What if a Tolerant Drug Addict or Sub Patient Needs Emergency Care?

[euphoricontin17]

Hey all, I have had this topic on my mind for a while now. What would happen if say someone who has a habit of 1-2 bundles a day or 300-400mg oxy a day got into a bad car wreck and needed to be taken to the hospital? If the person was just screaming they're lungs off in pain and the measly 10mg morphine clearly didn't do shit, would they give him more? Like if you say " I am highly tolerant to narcotics, I am a heroin/oxy/insert doc addict " will they just let you suffer or what. I'm really not too sure on this one because what If you just did not stop screaming. Like I'm sure you all know what unbearable, intolerable pain feels like, where any action or inaction is unbearable. What if it was pain like this and you just didn't shut up? What would they do? sedate you? Haha probably so they would contribute to your addiction! I think socitety as a whole has their prioritys REALLY fucked up. Duckfeet said it best when he said " I know I'll be trying to hustle up a shot of dilaudid on my deathbed, but they'll probably give me tramadol so they don't turn me into an ADDICT! " What I mean here is that as bad and " detrimental " as addiction is, it should take second place to pain, and fucking life for that matter. People need to see that YES, you should not take pain meds abusingly if you are an addict and you can easily make that choice, BUT when someone is writhing in pain or cannot live a normal life without them, the addiction " status " should take the backseat. I'd MUCH rather be an addict who's not in extreme pain than a sober person who is. You see what I mean? Food for thought...

[Cherry's Jubilee]

ahhh every junkie's greatest fear...(ok, one of them)

i've learned the only thing you can do is have someone who loves you come to the hospital with real drugs to supplement the 4mg of morphine you're getting every 4-6 hours because all the doctors and nurses are completely incompetent and trying to explain baffling concepts like "tolerance" and "physical dependence" to a bunch of self-righteous idiots is a complete waste of time.

[nodrover]

http://forum.opiophile.org/showthread.php?t=25848 Check that out. I was in a bad accident where my bottom teeth went all the way through my bottom lip. Very gory scene. I am on subs, and as soon as the ER doc found out, he turned into the painkiller nazi- "No pill for youa"!:(

[euphoricontin17]

Hey, yeah no drover I read that. I am so sorry to hear that you got treated that way. i have quite a story myself. I went to the ER about 2 years ago because the sub had made me constipated. I hadn't shit for over a week but didn't realize that was what was causing the excruciating pain in my intestines. IT LITTERALLY FELT LIKE THERE WERE RAZORBLADES INSIDE MY INTESTINE! I was screaming, even crying for help. I asked to be sedated or anything to stop the pain. They basically tole me " sorry honey, your an addict, protocol doesn't allow for us to dispense narcotics to addicts "

OK lets stop right here in the middle. I want to make something very clear. PEOPLE IN THE WORLD HAVE MANY TITLES SUCH AS "DAD" "DR" "PROFESSOR" "FRIEND" "DRUG ADDICT" THESE ARE ALL VARIOUS ROLES WE FILL AS PEOPLE! WE ARE PEOPLE FIRST, DRUG ADDICTS SECOND! NOT VICE VERSA! WE DO NOT DESERVE TORTURE! I am sorry for that but it is rediculous how they will let someone's life be destroyed by pain so as not to turn them into an addict or feed they're addiction. We get treated worse than fucking criminals! The one thing I always say to people who talk badly about addicts is " what if you could not function without a drug, what if when you didn't take it you were overcome with the most bone-crushing suicidal depression and melancholy. What If you didn't even get HIGH you just felt what people describe as normal. WOuld you still hate drug addicts then? Is it really such a bad thing for us to want to be HAPPY? Is that all that bad, just to feel good about yourself and enjoy life? "

I am sorry this is just such a sensitive topic for me.

P.S. the outcome of my hospital stay was I had to shit out this boulder the diameter of a soda can and the toilet was filled with blood and I had to have my asshole stiched up. Sorry for the detail, it just helps to illustrate how I felt with NO pain meds.

[Actavis]

http://forum.opiophile.org/showthread.php?t=25848 Check that out. I was in a bad accident where my bottom teeth went all the way through my bottom lip. Very gory scene. I am on subs, and as soon as the ER doc found out, he turned into the painkiller nazi- "No pill for youa"!:(


that is just not right on so many levels, bordering on malpractice. farging nazis... they could have easily knocked the sub off of your receptors with fent injections. many hospitals will do this when a patient is on sub and is in an accident, or has to go in for a surgery and consults with the surgeon and anesthesiologist (along with sub doc) prior to the surgery.

it is maddening that they would let you sit there in pain. gotta love the new amerika. lets let meth and crack run rampant but deny people that are in pain some comfort.

[30_Units]

Reading stories like this make me feel really gifted for the amount of care I got at the Cleveland Clinic, in Ohio. I had to have stomach surgery there for a bleeding disorder I had a few years ago, and was on methadone at the time.

The woman writing up my med history before I had anything done was just like, "oh, methadone? What dose?" And because they only had it in the computer as a "for pain" med in amounts of 5mg or 10mg, she made it so that it showed a compunded dose, to account for my 90mg dose.

I got plenty of midazolam before surgery, and waking up, in severe pain so bad I was hysterical, They gave me 2 shots of either 2 or 4mg dilaudid, of course in the 10cc rig, pushed in slowly to not give any euphoria. After that they took me off my morphine button, and moved it to .2mg of dilaudid available every 5 minutes.

When it came time for me to go home, my doc wrote it out to give me 30 days worth of methadone, and 60 perc 5's. The pharmacy downstairs messed up and only gave me 30 10mg done, but that's okay, It was an honest mistake.

Pretty much I'm really grateful to all the GI docs in the cleveland clinic who took such good care of me. And if anybody needs surgery that's not emergeny-go there. They're the best.

Now, in cases of sub blockade-Unless I'm unconscious and they see the card in my wallet, I'm just not going to tell them. You guys have given me enough to know that that's a bad idea, and being on 1-2mg a day, I'm just going to go with the 10mg they give standard.

If they have compassion, the typical procedure as I understand it is to give fentanyl until it breaks through the blaockade, but that's only if they don't feel like demonizing you and letting you suffer. Something I'm not going to bet my agony on.

[Leave it ta Beaver]

I'm on sub. maitnence & they gave me a card to carry that says if i'm ever in a situation that requires opiod analgesia the dose would have to be greater than usual, also states somethig 'bout concious sedation w/benzodiazepine or regional anethesia.

But I have had an ex who was close to death an had a very high tolerance & the hospital gave her diluadid i.v. (she also said she had a cool nurse that would give her extra cuz she new 'bout her habit an she could handle it) Guess she got lucky cuz i know some dr.'s would look down on ya & let ya suffer.

[EleusisII]

but it is rediculous how they will let someone's life be destroyed by painSorry, but ONE undermedicated hospital stay hardly destroys your entire life...


I went to the ER about 2 years ago because the sub had made me constipated. I hadn't shit for over a week but didn't realize that was what was causing the excruciating pain in my intestines.So you were backed up because of opiate use. No wonder that they didn't give you any more opiates... Would kinda be counterproductive, no?

Sorry if you think I'm being harsh or whatever, but crying over one bad experience, and using it to generalize an entire profession and a complicated problem hardly seems productive.

As to the original topic, I guess that kinda depends on the situation... They'd usually give opiates until the pain stops. Obviously that would mean deadly doses for people with no tolerance. I'd say that what would happen if all your vital signs are fine, and you're still crying out with pain and being coherent, after being given high amount of morphine, would be up to the individual doctor. The usual protocol would be to give PK until the pain is under control.

To play it safe, I wouldn't mention anything about an addiction or tolerance.

[euphoricontin17]

When I said have someone's life destroyed by pain, I was referring to CP pain patients who are classified as addicts and therefore cannot get medications. I did not mean my experience. I realize that they may not have given me opi's due to constipation, but at the time they did not even know what was wrong with me. I just had come in with horrible abdominal pain. I'm not trying to be an ass here but are you a doctor or med professional? I am just asking because I can not see any reason why someone on this site who uses opi's would defend not giving opi's to anyone? I just don't see how denying someone analgesia could could do any good? Sure, it could be considered a GOOD thing NOT to give opiates to an addict but it can also be considered a GOOD thing to give pain relief to a human being who is suffering. I think the benefits for the administation of narcotics far outweigh the downfalls. Look man, I am really not trying to be rude or anything but I just feel so strongly about people suffering. I HATE PAIN! I watched my mother die an agonizing death with inadequate pain relief and I also have had to suffer some pretty bad pain as well. I just think that as humans, none of us deserve to endure that. No matter what you are drug-addict, sex addict, etc. were all humans and if you wouldn't treat a DOG that way, why treat us that way ya know?

[EleusisII]

Some doctors are great, some doctors are shitty, but it's useless and counterproductive to call a waahmbulance every time you don't get scripted narcotics.

It's not as simple as "He's in pain, he needs narcotics!" In some cases it's counterproductive to use narcotics at all.
(Such as in your case for example, sorry to say. And the reason they didn't give you narcotics when you first came in, is because a doctor has to approve it. And yeah, they prob had a pretty good idea of what was going on because of your symptoms and possibly through prescription records)

And yeah, while some people on the site are undermedicated and are treated by really shitty doctors, there are just as many that are treated adequately, if not overprescribed, so it's not something you can make generalizations about.

The US is using more narcotics pr. capita than any other country, so whenever somebody writes that painpatients are treated oh so horribly in this country, it's simply not true.

[Cherry's Jubilee]

There may be a bunch of script-happy private docs in the US but it's a totally different story at ERs, Eleusis. They certainly DO NOT "give painkillers until the pain stops!" Where did you get that idea? Denmark? Haha. (Eye heart you.)

[EleusisII]

It was at American ER's I've been to :p
Maybe that's just because of my cheerful demeanor, and the fact that I'm foreigner ;)

It always depends on the individual doctor, whether he's an asshole, and a host of other circumstances of course, but as I understand it, it's standard practice to give pks until the pain is under control, no?

And love ya too!

[Restharrow]

There may be a bunch of script-happy private docs in the US but it's a totally different story at ERs, Eleusis. They certainly DO NOT "give painkillers until the pain stops!" Where did you get that idea? Denmark? Haha. (Eye heart you.)
ER's are notorious for NOT treating pain. Most ER's consider their mission to treat heart attacks, strokes, car wrecks, etc. and provide life saving services. Pain is a low priority for them.

My wife fainted at the mall last year (on a Saturday night) and we spent about 10 hours in the ER at the largest local hospital. It was a zoo. People were literally SCREAMING in pain and crying and begging for pain treatement. I asked the doctors / nurses what was going on and they said it was a normal Saturday night. (It was the 1st saturday night after the monthly welfare deposits had been made and things were wild).

[SHELLEY]

i would just not say that i was on whatever opiate when i got there
and then have a friend bring me something that actually works
the IV port that you get in the hospital makes things a lot easier

[digby]

I've gone into surgery a few times - one in ER, others with planned appointment. Each time, I just explained that I was on opiates for chronic pain and how much I was currently taking, and they modified their dosage accordingly. Dilaudid IV, Fentanyl and Valium IV at different times and I can honestly say the dosages were more than adequate. :)

[OpiateQueen]

ER's are notorious for NOT treating pain. Most ER's consider their mission to treat heart attacks, strokes, car wrecks, etc. and provide life saving services. Pain is a low priority for them.

My wife fainted at the mall last year (on a Saturday night) and we spent about 10 hours in the ER at the largest local hospital. It was a zoo. People were literally SCREAMING in pain and crying and begging for pain treatement. I asked the doctors / nurses what was going on and they said it was a normal Saturday night. (It was the 1st saturday night after the monthly welfare deposits had been made and things were wild).
I dunno, I've always been under the impression that US ER's give out way more narcs than other countries - well i can only compare to Australia etc.. You see people writing on these forums things like "I even go to the ER once every couple of months and fake a migraine to get a shot of dilaudid..." That would just NEVER NEVER happen in Australia... They would tell you to take a couple of panadol and go home... I've also read several times on these forums of other US people talking about their trips to the ER and coming out with vicodins and being disappointed... That would just never happen here - people would be totally blown away if they got any kind of scripted narc.

If you were in a serious serious accident I hope they would be a little sympathetic with the immediate pain relief given.... but yeah, if they see any evidence of track marks - i'd be telling them about your addiction or tolerance cos you'd be pretty much fucked anyway and at least then you may have a small chance of getting a decent dose, if you got a nice dr that actually understood opiate addiction. I think alot of them are scared cos as someone mentioned earlier - a dose that would relieve our pain would prob kill a opiate naive lucky person...