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- Jan 2, 2016
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Feeling bad for a doctor in Corvallis right now.
I simply refuse.As seen above in those comments, none are ready to transition to buprenorphine, they’d rather threaten providers and claim they’re going to buy meds off the street or hurt themselves. Very high risk to even see for a consult.
Wow wtf is this?
I wouldn’t go that far, but this is a trap physicians will fall into if they manage high MME patients.I simply refuse.
Won't be a part of it.
This is ANOTHER reason the ortho model works best for physician QoL.
As Nancy Reagan saidI simply refuse.
Won't be a part of it.
This is ANOTHER reason the ortho model works best for physician QoL.
The third patient that died of Bockoffs that unfortunately died was reportedly on scheduled injections at home of hydromorphone ….PainNewsNetwork is a pro-opioid website. If you notice, Dr. Forest Tennant is on the board.
If I'm not mistaken, the couple who killed themselves (mentioned in the article) were on several 1200mcg Subsys lollipops every day.
Also, now that I'm thinking about this, why are none of these stupidly-high dose patients on a pump? I'm not for pumps in general, but you'd think that'd be a lot safer than writing all those meds.
PainNewsNetwork is a pro-opioid website. If you notice, Dr. Forest Tennant is on the board.
If I'm not mistaken, the couple who killed themselves (mentioned in the article) were on several 1200mcg Subsys lollipops every day.
Also, now that I'm thinking about this, why are none of these stupidly-high dose patients on a pump? I'm not for pumps in general, but you'd think that'd be a lot safer than writing all those meds.
Because it’s a psych problem and not a pain problem. Even on those horrifically high doses they’re probably still complaining of 8/10 pain. A beautifully placed pump will do nothing.PainNewsNetwork is a pro-opioid website. If you notice, Dr. Forest Tennant is on the board.
If I'm not mistaken, the couple who killed themselves (mentioned in the article) were on several 1200mcg Subsys lollipops every day.
Also, now that I'm thinking about this, why are none of these stupidly-high dose patients on a pump? I'm not for pumps in general, but you'd think that'd be a lot safer than writing all those meds.
I agree it's not a pain problem at that point, it's a tolerance problem. Every person I know on chronic daily opioids complains of severe pain. I would just think a pump would have been put in long before someone gets subsys.Because it’s a psych problem and not a pain problem. Even on those horrifically high doses they’re probably still complaining of 8/10 pain. A beautifully placed pump will do nothing.
I agree. Had one legit arachnoiditis patient post surgery. Chronic back and radicular pain. Nerve clumping on CT myelogram. Tried a bunch of stuff (injections and non opioid meds) that didn’t really end up helping too much. Was a very reasonable patient who said he’d ultimately live with it rather than being on opioids. Even refused butrans patch I offered.I’m always suspicious of these sensationalized arachnoiditis patients that “need” high dose opioids. I’ve gone down the rabbit hole on arachnoiditis and the “epidemic” we pain doctors have caused with our ESIs. In my practice I’ve seen maybe 10-15 patients with nerve root clumping on MRI and maybe 2 had mild to moderate chronic neuropathic pain and the rest had no pain related to the condition.
And this is why no one will touch these folks.. all risk and difficult personalities with zero reward. Most of these types have deep seated personality disorders and would be better off seeing psych/addiction medicine physicians. Not my circus not my monkeys.. if there was some sort of legal protection for trying to help these people maybe more would be willing.
Pumps do nothing for those who are addicted, as some of these patients are.PainNewsNetwork is a pro-opioid website. If you notice, Dr. Forest Tennant is on the board.
If I'm not mistaken, the couple who killed themselves (mentioned in the article) were on several 1200mcg Subsys lollipops every day.
Also, now that I'm thinking about this, why are none of these stupidly-high dose patients on a pump? I'm not for pumps in general, but you'd think that'd be a lot safer than writing all those meds.
Any legitimate data/sources you would recommend I should be educating myself with?I’ve gone down the rabbit hole on arachnoiditis and the “epidemic” we pain doctors have caused with our ESIs.
Can you please elaborate on this?I simply refuse.
Won't be a part of it.
This is ANOTHER reason the ortho model works best for physician QoL.