Author Topic: PAIN RELIEF FOR OPIATE DEPENDANT  (Read 79 times)

timtrash

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PAIN RELIEF FOR OPIATE DEPENDANT
« on: February 24, 2020, 01:23:38 PM »
If someone is suffering from bowel cancer, literally only just having had both testicles removed due to testicular cancer, what opiate painkillers are allowed to be prescribed. he has been told, if this tumor has reached a certain level, all they can offer him is palliative care, obviously this would include pain relief. However he has been told they'll not script him Morphine because having been a heroin addict for so many years, the dose they feel he'd need would actually have him over dose. my first personal thought was either Diamorphine, or maybe fentanyl. whatever, to leave someone dying of cancer, not furnishing them with effective painkillers is a total disgrace! I've always said it, there's one rule when it comes to treating your average joe and another for treating an addict.... Uuuum, are we not also human being, do we not feel hurt and pain. Of course we do, but it seems someone somewhere with some dumbass axe to grind simply wants to see addicts suffer. My very own father died of pancreatic cancer and he was written up for Diamorphine so I just fail to see the issue. The lads is dying of cancer ffs! And it seems having that moniker is condemning him to a slow agonising death.... Not a person on this planet will justify this choice to me and i sincerely hope who's made it is thoroughly ashamed, they bloody should be. If anyone has any ideas, thoughts, suggestions, please please let me know. Cheers guys. Tim x

OP8S

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Re: PAIN RELIEF FOR OPIATE DEPENDANT
« Reply #1 on: February 24, 2020, 02:01:23 PM »
Pretty sure my GP told me that in the case of cancer 200mg MST Continus bi-daily + PRN doses if required was as high as they would go with pain relief for someone who isn't opiate dependent. To be honest though I'm not really sure as anybody that I have seen getting pallative care hasn't been opiate dependent in the past & when it comes to that stage  diamorphine is usually delivered through a driver, slowly pumping it into their vein over 24 hours.
I do remember a fellow years ago suffering from lung cancer who had been opioid dependent & his friends told me that he was prescribed methadone only, though not the green liquid.
I'd be asking for 2nd opinions from different Consultants. I'm sure Simon will have a better idea of Guidelines in pallative care.
It is rather shocking that even when being given pallative care your past drug use & the fact they think you might be " drug seeking " is an issue in my opinion.
When it comes down to it pain is subjective so how accurately can you assess someone else's pain?
" The problem with the world is that the fanatics are so sure of themselves while the wiser people acknowledge doubts "      Bertrand Russell

Odysseus

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Re: PAIN RELIEF FOR OPIATE DEPENDANT
« Reply #2 on: February 25, 2020, 05:27:59 PM »
Its a horrible situation and to be honest one I'm afraid off in the back of my mind. My Mum is on Bupe patches currently on 30Mcg per hour.  A GP started her on the 5Mcg great I thought.  However, that was it he was not prepared to increase it despite starting her on the lowest dose available.  We changed GP but though she got better care there when it came to pain they would not sign off on a increase.  So they started her on a drug that causes dependence with long term use, but would not supply enough to address her pain! I just couldn't understand it.  in order to get her increased along with a small amount of Oxy norm liquid for BTP we had to get her seen privately, which is I suppose my point can your friend afford to see a pain specialist privately? All the literature argues that patient in ORT should be treated like any other patient when it comes to pain.

OP8S

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Re: PAIN RELIEF FOR OPIATE DEPENDANT
« Reply #3 on: February 28, 2020, 12:14:04 PM »
They should as you say be treated like any other pain patient but saying that & because of my own problems I have a Dear Doctor letter which I got from a MMT research paper that says " due to the possibility of tolerances the patient may need 25-50% higher dose than normal patient ". Exchange supplies used to have a good video on their site from one of there confrences where a specialist prescriber suggests Remifentanil for those on MMT suffering from acute pain. Unfortunately this is an old confrence & the chances of getting much more than a asprin are more likely in these days of opiophobic prescribing. I'll see if I can find the Dear Dr. letter & post the address for it to be downloaded if I can still find it. Got to dash now though I'm afraid.
" The problem with the world is that the fanatics are so sure of themselves while the wiser people acknowledge doubts "      Bertrand Russell

sapphire

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Re: PAIN RELIEF FOR OPIATE DEPENDANT
« Reply #4 on: March 04, 2020, 01:47:55 PM »
This is just complete bullshit.  The patient should receive the exact same care as any other patient.

Any good palliative care specialist will know that a person who is on methadone will get next to no pain relief from it and should be prescribed the same meds as anyone else.

Depending on the pain levels, I imagine this would be morphine and fentanyl.

Definitely ask for a 2nd opinion, there is no good reason that anyone should needlessly suffer because of some uneducated Dr's old fashioned and stigma fuelled beliefs about people on methadone,  or who have prior opioid use issues.
Disgusting that someone should be made to feel like theyre getting 2nd class treatment and are being left in pain because of some idiotic, prejudiced Dr.

OP8S

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Re: PAIN RELIEF FOR OPIATE DEPENDANT
« Reply #5 on: March 06, 2020, 08:23:07 AM »
Don't mess with Sapph!
" The problem with the world is that the fanatics are so sure of themselves while the wiser people acknowledge doubts "      Bertrand Russell

sapphire

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Re: PAIN RELIEF FOR OPIATE DEPENDANT
« Reply #6 on: March 13, 2020, 05:25:48 PM »
Don't mess with Sapph!

Lol, I'm feeling extra feisty at the moment.

Feel like going down to Tesco and standing in front of the toilet roll! In my local Asda, they've actually got extra security guards in because people were fighting over loo roll and (of all the random crap) Easter eggs!

Seems like the #1 and 2 items on the shopping list for the British apocalypse are bog roll and chocolate!

OP8S

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Re: PAIN RELIEF FOR OPIATE DEPENDANT
« Reply #7 on: March 14, 2020, 01:50:54 PM »
Went shopping yesterday, the local shop is offering to deliver to customers now though. It's a bit more expensive but I might do it next week. The pharmacy had drug workers hanging around to deliver scripts....I might tell them I've got a fever next week, save going out at all :)
" The problem with the world is that the fanatics are so sure of themselves while the wiser people acknowledge doubts "      Bertrand Russell