselves TRAILBLAZERS!

Ultimately, we are all responsible for ourselves.

Just pondering:
Addicts will come and go.
Some will take pain pills. Some won't.
Some will make a career of detoxing.
Some will maintain long term abstinence. Some won't.
Some will get on with life. Some won't.

I hope the best for all.

[worried878]

i agree sad....but people should not get upset...which does happen...when forum members dont agree that it is ok to take narcs for sinus pressure and toe pain...these are just 2 that stand out from the last day or two....in the non-addict world people would never dream of taking narcs for some of the things that are brought up on this forum...it is the addictive mentality....guilty as charged right here LOL ..but not something that should be encouraged or agreed with in my opinion unless u really do agree with it..then speak ur mind....the forum is for feelings to be expressed....but the feelings may not always be what the person wants to hear....as the others have the right to express their feelings as well...different personalities just like the real world here...victims, fixers, stong minded, weak minded, drama queens/kings, shy ones, people in need of advice...it takes all to make the world go round

[sadinmichigan]

I am sure there are those types of posts where they want confirmation that it's ok...but I don't think that is everyone..if someone has had to take a couple pills,or may need too and posts about it.I think they want to keep themselves in check and staying away from the forum isn't beneficial. Thats when they should post to keep being reminded to not get caught again..to be careful etc..and to have some accoutability..

[SableZen]

Thank you everyone for throwing some responses in. I just wanted to reiterate that I was not singling any one post or person... the topic has been on my mind for the past week or so.

r2h: "Everyone is going to have a situation or condition that involves pain at some time in their lives. Unfortunately, for the addict, this can be a crucial point, the proverbial fork-in-the-road. Actually, not to be too dramatic, but it could be the difference between life and death. That's why having a relapse prevention plan in place is so vital.


I think exactly the same way when it comes down to possibly being the difference between life or death. And I don't think that's exaggerated in the least. This seems to be another area where structured support helps a person prepare for a lot of things that  people might miss (including myself) without any aftercare.

By the way, according to the ASAM website, they are currently developing a core curriculum which covers this exact topic:


Development of a core curriculum in pain medicine and addiction medicine

There is currently burgeoning interest in the overlapping areas of pain medicine and addiction medicine. This project is intended to define the body of knowledge necessary for health care providers to provide safe and effective therapy of pain, to identify and manage addictive disorders in patients with pain and to treat pain in individuals with addictive disorders. It will include essential knowledge in overlapping areas of interest in the fields of pain medicine and addiction medicine. Due to the different focuses of their work, generalist physicians and various specialists, both physicians and non-physicians, need to have various depths of knowledge in different parts of this curriculum, but it is believed that all practitioners who treat pain as a prominent part of their practice, should have a basic level of understanding of all parts of the curriculum.

It is anticipated that the defined body of knowledge (core curriculum) will be used selectively as a template to develop courses, conferences, training curricula and other educational projects, as well as, as a reference standard for the development of certification criteria in the fields of pain medicine and addiction medicine.



...better late than never!

[worried878]

If someone has decided to take pain meds for a "hurt toe" or whatever...they may come on and plead their case....happens often....and their will be some negativity/realism/whatever u wish to call it/ from time to time...that is part of life....if everyone always said...."go ahead sweetie, take 5 oxys for ur toe or ur migraine" would the forum be very helpful or realistic..sometimes people want comfirmation for something they are going to do no matter what anyone says ..to me that is personal and unless u r abusing it is their own business...if i had a painful surgery/procedure/accident that required pain meds, i do not feel like i would need to come on the forum to make sure it is ok to take pain meds....to me it is a given...i may ask for support if i started abusing past the point of needing them....to each his own but it seems like alot of the time these posts are wanting an OK to use when it is obviously not OK...no one knows that except the person themsleves so it is really not fair to ask for an opinion if u are going to get upset by the responses that occur

[ready2help]

This certainly can be controversial. I think one reason is that people get defensive if their pain is questioned. Completely understandable. But it seems that addicts are exaggerated and overly sensitive in this regard. And the nature of the disease is that it makes one's thinking processes off, delusional to less or more of a degree. Denial is the central feature of the disease, right? It is such a sneaky wolf, lying in wait, for the addict to be off guard even a little bit. So, if physical pain gets thrown in to the equation, the disease can maximize on it.

I think what we are really debating is related to the phenomenon of RELAPSE. I found this little blurb - it says it better than I can right now:

>Relapse Set-Ups

>In most of the relapse episodes we have studied or worked with clinically, the first >lapse is precipitated in a high-risk situation that clients report they were not expecting >and/or were poorly prepared for.

>Often, our clients found themselves in rapidly escalating circumstances they could not >deal with effectively. Usually, after extensive debriefing, the lapse or subsequent >relapse appear to be the last link in a chain of events that preceded exposure to the >high-risk situation itself. It seems as if, perhaps unknowingly, even paradoxically, >clients set themselves up for relapse because they did not or could not see the early >warning signs.

>Cognitive distortions such as denial and rationalization make it easier to set up one's >own relapse episode. The process of relapse set-ups is determined by a number of >covert antecedents that eventually lead to exposure to a high-risk situation, but also >allow the individual to deny any responsibility for it.


I will say this: it has been my experience that people that do not have addiction problems do not focus on pain meds - they take one or two doses, maybe (often just take ibuprofen) and then that's the end of it. I see this time and time again. Honestly. I have seen many addicts decide when they need to have surgery, for example, that they will not take opiates - they decide this in advance. Others have a safe plan put in place, always involving others to maintain accountability. They know they cannot take their disease for granted - and they respect the power of the disease.

Everyone is going to have a situation or condition that involves pain at some time in their lives. Unfortunately, for the addict, this can be a crucial point, the proverbial fork-in-the-road. Actually, not to be too dramatic, but it could be the difference between life and death. That's why having a relapse prevention plan in place is so vital.

Like anything else in medical treatment, the risks of the treatment (relapse) must be examined in view of the benefits (pain relief/management). Whether to treat pain with opiates or not isn't a moral question. No one is a bad person or a good person. Just an addict trying to do the best they can.

[cathy5841]

one thing to consider here too is...if a person is truly in pain and NEEDS pain meds, they are not going to come here and ask about it.  when i came home from my surgery, i was inpain and i was not going to ask anybody if i should take the pills.  even though i TOLD the dr i didnt need them.  my tune changed when the pain hit.  my point is, if a person is hurting bad enough to NEED meds they are gonna take um.

[sadinmichigan]

I don't think everyone has had negative responses either..I love this forum..and the people here for the most part..

[beentrying2quit]

I think that most of us here have been or are addicts and we know all to well what kind of lies we tell and how we can come up with the most convincing stories to get our fix.  I've been on Norcos for a little less than 3 years now for feet/leg problems.  Both feet sting/burn/tingle and at times I get realy achy in both knees.  I have been to 9 different docs with 9 different  diagnosis and each time the doc would give me some kind of pain med.  Don't ge me wrong....my pain is very real....but...there are days that the pain is gone and I still take my Norcos...makes me really mad when I do that.

I think it is difficult to tell from a persons email just what situation they are in.  The simpel fact that a person makes an effort to post a message here tells me they are looking for help or direction.  There are also some people here that are just looking for another person to tell them that what they are doing is fine.  I've been posting on this board for quite some time and I've seen and read some pretty good stories.

The bottom line is this.  If you respond to a another persons plea for help it should be done in a non-judgemental way but be direct.  I'm a firm believer in "tough love" and if a person gets mad because they are told to "suck it up" then, in my opinion, that person is not truly looking for help...just an excuse.

We all have problems and we all deal with those problems in different way.  Well...I guess all of us deal with our problems by taking pain meds.  Lets say a person takes 2-3 tabs a day to take the edge off of life...does that make them an addict?  What about a person that likes to go shopping to deal with lifes problems or the person that gambles so they can forget...are they an addict?  Which one is worse?

All of us also need help, guidance and support.  I think one reason most people come to this forum is they have no kind of support system at home and nobody understands what they are going through.  I am trying to "white knuckle" this addiciton on my own and have found that without someone to hold me accountable it is impossible for me.  My bro-in-law has has a life of drug addiction...all recreational use.  He was kicked out of his home when he was 17 for dealing drugs out of his parents home...a decision I totally agrreed with.

I remember one day my father-in-law saying "why dont you just quit?"  He did not understand they hold drugs can have on a person.  Now my father in law is addicted to pain meds due to a severe back injury and he said today "I now understand why Rick could not just quit."  Kinda funny when the shoe is on the other foot.  I know this is long but I'm not able to sleep right now, 11:33pm in Oklahoma now, and I felt I needed to post my 2 cents.  

[cathy5841]

okay time for my 2 cents.  i donot think ppl in pain are all treated negatively here.  when i was 100 days clean i found out i was going to have to have a disc replaced in my jaw.  i did not want to take pain meds, but was informed by the dr it was a necessity.  i was upset and came here and posted my feelings.  i got total support.  not one sngle negative post.  i was told by the dr i would probably have days i would need the meds for up to 6 months.  i stopped the pills after 5 days and flushed the 400 i had left.  i took ibuprofen after that.  yes, there were days i needed something stronger and could have used i made a choice not to.  i too suffer migraines and have since i was 8 years old.  i have seen tons of dr who have offered me scripts...a true migraine does not respond to narcotics.  many drs have told me that.  i have never heard of anyone taking narcotics for allergies.  since this person made 2 post i felt i should respond.  i did so with honesty.  if it was harsh i am sorry.....thats my 2 cents.

[sadinmichigan]

I agree with you..Just because we are "addicts" doesn't mean there is never going to be a time that we experience real pain..I for one was terrified of thinking about...what if I have an emergency??what if I have to have surgery ?/etc..Well, I for one, am not going to refrain from obtaining relief from pain just to appease others..If a person is going to take it to the next level and continue back into taking rx's well after the reason they took it for...then thats whats going to happen..It is possible to take pain medicine for a few times when needed and not become a full blown 20/ a day.pill popper..I have had sever pain in my back the past 4 weeks..It is much better now although it is still hurting..I chose to take a couple Norco a couple weeks ago..I have not taken anymore..that is because I don't want to.

[SableZen]

avisg - I honestly don't won't to refer to a specific post or any specific response. I'm not criticizing any person for doing anything wrong - I'm speaking as a generality for the same questions that come up time after time. I apologize if it seems that this was a drama post or an attack on anyone.

But I do agree with what you are saying! I can think of a recent example where one person joined, stated they had gone through detoxing themselves two times in the past, and were asking if it was ok to take one every now and then for the enjoyment factor. Then went on to tell everyone here they didn't have a problem and to insult other people for telling them the truth.

But it's just a reality that everyone here, at one point or another, is going to have to face the prescribed use of a narcotic for pain control further down the road at some point. Like you stated you had to do and I recently almost had to do... And there seems to be no support or guidelines to help anyone in making that decision beyond saying 'your mind plays tricks on you' or to ignore the specific question.

Perhaps I'm just over-reacting? I don't know - but I feel a lot like Corey does. It just seems like such a crucial thing to have an answer for and just an ugly reality.

Was hoping there were some guidelines out there - but I was unable to find anything really related for medical practitioners. Pain control for people with addictions just isn't a subject that anyone wants to face medically as well... I've written someone at ASAM on the subject and haven't heard any response yet...

So I'll stop rambling on about it too... lol

[kim715]

I never respond to a post like the one we're speaking of unless I have first hand knowledge of the situation.I don't have allergies and never had migraines so I don't know how painful they are.I have however had kidney stones and know the pain they can cause and I just recently had to experience that again,which I got through without taking prescription painpills because the otc motrin kept the pain from being too severe.Right now I am dealing with diverticulitis again,and I have had a prescription for vicodin for nearly a week now,that I haven't filled as of yet,but if the pain becomes too much I will fill them and will give them to my son to lock up and only give to me as needed.There will be times when we NEED to take painmeds,but as Avisg said only we can determine when that time is.I think overall that people keep their responses well rounded and give their opinion,offer alternative suggestions,but in the end leave it up to the individual.I don't think when people point out that perhaps it may be our addiction trying to trick us that it is meant to offend anyone only to show concern.I do agree that sometimes it comes off that way and could have perhaps been worded differently so as not to cause offense.Overall I think that we have all walked this rough road of addiction and recovery and we become so passionate about saving others from the stumbles we have made along the way that questions like that scare the h*** out of us.We don't want others to make the same mistakes we may have made and so perhaps that clouds our judgement sometimes.I think that a person who is truly in pain and fears a relapse will take the alternative suggestions offered to them.A person looking for an excuse to use will take the suggestions that say 'if you need it take it.'Maybe it's better to have people responding differently,since we don't really know the original posters' mindset,or the degree of pain they're in.We don't know if they're sincere or looking for an excuse.We have all been in legitimate pain and needed to take pain meds.,but as addicts we have all played up pain to get pain meds.How do you determine what response is appropiate?Just my two cents.Much love to all of you.Peace.

[corey411]

Your welcome and agree with the above. Sometimes we post too hastily. I've been guilty too. If you post with a problem and get 6 supportive answers and 3 not so thoughtlul ones the negative ones are the ones that bite you. I once posted about being depressed and my brother in law attempting suicide and I woke up feeling like it wasn't such a bad idea and got mostly words of compassion but also a post that said "we all feel like that sometimes. Its normal"???? It's normal to wake up and think I want to die? I don't think that the person meant it to sound like that but it made me not want to post anymore when I feel bad. I think sometimes the origional post gets overlooked and "group think" occurs. One post feeds off the other and someone sees what is happening and posts to attempt to redirect it and that post just gets stomped on.  I post alot to new people and just drop a few lines of encouragement  even though other have said the same things but I think the volume of support is needed and being reached out for by many. I try not to post on alot of others unless I think I can help. Mostly I still try to sit back, read and learn from others. Sorry to ramble but to conclude I do think we should read the post and decide if it is something we can have a positive impact on and not allow the other posts to mold our response.....And answer in a way that will only help and not harm. Corey

[avisg]

Sable ,
Yes there are people that come on here that want to be told its OK to take a narcotic .I know I have done it .I am sure that I am not alone .At the time I would have told you my pain was sooooo bad I couldn't take it .looking back I know I used it as an excuse to use.I dont know what post you were referring to so I cant comment on that situation.
There has been a time however a month ago when I had no choice but to use something and I did .I kept my scripts to low amounts And used Motrin and a heating pad as soon as I could to stop taking the oxys.There will be times that you will need narcotics but you have to be very honest with yourself ,do you want to take them or do you need to take them only you know that.

[SableZen]

Right, I just don't know - I just get the feeling that there is a lot of stigma involved here...

A person that has detoxed and still wants to make up excuses to just go back to using isn't going to jump on a forum and ask for permission to relapse first are they? On the contrary, aren't most people in recovery ashamed if they relapse, and have a hard time even admitting that on a forum? I'm just trying to point out, that if someone has a real issue (no matter how small we think it is personally) and asks about it here - don't they deserve to be treated like an adult and given and adult answer? I mean, pointing out how dangerous going back to using an opiate can and should be a part of the response, but it rather ignores the original question and could easily leave them feeling like they are defective, a liar, or crazy (especially if they are in the middle of a migraine when they ask).

Seriously, if someone had told me my mind was playing tricks on me when I had the kidney stone recently - I probably wouldn't have very nice words for them. lol

Just sort of trying to figure this murky grey area out so thanks for being brave. lol