Chronic pain, opiates, and working?

[chibipinkneko]

I have a unique situation being that I'm 28 years old and suffering from chronic pain. I have confirmed bulging discs in my neck with bone spurs, degenerative disc disease, torn right hip labrum, post-op for left hip labral tear, and hypermobility syndrome. If you've never torn your hip labrum, it can be incredibly painful and disabling. It has made me couch-bound for the past few years. I could barely walk around to even do the household chores

I've had two surgeries on my hips, and will be needing another one in a few months. I have been going through this for the past 4 years, so I'm hoping this is the last hip surgery, but nothing is ever certain. My spine isn't bad enough for surgery yet. I've tried many things for pain including max dose naproxen (1.2 grams daily), ice, heat, TENS, etc. They help, but I still need pain medicine if I want to do more than just lie in bed all day. I take about 2-3 Vicodin daily depending on my pain levels. I also take Gabapentin, but I suppose employers don't care about that.

This is my question. I'm starting to apply for jobs. I am not in any way mentally impaired by Vicodin because I take a low dose of it, and only take enough to take the edge off of the pain. The pain keeps me pretty alert, unfortunately. If I bring my medical prescriptions to the drug testing agency, will they disclose my Vicodin positive results to the pharmacy hiring me? If possible I would like to not let them know about my health issues because people have lots of preconceived notions about Vicodin and drug addiction. I'm not a drug addict in any sense of the word. There's a huge difference between addiction and dependence.

And please don't criticize me for using pain meds unless you too suffer from debilitating chronic pain. You don't know what it's like until you've lived it. . .

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[pharmdpharmd]

If you tested positive and have a prescribition, and discolse it in advance, it's ok,That wouldn't be a problem.. The problem is, I dont know of any pharmacy jobs that do not require some physical movement that is more than house chores.

 

[bacillus1]

If you tested positive and have a prescribition, and discolse it in advance, it's ok,That wouldn't be a problem.. The problem is, I dont know of any pharmacy jobs that do not require some physical movement that is more than house chores.

There are some fields of pharmacy where you just work from your desk, such as phone MTM.

 

[Ackj]

From my understanding, when you "test positive" on a drug test, you are then asked to submit documentation, such as your prescriptions. This should be handled by the drug testing company, who will then say you "pass" your test. Your boss/HR will most likely not be notified by the testing group, as it can be a patient privacy issue.

 

[chibipinkneko]

If you tested positive and have a prescribition, and discolse it in advance, it's ok,That wouldn't be a problem.. The problem is, I dont know of any pharmacy jobs that do not require some physical movement that is more than house chores.

Well I'm better off at this point because I just had surgery on my left hip, so I can do household chores NOW. Prior to my last surgery I was pretty disabled. That's why I wasn't working I'm at my worst right after the labrum tear, and then the pain does abate some. When I first tore my left hip labrum, June 2011, I could barely walk. . . It did improve over time, but not enough to avoid surgery. I'm about 12 weeks post-op now It takes about a year post-op for the pain to go away though, for me at least. It's a pretty intense surgery and recovery, worse than a hip replacement most would say.

It's not that I haven't worked with pain. I did my rotations starting 2 weeks after my first hip surgery (right hip). My neck pain had just started, and was about a 7 to 8 out of 10 on the pain scale, which is really bad. I worked 80 hour weeks at times. I was on 1.5 tablets of Vicodin daily at the time. I will admit, working 80 hour weeks with severe pain is intense :S

I also worked in a retail pharmacy for several months post graduation (class of 2011) because I didn't get enough hours during school. This was a few months after I had torn my left hip labrum. I brought a stool to sit on so if I was stationary for a bit I could sit. It helps to alternate between standing and sitting for me. I worked 40 hour weeks there, and was able to perform all of my duties, so I'm pretty confident I can do it. I was hoping for part time positions right now, and if that goes well working up to full time

 

[chibipinkneko]

From my understanding, when you "test positive" on a drug test, you are then asked to submit documentation, such as your prescriptions. This should be handled by the drug testing company, who will then say you "pass" your test. Your boss/HR will most likely not be notified by the testing group, as it can be a patient privacy issue.

Ah okay, thanks Could I have the pharmacy or doctor fax them the documentation? I suppose I could photocopy my next prescription. I haven't had a need to do that yet, but I could if needed.

 

[rph3664]

If you are taking pain medications, or any other controlled substance, for a legitimate need, you should not have a problem whether you're working as a pharmacist or as a minimum-wage fast food worker (and yes, many of those places do drug testing!). That's what these drugs are for in the first place.

 

[daojones]

It's really up to you. If it were me, I would hold off on disclosing the information before getting hired (if no one asks about it). In a perfect world, employers should not discriminate hiring someone who is on medication for chronic pain treatment or past injury (unless its something like the military or law enforcement where rigorous physical activity is required). The reality is that your debilitation from injury and need to take medication will be on their mind. If the choice for employment comes down to you and someone who is healthy as a horse, I'm guessing a lot of employers will go with the latter.

Once I got the job, however, I would disclose injuries and current medications, just in case of an emergency. For example, someone who is diabetic or suffers from seizures should absolutely make their coworkers aware.

 

[Digsbe]

You might want to check your state laws too. I was working with a pharmacist who had dental surgery done and was prescribed lortab for the post-op pain. He could just be overly cautious and I haven't taken my pharmacy law course yet so I'm not certain. But he told me he was not allowed to take it at work because it is illegal in my state to practice pharmacy, medicine, or nursing under the influence of alcohol or any prescription narcotic.

 

[chibipinkneko]

Thank you everyone for your responses. In an ideal world I would have found out about my pain issues prior to attending pharmacy school. It happened after I was two years in, so I sort of just kept going :/ I will talk to my pain management doctor about this. Perhaps switching back to Tramadol will be more acceptable to employers, or Butrans. If necessary I will have to wean off my medication, but I'm not sure I would be able to work in that much pain :S When the pain is bad I can't eat or sleep. It's just awful. It might even be possible for me to take it only during non working hours as my biggest issue is sleeping with the pain. And if I can't sleep then the pain gets even worse the next day.

 

[Digsbe]

Thank you everyone for your responses. In an ideal world I would have found out about my pain issues prior to attending pharmacy school. It happened after I was two years in, so I sort of just kept going :/ I will talk to my pain management doctor about this. Perhaps switching back to Tramadol will be more acceptable to employers, or Butrans. If necessary I will have to wean off my medication, but I'm not sure I would be able to work in that much pain :S When the pain is bad I can't eat or sleep. It's just awful. It might even be possible for me to take it only during non working hours as my biggest issue is sleeping with the pain. And if I can't sleep then the pain gets even worse the next day.

I hope you are able to find a solution that also allows you to work without having to suffer from chronic pain.

 

[rph3664]

You might want to check your state laws too. I was working with a pharmacist who had dental surgery done and was prescribed lortab for the post-op pain. He could just be overly cautious and I haven't taken my pharmacy law course yet so I'm not certain. But he told me he was not allowed to take it at work because it is illegal in my state to practice pharmacy, medicine, or nursing under the influence of alcohol or any prescription narcotic.

That's utterly cruel. People who are using pain medication properly don't get any kind of "kick" from it, and function better because they just plain old feel better.

 

[chibipinkneko]

That's utterly cruel. People who are using pain medication properly don't get any kind of "kick" from it, and function better because they just plain old feel better.

You would be surprised how unsympathetic most people are. The majority of the people on the chronic pain forum told me it was impossible for me to be a pharmacist and I needed to pick another career. Well that's easy for them to say. They didn't go to college for 9 years, and rack up $150,000 in loans. And if I had to go off of painkillers completely there would be many nights where I won't be able to sleep, and I'm very impaired on 0 hours of sleep. Who wouldn't be?

Although, lots of medications make people drowsy. I think it's discrimination to say a pharmacist has to be 100% healthy. Well, if you ask me What about the pharmacists on anxiety medication, antidepressants, allergy medicine, and anti-seizure meds? Aren't they impaired too? I was on Cymbalta for a while for nerve pain, and that impaired me a good deal. I slept like 15 hours a day on it. Chronic pain patients just get the brunt of it because opiates are fun to abuse, and that does happen, sometimes even within the pharmacy. Nothing frustrates me more than people who abuse opiate pain killers because that makes it so much harder for people with real pain to get adequate treatment.

Well, you can see I'm opinionated on this subject. There's a lot more on this subject and nursing because more nurses are injured. The Texas nursing board actually supports the use of pain killers in nurses with chronic pain. Pharmacy doesn't predispose one to injury, I just have bad genetics I hope in the future there is more acceptance for those with chronic pain issues. I'll just have to see how this whole thing plays out.

 

[BidingMyTime]

You might want to check your state laws too. I was working with a pharmacist who had dental surgery done and was prescribed lortab for the post-op pain. He could just be overly cautious and I haven't taken my pharmacy law course yet so I'm not certain. But he told me he was not allowed to take it at work because it is illegal in my state to practice pharmacy, medicine, or nursing under the influence of alcohol or any prescription narcotic.

I have never heard of that before (although I'm not familiar with laws in all 50 states), but I doubt that is true. Most employers are NOT allowed to discriminate against someone because of a disability, as long as they can perform the essential functions of the job. Bear in mind that being "under the influence" is not the same as taking a medically prescribed narcotic.

I would also point out that someone taking short-term narcotics would be more likely to be impaired by those narcotics, than someone who is on narcotics chronically (and would most likely have a tolerance to the adverse effects of them.)

 

[jtrouty]

You would be surprised how unsympathetic most people are. The majority of the people on the chronic pain forum told me it was impossible for me to be a pharmacist and I needed to pick another career. Well that's easy for them to say. They didn't go to college for 9 years, and rack up $150,000 in loans. And if I had to go off of painkillers completely there would be many nights where I won't be able to sleep, and I'm very impaired on 0 hours of sleep. Who wouldn't be?

Although, lots of medications make people drowsy. I think it's discrimination to say a pharmacist has to be 100% healthy. Well, if you ask me What about the pharmacists on anxiety medication, antidepressants, allergy medicine, and anti-seizure meds? Aren't they impaired too? I was on Cymbalta for a while for nerve pain, and that impaired me a good deal. I slept like 15 hours a day on it. Chronic pain patients just get the brunt of it because opiates are fun to abuse, and that does happen, sometimes even within the pharmacy. Nothing frustrates me more than people who abuse opiate pain killers because that makes it so much harder for people with real pain to get adequate treatment.

Well, you can see I'm opinionated on this subject. There's a lot more on this subject and nursing because more nurses are injured. The Texas nursing board actually supports the use of pain killers in nurses with chronic pain. Pharmacy doesn't predispose one to injury, I just have bad genetics I hope in the future there is more acceptance for those with chronic pain issues. I'll just have to see how this whole thing plays out.

I hope you are doing well now. I am a pharmacist specializing in chronic pain and I totally empathize with your situation. If you would like, PM me and maybe I can point you toward some useful information to help you with the management of your chronic pain. Your story really intrigued me, especially since your are a fellow PharmD.

In good health,

Justin