IT pump for addiction/abuse

[kstarm]

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Hi,

Saw a lady inpatient with bad mental health issues, and opioid abuse. Main DX of fibromyalgia. Guy down the street has her lined up for an IT pain pump to help mitigate opioid abuse. On the surface I thought this was about the last person I would want to implant anything in, but it got me thinking...

Has anyone had any experience with this, and if so any success?

 

[lonelobo]

Sounds like possibly the worst Idea I have ever heard!

 

[Jcm800]

Sounds like possibly the worst Idea I have ever heard!

if by success you mean the doctor? by financially fleecing a mental health patient who absolutely no way will benefit what is a step away from malpractice, IMO? or the patient who is clearly going to be more fuc ked up after this insane plan?

yes for the i wish they would loose their license doctor, and no for the patient.

I couldnt even consider a pump for this patient, i actually couldnt even handle an office visit with this patient...

 

[lord_jeebus]

Maybe if you fill the pump with narcan

 

[lobelsteve]

+1 for malpractice.

 

[ultm8frisbee]

the patient will start self extracting the meds and injecting IV. Sounds like a great idea (sarcasm)

 

[PinchandBurn]

how will they pass the psych test..

 

[Aether2000]

This doctor hasn't a clue about the fundamental criteria for IT pump patient selection. This physician should not be implanting pumps, period.

 

[kstarm]

Verbatim what my attending said:

Sounds like possibly the worst Idea I have ever heard!

I get this is crazy. Has anyone actually seen it before?

 

[emd123]

The patient needs an addiction psych consultation, not more opioids. The route, whether IV, snorted, transdermal patch, injected, smoked or intrathecal makes no difference.

 

[101N]

Hi,

Saw a lady inpatient with bad mental health issues, and opioid abuse. Main DX of fibromyalgia. Guy down the street has her lined up for an IT pain pump to help mitigate opioid abuse. On the surface I thought this was about the last person I would want to implant anything in, but it got me thinking...

Has anyone had any experience with this, and if so any success?

Opioids have no role in the mgt of FMS. Particularly high-dose opioids. This is a medical board report.


1.


Chronic opioid use in fibromyalgia syndrome: a clinical review.


Painter JT, Crofford LJ.

J Clin Rheumatol. 2013 Mar;19(2):72-7. doi: 10.1097/RHU.0b013e3182863447.


PMID: 23364665 [PubMed - in process]
Related citations


Select item 219623162.


Opioid use, misuse, and abuse in patients labeled as fibromyalgia.


Fitzcharles MA, Ste-Marie PA, Gamsa A, Ware MA, Shir Y.

Am J Med. 2011 Oct;124(10):955-60. doi: 10.1016/j.amjmed.2011.05.031.


PMID: 21962316 [PubMed - indexed for MEDLINE]
Related citations


Select item 213034763.


The use of opioids in fibromyalgia.


Ngian GS, Guymer EK, Littlejohn GO.

Int J Rheum Dis. 2011 Feb;14(1):6-11. doi: 10.1111/j.1756-185X.2010.01567.x. Epub 2010 Aug 23. Review.


PMID: 21303476 [PubMed - indexed for MEDLINE]
Related citations

 

[emd123]

(Will move to more appropriate thread)

 

[Jitter Bug]

Doesn't matter what the pain generator is. What matters is she is addicted to opiates and is abusing them. She will get a pump and make no change in her oral use of opiates. So now she's still an addict but has an implanted pump too. She is not responsible enough to care for an IT pump correctly.

You are drinking the pesudo-addiction Koolaid.

 

[emd123]

(Will move to more appropriate thread)

 

[nvrsumr]

Shell OD when she accesses her port and injects the IT meds IV.

 

[Jitter Bug]

Well I think if you look hard enough for a "legitimate pain generator" to justify opiates vs lyrica savella psych PT exercise you will find one.

We all see what we want to see when it comes to our strongly held beliefs.

 

[emd123]

(Will move to more appropriate thread)

 

[101N]

(Will move to more appropriate thread)

Interesting decision to remove the original content.

 

[emd123]

Interesting decision to remove the original content.

There's no conspiracy. I just don't want to hijack the thread. Take it to the "fibro plus other diagnosis thread". It's two different discussions.