Opioids until....

[kstarm]

I have a number of patients requesting opioids until whatever next step in care there is. Until I see orthopedics and I get a plan for my knee. Until you complete the ablation and that starts to work or whatever other interventional procedure. I don't prescribe in these situations because previously it seemed like patients always found something else before they want to stop. Do others consider short term opioids while completing procedures/further work-up?

---

Members don't see this ad.

 

[Ducttape]

I do not, although I know a few that do.

And invariably when I see them after they are booted out of the other clinic for misusing their opioids/fixated on opioids, they always tell me "the meds helped but the shots never did but the doc wouldn't just give me the pills".

 

[lobelsteve]

10 pills to last 3 months? Who cares.
10 pills to last until Friday? No thanks.

 

[deleted131481]

What if your treatment plan doesn't work? I told them it's not indicated whether the treatment works or not.

 

[callmeanesthesia]

Nope. Great way to guarantee that the procedures help, but not quiiite enough for them to stop the meds.
I will in cases of acute severe pain with known or strongly clinically suspected diagnosis (e.g. new compression fracture, disc herniation), with the explanation that it will not be continued chronically.

 

[Crybaby]

yup, never successful enough to come off. There has been some literature that shows people on chronic opioids seem to have less successful outcomes and higher complication rates after surgery- something I tell people about

 

[Ferrismonk]

I don't have a problem giving short opiate Rx for severe acute pain for obvious painful diagnosis that I can't treat in other ways as quickly as I would like, but this is very rare. Usually these people decline the meds anyway.

Definitely do not Rx opiate meds "until relief", "until procedure", or they see someone else.

 

[au bon pain]

Recent one that gave me a brief pause was: "doc if I can get a script for norco for a month or two I'll be able to do the PT, hit the gym, and lose the weight I need to get back in shape. And you pain docs always say that dropping pounds can be the best option for long-term pain relief."

A for effort buckaroo

 

[bedrock]

Recent one that gave me a brief pause was: "doc if I can get a script for norco for a month or two I'll be able to do the PT, hit the gym, and lose the weight I need to get back in shape. And you pain docs always say that dropping pounds can be the best option for long-term pain relief."

A for effort buckaroo

Many have tried that one. I counter with they can just swim which is non weightbearing.

 

[paindoc007]

Recent one that gave me a brief pause was: "doc if I can get a script for norco for a month or two I'll be able to do the PT, hit the gym, and lose the weight I need to get back in shape. And you pain docs always say that dropping pounds can be the best option for long-term pain relief."

A for effort buckaroo

Never let them get away with that crap. Every study shows diet change is 4-5x more important for weight reduction than periodic exercise. My back hurts so I can’t exercise so I can’t lose weight so I’m fat so I’m hurting more so if I get opioids I can change is 100% nonsense every time. Excuses.

 

[callmeanesthesia]

Never let them get away with that crap. Every study shows diet change is 4-5x more important for weight reduction than periodic exercise. My back hurts so I can’t exercise so I can’t lose weight so I’m fat so I’m hurting more so if I get opioids I can change is 100% nonsense every time. Excuses.

“Weight is lost in the kitchen, not the gym.”

 

[MitchLevi]

"Don't doesn't hurt."

I use that line several times per week.